Sample records for playbook requirements guidelines
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Information protection playbook
Kane, Greg
2013-01-01
The primary goal of the Information Protection Playbook is to serve as a comprehensive resource for information protection (IP) professionals who must provide adequate information security at a reasonable cost. It emphasizes a holistic view of IP: one that protects the applications, systems, and networks that deliver business information from failures of confidentiality, integrity, availability, trust and accountability, and privacy. Using the guidelines provided in the Information Protection Playbook, security and information technology (IT) managers will learn how to
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Energy Transition Initiative: Islands Playbook (Book)
Energy Technology Data Exchange (ETDEWEB)
2015-01-01
The Island Energy Playbook (the Playbook) provides an action-oriented guide to successfully initiating, planning, and completing a transition to an energy system that primarily relies on local resources to eliminate a dependence on one or two imported fuels. It is intended to serve as a readily available framework that any community can adapt to organize its own energy transition effort.
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Making Multi-Level Tsunami Evacuation Playbooks Operational in California and Hawaii
Wilson, R. I.; Peterson, D.; Fryer, G. J.; Miller, K.; Nicolini, T.; Popham, C.; Richards, K.; Whitmore, P.; Wood, N. J.
2016-12-01
In the aftermath of the 2010 Chile, 2011 Japan, and 2012 Haida Gwaii tsunamis in California and Hawaii, coastal emergency managers requested that state and federal tsunami programs investigate providing more detailed information about the flood potential and recommended evacuation for distant-source tsunamis well ahead of their arrival time. Evacuation "Playbooks" for tsunamis of variable sizes and source locations have been developed for some communities in the two states, providing secondary options to an all or nothing approach for evacuation. Playbooks have been finalized for nearly 70% of the coastal communities in California, and have been drafted for evaluation by the communities of Honolulu and Hilo in Hawaii. A key component to determining a recommended level of evacuation during a distant-source tsunami and making the Playbooks operational has been the development of the "FASTER" approach, an acronym for factors that influence the tsunami flood hazard for a community: Forecast Amplitude, Storm, Tides, Error in forecast, and the Run-up potential. Within the first couple hours after a tsunami is generated, the FASTER flood elevation value will be computed and used to select the appropriate minimum tsunami phase evacuation "Playbook" for use by the coastal communities. The states of California and Hawaii, the tsunami warning centers, and local weather service offices are working together to deliver recommendations on the appropriate evacuation Playbook plans for communities to use prior to the arrival of a distant-source tsunami. These partners are working closely with individual communities on developing conservative and consistent protocols on the use of the Playbooks. Playbooks help provide a scientifically-based, minimum response for small- to moderate-size tsunamis which could reduce the potential for over-evacuation of hundreds of thousands of people and save hundreds of millions of dollars in evacuation costs for communities and businesses.
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The CIO playbook strategies and best practices for IT leaders to deliver value
Colisto, Nicholas R
2012-01-01
Praise for The CIO Playbook "The most trusted advisors chief information officers have are other CIOs, and Nicholas Colisto capitalizes beautifully on that fact in The CIO Playbook. This highly readable guide to succeeding in one of the toughest jobs in the C-suite features a step-by-step framework that is practical, focused, and quite specific. The strategies Nicholas describes come to life through anecdotes and straightforward advice from many of the industry's most respected CIOs who share their advice on everything from partnering with business colleagues to innovating and delivering res
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Duncan, Lindsay R; Hieftje, Kimberly D; Culyba, Sabrina; Fiellin, Lynn E
2014-03-01
As mobile technologies and videogaming platforms are becoming increasingly prevalent in the realm of health and healthcare, so are the opportunities to use these resources to conduct behavioral interventions. The creation and empirical testing of game style interventions, however, is challenged by the requisite collaboration of multidisciplinary teams, including researchers and game developers who have different cultures, terminologies, and standards of evidence. Thus, traditional intervention development tools such as logic models and intervention manuals may need to be augmented by creating what we have termed "Game Playbooks" which are intervention guidebooks that are created by, understood by, and acceptable to all members of the multidisciplinary game development team. The purpose of this paper is to describe the importance and content of a Game Playbook created to aide in the development of a videogame intervention designed specifically for health behavior change in young teens as well as the process for creating such a tool. We draw on the experience of our research and game design team to describe the critical components of the Game Playbook and the necessity of creating such a tool.
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Energy Technology Data Exchange (ETDEWEB)
Reis, Chuck [CTA Architects Engineers, Boise, ID (United States); Nelson, Eric [CTA Architects Engineers, Boise, ID (United States); Armer, James [CTA Architects Engineers, Boise, ID (United States); Johnson, Tim [CTA Architects Engineers, Boise, ID (United States); Hirsch, Adam [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Doebber, Ian [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
2015-03-01
The purpose of this playbook and accompanying spreadsheets is to generalize the detailed CBP analysis and to put tools in the hands of experienced refrigeration designers to evaluate multiple applications of refrigeration waste heat reclaim across the United States. Supermarkets with large portfolios of similar buildings can use these tools to assess the impact of large-scale implementation of heat reclaim systems. In addition, the playbook provides best practices for implementing heat reclaim systems to achieve the best long-term performance possible. It includes guidance on operations and maintenance as well as measurement and verification.
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Coaching Model + Clinical Playbook = Transformative Learning.
Fletcher, Katherine A; Meyer, Mary
2016-01-01
Health care employers demand that workers be skilled in clinical reasoning, able to work within complex interprofessional teams to provide safe, quality patient-centered care in a complex evolving system. To this end, there have been calls for radical transformation of nursing education including the development of a baccalaureate generalist nurse. Based on recommendations from the American Association of Colleges of Nursing, faculty concluded that clinical education must change moving beyond direct patient care by applying the concepts associated with designer, manager, and coordinator of care and being a member of a profession. To accomplish this, the faculty utilized a system of focused learning assignments (FLAs) that present transformative learning opportunities that expose students to "disorienting dilemmas," alternative perspectives, and repeated opportunities to reflect and challenge their own beliefs. The FLAs collected in a "Playbook" were scaffolded to build the student's competencies over the course of the clinical experience. The FLAs were centered on the 6 Quality and Safety Education for Nurses competencies, with 2 additional concepts of professionalism and systems-based practice. The FLAs were competency-based exercises that students performed when not assigned to direct patient care or had free clinical time. Each FLA had a lesson plan that allowed the student and faculty member to see the competency addressed by the lesson, resources, time on task, student instructions, guide for reflection, grading rubric, and recommendations for clinical instructor. The major advantages of the model included (a) consistent implementation of structured learning experiences by a diverse teaching staff using a coaching model of instruction; (b) more systematic approach to present learning activities that build upon each other; (c) increased time for faculty to interact with students providing direct patient care; (d) guaranteed capture of selected transformative
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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
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Shah, Hemant; Allard, Raymond D; Enberg, Robert; Krishnan, Ganesh; Williams, Patricia; Nadkarni, Prakash M
2012-03-09
A large body of work in the clinical guidelines field has identified requirements for guideline systems, but there are formidable challenges in translating such requirements into production-quality systems that can be used in routine patient care. Detailed analysis of requirements from an implementation perspective can be useful in helping define sub-requirements to the point where they are implementable. Further, additional requirements emerge as a result of such analysis. During such an analysis, study of examples of existing, software-engineering efforts in non-biomedical fields can provide useful signposts to the implementer of a clinical guideline system. In addition to requirements described by guideline-system authors, comparative reviews of such systems, and publications discussing information needs for guideline systems and clinical decision support systems in general, we have incorporated additional requirements related to production-system robustness and functionality from publications in the business workflow domain, in addition to drawing on our own experience in the development of the Proteus guideline system (http://proteme.org). The sub-requirements are discussed by conveniently grouping them into the categories used by the review of Isern and Moreno 2008. We cite previous work under each category and then provide sub-requirements under each category, and provide example of similar work in software-engineering efforts that have addressed a similar problem in a non-biomedical context. When analyzing requirements from the implementation viewpoint, knowledge of successes and failures in related software-engineering efforts can guide implementers in the choice of effective design and development strategies.
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77 FR 45378 - Guidelines for Cases Requiring On-Scene Death Investigation
2012-07-31
... DEPARTMENT OF JUSTICE Office of Justice Programs [OJP (NIJ) Docket No. 1600] Guidelines for Cases... entitled, ``Guidelines for Cases Requiring On-Scene Death Investigation''. The opportunity to provide comments on this document is open to coroner/medical examiner office representatives, law enforcement...
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Braspenning, J C C; Mettes, T G P H; van der Sanden, W J M; Wensing, M J P
2015-03-01
Adherence to clinical guidelines requires support in practice. However, systematic implementation of evidence-based guidelines is not common practice in oral healthcare. The Knowledge Institute Oral Care (KiMo) offers the opportunity to take into account potential barriers and facilitators during the development of evidence-based clinical practice guidelines. These factors which are relevant to the guideline and the oral healthcare practice provide the ingredients for a tailor-made programme of implementation that has a scientific basis. Elements of any implementation programme are the quality indicators derived from the oral healthcare guidelines. These indicators should fit, on the one hand, the specific goals of the guidelines (patient safety, effectiveness, efficiency, patient-centred, timeliness, accessibility) and, onthe other hand, the various perspectives of the different stakeholders, such as patients, caregivers, health insurers and inspectorate. These quality indicators provide information on adherence to the guidelines, the results of a certain treatment and the success of the implementation strategy, all with the aim to improve the quality of oral healthcare.
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Film Adaptation as Translation: An Analysis of Adaptation Shifts in Silver Linings Playbook
Directory of Open Access Journals (Sweden)
Katerina Perdikaki
2017-12-01
Full Text Available The purpose of this paper is to approach film adaptation as a modality of translation and to provide a systematic analysis of the changes occurring in the adaptation of a novel for the big screen. These changes, i.e. adaptation shifts, are examined by means of a model that consists of a descriptive/comparative component and an interpretive component. The model is derived from combining insights from adaptation and translation studies and thus builds on the interdisciplinary nature of adaptation studies so as to offer a comprehensive methodological tool for the analysis of adaptations. As processes and products, adaptation and translation involve an act of communication between a source and a target text within a new sociocultural context. In this light, adaptation can be examined as a case of intersemiotic translation in that it involves the transfer of meaning between two different media; in the case of film adaptation, more specifically, meaning is transferred from book to film and the dynamics between the source novel and adaptation is juxtaposed with that between a source text and its translation. The adaptation model is applied to the film adaptation Silver Linings Playbook with an aim to understand the aspects in which the adaptation differs from the source novel and the rationale behind the adaptation shifts. Finally, it is argued that such an analysis from a descriptive as well as an interpretive perspective can lead to a more holistic understanding of adaptation as a cultural phenomenon in the contemporary creative industries.
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Application Reuse Library for Software, Requirements, and Guidelines
Malin, Jane T.; Thronesbery, Carroll
1994-01-01
Better designs are needed for expert systems and other operations automation software, for more reliable, usable and effective human support. A prototype computer-aided Application Reuse Library shows feasibility of supporting concurrent development and improvement of advanced software by users, analysts, software developers, and human-computer interaction experts. Such a library expedites development of quality software, by providing working, documented examples, which support understanding, modification and reuse of requirements as well as code. It explicitly documents and implicitly embodies design guidelines, standards and conventions. The Application Reuse Library provides application modules with Demo-and-Tester elements. Developers and users can evaluate applicability of a library module and test modifications, by running it interactively. Sub-modules provide application code and displays and controls. The library supports software modification and reuse, by providing alternative versions of application and display functionality. Information about human support and display requirements is provided, so that modifications will conform to guidelines. The library supports entry of new application modules from developers throughout an organization. Example library modules include a timer, some buttons and special fonts, and a real-time data interface program. The library prototype is implemented in the object-oriented G2 environment for developing real-time expert systems.
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International Nuclear Information System (INIS)
1988-01-01
The guideline which entered into force on 1 May 1988 stipulates the radiation protection requirements for shielding against ionizing radiation to be met in the design, construction, commissioning, operation, and decommissioning of nuclear power plants
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Ochieng, R.M.; Visseren-Hamakers, Ingrid; Arts, B.; Brockhaus, M.; Herold, M.
2016-01-01
The UNFCCC requires REDD+ countries wishing to receive results-based payments to measure, report and verify (MRV) REDD+ impacts; and outlines technical guidelines and good governance requirements for MRV. This article examines institutional effectiveness of REDD+ MRV by assessing countries’ progress
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Wilson, R. I.; Lynett, P. J.; Miller, K.; Eskijian, M.; Dengler, L. A.; Ayca, A.; Keen, A.; Admire, A. R.; Siegel, J.; Johnson, L. A.; Curtis, E.; Hornick, M.
2015-12-01
The 2010 Chile and 2011 Japan tsunamis both struck the California coast offering valuable experience and raised a number of significant issues for harbor masters, port captains, and other maritime entities. There was a general call for more planning products to help guide maritime communities in their tsunami response, mitigation, and recovery activities. The State of California is working with the U.S. Federal Emergency Management Agency (FEMA), the U.S. National Tsunami Hazard Mitigation Program (NTHMP), and other tsunami experts to provide communities with new tsunami planning tools to address these issues: Response Playbooks and plans have been developed for ports and harbors identifying potential tsunami current hazards and related damage for various size events. Maps have been generated showing minor, moderate, and severe damage levels that have been linked to current velocity thresholds of 3, 6, and 9 knots, respectively. Knowing this information allows harbor personnel to move ships or strengthen infrastructure prior to the arrival of distant source tsunamis. Damage probability tools and mitigation plans have been created to help reduce tsunami damage by evaluating the survivability of small and large vessels in harbors and ports. These results were compared to the actual damage assessments performed in California and Japan following the 2011 Japanese tsunami. Fragility curves were developed based on current velocity and direction to help harbor and port officials upgrade docks, piles, and related structures. Guidance documents are being generated to help in the development of both local and statewide recovery plans. Additional tools, like post-tsunami sediment and debris movement models, will allow harbors and ports to better understand if and where recovery issues are most likely to occur. Streamlining the regulatory and environmental review process is also a goal of the guidance. These maritime products and procedures are being integrated into guidance
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Developing clinical guidelines: how much rigour is required?
Haroon, Munib; Ranmal, Rita; McElroy, Helen; Dudley, Jan
2015-04-01
Clinical guidelines that are rigorously developed play a fundamental role in improving healthcare and reducing unnecessary variations in practice. National guidelines are increasingly used by healthcare professionals, patients and commissioners; however, national bodies are unable to meet the demand for guidance on all topics. There are fewer resources available for guidance produced locally or by specialty groups, and it is necessary to achieve a balance between pragmatism and rigour while conforming to the widely accepted norms of what constitutes a good guideline. This paper introduces the key concepts around this topic with suggestions for those interested in developing their own guideline. An example of challenges encountered in generating high-quality clinical guidance is given in box 1. Box 1 Challenges in guideline development Professor Johnson runs a local developmental paediatrics service with eight other colleagues. All have different ways of managing children with PAVING syndrome. This was difficult for patients and staff and has led to disagreements on how certain patients should be managed. As a result, Professor Johnson developed a Guideline Development Group to look at the management of PAVING syndrome. The group identified 12 clinical questions (including diagnosis, exclusion of comorbidities, treatment modalities), searched the PubMed database and found some useful evidence that they used to formulate key recommendations. For one question about behavioural therapy, PubMed did not suggest any evidence so they informally arrived at a consensus among themselves and wrote up their guideline. On the back of this success, they applied for the guideline to be endorsed or supported by the Royal College of Paediatrics and Child Health (RCPCH). To their frustration, it was turned down on methodological grounds. Professor Johnson wrote to the RCPCH saying that he was "pretty peeved that the PAVING syndrome guideline had been rejected" for the College
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Training Requirements in OSHA Standards and Training Guidelines. Revised.
Occupational Safety and Health Administration, Washington, DC.
This guide provides an overview of Occupational Safety and Health Act (OSHA) standards and training guidelines for various industries. The first section introduces the concept of voluntary training guidelines, explaining that the guidelines are designed to help employers determine whether a worksite problem can be solved by training, what training…
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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
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Energy Technology Data Exchange (ETDEWEB)
Stehfest, E; De Waal, L.
2010-09-15
This document describes the requirements and guidelines for the software of the IMAGE system. The motivation for this report was a substantial restructuring of the source code for IMAGE version 2.5. The requirements and guidelines relate to design considerations as well as to aspects of maintainability and portability. The design considerations determine guidelines about subjects, such as program structure, model hierarchy, the use of data modules, and the error message system. Maintainability and portability aspects determine the guidelines on, for example, the Fortran 90 standard, naming conventions, code lay-out, and internal documentation.
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McGrath, John C; Lilley, Elliot
2015-01-01
The ARRIVE guidelines have been implemented in BJP for 4 years with the aim of increasing transparency in reporting experiments involving animals. BJP has assessed our success in implementing them and concluded that we could do better. This editorial discusses the issues and explains how we are changing our requirements for authors to report their findings in experiments involving animals. This is one of a series of editorials discussing updates to the BJP Instructions to Authors Video To view the video on the ARRIVE guidelines, visit: https://www.youtube.com/watch?v=DYXoUAnhoPM PMID:25964986
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Marion, H
2012-04-01
The International Cooperation on Harmonisation of Technical Requirements for Registration of Veterinary Medicinal Products (VICH) is an international tripartite cooperation programme that brings together regulatory authorities and industry representatives from the European Union, Japan and the United States, with Australia, New Zealand and Canada as observers. VICH aims to improve international coordination and cooperation to achieve greater harmonisation of the requirements for veterinary product registration in the regions concerned. VICH develops harmonised data requirements, i.e., standards for the scientific studies on quality, safety and efficacy that are required to obtain a marketing authorisation for a veterinary medicinal product. It does this by publishing guidelines that provide uniform and consistent guidance for sponsors to follow in developing data for application dossiers as well as for post-marketing safety monitoring of veterinary medicinal products. Of the 49 VICH guidelines that have been developed so far, two guidelines in particular address issues related to antimicrobial resistance.
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DEFF Research Database (Denmark)
Ferraz, Mariana; Pigosso, Daniela Cristina Antelmi; Teixeira, Cláudia Echevenguá
2013-01-01
Environmental legislation is increasingly changing its focus from end-of-pipe approaches to a life cycle perspective. Therefore, manufacturing companies are increasingly identifying the need of deploying and incorporating product-related environmental requirements into the product development...... process. This paper presents twelve guidelines, clustered into three groups, to support companies in the identification, analysis and deployment of product requirements from product-related environmental legislation....
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Struwe, Weston B; Agravat, Sanjay; Aoki-Kinoshita, Kiyoko F; Campbell, Matthew P; Costello, Catherine E; Dell, Anne; Ten Feizi; Haslam, Stuart M; Karlsson, Niclas G; Khoo, Kay-Hooi; Kolarich, Daniel; Liu, Yan; McBride, Ryan; Novotny, Milos V; Packer, Nicolle H; Paulson, James C; Rapp, Erdmann; Ranzinger, Rene; Rudd, Pauline M; Smith, David F; Tiemeyer, Michael; Wells, Lance; York, William S; Zaia, Joseph; Kettner, Carsten
2016-09-01
The minimum information required for a glycomics experiment (MIRAGE) project was established in 2011 to provide guidelines to aid in data reporting from all types of experiments in glycomics research including mass spectrometry (MS), liquid chromatography, glycan arrays, data handling and sample preparation. MIRAGE is a concerted effort of the wider glycomics community that considers the adaptation of reporting guidelines as an important step towards critical evaluation and dissemination of datasets as well as broadening of experimental techniques worldwide. The MIRAGE Commission published reporting guidelines for MS data and here we outline guidelines for sample preparation. The sample preparation guidelines include all aspects of sample generation, purification and modification from biological and/or synthetic carbohydrate material. The application of MIRAGE sample preparation guidelines will lead to improved recording of experimental protocols and reporting of understandable and reproducible glycomics datasets. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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International Nuclear Information System (INIS)
Lehnert, G.; Philpot, L.
1995-11-01
This report documents the initial results of the Nuclear Energy Institute License Renewal Implementation Guideline Task Force over the period August 1994 to July 1995 to develop guidance for complying with technical requirements of 10CFR54. The report also provided a starting point for the development of NEI 95-10, ''Industry Guideline for Implementing the Requirements of 10CCR54-The License Renewal Rule''. Information in this document can be used by utilities to prepare the technical material needed in an application for license renewal (LR) of a nuclear power unit. This guideline provides methods for identifying systems, structures, and components (SSCs) and their intended functions within the scope of license renewal. It identifies structures and components (SCs) requiring aging management review and methods for performing the aging management review. The guideline provides a process for identifying and evaluating time-limited aging analyses
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International Nuclear Information System (INIS)
1987-01-01
It is the purpose of this document to present the regulatory basis for judging the long-term acceptability of radioactive waste disposal options, assuming that the operational aspects of waste emplacement and facility closure satisfy the existing regulatory framework of requirements. Basic objectives of radioactive waste disposal are given, as are the regulatory requirements which must be satisfied in order to achieve these objectives. In addition, guidelines are given on the application of the radiological requirements to assist proponents in the preparation of submissions to the Atomic Energy Control Board (AECB). The primary focus of the requirements is on radiation protection, although environmental protection and institutional controls are also addressed in a more general way since these factors stem directly from the overall objectives for radioactive waste disposal
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Real, J; Cleries, R; Forné, C; Roso-Llorach, A; Martínez-Sánchez, J M
In medicine and biomedical research, statistical techniques like logistic, linear, Cox and Poisson regression are widely known. The main objective is to describe the evolution of multivariate techniques used in observational studies indexed in PubMed (1970-2013), and to check the requirements of the STROBE guidelines in the author guidelines in Spanish journals indexed in PubMed. A targeted PubMed search was performed to identify papers that used logistic linear Cox and Poisson models. Furthermore, a review was also made of the author guidelines of journals published in Spain and indexed in PubMed and Web of Science. Only 6.1% of the indexed manuscripts included a term related to multivariate analysis, increasing from 0.14% in 1980 to 12.3% in 2013. In 2013, 6.7, 2.5, 3.5, and 0.31% of the manuscripts contained terms related to logistic, linear, Cox and Poisson regression, respectively. On the other hand, 12.8% of journals author guidelines explicitly recommend to follow the STROBE guidelines, and 35.9% recommend the CONSORT guideline. A low percentage of Spanish scientific journals indexed in PubMed include the STROBE statement requirement in the author guidelines. Multivariate regression models in published observational studies such as logistic regression, linear, Cox and Poisson are increasingly used both at international level, as well as in journals published in Spanish. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.
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Simpson, Kathleen Rice; Lyndon, Audrey; Wilson, Jane; Ruhl, Catherine
2012-01-01
To solicit input from registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) on critical considerations for review and revision of existing nurse staffing guidelines. Thematic analysis of responses to a cross-sectional on-line survey question: "Please give the staffing task force your input on what they should consider in the development of recommendations for staffing of perinatal units." Members of AWHONN (N = 884). Descriptions of staffing concerns that should be considered when evaluating and revising existing perinatal nurse staffing guidelines. Consistent themes identified included the need for revision of nurse staffing guidelines due to requirements for safe care, increases in patient acuity and complexity, invisibility of the fetus and newborn as separate and distinct patients, difficulties in providing comprehensive care during labor and for mother-baby couplets under current conditions, challenges in staffing small volume units, and the negative effect of inadequate staffing on nurse satisfaction and retention. Participants overwhelmingly indicated current nurse staffing guidelines were inadequate to meet the needs of contemporary perinatal clinical practice and required revision based on significant changes that had occurred since 1983 when the original staffing guidelines were published. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
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Design patterns for modelling guidelines
Serban, Radu; Ten Teije, Annette; Marcos, Mar; Polo-Conde, Cristina; Rosenbrand, Kitty C J G M; Wittenberg, Jolanda; van Croonenborg, Joyce
2005-01-01
It is by now widely accepted that medical guidelines can help to significantly improve the quality of medical care. Unfortunately, constructing the required medical guidelines is a very labour intensive and costly process. The cost of guideline construction would decrease if guidelines could be
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32 CFR 310.36 - OMB training guidelines.
2010-07-01
... 32 National Defense 2 2010-07-01 2010-07-01 false OMB training guidelines. 310.36 Section 310.36... PROGRAM DOD PRIVACY PROGRAM Training Requirements § 310.36 OMB training guidelines. The OMB guidelines (OMB Privacy Guidelines, 40 FR 28948 (July 9, 1975) require all agencies additionally to: (a) Instruct...
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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
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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.
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Requirements and guidelines for NSLS experimental beam line vacuum systems: Revision A
International Nuclear Information System (INIS)
Foerster, C.; Halama, H.; Thomlinson, W.
1986-10-01
Requirements are provided for NSLS beam line front ends and vacuum interlocks. Guidelines are provided for UHV beam line vacuum systems, including materials, vacuum hardware (pumps, valves, and flanges), acoustic delay lines and beam line fast valves, instrumentation, fabrication and testing, and the NSLS cleaning facility. Also discussed are the design review for experimenters' equipment that would be connected to the NSLS and acceptance tests for any beam line to be connected with the ring vacuum. Also appended are a description of the acoustic delay line as well as the NSLS vacuum standards and NSLS procedures
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RSK-guidelines for PWR reactors
International Nuclear Information System (INIS)
1979-01-01
The RSK guidelines for PWA reactors of April 24, 1974, have been revised and amended in this edition. The RSK presents a summary of safety requirements to be observed in the design, construction, and operation of PWR reactors in the form of guidelines. From January 1979 onwards these guidelines will be the basis of siting and safety considerations for new PWR reactors, and newly built nuclear power plants will have to form these guidelines. They are not binding for existing nuclear power plants under construction or in operation. It will be a matter of individual discussion whether or not the guidelines will be applied in these plants. The main purpose of the guidelines is to facilitate discussion among RSK members and to give early information on necessary safety requirements. If the guidelines are observed by producers and operators, the RSK will make statements on individual projects at short notice. (orig./HP) [de
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DEFF Research Database (Denmark)
Ijäs, Jarja; Alanen, Seija; Kaila, Minna
2009-01-01
OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p ...: Hypertension Guideline recommendations that require joint agreements between professionals are less often adopted than simple, precise recommendations. More emphasis on effective multidisciplinary collaboration is needed....
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Bohus, M; Schmahl, C; Herpertz, S C; Lieb, K; Berger, M; Roepke, S; Heinz, A; Gallinat, J; Lyssenko, L
2016-07-01
Borderline personality disorders (BPD) are severe mental diseases which place high pressure on the psychiatric healthcare system. Nowadays, well-tested, disorder-specific treatment concepts are available also for inpatient treatment in Germany. These show very good and long-term improvements in the psychopathology as well as posttreatment social participation; however, prerequisites for the implementation of these evidence-based inpatient psychotherapy programs are well-trained treatment teams and appropriate financing of resource expenditure. The aim was to formulate a definition of normative needs for treatment duration and intensity for a guideline-conform, empirically proven and effective inpatient treatment of borderline personality disorder as well as the derived personnel requirements in comparison to the currently available resources within the framework of the Psychiatry Personnel Act (Psych-PV). The resource requirements were established based on evaluated hospital ward models, the recommendations of the S2 guidelines and the criteria of specialist societies and compared with the personnel stipulations according to the Psych-PV. The results for a normatively established treatment program showed a pronounced deficit in the financing of the evaluated resource requirements, even when the stipulations laid down in the Psych-PV were implemented to 100 %. Disorder-specific inpatient treatment programs for borderline personality disorder have been scientifically proven to be highly effective; however, resource analyses show that the personnel requirements necessary for effective implementation of these programs are much higher than those allocated by the funding according to the Pysch-PV. The current underfunding leads to inadequate treatment outcomes with high readmission rates and as a result high direct and indirect costs of illness.
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Implementation guidelines for seismic PSA
International Nuclear Information System (INIS)
Coman, Ovidiu; Samaddar, Sujit; Hibino, Kenta; )
2014-01-01
The presentation was devoted to development of guidelines for implementation of a seismic PSA. If successful, these guidelines can close an important gap. ASME/ANS PRA standards and the related IAEA Safety Guide (IAEA NS-G-2.13) describe capability requirements for seismic PSA in order to support risk-informed applications. However, practical guidance on how to meet these requirements is limited. Such guidelines could significantly contribute to improving risk-informed safety demonstration, safety management and decision making. Extensions of this effort to further PSA areas, particularly to PSA for other external hazards, can enhance risk-informed applications
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5 CFR 720.206 - Selection guidelines.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Selection guidelines. 720.206 Section 720... guidelines. This subpart sets forth requirements for a recruitment program, not a selection program... procedures and criteria must be consistent with the Uniform Guidelines on Employee Selection Procedures (43...
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Space station pressurized laboratory safety guidelines
Mcgonigal, Les
1990-01-01
Before technical safety guidelines and requirements are established, a common understanding of their origin and importance must be shared between Space Station Program Management, the User Community, and the Safety organizations involved. Safety guidelines and requirements are driven by the nature of the experiments, and the degree of crew interaction. Hazard identification; development of technical safety requirements; operating procedures and constraints; provision of training and education; conduct of reviews and evaluations; and emergency preplanning are briefly discussed.
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Maintaining formal models of living guidelines efficiently
Seyfang, Andreas; Martínez-Salvador, Begoña; Serban, Radu; Wittenberg, Jolanda; Miksch, Silvia; Marcos, Mar; Ten Teije, Annette; Rosenbrand, Kitty C J G M
2007-01-01
Translating clinical guidelines into formal models is beneficial in many ways, but expensive. The progress in medical knowledge requires clinical guidelines to be updated at relatively short intervals, leading to the term living guideline. This causes potentially expensive, frequent updates of the
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Technical guideline technology according to the X-ray regulations
International Nuclear Information System (INIS)
2011-01-01
The guideline covers the required technical knowledge concerning radiation protection and knowledge concerning for the operation of X-ray devices for technical purposes and stray radiation sources requiring licensing, and requirements for the qualification of officially authorized inspectors. The guidelines includes the following chapters: (1) introductory regulations; (2) Volume of the required technical knowledge; (3) Acquirement and certification of the technical knowledge; (4) Actualization of the technical knowledge; (5)Approval of courses and other training measures; (6) Combination of courses and training measures according to the guideline; (7) Requirements for qualification of officially authorized inspectors; (8) Interim regulations.
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5 CFR 1312.10 - Systematic review guidelines.
2010-01-01
... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Systematic review guidelines. 1312.10... Declassification of National Security Information § 1312.10 Systematic review guidelines. The EOP Security Officer will prepare and keep current such guidelines as are required by Executive Order 12958 for the...
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Olympic emblem guidelines: London 2012
2013-01-01
These guidelines issued by the London Organising Committee of the Olympic Games and Paralympic Games Ltd (“LOCOG”) provide standards, requirements and guidelines for use of the London 2012 Olympic Games Emblem (the “Emblem”) by LOCOG and the International Olympic Committee (IOC) creative, marketing and communications personnel, agencies and consultants only who are authorised to use the London 2012 marks. The purpose of these guidelines is to preserve and enhance the value of the Emblem for t...
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ESUR prostate MR guidelines 2012
DEFF Research Database (Denmark)
Barentsz, Jelle O; Richenberg, Jonathan; Clements, Richard
2012-01-01
The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated......, but a compromise, reflected by "minimal" and "optimal" requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines...... provides guidelines for magnetic resonance imaging (MRI) in prostate cancer. Clinical indications, and minimal and optimal imaging acquisition protocols are provided. A structured reporting system (PI-RADS) is described....
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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
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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
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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
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General guidelines for recommendation of sites for nuclear waste repositories
International Nuclear Information System (INIS)
1983-01-01
These guidelines were developed in accordance with the requirements of Section 112(a) of the Nuclear Waste Policy Act of 1982 for use by the Secretary of Energy in evaluating the suitability of sites for the development of repositories. The guidelines will be used for suitability evaluations and determinations made pursuant to Section 112(b) and any preliminary suitability determinations required by Section 114(f). The guidelines set forth in this Part are intended to complement the requirements set forth in the Act, 10 CFR Part 60, and 40 CFR Part 191. In applying these guidelines, the DOE will resolve any inconsistencies between these guidelines and the above documents in a manner determined by the DOE to most closely agree with the intent of the Act
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Postma, Douwe F; van Werkhoven, Cornelis H; Oosterheert, Jan Jelrik
2017-05-01
This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence. The diagnosis and management of CAP has hardly changed for decades. The recommendation to cover atypical pathogens in all hospitalized CAP patients is based on observational studies only and is challenged by two recent trials. The following years, improved diagnostic testing, radiologically by low-dose Computed Tomography or ultrasound and/or microbiologically by point-of-care multiplex PCR, has the potential to largely influence the choice and start of antibiotic therapy in hospitalized CAP patients. Rapid microbiological testing will hopefully improve antibiotic de-escalation or early pathogen-directed therapy, both potent ways of reducing broad-spectrum antibiotic use. Current guideline recommendations on the timing and duration of antibiotic therapy are based on limited evidence, but will be hard to improve.
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Directory of Open Access Journals (Sweden)
Majara Bosielo P
2006-08-01
Full Text Available Abstract Background To evaluate the diagnostic accuracy of the integrated Practical Approach to Lung Health in South Africa (PALSA guideline in identifying patients requiring bacteriological screening for tuberculosis (TB, and to determine which clinical features best predict suspected and bacteriologically-confirmed tuberculosis among patients with respiratory symptoms. Methods A prospective, cross-sectional study in which 1392 adult patients with cough and/or difficult breathing, attending a primary care facility in Cape Town, South Africa, were evaluated by a nurse using the guideline. The accuracy of a nurse using the guideline to identify TB suspects was compared to that of primary care physicians' diagnoses of (1 suspected TB, and (2 proven TB supported by clinical information and chest radiographs. Results The nurse using the guideline identified 516 patients as TB suspects compared with 365 by the primary care physicians, representing a sensitivity of 76% (95% confidence interval (CI 71%–79%, specificity of 77% (95% CI 74%–79%, positive predictive value of 53% (95% CI 49%–58%, negative predictive value of 90% (95% CI 88%–92%, and area under the receiver operating characteristic curve (ARUC of 0.76 (95% CI 0.74–0.79. Sputum results were obtained in 320 of the 365 primary care physicians TB suspects (88%; 40 (13% of these were positive for TB. Only 4 cases were not identified by the nurse using the guideline. The primary care physicians diagnostic accuracy in diagnosing bacteriologically-confirmed TB (n = 320 was as follows: sensitivity 90% (95% CI 76%–97%, specificity 65% (95% CI 63%–68%, negative predictive value 7% (95% CI 5%–10%, positive predictive value 99.5% (95% CI 98.8%–99.8%, and ARUC 0.78 (95% CI 0.73–0.82. Weight loss, pleuritic pain, and night sweats were independently associated with the diagnosis of bacteriologically-confirmed tuberculosis (positive likelihood ratio if all three present = 16.7, 95% CI 5
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LENUS (Irish Health Repository)
Humphreys, H
2012-02-01
There have been many changes in healthcare provision in recent years, including the delivery of some surgical services in primary care or in day surgery centres, which were previously provided by acute hospitals. Developments in the fields of interventional radiology and cardiology have further expanded the range and complexity of procedures undertaken in these settings. In the face of these changes there is a need to define from an infection prevention and control perspective the basic physical requirements for facilities in which such surgical procedures may be carried out. Under the auspices of the Healthcare Infection Society, we have developed the following recommendations for those designing new facilities or upgrading existing facilities. These draw upon best practice, available evidence, other guidelines where appropriate, and expert consensus to provide sensible and feasible advice. An attempt is also made to define minimal access interventions and minor surgical procedures. For minimal access interventions, including interventional radiology, new facilities should be mechanically ventilated to achieve 15 air changes per hour but natural ventilation is satisfactory for minor procedures. All procedures should involve a checklist and operators should be appropriately trained. There is also a need for prospective surveillance to accurately determine the post-procedure infection rate. Finally, there is a requirement for appropriate applied research to develop the evidence base required to support subsequent iterations of this guidance.
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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.
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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.
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The complete European guidelines on phenylketonuria
DEFF Research Database (Denmark)
van Wegberg, A M J; MacDonald, A; Ahring, K
2017-01-01
severe intellectual disability, epilepsy and behavioural problems. PKU management differs widely across Europe and therefore these guidelines have been developed aiming to optimize and standardize PKU care. Professionals from 10 different European countries developed the guidelines according to the AGREE...... (Appraisal of Guidelines for Research and Evaluation) method. Literature search, critical appraisal and evidence grading were conducted according to the SIGN (Scottish Intercollegiate Guidelines Network) method. The Delphi-method was used when there was no or little evidence available. External consultants....... In addition, knowledge gaps are identified which require further research in order to direct better care for the future....
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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
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Expert validation of fit-for-purpose guidelines for designing programmes of assessment
Directory of Open Access Journals (Sweden)
Dijkstra Joost
2012-04-01
Full Text Available Abstract Background An assessment programme, a purposeful mix of assessment activities, is necessary to achieve a complete picture of assessee competence. High quality assessment programmes exist, however, design requirements for such programmes are still unclear. We developed guidelines for design based on an earlier developed framework which identified areas to be covered. A fitness-for-purpose approach defining quality was adopted to develop and validate guidelines. Methods First, in a brainstorm, ideas were generated, followed by structured interviews with 9 international assessment experts. Then, guidelines were fine-tuned through analysis of the interviews. Finally, validation was based on expert consensus via member checking. Results In total 72 guidelines were developed and in this paper the most salient guidelines are discussed. The guidelines are related and grouped per layer of the framework. Some guidelines were so generic that these are applicable in any design consideration. These are: the principle of proportionality, rationales should underpin each decisions, and requirement of expertise. Logically, many guidelines focus on practical aspects of assessment. Some guidelines were found to be clear and concrete, others were less straightforward and were phrased more as issues for contemplation. Conclusions The set of guidelines is comprehensive and not bound to a specific context or educational approach. From the fitness-for-purpose principle, guidelines are eclectic, requiring expertise judgement to use them appropriately in different contexts. Further validation studies to test practicality are required.
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Thole, Henning
2011-01-01
While methods for the production of guidelines (evidence analysis, assessment, adaptation) have been continually refined throughout the past years, there is a lack of instruments for the production of easily understandable synopses. Definition of a methodological approach to encompass synopses by Spidernet diagrams. Tables of synopses can be generated with distinct information to bring down the main results in one Spidernet diagram. This is possible for both the entire synopsis and parts of it. Guideline comparisons require detailed analyses on the one hand and easily understandable presentations of their results on the other. Guideline synopses can be substantially supported by graphic presentation of the results of synopsis. Graphic synopsis is also helpful in other cases; it may be used, for example, to summarise HTA reports, systematic reviews or guidelines. Copyright © 2011. Published by Elsevier GmbH.
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Laidsaar-Powell, Rebekah; Butow, Phyllis; Boyle, Frances; Juraskova, Ilona
2018-06-01
Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial. Copyright © 2018 Elsevier B.V. All rights reserved.
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American Psychologist, 2007
2007-01-01
These guidelines are designed to educate psychologists and provide a framework for making decisions regarding professional record keeping. State and federal laws, as well as the American Psychological Association's "Ethical Principles of Psychologists and Code of Conduct," generally require maintenance of appropriate records of psychological…
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International Nuclear Information System (INIS)
Reedy, R.F.; Hegglin, D.P.
1988-11-01
The record systems at many nuclear power plant sites are becoming overloaded with unnecessary and superfluous records. The reason for this overload is that although the Codes and Standards list the record types to be retained, there is no definition for the contents of the records. This encourages varied interpretations which often lead to the approach of ''save everything''. This document provides guidelines for the content of records to support nuclear power plant operation, maintenance and modification. These Guidelines are based on an engineering approach to identify which data in the records are of ''significant value'' in (1) demonstrating capability for safe operation; (2) maintaining, reworking, repairing, replacing, or modifying an item; (3) determining the cause of an accident or malfunction of an item; and (4) providing required baseline data for in-service inspection. Particular topical issues affecting record retention needs, such as plant life extension activities, may require additional evaluation of data or records. By identifying the data to be retained in the records, it is possible to modify the record management system to substantially reduce the amount of unnecessary information being retained in the records. These Guidelines will provide for more uniform interpretation of requirements. The Guidelines are meant as an interpretation of current Codes, Standards and Regulatory Guides, and not as new requirements. Should any conflict exist between these Guidelines and the specified requirements of the NRC Regulations, the regulations govern. 4 tabs
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DEFF Research Database (Denmark)
Ejegod, Ditte; Bottari, Fabio; Pedersen, Helle
2016-01-01
This study describes a validation of the BD Onclarity HPV (Onclarity) assay using the international guidelines for HPV test requirements for cervical cancer screening of women 30 years and above using Danish SurePath screening samples. The clinical specificity (0.90, 95% CI: 0.88-0.91) and sensit......This study describes a validation of the BD Onclarity HPV (Onclarity) assay using the international guidelines for HPV test requirements for cervical cancer screening of women 30 years and above using Danish SurePath screening samples. The clinical specificity (0.90, 95% CI: 0.......88-0.91) and sensitivity (0.97, 95% CI: 0.87-1.0) of the Onclarity assay were shown to be non-inferior to the reference assay (specificity 0.90, 95% CI: 0.88-0.92, sensitivity 0.98, 95% CI: 0.91-1.0). The intra-laboratory reproducibility of Onclarity was 97% with a lower confidence bound of 96% (kappa value: 0...
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Development of international guidelines for RAM shipment security
Energy Technology Data Exchange (ETDEWEB)
Luna, R.E.
2004-07-01
In October of 2003 a weeklong IAEA Technical Meeting developed a set of guidelines for providing security to consignments of radioactive materials in transport. These guidelines will be published shortly in an IAEA TECDOC. The guidelines produced reflect consideration of many influences and concerns that currently revolve around the potential for terrorist use of radioactive material for malevolent ends. The influences discussed here include: public perception of hazard and concern that new requirements will further limit global shipping capability, international efforts to control sealed sources, national efforts to increment protection on selected materials, the basis for exemption of materials, concern for cost impacts of overly broad requirements, questions on how to adjust requirements for a national threat assessment, and issues relating to consistency within the international community on security needs.
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Development of international guidelines for RAM shipment security
International Nuclear Information System (INIS)
Luna, R.E.
2004-01-01
In October of 2003 a weeklong IAEA Technical Meeting developed a set of guidelines for providing security to consignments of radioactive materials in transport. These guidelines will be published shortly in an IAEA TECDOC. The guidelines produced reflect consideration of many influences and concerns that currently revolve around the potential for terrorist use of radioactive material for malevolent ends. The influences discussed here include: public perception of hazard and concern that new requirements will further limit global shipping capability, international efforts to control sealed sources, national efforts to increment protection on selected materials, the basis for exemption of materials, concern for cost impacts of overly broad requirements, questions on how to adjust requirements for a national threat assessment, and issues relating to consistency within the international community on security needs
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Appraising and comparing pressure ulcer guidelines.
Wimpenny, Peter; van Zelm, Ruben
2007-01-01
Whilst considerable activity has been related to guideline development for nurses regarding pressure ulcer prevention and management, no attempt has been made to comparatively evaluate these guidelines against some form of quality indicators. To compare and contrast four national pressure ulcer guidelines, and identify similarities and differences in their quality and content. An international comparative appraisal method, using the AGREE (Appraisal of Guidelines Research and Evaluation) instrument, was undertaken to appraise four published pressure ulcer guidelines. Two further domains were added to the AGREE instrument to assess comparability of the guidelines and their perceived contribution to practice. An international group undertook the comparative appraisal. The domain scores for each guideline show some but not total agreement among reviewers. One particular set of guidelines was identified as scoring highest in a majority of AGREE domains. Overall, evidence of variability exists between pressure ulcer guidelines and common areas of development to consider for all guidelines. The results raise many questions concerning the "best" pressure ulcer guideline to use, particularly related to the AGREE scoring. Some notable shortcomings exist in all the pressure ulcer guidelines reviewed and these shortcomings need to be addressed from a quality perspective. However, other issues such as style of reporting and potential contribution to practice might more fully affect choice by practitioners as opposed to guideline developers. Notable differences exist among the four guidelines that are possibly explained by different approaches to development and also because of different cultural factors and intentions for use. Whilst the AGREE tool identifies the quality of the guideline development process it still requires local engagement with practitioners to determine which guideline should be implemented.
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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
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Guidelines for identifying suspect/counterfeit material
Energy Technology Data Exchange (ETDEWEB)
NONE
1995-09-01
These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.
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Curriculum Guidelines for Periodontics.
Journal of Dental Education, 1985
1985-01-01
Guidelines describe the interrelationships of this and other dental fields, give an overview of the curriculum and its primary educational objectives, and outline the suggested prerequisites, core content, specific behavioral objectives, sequencing, and faculty requirements. (MSE)
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International Nuclear Information System (INIS)
Spampinato, P.T.; Tabor, M.A.
1988-01-01
Remote maintenance systems requirements are being developed to provide design guidelines for machine components, to define maintenance interfaces, and to quantify maintenance equipment and procedures needed
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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.
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Hematology journals do not sufficiently adhere to reporting guidelines: a systematic review.
Wayant, C; Smith, C; Sims, M; Vassar, M
2017-04-01
Essentials Reporting guidelines and trial/review registration aim to limit bias in research. We systematically reviewed hematology journals to examine the use of these policies. Forty-eight percent of journals made no use of these policies. Improving the use of reporting guidelines will improve research for all stakeholders. Background Reporting guidelines and trial/review registration policies have been instituted in order to minimize bias and improve research practices. Objective The objective of this study was to investigate the policies of hematology journals concerning reporting guideline adoption and trial/review registration. Methods We performed a web-based data abstraction from the Instructions for Authors of 67 hematology journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports to identify whether each journal required, recommended or made no mention of the following reporting guidelines: EQUATOR, ICMJE, CONSORT, MOOSE, QUOROM, PRISMA, STARD, STROBE, ARRIVE and CARE. We also extracted whether journals required or recommended trial or systematic review registration. We e-mailed editors three times to determine which types of studies their journal accepts. Results Forty-eight per cent (32/67) of hematology journals do not adhere to any reporting guidelines. For responding journals, the QUOROM statement, MOOSE, CARE and PROSPERO were the least often mentioned, whereas the ICMJE guidelines, CONSORT statement and general trial registration were most often mentioned. Discussion Reporting guidelines are infrequently required or recommended by hematology journals. Furthermore, few require clinical trial or systematic review database registration. A higher rate of adherence to reporting guidelines can prevent bias from entering the literature. Participation from all stakeholders, including authors and journal editors, to improve reporting guideline and policy practices is required. © 2017 International Society on Thrombosis
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Deriving cleanup guidelines for radionuclides at Brookhaven National Laboratory
Energy Technology Data Exchange (ETDEWEB)
Meinhold, A.F.; Morris, S.C.; Dionne, B.; Moskowitz, P.D.
1997-01-01
Past activities at Brookhaven National Laboratory (BNL) resulted in soil and groundwater contamination. As a result, BNL was designated a Superfund site under the Comprehensive Environmental Response Compensation and Liability Act (CERCLA). BNL`s Office of Environmental Restoration (OER) is overseeing environmental restoration activities at the Laboratory. With the exception of radium, there are no regulations or guidelines to establish cleanup guidelines for radionuclides in soils at BNL. BNL must derive radionuclide soil cleanup guidelines for a number of Operable Units (OUs) and Areas of Concern (AOCs). These guidelines are required by DOE under a proposed regulation for radiation protection of public health and the environment as well as to satisfy the requirements of CERCLA. The objective of this report is to propose a standard approach to deriving risk-based cleanup guidelines for radionuclides in soil at BNL. Implementation of the approach is briefly discussed.
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Deriving cleanup guidelines for radionuclides at Brookhaven National Laboratory
International Nuclear Information System (INIS)
Meinhold, A.F.; Morris, S.C.; Dionne, B.; Moskowitz, P.D.
1997-01-01
Past activities at Brookhaven National Laboratory (BNL) resulted in soil and groundwater contamination. As a result, BNL was designated a Superfund site under the Comprehensive Environmental Response Compensation and Liability Act (CERCLA). BNL's Office of Environmental Restoration (OER) is overseeing environmental restoration activities at the Laboratory. With the exception of radium, there are no regulations or guidelines to establish cleanup guidelines for radionuclides in soils at BNL. BNL must derive radionuclide soil cleanup guidelines for a number of Operable Units (OUs) and Areas of Concern (AOCs). These guidelines are required by DOE under a proposed regulation for radiation protection of public health and the environment as well as to satisfy the requirements of CERCLA. The objective of this report is to propose a standard approach to deriving risk-based cleanup guidelines for radionuclides in soil at BNL. Implementation of the approach is briefly discussed
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12 CFR 528.1a - Supplementary guidelines.
2010-01-01
... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Supplementary guidelines. 528.1a Section 528.1a Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY NONDISCRIMINATION REQUIREMENTS § 528.1a Supplementary guidelines. The Office's policy statement found at 12 CFR 528.9 supplements...
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Annotating Evidence Based Clinical Guidelines : A Lightweight Ontology
Hoekstra, R.; de Waard, A.; Vdovjak, R.; Paschke, A.; Burger, A.; Romano, P.; Marshall, M.S.; Splendiani, A.
2012-01-01
This paper describes a lightweight ontology for representing annotations of declarative evidence based clinical guidelines. We present the motivation and requirements for this representation, based on an analysis of several guidelines. The ontology provides the means to connect clinical questions
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A comparative review of the pharmacoeconomic guidelines in South Africa.
Carapinha, João L
2017-01-01
To compare the pharmacoeconomic guidelines in South Africa (SA) with other middle- and high-income countries. A comparative review of key features of the pharmacoeconomic guidelines in SA was undertaken using the Comparative Table of Pharmacoeconomic Guidelines developed by the International Society of Pharmacoeconomics and Outcomes Research, and published country-level pharmacoeconomics guidelines. A random sample of guidelines in high- and middle-income countries were analyzed if data on all key features were available. Key features of the pharmacoeconomic guidelines in SA were compared with those in other countries, and divergent features were identified and elaborated. Five upper middle-income countries (Brazil, Colombia, Cuba, Malaysia, and Mexico), one lower middle-income country (Egypt), and six high-income countries (Germany, Ireland, Norway, Portugal, Taiwan, and the Netherlands) were analyzed. The pharmacoeconomic guidelines in SA differ in important areas when compared with other countries. In SA, the study perspective and costs are limited to private health-insurance companies, complex modelling is discouraged and models require pre-approval, equity issues are not explicitly stated, a budget impact analysis is not required, and pharmacoeconomic submissions are voluntary. Future updates to the pharmacoeconomic guidelines in SA may include a societal perspective with limitations, incentivize complex and transparent models, and integrate equity issues. The pharmacoeconomic guidelines could be improved by addressing conflicting objectives with policies on National Health Insurance, incentivize private health insurance companies to disclose reimbursement data, and require the inclusion of a budget impact analysis in all pharmacoeconomic submissions. Further research is also needed on the impact of mandatory pharmacoeconomic submissions in middle-income countries.
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Are existing irrigation salinity leaching requirement guidelines overly conservative or obsolete?
Water scarcity and increased frequency of drought, resulting from erratic weather attributable to climatic change or alterations in historical weather patterns, have caused greater scrutiny of irrigated agriculture’s demand on water resources. The traditional guidelines for the calculation of the c...
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Guidelines for bone scintigraphy in children
International Nuclear Information System (INIS)
Hahn, K.; Fischer, S.; Gordon, I.; Mann, M.; Piepsz, A.; Olivier, P.; Sixt, R.; Velzen, J. van
2000-01-01
The guidelines are intended to help nuclear medical teams in their daily routine. The guidelines give information relating to indications, performance of examinations, analysis and interpretation of the diagnostic results. The guidelines should be applied in the context of adopted basic quality criteria in nuclear medicine, requirements of the German radiation protection ordinance, as well as the regulatory codes for radiation protection in the medical field. The guidelines express the opinions of the Paediatric Committee of the EANM and hence focus on compliance with the relevant European standards in nuclear medicine. In order to enhance the specificity of results obtained with a bone scintigraphy, the interpretation of the results should be based on combined analysis with information drawn from X-rays. (orig./CB) [de
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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.
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Protocol-developing meta-ethnography reporting guidelines (eMERGe).
France, E F; Ring, N; Noyes, J; Maxwell, M; Jepson, R; Duncan, E; Turley, R; Jones, D; Uny, I
2015-11-25
Designing and implementing high-quality health care services and interventions requires robustly synthesised evidence. Syntheses of qualitative research studies can provide evidence of patients' experiences of health conditions; intervention feasibility, appropriateness and acceptability to patients; and advance understanding of health care issues. The unique, interpretive, theory-based meta-ethnography synthesis approach is suited to conveying patients' views and developing theory to inform service design and delivery. However, meta-ethnography reporting is often poor quality, which discourages trust in, and use of, meta-ethnography findings. Users of evidence syntheses require reports that clearly articulate analytical processes and findings. Tailored research reporting guidelines can raise reporting standards but none exists for meta-ethnography. This study aims to create an evidence-based meta-ethnography reporting guideline articulating the methodological standards and depth of reporting required to improve reporting quality. The mixed-methods design of this National Institute of Health Research-funded study (http://www.stir.ac.uk/emerge/) follows good practice in research reporting guideline development comprising: (1) a methodological systematic review (PROSPERO registration: CRD42015024709) to identify recommendations and guidance in conducting/reporting meta-ethnography; (2) a review and audit of published meta-ethnographies to identify good practice principles and develop standards in conduct/reporting; (3) an online workshop and Delphi studies to agree guideline content with 45 international qualitative synthesis experts and 45 other stakeholders including patients; (4) development and wide dissemination of the guideline and its accompanying detailed explanatory document, a report template for National Institute of Health Research commissioned meta-ethnographies, and training materials on guideline use. Meta-ethnography, devised in the field of education
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Swiss guideline: Protection objectives for the disposal of radioactive waste
International Nuclear Information System (INIS)
Zurkinden, A.
1994-01-01
The Swiss guideline R-21 establishing the protection objectives for the disposal of radioactive waste has been reviewed and amended in order to adapt it to improvements made in the field of radioactive waste disposal. In an introductory part, the new guideline states the overall objective of radioactive waste disposal and the associated principles which have to be observed. The guideline then establishes the safety requirements applied to a geological disposal facility. These safety requirements are formulated as protection goals for the whole disposal system and not as specific criteria applying to the system components. The guideline gives finally a series of explanatory comments and indications concerning the conduct of the safety assessment for a disposal facility
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[Elaboration and critical evaluation of clinical guidelines].
García Villar, C
2015-11-01
Clinical guidelines are documents to help professionals and patients select the best diagnostic or therapeutic option. Elaborating guidelines requires an efficient literature search and a critical evaluation of the articles found to select the most appropriate ones. After that, the recommendations are formulated and then must be externally evaluated before they can be disseminated. Even when the guidelines are very thorough and rigorous, it is important to know whether they fulfill all the methodological requisites before applying them. With this aim, various scales have been developed to critically appraise guidelines. Of these, the AGREE II instrument is currently the most widely used. This article explains the main steps in elaborating clinical guidelines and the main aspects that should be analyzed to know whether the guidelines are well written. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.
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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.
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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
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OSART guidelines. 1994 edition
International Nuclear Information System (INIS)
1994-05-01
These guidelines have been prepared to provide a basic structure and common reference both across the various areas covered by an OSART mission and across all the missions in the programme. As such, they are addressed, principally, to the team members of OSART missions but they will also provide guidance to a host nuclear plant preparing to receive a mission. The guidelines are intended to help each expert to formulate his review in the light of this own experience. They are not all inclusive and should not limit the expert's investigations, but are better considered as illustrating the adequate requirements for his review
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Quast, Ulrich; Kaulich, Theodor W; Lorenz, Joachim
2002-02-01
The success of intravascular brachytherapy relies entirely on the interdisciplinary approach. Interventional cardiologists, radiation oncologists and medical physicists must form a team from day 1. All members of the team need special knowledge and regular training in the field of vascular radiation therapy. Optimization of intravascular brachytherapy requires the use of standardized methods of dose specification, recording and reporting. This also implies using standardized methods of source calibration in terms of absorbed dose to water and having methods for simple internal control of the dosimetric quantities of new or replaced sources. Guidance is offered by international recommendations (AAPM TG 60, DGMP Report 16, NCS and EVA GEC-ESTRO). LEGAL REQUIREMENTS FOR RADIATION PROTECTION--WHAT'S NEW?: In Europe, new legal requirements on radiation protection issues have to be fulfilled. For Germany, the revised "Strahlenschutzverordnung" has been released recently. Nearly all organizational and medical processes are affected. For intravascular brachytherapy, several changes of requirements have to be considered. However, to follow these requirements does not cause serious problems. DGMP REPORT 16: GUIDELINES FOR MEDICAL PHYSICAL ASPECTS OF INTRAVASCULAR BRACHYTHERAPY: Evaluation of clinical results by comparison of intravascular brachytherapy treatment parameters is possible only if the prescribed dose and the applied dose distribution are reported clearly, completely and uniformly. The DGMP guidelines thus recommend to prescribe the dose to water at the system related reference point PRef at 2 mm radial distance for intracoronary application (and at 5 mm for peripheral vessels). The mean dose at 1 mm tissue depth (respectively at 2 mm) should be reported in addition. To safely define the planning target volume from the injured length, safety margins of at least 5 mm (10 mm) have to be taken into account on both ends. Safety margins have also to be considered for
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European guidelines for workplace drug testing in urine.
Taskinen, Sanna; Beck, Olof; Bosch, Tessa; Brcak, Michaela; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Weinmann, Wolfgang
2017-06-01
These European Guidelines for Workplace Drug Testing in Urine have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The first version of these urine guidelines was published in 2002. Since then, the guidelines have been followed by many laboratories in different European countries and their role has been essential particularly in countries lacking legislation for workplace drug testing. In 2014, the EWDTS started a guidelines updating project and published a new version of the urine guidelines in 2015. Here we represent this updated version of the urine guidelines. The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
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Practice guidelines. Cookbook medicine.
Harding, J
1994-08-01
A large measure of the confusion and doubt currently being sowed in the ongoing debate over the advisability and effectiveness of practice guidelines is a matter of terminology. In deference to the wishes and fears of physicians, the term "requirements" is not used. But requirements they are. Their quality and the degree to which they are useful will depend on their level of detail and the degree to which they are based on positive outcomes. Regardless, attorneys and others will always view and use them as requirements.
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ESUR prostate MR guidelines 2012
Energy Technology Data Exchange (ETDEWEB)
Barentsz, Jelle O.; Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands); Richenberg, Jonathan [Brighton and Sussex University Hospital Trust, Brighton (United Kingdom); Clements, Richard [Royal Gwent Hospital, Department of Clinical Radiology, Newport, South Wales (United Kingdom); Choyke, Peter [National Cancer Institute, Molecular Imaging Program, Bethesda, MD (United States); Verma, Sadhna [University Of Cincinnati Medical Center, Cincinnati, OH (United States); Villeirs, Geert [Ghent University Hospital, Division of Genitourinary Radiology, Ghent (Belgium); Rouviere, Olivier [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Lyon (France); Universite de Lyon, Lyon (France); Universite Lyon 1, Faculte de Medecine Lyon Est, Lyon (France); Logager, Vibeke [Copenhagen University, Hospital Herlev, Herlev (Denmark)
2012-04-15
The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a compromise, reflected by ''minimal'' and ''optimal'' requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines for the optimal technique and three protocols for ''detection'', ''staging'' and ''node and bone'' are presented. The use of endorectal coil vs. pelvic phased array coil and 1.5 vs. 3 T is discussed. Clinical indications and a PI-RADS classification for structured reporting are presented. (orig.)
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Energy Technology Data Exchange (ETDEWEB)
Lstiburek, Joseph [Building Science Corporation, Westford, MA (United States)
2017-01-01
The measure guideline provides ventilation guidance for residential high performance multifamily construction that incorporates the requirements of the ASHRAE 62.2 ventilation and indoor air quality standard. The measure guideline focus is on the decision criteria for weighing cost and performance of various ventilation systems. The measure guideline is intended for contractors, builders, developers, designers and building code officials. The guide may also be helpful to building owners wishing to learn more about ventilation strategies available for their buildings. The measure guideline includes specific design and installation instructions for the most cost effective and performance effective solutions for ventilation in multifamily units that satisfies the requirements of ASHRAE 62.2-2016.
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9 CFR 114.9 - Outline of Production guidelines.
2010-01-01
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Outline of Production guidelines. 114.9 Section 114.9 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT... REQUIREMENTS FOR BIOLOGICAL PRODUCTS § 114.9 Outline of Production guidelines. Each Outline of Production shall...
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Kötter, Thomas; Bartel, Carmen; Schramm, Susanne; Lange, Petra; Höfer, Eva; Hänsel, Michaela; Waffenschmidt, Siw; Waldt, Susanne Ein; Hoffmann-Eßer, Wiebke; Rüther, Alric; Lühmann, Dagmar; Scherer, Martin
2013-01-01
Disease Management Programmes (DMPs) are structured treatment programmes for chronic diseases. The DMP requirements are primarily derived from evidence-based guidelines. DMPs are regularly revised to ensure that they reflect current best practice and medical knowledge. The aim of this study was to assess the need for updating the German DMP module on heart failure by comparing it to relevant guidelines and identifying recommendations that should be revised. We systematically searched for clinical guidelines on heart failure published in German, English or French, and extracted relevant guideline recommendations. All included guidelines were assessed for methodological quality. To identify revision needs in the DMP, we performed a synoptic analysis of the extracted guideline recommendations and DMP requirements. 27 guidelines were included. The extracted recommendations covered all aspects of the management of heart failure. The comparison of guideline recommendations with DMP requirements showed that, overall, guideline recommendations were more detailed than DMP requirements, and that the guidelines covered topics not included in the DMP module. The DMP module is largely consistent with current guidelines on heart failure. We did not identify any need for significant revision of the DMP requirements. However, some specific recommendations of the DMP module could benefit from revision. Copyright © 2013. Published by Elsevier GmbH.
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Computerization of guidelines: towards a "guideline markup language".
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.
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Guidelines in lower-middle income countries.
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.
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PWR secondary water chemistry guidelines
International Nuclear Information System (INIS)
Bell, M.J.; Blomgren, J.C.; Fackelmann, J.M.
1982-10-01
Steam generators in pressurized water reactor (PWR) nuclear power plants have experienced tubing degradation by a variety of corrosion-related mechanisms which depend directly on secondary water chemistry. As a result of this experience, the Steam Generator Owners Group and EPRI have sponsored a major program to provide solutions to PWR steam generator problems. This report, PWR Secondary Water Chemistry Guidelines, in addition to presenting justification for water chemistry control parameters, discusses available analytical methods, data management and surveillance, and the management philosophy required to successfully implement the guidelines
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Boyd, Elizabeth A; Akl, Elie A; Baumann, Michael; Curtis, J Randall; Field, Marilyn J; Jaeschke, Roman; Osborne, Molly; 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 healthcare recommendations are informed by the best available research evidence. This is the fourth of a series of 14 articles prepared to advise guideline developers in respiratory and other disease. It focuses on commercial funding of guidelines and managing conflict of interest effectively in the context of guidelines. In this review, we addressed the following topics and questions. (1) How are clinical practice guidelines funded? (2) What are the risks associated with commercial sponsorship of guidelines? (3) What relationships should guideline committee members be required to disclose? (4) What is the most efficient way to obtain complete and accurate disclosures? (5) How should disclosures be publicly shared? (6) When do relationships require management? (7) How should individual conflicts of interest be managed? (8) How could conflict of interest policies be enforced? The literature review included a search of PubMed and other databases for existing systematic reviews and relevant methodological research. Our conclusions are based on available evidence, consideration of what guideline developers are doing, and workshop discussions. Professional societies often depend on industry funding to support clinical practice guideline development. In addition, members of guideline committees frequently have financial relationships with commercial entities, are invested in their intellectual work, or have conflicts related to clinical revenue streams. No systematic reviews or other rigorous evidence regarding best practices for funding models, disclosure mechanisms, management strategies, or enforcement presently exist, but the panel drew several conclusions that could improve transparency and process.
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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.)
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Energy Technology Data Exchange (ETDEWEB)
1981-02-01
These guidelines were designed to assist National Rural Electric Cooperative Association staff and consultants involved in the implementation of Sections 201 and 210 of the Public Utilities Regulatory Policies Act (PURPA). The guidelines were structured to meet anticipated use as: a self-contained legal, technical and economic reference manual helpful in dealing with small power producers and cogenerators; a roadmap through some of the less obvious obstacles encountered by utilities interacting with small power producers and cogenerators; a starting point for those utilities who have not yet formulated specific policies and procedures, nor developed rates for purchasing power from small power producers and cogenerators; a discussion vehicle to highlight key issues and increase understanding in workshop presentations to rural electric cooperatives; and an evolutionary tool which can be updated to reflect changes in the law as they occur. The chapters in these Guidelines contain both summary information, such as compliance checklists, and detailed information, such as cost rate calculations, on regulatory requirements, operational considerations, and rate considerations. The appendices contain more specific material, e.g. rural electric cooperative sample policy statements. (LCL)
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Dubravcsik, Zsolt; Farkas, Gyula; Hegyi, Péter; Hritz, István; Kelemen, Dezső; Lásztity, Natália; Morvay, Zita; Oláh, Attila; Pap, Ákos; Párniczky, Andrea; Sahin-Tóth, Miklós; Szentkereszti, Zsolt; Szmola, Richárd; Takács, Tamás; Tiszlavicz, László; Szücs, Ákos; Czakó, László
2015-02-22
Autoimmune pancreatitis is a rare disease which can even mimic pancreatic tumor, however, unlike the latter, it requires not surgical but conservative management. Correct diagnosis and differential diagnosis of autoimmune pancreatitis and treatment of these patients requires up-to-date and evidence based management guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available international guidelines and evidences. The preparatory and consultation task force appointed by the Hungarian Pancreatic Study Group translated and complemented and/or modified the international guidelines if it was necessary. 29 relevant clinical questions in 4 topics were defined (Basics; Diagnosis; Differential diagnostics; Therapy). Evidence was classified according to the UpToDate(®) grading system. The draft of the guidelines was presented and discussed at the consensus meeting on September 12, 2014. All clinial questions were accepted with almost total (more than 95%) agreement. The present guideline is the first evidence based autoimmune pancreatitis guideline in Hungary. The guideline may provide very important and helpful data for tuition of autoimmune pancreatitis, for everyday practice and for establishing proper finance. Therefore, the authors believe that these guidelines will widely become a basic reference in Hungary.
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Serving our communities better. Guidelines for planning and developing integrated delivery networks.
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.
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Procedure guideline for thyroid scintigraphy (version 3)
International Nuclear Information System (INIS)
Dietlein, M.; Schicha, H.; Eschner, W.; Deutsche Gesellschaft fuer Medizinische Physik; Koeln Univ.; Leisner, B.; Allgemeines Krankenhaus St. Georg, Hamburg; Reiners, C.; Wuerzburg Univ.
2007-01-01
The version 3 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline previously published in 2003. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of the TSH-level. As a consequence of the improved alimentary iodine supply the 99m Tc-uptake has decreased; 100 000 counts per scintigraphy should be acquired. For this, an imaging time of 10 minutes is generally needed using a high resolution collimator for thyroid imaging. (orig.)
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2008-11-01
This document provides information on the compliance of the LTPP program with the guidelines the Department of Transportation (DOT) issued Information Dissemination Quality Guidelines (IDQG). These guidelines were developed in response to requirement...
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Hardware Transactional Memory Optimization Guidelines, Applied to Ordered Maps
DEFF Research Database (Denmark)
Bonnichsen, Lars Frydendal; Probst, Christian W.; Karlsson, Sven
2015-01-01
efficiently requires reasoning about those differences. In this paper we present 5 guidelines for applying hardware transactional memory efficiently, and apply the guidelines to BT-trees, a concurrent ordered map. Evaluating BT-trees on standard benchmarks shows that they are up to 5.3 times faster than...
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Overview and status of Department of Energy siting guidelines
International Nuclear Information System (INIS)
Hanlon, C.
1984-01-01
One of the initial requirements of the Nuclear Waste Policy Act of 1982 was the development of siting guidelines for use in the selection of repository sites. The key issues raised during the consultation process are summarized as follows: the use of NRC and EPA regulations; the application of the guidelines in the siting process; the structure and specificity of the guidelines; the relationship between system and technical guidelines; the use of the systems approach in evaluating the overall performance of the repository system; the relative importance of individual guidelines; the degree of reliance placed on engineered barriers; impacts on the local population; impacts on the environment; protection of ground-water resources; and transportation. All of these issues were considered in revising the guidelines, and the responses to them are summarized in general terms
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International Nuclear Information System (INIS)
1987-01-01
The IMO and ILO guidelines are given, which help to meet the requirements of the Maritime Safety Ordinance and the Ordinance on Ocean Transport of Dangerous Goods. The guidelines explain the principles of safe packing and stowing of cargo in freight containers and vehicles for ocean transports. Further information and practical hints are given in international publications referred to in the annex. The guidelines are also meant for training purposes. (orig./HSCH) [de
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Misguided guidelines for managing labor.
Cohen, Wayne R; Friedman, Emanuel A
2015-06-01
In a recent review we expressed concerns about new guidelines for the assessment and management of labor recommended jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). These guidelines are based heavily on a new concept of how cervical dilatation and fetal descent progress, derived from the work of Zhang et al. In their Viewpoint article they have addressed, but not allayed, the concerns we described in our review. We assert that the dilatation curve promulgated by Zhang et al cannot be reconciled with direct clinical observation. Even if they were correct, however, it still does not follow that the ACOG/SMFM guidelines should recommend replacing the coherent system of identifying and managing labor aberrations described by Friedman. That system is grounded in well-established clinical principles based on decades of use and the objectively documented association of some labor abnormalities with poor fetal and maternal outcomes. Recommendations for new clinical management protocols should require the demonstration of superior outcomes through extensive, preferably prospective, assessment. Using untested guidelines for the management of labor may adversely affect women and children. Even if those guidelines were to reduce the currently excessive cesarean delivery rate, the price of that benefit is likely to be a trade-off in harm to parturients and their offspring. The nature and degree of that harm needs to be documented before considering adoption of the guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.
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Guidelines for the treatment of patients with dementia
Directory of Open Access Journals (Sweden)
Aleš Kogoj
2014-08-01
Full Text Available In this article we suggest guidelines for the diagnostic process with appropriate investigations to be carried out. Part of the guidelines is intended for pharmacotherapeutic treatment and ranges from already established treatment of cognitive decline to treating behavioral and psychological changes. These have a significant impact on the quality of life of patients and their families, in particular, because of often controversial reports on the effectiveness of pharmacological therapy. Current guidelines focus on the role of physicians, although we are aware of the fact that dementia care requires a highly multidisciplinary approach.
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Clinical practice guidelines in breast cancer
Tyagi, N. Kumar; Dhesy-Thind, S.
2018-01-01
Background A number of clinical practice guidelines (cpgs) concerning breast cancer (bca) screening and management are available. Here, we review the strengths and weaknesses of cpgs from various professional organizations and consensus groups with respect to their methodologic quality, recommendations, and implementability. Methods Guidelines from four groups were reviewed with respect to two clinical scenarios: adjuvant ovarian function suppression (ofs) in premenopausal women with early-stage estrogen receptor–positive bca, and use of sentinel lymph node biopsy (slnb) after neoadjuvant chemotherapy (nac) for locally advanced bca. Guidelines from the American Society of Clinical Oncology (asco); Cancer Care Ontario’s Program in Evidence Based Care (cco’s pebc); the U.S. National Comprehensive Cancer Network (nccn); and the St. Gallen International Breast Cancer Consensus Conference were reviewed by two independent assessors. Guideline methodology and applicability were evaluated using the agree ii tool. Results The quality of the cpgs was greatest for the guidelines developed by asco and cco’s pebc. The nccn and St. Gallen guidelines were found to have lower scores for methodologic rigour. All guidelines scored poorly for applicability. The recommendations for ofs were similar in three guidelines. Recommendations by the various organizations for the use of slnb after nac were contradictory. Conclusions Our review demonstrated that cpgs can be heterogeneous in methodologic quality. Low-quality cpg implementation strategies contribute to low uptake of, and adherence to, bca cpgs. Further research examining the barriers to recommendations—such as intrinsic guideline characteristics and the needs of end users—is required. The use of bca cpgs can improve the knowledge-to-practice gap and patient outcomes.
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[Possible relation between clinical guidelines and legal standard of medicine].
Furukawa, Toshiharu; Kitagawa, Yuko
2010-10-01
Legal standard of medicine is not equal across the all kinds of medical institutions. Each medical institution is required its respective standard of medicine in which its doctors are expected to have studied medical informations, which have been spread among medical institutions with similar characteristics. Therefore, in principle, clinical guidelines for the treatment of a disease formed by public committees do not directly become the medical standards of respective disease treatment. However, doctors would be legally required to practice medicine with reference to the clinical guidelines because medical informations, mediated by internet or many kinds of media, have been spread very fast to all medical institutions these days. Moreover, doctors would be required to inform their patients of non-standardized new treatments, even if such treatments are not listed in clinical guidelines in case patients have special concern about new treat-
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Sedation in a radiology department--do radiologists follow their own guidelines?
Eason, D; Chakraverty, S; Wildsmith, J A W
2011-05-01
The Royal College of Radiologists (RCR) published guidelines in 2003 which aimed to standardise and improve the safety of sedation in the modern Radiology department. As sedation requirements increase, we decided to audit our own departments understandings and practice with respect to sedation. A repeat audit cycle was performed following a re-educational lecture, one year later. Three common sedation case scenarios were incorporated into a questionnaire which detailed questioning on requirements for fasting, monitoring and the order and use of sedation drugs alongside analgesics. These were compared to the 2003 RCR guidelines. The audit was recycled at one year. Despite the RCR guidelines, freely available on the RCR website, there was a persisting variation in practice which revealed a lack of awareness of the requirements for adequate fasting and the importance of giving the opiate before the benzodiazepine (sedative) agent in cases where a combination are chosen. The audit did show a trend towards using shorter acting benzodiazepines, which is in keeping with the guidelines. Monitoring of vital signs was generally, well carried out. General awareness of the RCR guidelines for safe sedation in the Radiology department was initially low and practice found to be variable. Re-education saw some improvements but also, some persisting habitual deviations from the guidelines, particularly with respect to the order in which the opiate and sedative benzodiazepine were given.
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A new hybrid thermal comfort guideline for the Netherlands : Background and development
Boerstra, A.C.; Van Hoof, J.; Van Weele, A.M.
2015-01-01
In 2004, the first adaptive thermal comfort guideline was introduced in the Netherlands. Recently, a new, upgraded version of this ISSO 74 (ATG) guideline has been developed. The new requirements are hybrid in nature as the 2014 version of the guideline combines elements of traditional non-adaptive
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The guidelines for the humanisation of care facilities
Directory of Open Access Journals (Sweden)
Daniela Bosia
2015-04-01
Full Text Available This article outlines the structure and contents of the guidelines for the humanisation of care facilities, which were produced from the research project The Humanisation of Healthcare Facilities: the new Dimension of Hospital Architecture conducted by the Tesis Inter-university Research Centre at the University of Florence and by the DINSE Department of the Politecnico di Torino for the Ministry of Health. The research work used a requirement-based approach that analysed the activities and requirements expressed by certain different users. For example, the guidelines on certain areas of the analysed healthcare facilities have been outlined.
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School Business Community Partnership Brokers. Program Guidelines, 2010-2013
Australian Government Department of Education, Employment and Workplace Relations, 2009
2009-01-01
These guidelines for 2010-2013 relate specifically to the Partnership Brokers program. This program is part of the Australian Government's contribution to the Youth Attainment and Transitions National Partnership and will commence on 1 January 2010. These Guidelines set out the requirements for the provision of services by organisations contracted…
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Belgian guidelines for economic evaluations: second edition.
Thiry, Nancy; Neyt, Mattias; Van De Sande, Stefaan; Cleemput, Irina
2014-12-01
The aim of this study was to present the updated methodological guidelines for economic evaluations of healthcare interventions (drugs, medical devices, and other interventions) in Belgium. The update of the guidelines was performed by three Belgian health economists following feedback from users of the former guidelines and personal experience. The updated guidelines were discussed with a multidisciplinary team consisting of other health economists, assessors of reimbursement request files, representatives of Belgian databases and representatives of the drugs and medical devices industry. The final document was validated by three external validators that were not involved in the previous discussions. The guidelines give methodological guidance for the following components of an economic evaluation: literature review, perspective of the evaluation, definition of the target population, choice of the comparator, analytic technique and study design, calculation of costs, valuation of outcomes, definition of the time horizon, modeling, handling uncertainty and discounting. We present a reference case that can be considered as the minimal requirement for Belgian economic evaluations of health interventions. These guidelines will improve the methodological quality, transparency and uniformity of the economic evaluations performed in Belgium. The guidelines will also provide support to the researchers and assessors performing or evaluating economic evaluations.
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Does Greenland need a guideline on how to deal with moisture in the construction phase?
DEFF Research Database (Denmark)
Hansen, Ernst Jan de Place
2012-01-01
. As the requirements concerning moisture control are function-based, the construction client and the authorities are entrusted with interpreting requirements in a specific case, which caused the introduction of a guideline based on humidity risk classes. This paper presents the Danish requirements and guideline...... and gives examples of moisture-related problems in buildings in Greenland. Requirements and guidelines are needed in Greenland in order to deal with moisture in the construction phase, but as the conditions for constructing houses and the way that houses are used in Greenland are different from Denmark...
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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
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[Current guidelines on carotid artery stenting. Critical evaluation].
Hein-Rothweiler, R; Mudra, H
2013-11-01
Scientific data underlying current guidelines on treatment of carotid artery stenosis is subject to interdisciplinary discussion. In particular selective weighting of the randomized European studies leads to conflicting levels of recommendation and levels of evidence, especially when directly comparing guidelines under surgical versus endovascular guidance. Surgical guidelines recommend a limitation of carotid artery stenting (CAS) to symptomatic patients with specific surgical/anatomical disadvantages and/or severe comorbidities. The European Society of Cardiology (ESC) guidelines recommend the use of CAS only in patients at increased surgical risk but at the same time requires morbidity and mortality rates comparable to those of surgical interventions. Even one step further, the American guidelines and specifically the associated comments of the German Society of Cardiology on the above mentioned ESC guidelines put CAS and carotid endarterectomy (CEA) on a par in terms of treatment alternatives, presupposing analogous CEA complication rates. Differential interpretation of the so far inadequate data is a common issue of current evidence-based medicine. The difficulty in conceptualization of new studies concerning the therapy of carotid stenosis lies in the funding these large projects and also on the high patient number required to achieve adequate statistical power. Furthermore, during the estimated long study period substantial changes of current techniques and devices can be anticipated which might render the study results in part outdated by the time of publication. However, as long as no new randomized study results comparing medical, surgical and interventional treatment of carotid stenosis are available, the question on the optimal therapy for patients with carotid artery disease remains unanswered.
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Guidelines for prevention in psychology.
2014-04-01
The effectiveness of prevention to enhance human functioning and reduce psychological distress has been demonstrated. From infancy through adulthood, access to preventive services and interventions is important to improve the quality of life and human functioning and reduce illness and premature death. The importance of prevention is consistent with the Patient Protection and Affordable Care Act of 2010. Even with the increased focus on prevention, psychology training programs rarely require specific courses on prevention. In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking. Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices. Accordingly, the Guidelines for Prevention in Psychology are intended to "inform psychologists, the public, and other interested parties regarding desirable professional practices" in prevention. The Prevention Guidelines are recommended based on their potential benefits to the public and the professional practice of psychology. They support prevention as an important area of practice, research, and training for psychologists. The Guidelines give increased attention to prevention within APA, encouraging psychologists to become involved with preventive activities relevant to their area of practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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2014-11-01
the signature database. Mozilla and Firefox Web Browsers (http://www.mozilla.org) – freeware Web browsers used to manually browse and inspect the Web...what operating systems ( OS ) and OS versions they run, what type of packet filters/firewalls are in use, and dozens of other characteristics. Nikto
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Shah, Gourav
2015-01-01
If you are a systems or automation engineer who intends to automate common infrastructure tasks, deploy applications, and use orchestration to configure systems in a coordinated manner, then this book is for you. Some understanding of the Linux/Unix command-line interface is expected.
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Physicians' preferences for asthma guidelines implementation.
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.
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Design Guidelines for New Generation Network Architecture
Harai, Hiroaki; Fujikawa, Kenji; Kafle, Ved P.; Miyazawa, Takaya; Murata, Masayuki; Ohnishi, Masaaki; Ohta, Masataka; Umezawa, Takeshi
Limitations are found in the recent Internet because a lot of functions and protocols are patched to the original suite of layered protocols without considering global optimization. This reveals that end-to-end argument in the original Internet was neither sufficient for the current societal network and nor for a sustainable network of the future. In this position paper, we present design guidelines for a future network, which we call the New Generation Network, which provides the inclusion of diverse human requirements, reliable connection between the real-world and virtual network space, and promotion of social potentiality for human emergence. The guidelines consist of the crystal synthesis, the reality connection, and the sustainable & evolutional guidelines.
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Aligning guidelines and medical practice: Literature review on pediatric palliative care guidelines.
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.
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Training Requirements in OSHA Standards and Training Guidelines.
Occupational Safety and Health Administration, Washington, DC.
This booklet contains Occupational Safety and Health Administration (OSHA) training requirements, excerpted from OSHA standards. The booklet is designed to help employers, safety and health professionals, training directors, and others who need to know training requirements. (Requirements for posting information, warning signs, labels, and the…
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Agile Contracts: Designing an Agile Team Selection Guideline
DEFF Research Database (Denmark)
Pries-Heje, Lene; Pries-Heje, Jan
2014-01-01
with “endless” re-negotiation of the requirements; you need a more flexible way to develop IS. A new way of coping with many changes is to use an agile development approach and a fixed budget and resources contract. This paper presents an example case. We analyse the case and design a guideline for how......When you have stable and non-ambiguous requirements then a classic contract for IS between a supplier and a public sector institution based on a requirements specification may be well suited. However, if you have to accept many changes or have ambiguous requirements then you may end up...... to implement a fixed budget and resources contract in the public sector. The guideline includes elements to cope with challenges in a tender process such as transparency, criteria for supplier selection, and live assessment of resource skills and capabilities, as well as achieving the flexibility for change...
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Guidelines for international plutonium management: Overview and implications
International Nuclear Information System (INIS)
Bryson, M.C.; Fitzgerald, C.P.; Kincaid, C.
1998-01-01
In September, 1997, nine of the world's plutonium-using countries agreed to a set of guidelines for international plutonium management, with acceptances to be submitted to the International Atomic Energy Agency on December 1. Following three years of discussion, the guidelines provide a unified package of accepted rules for the storage, handling, and transportation of civil plutonium as well as military plutonium that has been declared as no longer required for defense purposes. New requirements include a formal declaration of national plutonium strategies, which will recognize the environmental, economic, and proliferation concerns and the consequent importance of balancing plutonium supply and demand. Nations will also make annual declaration of their non-military stockpiles of unirradiated plutonium, together with estimates of the plutonium content in spent reactor fuel. These guidelines represent the first formally accepted recognition of the need for plutonium management of this scope and could thus provide a partial basis for future monitoring and policy regimes
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International Nuclear Information System (INIS)
Oh, Keun Bae; Lee, Kwang Seok; Kim, Hyun Jun; Jeong, Ik; Yang, Myung Seung; Ko, Won Il
2003-10-01
This study surveyed and analyzed the existing activities and international status concerning proliferation resistance of nuclear energy systems, reviewed the features of proliferation resistance, and derived the requirements of future innovative nuclear energy systems. In IAEA INPRO, guidance for the evaluation of innovative nuclear reactors and fuel cycles on proliferation resistance was finalized through collaboration of member countries including Korea in reviewing technological status and developing the methodology for evaluation of proliferation resistance. This report, first, describes the progress of INPRO and the participation status of Korea in the project, and briefly summarizes the report of phase IA of INPRO. Next, features of proliferation resistance of nuclear systems, collaboration in the GIF and the INPRO for development of requirements and guidelines for proliferation resistance, and the final result of guidance for the evaluation of proliferation resistance were described. Finally, this study proposed measures for participation of further progress of the INPRO
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Yawn, Barbara P; Akl, Elie A; Qaseem, Amir; Black, Peter; Campos-Outcalt, Doug
2012-12-01
specialists may require guidelines with more details regarding complex COPD management. The purpose of the guidelines may determine the appropriate audience. Guidelines developed to improve care by enhancing education may have a very different audience than guidelines designed to improve care by limiting the scope of practice, punishing noncompliance, or saving money. The purpose will drive dissemination and implementation strategies, but should not influence the methods used to develop a guideline. Clinicians desire guidelines, but data suggest that the current development systems, content, format, and dissemination strategies may need to be altered to fit these audiences. After the purpose and audience are determined, the guideline committee must decide how to fairly address these audiences, which will usually require seeking their input.
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Sänger, Sylvia; Kopp, Ina; Englert, Gerhard; Brunsmann, Frank; Quadder, Bernd; Ollenschläger, Günter
2007-06-15
In discussions on the quality of cross-sectorial health-care services high importance is attributed to patient education and patient counseling, with guideline-based patient information being considered a crucial tool. Guideline-based patient information is supposed to serve patients as a decision-making basis and, in addition, to also support the implementation of the guidelines themselves. The article highlights how patient guidelines for National Disease Management Guidelines in Germany--within the scope of patient education and patient counseling--may provide a uniform information platform for physicians and patients aiming to promote shared decision-making. The authors will also address the issue which contents should be included in patient guidelines in order to meet these requirements and which measures are required to review their quality. The present paper continues the series of articles on the Program for German National Disease Management Guidelines.
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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
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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.
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Guideline of guidelines: asymptomatic microscopic haematuria.
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.
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International Nuclear Information System (INIS)
Group of study 'Assicurazione di qualita' in radioterapia'.
1996-12-01
The document, based on European guidelines, was jointly developed by radiation oncologists, radiation physicists and radiation technologists. In contains the aims of the guidelines, professional profiles, roles and responsibilities, personnel and equipment requirements, procedures
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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.
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Cosgrove, Lisa; Krimsky, Sheldon; Wheeler, Emily E; Peters, Shannon M; Brodt, Madeline; Shaughnessy, Allen F
2017-01-01
Because of increased attention to the issue of trustworthiness of clinical practice guidelines, it may be that both transparency and management of industry associations of guideline development groups (GDGs) have improved. The purpose of the present study was to assess a) the disclosure requirements of GDGs in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. Treatment guidelines for major depression were identified and searched for conflict of interest policies and disclosure statements. Multi-modal screens for undeclared conflicts were also conducted. Fourteen guidelines with a total of 172 panel members were included in the analysis. Eleven of the 14 guidelines (78%) had a stated conflict of interest policy or disclosure statement, although the policies varied widely. Most (57%) of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication. However, only a minority of total panel members (18%) had such conflicts of interest. Drug company speakers bureau participation was the most common type of conflict. Although some progress has been made, organizations that develop guidelines should continue to work toward greater transparency and minimization of financial conflicts of interest.
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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
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75 FR 27362 - Supplemental Guidelines for Sex Offender Registration and Notification
2010-05-14
... posting, pursuant to the KIDS Act, 42 U.S.C. 16915a. (3) Require jurisdictions to have sex offenders...] RIN 1105-AB36 Supplemental Guidelines for Sex Offender Registration and Notification AGENCY: Department of Justice. ACTION: Notice; Proposed guidelines. SUMMARY: The Sex Offender Registration and...
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International Nuclear Information System (INIS)
1997-01-01
The purpose of Regulatory Guide G-129 (E) is to provide Atomic Energy Control Board (AECB) licensees with guidelines on how to meet the forthcoming AECB regulatory requirement to keep doses received by workers and members of the public As Low As Reasonably Achievable (ALARA), social and economic factors taken into account. it is realized that the scope for realistic dose reductions will vary depending on the nature of the licensed activity. Therefore, criteria are given in section D for determining if doses can be deemed to be as low as reasonably achievable without further evaluation. The elements that the AECB considers to be essential in the approach to ALARA are described in section E and are summarized as follows: a demonstrated management commitment to the ALARA principle; the implementation of ALARA through a licensee's organization and management, provision of resources, training, establishment of action levels, documentation and other measures; and regular operational reviews. The above elements will be the focus of any AECB assessment to verify compliance with the requirement to keep radiation exposures as low as reasonably achievable. (author)
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Directory of Open Access Journals (Sweden)
Turner Tari J
2009-12-01
Full Text Available Abstract Background Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. These recommendations are developed by integrating the expertise of a multidisciplinary group of clinicians with the perspectives of consumers and the best available research evidence. However studies have raised concerns about the quality of guideline development, and particularly the link between research and recommendations. The reasons why guideline developers are not following the established development methods are not clear. We aimed to explore the barriers to developing evidence-based guidelines in eleven hospitals in Australia, Indonesia, Malaysia, the Philippines and Thailand, so as to better understand how evidence-based guideline development could be facilitated in these settings. The research aimed to identify the value clinicians place on guidelines, what clinicians want in guidelines developed in hospital settings and what factors limit rigorous evidence-based guideline development in these settings. Methods Semi-structured, face-to-face interviews were undertaken with senior and junior healthcare providers (nurses, midwives, doctors, allied health from the maternal and neonatal services of the eleven participating hospitals. Interviews were audio-recorded, transcribed and a thematic analysis undertaken. Results Ninety-three individual, 25 pair and eleven group interviews were conducted. Participants were clear that they want guidelines that are based on evidence and updated regularly. They were also clear that there are major barriers to this. Most of the barriers were shared across countries, and included lack of time, lack of skills in finding, appraising and interpreting evidence, lack of access to relevant evidence and difficulty arranging meetings and achieving consensus. Barriers that were primarily identified in Australian hospitals include cumbersome organisational
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General Guidelines for Remote Operation and Maintenance of Pyroprocess Equipment
Energy Technology Data Exchange (ETDEWEB)
Kim, S. H.; Park, B. S.; Park, H. S.; Lee, H. J.; Choi, C. W.; Lee, J. K
2007-12-15
As the pyroprocess handle the high radioactive materials, a high radioactive material handling facility required high safety, radioactive shielding, strict quality control, and the remote handling equipment of high technology. This report describes the guidelines of for pyroprocess based the design guides for radioactive material handling facility and equipment from American Nuclear Society(ANS), design guidelines for remotely maintained equipment from Oak Ridge National Laboratory(ORNL), and the experience of design for ACP equipment installed at the ACPF(Advanced Conditioning Process Facility). The General guidelines in this report are as follows. The General guidelines for remote operation and maintenance of pyroprocess equipment: Pyroprocess, Remote handling equipment for pyroprocess, General guide for remote operation and maintenance, general guidelines for the design of remotely operated and maintained equipment, Estimation and analysis for remote maintenance.
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Guidelines for use of fishes in research
Use of Fishes in Research Committee (joint committee of the American Fisheries Society, the American Institute of Fishery Research Biologists
2014-01-01
The 2004 and 2014 Guidelines were developed to provide a structure that advances appropriate attention toward valid experimental designs and procedures with aquatic animals while ensuring humane treatment of the experimental subjects. At a practical level, the Guidelines are intended to provide general recommendations on field and laboratory endeavors, such as sampling, holding, and handling fishes; to offer information on administrative matters, including regulations and permits; and to address typical ethical concerns, such as perceptions of pain or discomfort experienced by experimental subjects. These Guidelines must be recognized as guidelines. They are not intended to provide detailed instructions but rather to alert investigators to a broad array of topics and concerns to consider prior to initiating study. At a comprehensive level, the principles upon which these Guidelines are based are broadly applicable, and many of the described practices and approaches can be adapted to situations involving other aquatic animal species and conditions. Understanding the differences between fishes and other vertebrates, especially mammals, is critically important to conducting scientifically sound research with fishes. Disparities in life histories and mortality rates in fishes versus other vertebrates are critical in designing sustainable sampling levels in fish populations. The UFR Committee points out that (1) compared to mammalian populations, adult populations of many fish species persist despite very high natural mortality rates in juvenile stages by virtue of the fact that most species lay thousands or tens of thousands of eggs; (2) because of these mortality patterns, research on fishes, especially field research or research on early life stages, can involve, and often requires, much larger numbers of research subjects than does research on mammals; and (3) the animal handling and husbandry requirements for fishes are fundamentally different from those for
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Guidelines for selection of radiological protective head covering
International Nuclear Information System (INIS)
Galloway, G.R. Jr.
1995-08-01
The hood is recognized throughout the nuclear industry as the standard radiological protective head covering for use in radioactively contaminated work environments. As of June 15, 1995, hoods were required for all activities performed in contaminated areas at the Y-12 Plant. The use of hoods had historically been limited to those radiological activities with a high potential for personnel contamination. Due to the large size of many posted contaminated areas at the Y-12 Plant, and compounding safety factors, requirements for the use of hoods are being reevaluated. The purpose of the evaluation is to develop technically sound guidelines for the selection of hoods when prescribing radiological protective head covering. This report presents the guidelines for selection of radiological protective hoods
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Energy Technology Data Exchange (ETDEWEB)
Lee, Jung Woon; Oh, In Suk; Lee, Hyun Chul; Cheon, Se Woo [Korea Atomic Energy Research Institute, Taejon (Korea)
1999-02-01
The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25. Human Factors Engineering Program Review Model' and '26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation', which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and the characteristics of the KNGR design, and reviewing the reference documents of NURGE-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides at KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system design review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we updated the guidelines by reviewing the literature related to alarm design that published after 1994. 12 refs., 11 figs., 2 tabs. (Author)
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Energy Technology Data Exchange (ETDEWEB)
Lee, Jung Woon; Oh, In Suk; Lee, Hyun Chul; Cheon, Se Woo [Korea Atomic Energy Research Institute, Taejon (Korea)
1999-02-01
The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25. Human Factors Engineering Program Review Model' and '26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation', which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and the characteristics of the KNGR design, and reviewing the reference documents of NURGE-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides at KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system design review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we updated the guidelines by reviewing the literature related to alarm design that published after 1994. 12 refs., 11 figs., 2 tabs. (Author)
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Measure Guideline: Incorporating Thick Layers of Exterior Rigid Insulation on Walls
Energy Technology Data Exchange (ETDEWEB)
Lstiburek, Joseph [Building Science Corporation, Westford, MA (United States); Baker, Peter [Building Science Corporation, Westford, MA (United States)
2015-04-01
This measure guideline provides information about the design and construction of wall assemblies that use layers of rigid exterior insulation thicker than 1-½ inches and that require a secondary cladding attachment location exterior to the insulation. The guideline is separated into several distinct sections that cover: fundamental building science principles relating to the use of exterior insulation on wall assemblies; design principles for tailoring this use to the specific project goals and requirements; and construction detailing to increase understanding about implementing the various design elements.
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Bioassay guideline 1: general guidlines for bioassay programs
International Nuclear Information System (INIS)
1980-01-01
This guideline is the first of a series of documents which elaborate criteria for bioassay programs, to be presented as recommendations to the Atomic Energy Control Board. It specifies which workers require routine bioassays, the accuracy and frequency of measurements, the dose levels at which specific actions must be taken, and the documentation required
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Host government directorate: London 2012 Olympic and Paralympic emblem guidelines
2015-01-01
These guidelines issued by the London Organising Committee of the Olympic Games and Paralympic Games Ltd (“LOCOG”) provide standards, requirements and guidelines for use of the London 2012 Olympic Games Emblem (the “Emblem”), the London 2012 Paralympic Games Emblem (the “Paralympic Emblem”) and the Dual London 2012 Olympic and Paralympic Emblems (“Dual Emblems”) by authorised Host Government Directorate only.
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Clinical Guidelines on Long-Term Pharmacotherapy for Bipolar Disorder in Children and Adolescents
Directory of Open Access Journals (Sweden)
Joanna H. Cox
2014-01-01
Full Text Available Bipolar disorder is a severe affective disorder which can present in adolescence, or sometimes earlier, and often requires a pharmacotherapeutic approach. The phenomenology of bipolar disorder in children and adolescents appears to differ from that of adult patients, prompting the need for specific pharmacotherapy guidelines for long-term management in this patient population. Current treatment guidelines were mainly developed based on evidence from studies in adult patients, highlighting the requirement for further research into the pharmacotherapy of children and adolescents with bipolar disorder. This review compares and critically analyzes the available guidelines, discussing the recommended medication classes, their mechanisms of action, side effect profiles and evidence base.
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EPRI PWR primary water chemistry guidelines revision
International Nuclear Information System (INIS)
McElrath, Joel; Fruzzetti, Keith
2014-01-01
EPRI periodically updates the PWR Primary Water Chemistry Guidelines as new information becomes available and as required by NEI 97-06 (Steam Generator Program Guidelines) and NEI 03-08 (Guideline for the Management of Materials Issues). The last revision of the PWR water chemistry guidelines identified an optimum primary water chemistry program based on then-current understanding of research and field information. This new revision provides further details with regard to primary water stress corrosion cracking (PWSCC), fuel integrity, and shutdown dose rates. A committee of industry experts, including utility specialists, nuclear steam supply system (NSSS) and fuel vendor representatives, Institute of Nuclear Power Operations (INPO) representatives, consultants, and EPRI staff collaborated in reviewing the available data on primary water chemistry, reactor water coolant system materials issues, fuel integrity and performance issues, and radiation dose rate issues. From the data, the committee updated the water chemistry guidelines that all PWR nuclear plants should adopt. The committee revised guidance with regard to optimization to reflect industry experience gained since the publication of Revision 6. Among the changes, the technical information regarding the impact of zinc injection on PWSCC initiation and dose rate reduction has been updated to reflect the current level of knowledge within the industry. Similarly, industry experience with elevated lithium concentrations with regard to fuel performance and radiation dose rates has been updated to reflect data collected to date. Recognizing that each nuclear plant owner has a unique set of design, operating, and corporate concerns, the guidelines committee has retained a method for plant-specific optimization. Revision 7 of the Pressurized Water Reactor Primary Water Chemistry Guidelines provides guidance for PWR primary systems of all manufacture and design. The guidelines continue to emphasize plant
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Nuclear criticality safety training: guidelines for DOE contractors
International Nuclear Information System (INIS)
Crowell, M.R.
1983-09-01
The DOE Order 5480.1A, Chapter V, Safety of Nuclear Facilities, establishes safety procedures and requirements for DOE nuclear facilities. This guide has been developed as an aid to implementing the Chapter V requirements pertaining to nuclear criticality safety training. The guide outlines relevant conceptual knowledge and demonstrated good practices in job performance. It addresses training program operations requirements in the areas of employee evaluations, employee training records, training program evaluations, and training program records. It also suggests appropriate feedback mechanisms for criticality safety training program improvement. The emphasis is on academic rather than hands-on training. This allows a decoupling of these guidelines from specific facilities. It would be unrealistic to dictate a universal program of training because of the wide variation of operations, levels of experience, and work environments among DOE contractors and facilities. Hence, these guidelines do not address the actual implementation of a nuclear criticality safety training program, but rather they outline the general characteristics that should be included
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2011-04-01
Guidelines are produced in oncology to facilitate clinical decision making and improve clinical practice. However, existing guidelines are mainly developed for countries with a certain availability of means and cultural aspects are rarely taken into account. Around the Mediterranean Area, countries share common cultural backgrounds but also great disparities with respect to availability of means; current guidelines by most societies are not applicable to all of those countries. Association of Radiotherapy and Oncology of the Mediterranean Area (AROME) is a scientific organization for the promotion and overcoming of inequalities in oncology clinical practice around the Mediterranean Area. In an effort to accomplish this goal, members of the AROME society have developed clinical recommendations for most common cancer sites in countries around the Mediterranean Area. The structure of these recommendations lies in the concept of minimal requirements vs. standard of care; they are being presented and discussed in the main text. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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Laws, regulations and guidelines of developed countries ...
African Journals Online (AJOL)
Human biological material (HBM) is an invaluable resource in biomedical research. Although research ethics committees (RECs) are guided by international guidelines and frameworks, some RECs might not be fully informed about local ethical and regulatory requirements regarding the use, collection, storage, ownership, ...
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Guidelines for confirmatory inplant tests of safety-relief valve discharges for BWR plants
International Nuclear Information System (INIS)
Su, T.M.
1981-05-01
Inplant tests of safety/relief valve (SRV) discharges may be required to confirm generically established specifications for SRV loads and the maximum suppression pool temperature, and to evaluate possible effects of plant-unique parameters. These tests are required in those plants which have features that differ substantially from those previously tested. Guidelines for formulating appropriate test matrices, establishing test procedures, selecting necessary instrumentation, and reporting the test results are provided in this report. Guidelines to determine if inplant tests are required on the basis of the plant unique parameters are also included in the report
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Labour intensity of guidelines may have a greater effect on adherence than GPs' workload
Directory of Open Access Journals (Sweden)
Westert Gert P
2009-11-01
Full Text Available Abstract Background Physicians' heavy workload is often thought to jeopardise the quality of care and to be a barrier to improving quality. The relationship between these has, however, rarely been investigated. In this study quality of care is defined as care 'in accordance with professional guidelines'. In this study we investigated whether GPs with a higher workload adhere less to guidelines than those with a lower workload and whether guideline recommendations that require a greater time investment are less adhered to than those that can save time. Methods Data were used from the Second Dutch National survey of General Practice (DNSGP-2. This nationwide study was carried out between April 2000 and January 2002. A multilevel logistic-regression analysis was conducted of 170,677 decisions made by GPs, referring to 41 Guideline Adherence Indicators (GAIs, which were derived from 32 different guidelines. Data were used from 130 GPs, working in 83 practices with 98,577 patients. GP-characteristics as well as guideline characteristics were used as independent variables. Measures include workload (number of contacts, hours spent on continuing medical education, satisfaction with available time, practice characteristics and patient characteristics. Outcome measure is an indicator score, which is 1 when a decision is in accordance with professional guidelines or 0 when the decision deviates from guidelines. Results On average, 66% of the decisions GPs made were in accordance with guidelines. No relationship was found between the objective workload of GPs and their adherence to guidelines. Subjective workload (measured on a five point scale was negatively related to guideline adherence (OR = 0.95. After controlling for all other variables, the variation between GPs in adherence to guideline recommendations showed a range of less than 10%. 84% of the variation in guideline adherence was located at the GAI-level. Which means that the differences in
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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.
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Curricular Guidelines for Pharmacy Education: Substance Abuse and Addictive Disease.
Baldwin, Jeffrey N.; And Others
1991-01-01
American Association of Colleges of Pharmacy guidelines for required and elective instructional content concerning substance abuse for pharmacy students is presented. Recommended required content includes psychosocial aspects of drug use; pharmacology and toxicology; identification, intervention, and treatment of addiction; and legal issues.…
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OpenAIRE Guidelines: Supporting Interoperability for Literature Repositories, Data Archives and CRIS
DEFF Research Database (Denmark)
Príncipe, Pedro; Rettberg, Najla; Rodrigues, Eloy
2014-01-01
OpenAIRE – Open Access Infrastructure for Research in Europe – is moving from a publication infrastructure to a more comprehensive infrastructure that covers all types of scientific output. To put this into practice an integrated suite of guidelines were developed with specific requirements suppo...... supporting the goal of OpenAIRE and the European Commission. This poster outlines the OpenAIRE Guidelines, highlighting the set of guidelines for Literature Repository Managers, for Data Archive Managers and for CRIS Managers....
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Physician Requirements-1990. For Cardiology.
Tracy, Octavious; Birchette-Pierce, Cheryl
Professional requirements for physicians specializing in cardiology were estimated to assist policymakers in developing guidelines for graduate medical education. The determination of physician requirements was based on an adjusted needs rather than a demand or utilization model. For each illness, manpower requirements were modified by the…
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[Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].
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.
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Benchmarking of venous thromboembolism prophylaxis practice with ENT.UK guidelines.
Al-Qahtani, Ali S
2017-05-01
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT.UK guidelines to mitigate any gaps. ENT guidelines 2010 were downloaded from the ENT.UK Website. Our guidelines were compared with the possibilities that either our performance meets or fall short of ENT.UK guidelines. Immediate corrective actions will take place if there is quality chasm between the two guidelines. ENT.UK guidelines are evidence-based and updated which may serve as role-model for adoption and benchmarking. Our guidelines were accordingly amended to contain all factors required in providing a quality service to ENT surgical patients. While not given appropriate attention, benchmarking is a useful tool in improving quality of health care. It allows learning from others' practices and experiences, and works towards closing any quality gaps. In addition, benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning service provision. It is recommended to be included on the list of quality improvement methods of healthcare services.
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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
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Guidelines for Mass Screening of Congenital Hypothyroidism (2014 revision)
Nagasaki, Keisuke; Minamitani, Kanshi; Anzo, Makoto; Adachi, Masanori; Ishii, Tomohiro; Onigata, Kazumichi; Kusuda, Satoshi; Harada, Shohei; Horikawa, Reiko; Minagawa, Masanori; Mizuno, Haruo; Yamakami, Yuji; Fukushi, Masaru; Tajima, Toshihiro
2015-01-01
Purpose of developing the guidelines: Mass screening for congenital hypothyroidism started in 1979 in Japan, and the prognosis for intelligence has been improved by early diagnosis and treatment. The incidence was about 1/4000 of the birth population, but it has increased due to diagnosis of subclinical congenital hypothyroidism. The disease requires continuous treatment, and specialized medical facilities should make a differential diagnosis and treat subjects who are positive in mass screening to avoid unnecessary treatment. The Guidelines for Mass Screening of Congenital Hypothyroidism (1998 version) were developed by the Mass Screening Committee of the Japanese Society for Pediatric Endocrinology in 1998. Subsequently, new findings on prognosis and problems in the adult phase have emerged. Based on these new findings, the 1998 guidelines were revised in the current document (hereinafter referred to as the Guidelines). Target disease/conditions: Primary congenital hypothyroidism. Users of the Guidelines: Physician specialists in pediatric endocrinology, pediatric specialists, physicians referring patients to pediatric practitioners, general physicians, laboratory technicians in charge of mass screening, and patients. PMID:26594093
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Derivation of uranium residual radioactive material guidelines for the Ventron site
International Nuclear Information System (INIS)
Loureiro, C.; Yu, C.; Jones, L.
1992-03-01
Residual radioactive material guidelines for uranium were derived for the Ventron site in Beverly, Massachusetts. This site has been identified for remedial action under the Formerly Utilized Sites Remedial Action Program of the US Department of Energy (DOE). The derivations for the single radionuclides and the total uranium guidelines were based on the requirement that the 50-year committed effective dose equivalent to a hypothetical individual who lives or works in the immediate vicinity of the Ventron site should not exceed a dose of 100 mrem/yr following remedial action. The DOE residual radioactive material guideline computer code, RESRAD, which implements the methodology described in the DOE manual for implementing residual radioactive material guidelines, was used in this evaluation
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Are western guidelines good enough for Indians? My name is Borat
Directory of Open Access Journals (Sweden)
Sundeep Mishra
2015-03-01
Full Text Available Physicians in an attempt to give their patients the best possible care need to be updated on the evolving body of scientific research, trials, case reports, and combine this evidence with their own clinical experience keeping in mind each individual patient's circumstances and preferences. To address this felt need, guidelines are systematically developed statements designed to help clinicians make management decisions. While a multitude of guidelines are available from developed world they might not exactly fit into developing world context. Thus a host of fresh guidelines might be required to fill this void or the existing guidelines modified (supplemented, altered or deleted to be relevant to this part of the world.
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The healing arts radiation protection guidelines
International Nuclear Information System (INIS)
Yaffe, M.
1987-06-01
The objective of these guidelines is to help the health professional render the risks associated with diagnostic radiation as low as reasonably achievable. The guidelines contain advice and recommendations, but no mandatory requirements. They assist radiation protection officers in establishing and maintaining a Quality Assurance Program and in carrying out other duties required by the Healing Arts Radiation Protection Act; assist staff to comply with the X-ray Safety Code in a way that will raise the standards of x-ray diagnosis and patient safety; address the relationship between the radiation exposure of the patient and the quality of the image; address the problem of protecting the patient in x-ray examinations; summarize x-ray safety problems from the point of view of the operator and other staff; indicate what remedial measures can be taken; define the quality assurance needs of x-ray users; and encourage the users of x-rays for diagnostic purposes to go beyond the scope of the Act and comply with the ALARA principle
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Guidelines for comprehensive quality assurance in brachytherapy
International Nuclear Information System (INIS)
Goldson, A.L.; Nibhanupudy, J.R.
1984-01-01
Brachytherapy treatment techniques can provide significant improvement in local control and overall survival, but only when quality assurance can be guaranteed. To establish brachytherapy quality assurance, basic requirements for three predetermined subdivisions of clinical institutions will be forwarded. These are: (1) centers having minimum requirements to provide brachytherapy, (2) intermediate centers such as regional or community hospitals, and (3) optimal centers such as university hospital and cancer centers. This presentation will highlight personnel needs, equipment requirements, academic activities, clinical experience with these systems and proposed quality assurance guidelines
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AAPM-RSS Medical Physics Practice Guideline 9.a. for SRS-SBRT.
Halvorsen, Per H; Cirino, Eileen; Das, Indra J; Garrett, Jeffrey A; Yang, Jun; Yin, Fang-Fang; Fairobent, Lynne A
2017-09-01
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 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. Approved by AAPM Professional Council 3-31-2017 and Executive Committee 4-4-2017. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
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2010-10-22
...] Draft Guidelines on Pharmacovigilance of Veterinary Medicinal Products: Electronic Standards for... Requirements for the Registration of Veterinary Medicinal Products (VICH) has developed a draft guideline titled ``Pharmacovigilance of Veterinary Medicinal Products: Electronic Standards for Transfer of Data...
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Engineering design guidelines for nuclear criticality safety
International Nuclear Information System (INIS)
Waltz, W.R.
1988-08-01
This document provides general engineering design guidelines specific to nuclear criticality safety for a facility where the potential for a criticality accident exists. The guide is applicable to the design of new SRP/SRL facilities and to major modifications Of existing facilities. The document is intended an: A guide for persons actively engaged in the design process. A resource document for persons charged with design review for adequacy relative to criticality safety. A resource document for facility operating personnel. The guide defines six basic criticality safety design objectives and provides information to assist in accomplishing each objective. The guide in intended to supplement the design requirements relating to criticality safety contained in applicable Department of Energy (DOE) documents. The scope of the guide is limited to engineering design guidelines associated with criticality safety and does not include other areas of the design process, such as: criticality safety analytical methods and modeling, nor requirements for control of the design process
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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.
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[Essential guidelines for Quality Management System].
Daunizeau, A
2013-06-01
The guidelines describe the essential parts of the quality management system to fulfil the requirements of the standard EN ISO 15 189. It includes mainly the organisation, the definition of responsibilities, training of personnel, the document control, the quality control, identification and control of nonconformities, corrective actions, preventive actions and evaluation, as audits and the management review.
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Design requirement on KALIMER control rod assembly duct
International Nuclear Information System (INIS)
Hwang, W.; Kang, H. Y.; Nam, C.; Kim, J. O.; Kim, Y. J.
1998-03-01
This document establishes the design guidelines which are needs for designing the control rod assembly duct of the KALIMER as design requirements. it describes control rod assembly duct of the KALIMER and its requirements that includes functional requirements, performance requirements, interfacing systems, design limits and strength requirements, seismic requirements, structural requirements, environmental requirements, reliability and safety requirements, standard and codes, QA programs, and other requirements. The control rod system consists of three parts, which are drive mechanism, drive-line, and absorber bundle. This report deals with the absorber bundle and its outer duct only because the others are beyond the scope of fuel system design. The guidelines for design requirements intend to be used for an improved design of the control rod assembly duct of the KALIMER. (author). 19 refs
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Design requirement on KALIMER control rod assembly duct
Energy Technology Data Exchange (ETDEWEB)
Hwang, W.; Kang, H. Y.; Nam, C.; Kim, J. O.; Kim, Y. J
1998-03-01
This document establishes the design guidelines which are needs for designing the control rod assembly duct of the KALIMER as design requirements. it describes control rod assembly duct of the KALIMER and its requirements that includes functional requirements, performance requirements, interfacing systems, design limits and strength requirements, seismic requirements, structural requirements, environmental requirements, reliability and safety requirements, standard and codes, QA programs, and other requirements. The control rod system consists of three parts, which are drive mechanism, drive-line, and absorber bundle. This report deals with the absorber bundle and its outer duct only because the others are beyond the scope of fuel system design. The guidelines for design requirements intend to be used for an improved design of the control rod assembly duct of the KALIMER. (author). 19 refs.
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Commentary on recent therapeutic guidelines for osteoarthritis.
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
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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
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Insights from Guideline for Performance of Internal Flooding Probabilistic Risk Assessment (IFPRA)
International Nuclear Information System (INIS)
Choi, Sun Yeong; Yang, Joo Eon
2009-01-01
An internal flooding (IF) risk assessment refers to the quantitative probabilistic safety assessment (PSA) treatment of flooding as a result of pipe and tank breaks inside the plants, as well as from other recognized flood sources. The industry consensus standard for Internal Events Probabilistic Risk Assessment (ASME-RA-Sb-2005) includes high-level and supporting technical requirements for developing internal flooding probabilistic risk assessment (IFPRA). This industry standard is endorsed in Regulatory Guide 1.200, Revision 1 as an acceptable approach for addressing the risk contribution from IF events for risk informed applications that require U.S. Nuclear Regulatory commission (NRC) approval. In 2006, EPRI published a draft report for IFPRA that addresses the requirements of the ASME PRA consensus standard and have made efforts to refine and update the final EPRI IFPRA guideline. Westinghouse has performed an IFPRA analysis for several nuclear power plants (NPPs), such as Watts Bar and Fort Calhoun, using the draft EPRI guidelines for development of an IFPRA. Proprietary methodologies have been developed to apply the EPRI guidelines. The objectives of the draft report for IFPRA guideline are to: · Provide guidance for PSA practitioners in the performance of the elements of a PRA associated with internal flooding events consistent with the current state of the art for internal flooding PRA · Provide guidance regarding acceptable approaches that is sufficient to meeting the requirements of the ASME PRA Standard associated with internal flooding · Incorporate lessons learned in the performance of internal flooding PRAs including those identified as pilot applications of earlier drafts of this procedures guide The purpose of this paper is to present a vision for domestic nuclear power plants' IFPRA by comparing the method of the draft EPRI guidelines with the existing IFPRA method for domestic NPPs
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Insights from Guideline for Performance of Internal Flooding Probabilistic Risk Assessment (IFPRA)
Energy Technology Data Exchange (ETDEWEB)
Choi, Sun Yeong; Yang, Joo Eon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
2009-10-15
An internal flooding (IF) risk assessment refers to the quantitative probabilistic safety assessment (PSA) treatment of flooding as a result of pipe and tank breaks inside the plants, as well as from other recognized flood sources. The industry consensus standard for Internal Events Probabilistic Risk Assessment (ASME-RA-Sb-2005) includes high-level and supporting technical requirements for developing internal flooding probabilistic risk assessment (IFPRA). This industry standard is endorsed in Regulatory Guide 1.200, Revision 1 as an acceptable approach for addressing the risk contribution from IF events for risk informed applications that require U.S. Nuclear Regulatory commission (NRC) approval. In 2006, EPRI published a draft report for IFPRA that addresses the requirements of the ASME PRA consensus standard and have made efforts to refine and update the final EPRI IFPRA guideline. Westinghouse has performed an IFPRA analysis for several nuclear power plants (NPPs), such as Watts Bar and Fort Calhoun, using the draft EPRI guidelines for development of an IFPRA. Proprietary methodologies have been developed to apply the EPRI guidelines. The objectives of the draft report for IFPRA guideline are to: {center_dot} Provide guidance for PSA practitioners in the performance of the elements of a PRA associated with internal flooding events consistent with the current state of the art for internal flooding PRA {center_dot} Provide guidance regarding acceptable approaches that is sufficient to meeting the requirements of the ASME PRA Standard associated with internal flooding {center_dot} Incorporate lessons learned in the performance of internal flooding PRAs including those identified as pilot applications of earlier drafts of this procedures guide The purpose of this paper is to present a vision for domestic nuclear power plants' IFPRA by comparing the method of the draft EPRI guidelines with the existing IFPRA method for domestic NPPs.
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10 CFR 960.4-1 - System guideline.
2010-01-01
... DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE... at the site shall allow for the physical separation of radioactive waste from the accessible environment after closure in accordance with the requirements of 40 CFR part 191, subpart B, as implemented by...
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Sommer, A; Schopphoven, S; Land, I; Blaser, D; Sobczak, T
2014-05-01
As part of the physico-technical quality assurance of the German breast cancer screening program, the threshold contrast visibility and the average glandular dose of every digital mammography system have to fulfill the requirements of the "European guidelines for quality assurance in breast cancer screening and diagnosis" (4th Edition). To accomplish uniform measurements in all federal states of Germany, the physical board of the reference centers developed a special guideline in 2009. Due to recent changes in the guidelines and standards, a second version of the guideline was developed by the reference centers. This guideline describes the determination of the average glandular dose as well as the CDMAM image acquisition and the CDMAM image evaluation. The determination of the threshold contrast visibility can be performed visually or automatically. The determination of the average glandular dose is based on DIN 6868 - 162 and the threshold contrast visibility test is based on the German "Quality Assurance Guideline". © Georg Thieme Verlag KG Stuttgart · New York.
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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
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Practice Guidelines for Primary Care of Acute Abdomen 2015.
Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi
2016-01-01
Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine, in collaboration with four other medical societies, launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines (all clinical questions and recommendations were shown in supplementary information). A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on nine subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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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
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New guidelines for managing cow's milk allergy in infants.
Meyer, Rosan
2008-01-01
The prevalence of allergic disease has increased markedly over the last 50 years. Food allergy usually manifests in early childhood as part of the so-called atopic march and most commonly includes one or more of the following foods: cow's milk, hen's egg, soy, peanuts and tree nuts, wheat, sesame seed, kiwi fruit and seafood. In the UK about 2% of infants develop cow's milk protein allergy (CMPA), but as many as 15% of infants present with symptoms suggestive of an adverse reaction to cow's milk protein. The diagnosis of CMPA is based on one or more of the following: a detailed clinical history, allergy test results (skin prick testing [SPT] and/or specific immunoglobulin E [IgE]) and, if required, supervised incremental milk challenges. The majority of UK primary care centres do not have access to these tests and may also be unfamiliar with the interpretation or results. In addition, they do not have the facilities for supervised food challenges. Empirical treatment is often required pending confirmation of allergy or referral to a specialist centre, but requires clear guidelines. No consensus guidelines currently exist for the diagnosis and management of CMPA in the UK. An international task force has recently published proposed guidelines for the management of CMPA. These provide separate algorithms covering the diagnosis and management of CMPA for both breast-fed and formula-fed infants and discuss the use of hypoallergenic formulae, elimination diets and diagnostic tests. Revisions and adaptations for the UK market are required and are discussed in this article.
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Directory of Open Access Journals (Sweden)
Motohiro Ebisawa
2009-01-01
Full Text Available In 2005, the “Food Allergy Management Guideline 2005” was published. In order to encompass food allergy from infancy to adulthood, the project committee included not only pediatricians, but also internists, dermatologists, and otolaryngologists. After the release of the guideline, oral food challenge tests were approved as a medical examination on hospital admission by the national health insurance system in 2006, and the tests at outpatient clinics were also approved in 2008. As clearly stated in the guideline, it is essential for general practitioners to refer food allergy patients to specialists to receive accurate diagnosis. A specialist is needed because the oral food challenge test, which is sometimes required for accurate diagnosis, carries the potential risk of developing an adverse reaction. In 2008, the “Food Allergy Management Guideline 2008” was revised to update recent advances, such as the appropriate conditions needed to perform oral food challenge tests and probability curves for hen's egg and cow's milk developed in Japan. In the same year, “The Guidelines for the Treatment of Allergic Diseases in Schools” was published by the Japanese Society of School Health. In addition to the guideline, “School Life Management Certificate (for Allergic Diseases” was developed in order to allow the verification of the diagnosis and encourage the discussion of countermeasures by parents/guardians and school teachers for students requiring special care. It is hoped that this review article will be useful for doctors treating food allergy and that the quality of life of food allergy patients and their parents will be improved.
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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)
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Kim, Ji Hea Jay
2012-01-01
Help Wanted: Innovative, strategic-thinking entrepreneurs to turn around groups of low-performing schools. Competitive benefits, including working in newly formed operating units with charter-like autonomy, access to district's back-office resources and buildings, $3.5 billion federal money, and opportunity to transform schools for hundreds of…
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2012-01-01
Background Reducing the burden of disease relies on availability of evidence-based clinical practice guidelines (CPGs). There is limited data on availability, quality and content of guidelines within the Southern African Development Community (SADC). This evaluation aims to address this gap in knowledge and provide recommendations for regional guideline development. Methods We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated. Findings We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline. Conclusion This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders
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The Deployment of Product-Related Environmental Legislation into Product Requirements
Directory of Open Access Journals (Sweden)
Daniela C. A. Pigosso
2016-04-01
Full Text Available Environmental legislation is increasingly changing its focus from manufacturing-oriented to product-oriented instruments. Compliance with product-related environmental legislation is achieved by the incorporation of environmental requirements into the early phases of the product development process (PDP. Nevertheless, the deployment of product-related environmental legislation into product requirements is still a challenge. This study followed an inductive approach to propose a guideline to support the identification, analysis and deployment of product requirements based on product-related environmental legislation. The guideline is composed of nine steps, clustered into three groups according to their main objective: (A identification of environmental product-related legislation; (B identification of legislative topics to be considered for the deployment of requirements; and (C creation and validation of product requirements. The product requirements deployed are to be considered during the PDP. The guideline was evaluated in an expert consultation in a large manufacturing company, suggesting that it can be used to support the systematization and deployment of product-related environmental requirements.
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International Nuclear Information System (INIS)
1995-12-01
These general guidelines are intended to be used as a basis for what requirements are reasonable from a radiation protection point of view and should be part of the contract in connection with the purchase of equipment for x-ray diagnostics. Technical performance requirements are addressed as well as items like documentation, instructions for use and education and training. The guidelines are also useful for the design of quality assurance programs. In the comments in addition to these guidelines legal aspects are noted, including a list of relevant laws, regulations and directives. Standards, both national and international, within the field are referred to with a short description of their content. 40 refs
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Energy Technology Data Exchange (ETDEWEB)
NONE
1995-12-01
These general guidelines are intended to be used as a basis for what requirements are reasonable from a radiation protection point of view and should be part of the contract in connection with the purchase of equipment for x-ray diagnostics. Technical performance requirements are addressed as well as items like documentation, instructions for use and education and training. The guidelines are also useful for the design of quality assurance programs. In the comments in addition to these guidelines legal aspects are noted, including a list of relevant laws, regulations and directives. Standards, both national and international, within the field are referred to with a short description of their content. 40 refs.
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Wind power and bats : Ontario guideline
Energy Technology Data Exchange (ETDEWEB)
McGuiness, F. [Ontario Ministry of Natural Resources, Peterborough, ON (Canada). Renewable Energy Resources; Stewart, J. [Ontario Ministry of Natural Resources, Toronto, ON (Canada). Wildlife Section
2008-07-01
None of the 8 species of bats in Ontario are considered as species at risk. However, all bats in Ontario are protected under the Fish and Wildlife Conservation Act. The Ontario Ministry of Natural Resources (MNR) is responsible for identifying significant wildlife habitat for bats, including hibernacula and maternity roosts. The MNR's role in wind development includes environmental assessments (EA) and surveys. The MNR bat guideline includes a summary of Ontario species, a literature review of research related to wind turbines and bats, and a review of methods for assessing and monitoring bats. Guideline development includes a bat working group responsible for obtaining data on risk factors and monitoring requirements. The MNR has determined that site selection is critical for minimizing potential impacts. Wind farm proponents can use MNR data, information, and maps for their site selection process. Information requirements include bat species data; habitat data; and meteorological data. The presence of risk factors results in a sensitivity rating. The MNR is also developing a site sensitivity mapping project in order to assist proponents in making siting decisions. All proposed sites are required to conduct pre-construction site surveys. Acoustic detectors and radar are used to determine bat activity at the site. Monitoring and mitigation strategies include selective wind turbine shutdown during key periods or weather conditions. tabs., figs.
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Measure Guideline. Incorporating Thick Layers of Exterior Rigid Insulation on Walls
Energy Technology Data Exchange (ETDEWEB)
Lstiburek, Joseph [Building Science Corporation, Westford, MA (United States); Baker, Peter [Building Science Corporation, Westford, MA (United States)
2015-04-09
This measure guideline, written by the U.S. Department of Energy’s Building America team Building Science Corporation, provides information about the design and construction of wall assemblies that use layers of rigid exterior insulation thicker than 1-½ in. and that require a secondary cladding attachment location exterior to the insulation. The guideline is separated into several distinct sections that cover: (1) fundamental building science principles relating to the use of exterior insulation on wall assemblies; (2) design principles for tailoring this use to the specific project goals and requirements; and (3) construction detailing to increase understanding about implementing the various design elements.
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Developing and implementing health and sustainability guidelines for institutional food service.
Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian
2012-05-01
Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.
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Analysis of Existing Guidelines for the Systematic Planning Process of Clinical Registries.
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.
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... this page: https://medlineplus.gov/criteria.html MedlinePlus Quality Guidelines To use the sharing features on this ... materials must also meet our existing quality guidelines. Quality, authority and accuracy of health content The organization's ...
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Home mechanical ventilation: a Canadian Thoracic Society clinical practice guideline.
McKim, Douglas A; Road, Jeremy; Avendano, Monica; Abdool, Steve; Cote, Fabien; Duguid, Nigel; Fraser, Janet; Maltais, Fracois; Morrison, Debra L; O'Connell, Colleen; Petrof, Basil J; Rimmer, Karen; Skomro, Robert
2011-01-01
Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of userfriendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.
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International Nuclear Information System (INIS)
Ewen, K.; Lauber, I.
2004-01-01
Two important guidelines for the application of X-rays in medicine became effective on 1 October 2003 and 1 December 2003. These are testing guidelines for experts and quality assurance guidelines. Both guidelines are very extensive and not always easy to interpret. In the present paper the authors try to explain in detail some chapters important for radiology and to make the necessary technical background transparent. Both authors took an essential part in forming the guidelines. (orig.) [de
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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…
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Development of the International Guidelines for Home Health Nursing.
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.
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Examining Data Repository Guidelines for Qualitative Data Sharing.
Antes, Alison L; Walsh, Heidi A; Strait, Michelle; Hudson-Vitale, Cynthia R; DuBois, James M
2018-02-01
Qualitative data provide rich information on research questions in diverse fields. Recent calls for increased transparency and openness in research emphasize data sharing. However, qualitative data sharing has yet to become the norm internationally and is particularly uncommon in the United States. Guidance for archiving and secondary use of qualitative data is required for progress in this regard. In this study, we review the benefits and concerns associated with qualitative data sharing and then describe the results of a content analysis of guidelines from international repositories that archive qualitative data. A minority of repositories provide qualitative data sharing guidelines. Of the guidelines available, there is substantial variation in whether specific topics are addressed. Some topics, such as removing direct identifiers, are consistently addressed, while others, such as providing an anonymization log, are not. We discuss the implications of our study for education, best practices, and future research.
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Schünemann, Holger J; Woodhead, Mark; Anzueto, Antonio; Buist, A Sonia; Macnee, William; Rabe, Klaus F; Heffner, John
2012-12-01
Organizations around the world are recognizing that guidelines should be based on the best available evidence, that the development of recommendations needs to be transparent, and that appropriate processes should be followed. In June 2007, we convened an American Thoracic Society (ATS)/European Respiratory Society (ERS)-sponsored workshop with over 60 representatives from 36 international organizations to provide advice to guideline developers about the required steps and processes for guideline development using the management of chronic obstructive pulmonary disease (COPD) as an example. Following the workshop, participants completed a series of 14 review articles that underwent peer review and incorporated key new literature until June 2011 for most articles in this series. The review articles evaluate the guideline cycle including: priority setting, question formulation, managing conflict of interest, defining appropriate outcomes, stakeholder involvement, grading the quality of evidence and strength of recommendations, integration of values and preferences, considering resource use, reporting of guidelines, implementation, and adaptation. In this Introduction we frame the background and methods of these reviews and provide the key conclusions of the workshop. A summary of the workshop's conclusions and recommendations was published in The Lancet. Given the enormous resources that are spent on research and the importance of providing the best guidance to healthcare decision makers, attributing appropriate funds to research syntheses and transparent, independent guidance for the development of evidence-based guidelines is justified. Furthermore, given the immense amount of work that is required, individuals and organizations need to collaborate to achieve the best possible and cost-effective coordination of these efforts.
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Constructions complying with tightened Danish sound insulation requirements for new housing
DEFF Research Database (Denmark)
Rasmussen, Birgit; Hoffmeyer, Dan
New sound insulation requirements in Denmark in 2008 New Danish Building Regulations with tightened sound insulation requirements were introduced in 2008 (and in 2010 with unchanged acoustic requirements). Compared to the Building Regulations from 1995, the airborne sound insulation requirements...... were 2 –3 dB stricter and the impact sound insulation requirements 5 dB stricter. The limit values are given using the descriptors R’w and L’n,w as before. For the first time, acoustic requirements for dwellings are not found as figures in the Building Regulations. Instead, it is stated......), Denmark. [2] "Lydisolering mellem boliger – Nybyggeri" (Sound insulation between dwellings – Newbuild)". Publication expected in April 2011. The guideline is a part of a series of seven new SBi acoustic guidelines. Project leader Birgit Rasmussen. The series shall replace the existing guidelines 1984...
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Methodology for senior-proof guidelines: A practice example from the Netherlands.
van Munster, Barbara C; Portielje, Johanna E A; Maier, Andrea B; Arends, Arend J; de Beer, Johannes J A
2018-02-01
Evidence-based guidelines constitute a foundation for medical decision making. It is often unclear whether recommendations in general guidelines also apply to older people. This study aimed to develop a methodology to increase the focus on older people in the development of guidelines. The methodology distinguishes 4 groups of older people: (1) relatively healthy older people; (2) older people with 1 additional specific (interfering) comorbid condition; (3) older people with multimorbidity; and (4) vulnerable older people. The level of focus on older people required may be determined by the prevalence of the disease or condition, level of suffering, social relevance, and the expectation that a guideline may improve the quality of care. A specialist in geriatric medicine may be involved in the guideline process via participation, provision of feedback on drafts, or involvement in the analysis of problem areas. Regarding the patient perspective, it is advised to involve organisations for older people or informal carers in the inventory of problem areas, and additionally to perform literature research of patient values on the subject. If the guideline focuses on older people, then the relative importance of the various outcome measures for this target group needs to be explicitly stated. Search strategies for all the 4 groups are suggested. For clinical studies that focus on the treatment of diseases that frequently occur in older people, a check should be made regarding whether these studies produce the required evidence. This can be achieved by verifying if there is sufficient representation of older people in the studies and determining if there is a separate reporting of results applying to this age group. © 2017 John Wiley & Sons, Ltd.
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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
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[Implementation of Study Results in Guidelines and Adherence to Guidelines in Clinical Practice].
Waldfahrer, F
2016-04-01
Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. © Georg Thieme Verlag KG Stuttgart · New York.
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2012-02-06
... Guidelines for Determining Probability of Causation Under the Energy Employees Occupational Illness... provide a technical review of a proposed amendment to the probability of causation guidelines.\\2\\ All of..., and hence had required DOL to assign a probability of causation value of ``zero.'' There were two...
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Sims, Matthew T; Henning, Nolan M; Wayant, C Cole; Vassar, Matt
2016-11-24
The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of emergency medicine journals. We performed a web-based data abstraction from the "Instructions for Authors" of the 27 Emergency Medicine journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports and Google Scholar Metrics h5-index to identify whether each journal required, recommended, or made no mention of the following reporting guidelines: EQUATOR Network, ICMJE, ARRIVE, CARE, CONSORT, STARD, TRIPOD, CHEERS, MOOSE, STROBE, COREQ, SRQR, SQUIRE, PRISMA-P, SPIRIT, PRISMA, and QUOROM. We also extracted whether journals required or recommended trial registration. Authors were blinded to one another's ratings until completion of the data validation. Cross-tabulations and descriptive statistics were calculated using IBM SPSS 22. Of the 27 emergency medicine journals, 11 (11/27, 40.7%) did not mention a single guideline within their "Instructions for Authors," while the remaining 16 (16/27, 59.3%) mentioned one or more guidelines. The QUOROM statement and SRQR were not mentioned by any journals whereas the ICMJE guidelines (18/27, 66.7%) and CONSORT statement (15/27, 55.6%) were mentioned most often. Of the 27 emergency medicine journals, 15 (15/27, 55.6%) did not mention trial or review registration, while the remaining 12 (12/27, 44.4%) at least mentioned one of the two. Trial registration through ClinicalTrials.gov was mentioned by seven (7/27, 25.9%) journals while the WHO registry was mentioned by four (4/27, 14.8%). Twelve (12/27, 44.4%) journals mentioned trial registration through any registry platform. The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of
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Comparison of Quality And Content of Violence Guidelines For The Health Care Sector
Directory of Open Access Journals (Sweden)
Rabia Kahveci
2018-03-01
Full Text Available More than 50% of the employees in health sector are exposed to violence at any time. This study investigated international workplace violence guidelines for the health care sector to compare their quality and content and explore whether these guidelines could be used in different settings. We ran a broad review to identify international guidelines for violence in health care. After identification of the guidelines, the quality of the guidelines was assessed by personal experience and views of the authors, also taking AGREE domains into consideration as a guidance. The identified guidelines were later qualitatively analyzed for the content by two researchers and compared to each other. Canada, New Zealand, USA, UK and Turkey’s guidelines were involved in the study. Definitions of workplace violence, risk factors, objectives of the guideline, legal requirements, responsible stakeholders, target population, strategies recommended, physical environment, training and staffing were assessed in the content of the violence guidelines. It was found that current guidelines need improvement in both quality and content, but it is possible to have an international guidance that could be applicable in different settings. The development of violence guidelines should be the first and most strategic step for better protection of the health care workers. We expect our results to be useful in preparation of new guidelines for different settings.
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Severe accident management guidelines tool
International Nuclear Information System (INIS)
Gutierrez Varela, Javier; Tanarro Onrubia, Augustin; Martinez Fanegas, Rafael
2014-01-01
Severe Accident is addressed by means of a great number of documents such as guidelines, calculation aids and diagnostic trees. The response methodology often requires the use of several documents at the same time while Technical Support Centre members need to assess the appropriate set of equipment within the adequate mitigation strategies. In order to facilitate the response, TECNATOM has developed SAMG TOOL, initially named GGAS TOOL, which is an easy to use computer program that clearly improves and accelerates the severe accident management. The software is designed with powerful features that allow the users to focus on the decision-making process. Consequently, SAMG TOOL significantly improves the severe accident training, ensuring a better response under a real situation. The software is already installed in several Spanish Nuclear Power Plants and trainees claim that the methodology can be followed easier with it, especially because guidelines, calculation aids, equipment information and strategies availability can be accessed immediately (authors)
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Interim guidelines on performance constraints for nuclear waste disposal in crystalline rock
International Nuclear Information System (INIS)
1984-01-01
Performance constraint guidelines have been developed for geologic disposal of nuclear waste in crystalline rock. The approach taken in defining these guidelines was to consider the thermal, thermomechanical, and thermochemical behavior for three regions (very-near field, near field, and far field) of the repository during three time periods (operational, containment, and isolation) associated with the disposal system. Limits are proposed to ensure compliance with the current repository criteria proposed by the United States Nuclear Regulatory Commission (NRC) concerning repository siting and performance assessment. These criteria are: Substantial containment of all radionuclides within the waste package for a period of time between 300 and 1000 years after emplacement. Release rate after loss of containment of one part in 100,000 annually per radionuclide based on the nuclides inventory when the waste package is breached, and in situ ground-water transit time of 1000 years from the repository horizon to the accessible environment, compliance with the performance constraint guidelines presented herein will be required to ensure that the final repository design is in compliance with NRC criteria. The constraint guidelines have also been developed to satisfy the requirement for technical conservatism. 40 refs., 14 figs., 4 tabs
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International Nuclear Information System (INIS)
Mirsky, S.M.; Hayes, J.E.; Miller, L.A.
1995-03-01
This report is the fifth volume in a series of reports describing the results of the Expert System Verification C, and Validation (V ampersand V) project which is jointly funded by the U.S. Nuclear Regulatory Commission and the Electric Power Research Institute toward the objective of formulating Guidelines for the V ampersand V of expert systems for use in nuclear power applications. This report provides the rationale for and description of those guidelines. The actual guidelines themselves are presented in Volume 7, open-quotes User's Manual.close quotes Three factors determine what V ampersand V is needed: (1) the stage of the development life cycle (requirements, design, or implementation); (2) whether the overall system or a specialized component needs to be tested (knowledge base component, inference engine or other highly reusable element, or a component involving conventional software); and (3) the stringency of V ampersand V that is needed (as judged from an assessment of the system's complexity and the requirement for its integrity to form three Classes). A V ampersand V Guideline package is provided for each of the combinations of these three variables. The package specifies the V ampersand V methods recommended and the order in which they should be administered, the assurances each method provides, the qualifications needed by the V ampersand V team to employ each particular method, the degree to which the methods should be applied, the performance measures that should be taken, and the decision criteria for accepting, conditionally accepting, or rejecting an evaluated system. In addition to the Guideline packages, highly detailed step-by-step procedures are provided for 11 of the more important methods, to ensure that they can be implemented correctly. The Guidelines can apply to conventional procedural software systems as well as all kinds of Al systems
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Fong de Los Santos, Luis E; Evans, Suzanne; Ford, Eric C; Gaiser, James E; Hayden, Sandra E; Huffman, Kristina E; Johnson, Jennifer L; Mechalakos, James G; Stern, Robin L; Terezakis, Stephanie; Thomadsen, Bruce R; Pronovost, Peter J; Fairobent, Lynne A
2015-05-08
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.
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1996-01-01
In August 1995, new BLM regulations for rangeland administration went into effect. The new regulations require BLM to establish regional standards for rangeland health and guidelines for grazing management. This publication is a report on the alternatives being considered for the Montana/Dakotas Rangeland Health Standards and Guidelines process.
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International Nuclear Information System (INIS)
Zaers, J.; Brix, G.; Woudenberg, S. van
1997-01-01
The Program 'Europe against Cancer' published the 2nd edition of quality assurance guidelines for breast cancer screening in June 1996. For the enforcement of these guidelines, a European network of reference centres (EUREF) is being established. Although the EUREF protocol contains guidelines for all disciplines involved in breast cancer screening, this article concentrates on the physical and technical aspect. The comparison with the German regulations (DIN Norms) demonstrates the high requirements requested by the EUREF guidelines with its tighter limits and more extensive and more frequent tests. (orig.) [de
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The new hypertension guidelines.
Stern, Ralph H
2013-10-01
The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.
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Lord, J; Willis, S; Eatock, J; Tappenden, P; Trapero-Bertran, M; Miners, A; Crossan, C; Westby, M; Anagnostou, A; Taylor, S; Mavranezouli, I; Wonderling, D; Alderson, P; Ruiz, F
2013-12-01
National Institute for Health and Care Excellence (NICE) clinical guidelines (CGs) make recommendations across large, complex care pathways for broad groups of patients. They rely on cost-effectiveness evidence from the literature and from new analyses for selected high-priority topics. An alternative approach would be to build a model of the full care pathway and to use this as a platform to evaluate the cost-effectiveness of multiple topics across the guideline recommendations. In this project we aimed to test the feasibility of building full guideline models for NICE guidelines and to assess if, and how, such models can be used as a basis for cost-effectiveness analysis (CEA). A 'best evidence' approach was used to inform the model parameters. Data were drawn from the guideline documentation, advice from clinical experts and rapid literature reviews on selected topics. Where possible we relied on good-quality, recent UK systematic reviews and meta-analyses. Two published NICE guidelines were used as case studies: prostate cancer and atrial fibrillation (AF). Discrete event simulation (DES) was used to model the recommended care pathways and to estimate consequent costs and outcomes. For each guideline, researchers not involved in model development collated a shortlist of topics suggested for updating. The modelling teams then attempted to evaluate options related to these topics. Cost-effectiveness results were compared with opinions about the importance of the topics elicited in a survey of stakeholders. The modelling teams developed simulations of the guideline pathways and disease processes. Development took longer and required more analytical time than anticipated. Estimates of cost-effectiveness were produced for six of the nine prostate cancer topics considered, and for five of eight AF topics. The other topics were not evaluated owing to lack of data or time constraints. The modelled results suggested 'economic priorities' for an update that differed from
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Air quality guidelines for arenas in Nova Scotia
Energy Technology Data Exchange (ETDEWEB)
NONE
1999-05-01
A series of guidelines have been prepared to address the quality of air in skating arena facilities in Nova Scotia. They are limited to carbon monoxide and nitrogen dioxide emissions. Average nitrogen dioxide levels should not exceed 1 part per million (ppm). Average carbon monoxide levels should not exceed 25 ppm. These guidelines do not address other contaminants such as ammonia or chlorofluorocarbons (CFCs). The guidelines are considered to be the minimum standards required for safe arena operations. These standards can be met by reducing emissions of the ice resurfacer and edger which is one of the major sources of poor air quality in arenas. Other ways to meet the standards are to ensure proper equipment operation, ventilation and monitoring of indoor air quality levels. Symptoms of exposure and potential consequences were also described. It was noted that owners and operators may be found libel for injury if a proper environment is not maintained. 6 appendices.
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Bettmann, Michael A; Oikarinen, Helja; Rehani, Madan; Holmberg, Ola; del Rosario Perez, Maria; Naidoo, Anusha; Do, Kyung-Hyun; Dreyer, Keith; Ebdon-Jackson, Steve
2015-04-01
The effective development and use of clinical imaging guidelines requires an understanding of who the stakeholders are, what their interests in the process are, and what roles they should play. If the appropriate stakeholders are not engaged in the right roles, it is unlikely that clinical imaging guidelines will be successfully developed, relied on, and actually used. Some stakeholders are obvious: for the development of clinical imaging guidelines, both imagers and those who request examinations, such as general practitioners, internists, and medical specialists, must be involved. To gain acceptance, other relevant groups are stakeholders, including medical societies, other health care professionals, insurers, health IT experts and vendors, and patients. The role of stakeholders must be dictated by their specific interest. For some, involvement in the creation of guidelines is the right role. For others, such as regulators or insurers, reviews or invitations to comment are required, and for others, such as medical educators, it is probably sufficient to provide information and create awareness. Only through a careful consideration of who the stakeholders are and what are their interests are the successful development, acceptance, and use of clinical imaging guidelines likely to occur. Future efforts must focus on collaboration, particularly among groups that create clinical imaging guidelines and those that can support their use, and on regulatory roles and mandates. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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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”.
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The Practice Guidelines for Primary Care of Acute Abdomen 2015.
Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi
2016-01-01
Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine in collaboration with four other medical societies launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines [all clinical questions (CQs) and recommendations are shown in supplementary information]. A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on 9 subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.
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Guidelines for patient selection and performance of carotid artery stenting.
Bladin, Christopher; Chambers, Brian; New, Gishel; Denton, Michael; Lawrence-Brown, Michael
2010-06-01
The endovascular treatment of carotid atherosclerosis with carotid artery stenting (CAS) remains controversial. Carotid endarterectomy remains the benchmark in terms of procedural mortality and morbidity. At present, there are no consensus Australasian guidelines for the safe performance of CAS. We applied a modified Delphi consensus method of iterative consultation between the College representatives on the Carotid Stenting Guidelines Committee (CSGC). Selection of patients suitable for CAS needs careful consideration of clinical and patho-anatomical criteria and cannot be directly extrapolated from clinical indicators for carotid endarterectomy (CEA). Randomized controlled trials (including pooled analyses of results) comparing CAS with CEA for treatment of symptomatic stenosis have demonstrated that CAS is more hazardous than CEA. On current evidence, the CGSC therefore recommends that CAS should not be performed in the majority of patients requiring carotid revascularisation. The evidence for CAS in patients with symptomatic severe carotid stenosis who are considered medically high risk is weak, and there is currently no evidence to support CAS as a treatment for asymptomatic carotid stenosis. The use of distal protection devices during CAS remains controversial with increased risk of clinically silent stroke. The knowledge requirements for the safe performance of CAS include an understanding of the evidence base from randomized controlled trials, carotid and aortic arch anatomy and pathology, clinical stroke syndromes, the differing treatment options for stroke and carotid atherosclerosis, and recognition and management of periprocedural complications. It is critical that all patients being considered for a carotid intervention have adequate pre-procedural neuro-imaging and an independent, standardized neurological assessment before and after the procedure. Maintenance of proficiency in CAS requires active involvement in surgical/endovascular audit and
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Guidelines for the treatment of childhood-onset Graves' disease in Japan, 2016.
Minamitani, Kanshi; Sato, Hirokazu; Ohye, Hidemi; Harada, Shohei; Arisaka, Osamu
2017-01-01
Purpose behind developing these guidelines: Over one decade ago, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (Japan Thyroid Association (JTA)) were published as the standard drug therapy protocol for Graves' disease. The "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" were published to provide guidance on the treatment of pediatric patients. Based on new evidence, a revised version of the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2006" (JTA) was published in 2011, combined with the "Handbook of Radioiodine Therapy for Graves' Disease 2007" (JTA). Subsequently, newer findings on pediatric Graves' disease have been reported. Propylthiouracil (PTU)-induced serious hepatopathy is an important problem in pediatric patients. The American Thyroid Association's guidelines suggest that, in principle, physicians must not administer PTU to children. On the other hand, the "Guidelines for the Treatment of Graves' Disease with Antithyroid Drug, 2011" (JTA) state that radioiodine therapy is no longer considered a "fundamental contraindication" in children. Therefore, the "Guidelines for the Treatment of Childhood-Onset Graves' Disease with Antithyroid Drug in Japan, 2008" required revision.
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Cluzeau, F.A.; Burgers, J.S.; Brouwers, M.M.; Grol, R.P.T.M.; et al.,
2003-01-01
BACKGROUND: International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. OBJECTIVE: To develop and validate an
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Walter, U; Noachtar, S; Hinrichs, H
2018-02-01
The guidelines of the German Medical Association and the German Society for Clinical Neurophysiology and Functional Imaging (DGKN) require a high procedural and technical standard for electroencephalography (EEG) as an ancillary method for diagnosing the irreversible cessation of brain function (brain death). Nowadays, digital EEG systems are increasingly being applied in hospitals. So far it is unclear to what extent the digital EEG systems currently marketed in Germany meet the guidelines for diagnosing brain death. In the present article, the technical und safety-related requirements for digital EEG systems and the EEG documentation for diagnosing brain death are described in detail. On behalf of the DGKN, the authors sent out a questionnaire to all identified distributors of digital EEG systems in Germany with respect to the following technical demands: repeated recording of the calibration signals during an ongoing EEG recording, repeated recording of all electrode impedances during an ongoing EEG recording, assessability of intrasystem noise and galvanic isolation of measurement earthing from earthing conductor (floating input). For 15 of the identified 20 different digital EEG systems the specifications were provided by the distributors (among them all distributors based in Germany). All of these EEG systems are provided with a galvanic isolation (floating input). The internal noise can be tested with all systems; however, some systems do not allow repeated recording of the calibration signals and/or the electrode impedances during an ongoing EEG recording. The majority but not all of the currently available digital EEG systems offered for clinical use are eligible for use in brain death diagnostics as per German guidelines.
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Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India
Sharma, Surendra K.; Ryan, H.; Khaparde, Sunil; Sachdeva, K. S.; Singh, Achintya D.; Mohan, Alladi; Sarin, Rohit; Paramasivan, C N; Kumar, Prahlad; Nischal, Neeraj; Khatiwada, Saurav; Garner, Paul; Tharyan, Prathap
2017-01-01
Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research. PMID:28862176
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Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123
Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian
2012-01-01
Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909
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A Survey of the Prevalence and Impact of Reporting Guideline Endorsement in Pathology Journals.
Caron, Justin E; March, Jordon K; Cohen, Michael B; Schmidt, Robert L
2017-10-01
To determine the prevalence of reporting guideline endorsement in pathology journals and to estimate the impact of guideline endorsement. We compared the quality of reporting in two sets of studies: (1) studies published in journals that explicitly mentioned a guideline vs studies published in journals that did not and (2) studies that cited a guideline vs studies that did not. The quality of reporting in prognostic biomarker studies was assessed using the REporting recommendations for tumor MARKer prognostic studies (REMARK) guideline. We found that six (10%) of the 59 leading pathology journals explicitly mention reporting guidelines in the instructions to authors. Only one journal required authors to submit a checklist. There was significant variation in the rate at which various REMARK items were reported (P pathology journals, but guideline endorsement may improve the quality of reporting. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
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Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline
Directory of Open Access Journals (Sweden)
Douglas A McKim
2011-01-01
Full Text Available Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.
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41 CFR 304-6.5 - What guidelines must we follow when using the Standard Form (SF) 326?
2010-07-01
... REQUIREMENTS 6-PAYMENT GUIDELINES Reports § 304-6.5 What guidelines must we follow when using the Standard Form... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What guidelines must we follow when using the Standard Form (SF) 326? 304-6.5 Section 304-6.5 Public Contracts and Property...
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Forest residues management guidelines for the Pacific Northwest.
John M. Pierovich; Edward H. Clarke; Stewart G. Pickford; Franklin R. Ward
1975-01-01
Forest residues often require treatment to meet land management objectives. Guideline statements for managing forest residues are presented to provide direction for achieving these objectives. The latest research information and the best knowledge of experts in various land management disciplines were used to formulate these statements. A unique keying system is...
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Nokia pole ainus langev täht. RIM on hädas / Fredy-Edwin Esse
Esse, Fredy-Edwin
2011-01-01
Kanada tehnoloogiafirma Research In Motion kaotab ühe enam Põhja-Ameerikas turgu konkurentidele nagu Apple ja teised firmad, kes kasutavad Google'i Android operatsioonisüsteemi. Ka BlackBerry Playbook ei ole suutnud iPadiga konkureerida. Graafik
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The CARE guidelines: consensus-based clinical case report guideline development.
Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David
2014-01-01
A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.
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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.
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Clinical guideline representation in a CDS: a human information processing method.
Kilsdonk, Ellen; Riezebos, Rinke; Kremer, Leontien; Peute, Linda; Jaspers, Monique
2012-01-01
The Dutch Childhood Oncology Group (DCOG) has developed evidence-based guidelines for screening childhood cancer survivors for possible late complications of treatment. These paper-based guidelines appeared to not suit clinicians' information retrieval strategies; it was thus decided to communicate the guidelines through a Computerized Decision Support (CDS) tool. To ensure high usability of this tool, an analysis of clinicians' cognitive strategies in retrieving information from the paper-based guidelines was used as requirements elicitation method. An information processing model was developed through an analysis of think aloud protocols and used as input for the design of the CDS user interface. Usability analysis of the user interface showed that the navigational structure of the CDS tool fitted well with the clinicians' mental strategies employed in deciding on survivors screening protocols. Clinicians were more efficient and more complete in deciding on patient-tailored screening procedures when supported by the CDS tool than by the paper-based guideline booklet. The think-aloud method provided detailed insight into users' clinical work patterns that supported the design of a highly usable CDS system.
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Guideline-adherent therapy in patients with cardiovascular diseases in Taiwan
Directory of Open Access Journals (Sweden)
Jiann-Shing Jeng
2015-10-01
Conclusion: The guideline-recommended targets for lipids and BP in patients with CAD and CVD were still suboptimal in Taiwan. Greater efforts are required to achieve the targets, particularly in patients with CVD and in women.
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Technical basis for the CANDU steam generator tube fitness-for-service guidelines
International Nuclear Information System (INIS)
Kozluk, M.J.; Scarth, D.A.; Graham, D.B.
2002-01-01
Active degradation mechanisms in steam generators and preheaters in Canadian CANDU T M generating stations are managed through Steam Generator Programs that incorporate tube inspection, maintenance (cleaning), fitness-for-service assessment, and preventative plugging as part of the overall steam generator management strategy. Steam generator and preheater tubes are inspected in accordance with the CSA Standard CAN/CSA-N285.4-94[l]. When a detected flaw indication does not satisfy the criteria of acceptance by examination, CSA-N285.4-94 permits a fitness-for-service assessment to determine acceptability. In 1999 Ontario Power Generation issued, for trial use, fitness-for-service guidelines for steam generator and preheater tubes in CANDU nuclear power plants. The main objectives of the Fitness-for-Service Guidelines are to provide reasonable assurance that tube structural integrity is maintained, and to provide reasonable assurance that there are adequate margins between estimated accumulated dose and applicable site dose limits. The Fitness-for-Service Guidelines are intended to provide industry-standard acceptance criteria and evaluation procedures for assessing the condition of steam generator and preheater tubes in terms of tube structural integrity, operational leak rate, and consequential leakage during an upset or abnormal event. This paper describes the technical basis for the minimum required safety factors specified in Table IC-1 of the Fitness-for-Service Guidelines and for the flaw models used to develop the flaw stability requirements in the nonmandatory, Appendix C of the Fitness-for-Service Guidelines. (author)
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Guideline for dialysate quality of Spanish Society of Nephrology (second edition, 2015).
Pérez-García, Rafael; García Maset, Rafael; Gonzalez Parra, Emilio; Solozábal Campos, Carlos; Ramírez Chamond, Rafael; Martín-Rabadán, Pablo; Sobrino Pérez, Pedro Enrique; Gallego Pereira, Ovidio; Dominguez, Jon; de la Cueva Matute, Enrique; Ferllen, Ricardo
2016-01-01
A Best Practice Guideline about Dialysis fluid purity was developed under the leadership of the Spanish Society of Nephrology in 2004. The second edition revised Guideline considered new evidences and International Standard. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. This Guideline is based on the ISO13959, European Pharmacopoeia, the Real Farmacopea Española, the AAMI Standards and Recommended Practices, European Best Practice Guidelines for Haemodialysis, literature reviews, according to their level of evidence, and the opinion of the expert Spanish group. Two levels of quality of water were defined: purified water and high purified water (ultra pure) and for dialysate: ultra pure dialysate. Regular use of ultra pure dialysate is recommended for all type of hemodialysis to prevent and delay the occurrence of complications: inflammation, malnutrition, anaemia and amiloidosis. Water, concentrates and dialysate quality requirements are defined as maximum allowable contaminant levels: chemicals (4.1.2), conductivity, microbial and endotoxins (4.1.1): Monitoring frequency, maintenance and corrective actions were specified. Methods of sampling and analysis were described in appendix (anexos). For microbiological monitoring, R2A medium is recommended, incubated during 7-14 days at a temperature of 17-23°C. The dialysate quality assurance process involves all dialysis staff members and requires strict protocols. The physician in charge of hemodialysis has the ultimate responsibility for dialysate quality. All suggestions and questions about this Guideline are wellcome to www.senefro.org. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.
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Guidelines for sea dumping packages of radioactive waste. Revised version.
International Nuclear Information System (INIS)
Anon.
1979-04-01
The purpose of these Guidelines is to establish general requirements and provide practical information for the design and manufacture of packages for sea dumping of radioactive waste, in accordance with the terms of the OECD Council Decision establishing a Multilateral Consultation and Surveillance Mechanism for Sea Dumping of Radioactive Waste. These Guidelines are in compliance with the IAEA Revised Definition and Recommendations of 1978, for applying the London Dumping Convention to radioactive waste, and are intended for application under the responsibility of the appropriate national authorities of countries participating in the NEA Mechanism
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Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India
Directory of Open Access Journals (Sweden)
Surendra K Sharma
2017-01-01
Full Text Available Extrapulmonary tuberculosis (EPTB is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i use of Xpert MTB/RIF in diagnosis, (ii use of adjunct corticosteroids in treatment, and (iii duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.
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Guidelines for ground motion definition for the eastern United States
International Nuclear Information System (INIS)
Gwaltney, R.C.; Aramayo, G.A.; Williams, R.T.
1985-06-01
Guidelines for the determination of earthquake ground motion definition for the eastern United States are established here. Both far-field and near-field guidelines are given. The guidelines were based on an extensive review of the current procedures for specifying ground motion in the United States. Both empirical and theoretical procedures were used in establishing the guidelines because of the low seismicity in the eastern United States. Only a few large- to great-sized earthquakes (M/sub s/ > 7.5) have occurred in this region, no evidence of tectonic surface ruptures related to historic or Holocene earthquakes has been found, and no currently active plate boundaries of any kind are known in this region. Very little instrumented data have been gathered in the East. Theoretical procedures are proposed so that in regions of almost no data, a reasonable level of seismic ground motion activity can be assumed. The guidelines are to be used to develop the safe shutdown earthquake (SSE). A new procedure for establishing the operating basis earthquake (OBE) is proposed, in particular for the eastern United States. The OBE would be developed using a probabilistic assessment of the geological conditions and the recurrence of seismic events at a site. These guidelines should be useful in development of seismic design requirements for future reactors. 17 refs., figs., tabs
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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
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Guidelines for Planning the School Breakfast Program. Revised.
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…
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Grasses for energy production: hydrological guidelines
Energy Technology Data Exchange (ETDEWEB)
Hall, R.L.
2003-07-01
This report provides hydrological guidelines for growers, land and water resource managers, environmental groups and other parties interested in utilising grasses for energy production. The aim of the report is to help interested parties decide if a location is suitable for planting energy grasses by considering whether potential hydrological impacts will have an adverse effect on crop productivity and yield. The guidelines consider: the water use of energy grasses compared with other crops; the factors governing water use; the water requirements for a productive crop; and the likely impacts on the availability and quantity of water. The report points out that there are still gaps in our knowledge of the processes controlling the water use and growth of energy grasses and notes that, in some situations, there will be considerable uncertainty in predictions of water use and the magnitude of the associated hydrological impacts.
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Minimum acceptable face velocities of laboratory fume hoods and guidelines for their classification
International Nuclear Information System (INIS)
Bolton, N.E.; Porter, W.E.; Alcorn, S.P.; Everett, W.S.; Hunt, J.B.; Morehead, J.F.; Higdon, H.F.
1978-06-01
Data developed to support the requirement of a 100 LFM minimum face velocity requirement for laboratory fume hoods are summarized. Also included is a description of the Y-12 test hood as well as guidelines for a hood classification scheme
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International Nuclear Information System (INIS)
1993-11-01
This document contains guidelines that should be followed when preparing Criticality Safety Evaluations that will be used to demonstrate the safety of operations performed at DOE non-reactor nuclear facilities. Adherence to these guidelines will provide consistency and uniformity in criticality safety evaluations (CSEs) across the complex and will document compliance with the requirements of DOE Order 5480.24
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International Nuclear Information System (INIS)
Miller, L.A.; Hayes, J.E.; Mirsky, S.M.
1995-05-01
This report is the fifth volume in a series of reports describing the results of the Expert System Verification and Validation (V ampersand V) project which is jointly funded by US NRC and EPRI toward formulating guidelines for V ampersand V of expert systems for use in nuclear power applications. This report provides the rationale for and description of those guidelines. The actual guidelines themselves (and the accompanying 11 step by step Procedures) are presented in Volume 7, User's Manual. Three factors determine what V ampersand V is needed: (1) the stage, of the development life cycle (requirements, design, or implementation), (2) whether the overall system or a specialized component needs be tested (knowledge base component, inference engine or other highly reusable element, or a component involving conventional software), and (3) the stringency of V ampersand V that is needed (as judged from an assessment of the system's complexity and the requirement for its integrity to form three Classes). A V ampersand V guideline package is provided for each of the combinations of these three variables. The package specifies the V ampersand V methods recommended and the order in which they should be administered, the assurances each method provides, the qualifications needed by the V ampersand V team to employ each Particular method, the degree to which the methods should be applied, the performance measures that should be taken, and the decision criteria for accepting, conditionally accepting, or rejecting an evaluated system. In addition to the guideline packages, highly detailed step-by-step procedures are provided for 11 of the more important methods, to ensure that they Can be implemented correctly. The guidelines can apply to conventional procedural software systems as well as all kinds of AI systems
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Guidelines for earthquake ground motion definition for the Eastern United States
International Nuclear Information System (INIS)
Gwaltney, R.C.; Aramayo, G.A.; Williams, R.T.
1985-01-01
Guidelines for the determination of earthquake ground-motion definition for the eastern United States are established in this paper. Both far-field and near-field guidelines are given. The guidelines were based on an extensive review of the current procedures for specifying ground motion in the United States. Both empirical and theoretical procedures were used in establishing the guidelines because of the low seismicity in the eastern United States. Only a few large to great (M > 7.5) sized earthquakes have occurred in this region, no evidence of tectonic surface ruptures related to historic or Holocene earthquakes have been found, and no currently active plate boundaries of any kind are known in this region. Very little instrumented data has been gathered in the East. Theoretical procedures are proposed so that in regions of almost no data a reasonable level of seismic ground motion activity can be assumed. The guidelines are to be used to develop the Safe Shutdown Earthquake, SSE. A new procedure for establishing the Operating Basis Earthquake, OBE, is proposed, in particular for the eastern United States. The OBE would be developed using a probabilistic assessment of the geological conditions and the recurrence of seismic events at a site. These guidelines should be useful in development of seismic design requirements for future reactors
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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).
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A fall prevention guideline for older adults living in long-term care facilities.
Jung, D; Shin, S; Kim, H
2014-12-01
Falls are among the most frequent critical health problems for older adults over 65 years of age and often result in consequential injuries. This study developed a guideline covering risk factors and interventions for falls in order to prevent them from occurring in long-term care facilities. This study was grounded in the methodological approach of the Scottish Intercollegiate Guideline Network for establishing evidence-based guidelines: (1) establishment of the target population and scope of the guideline, (2) systematic literature review and critical analysis, (3) determination of the recommendation grade, (4) development of a draft nursing intervention guideline and algorithm, (5) expert evaluation of the draft nursing intervention guideline, and (6) confirmation of the final intervention guideline and completion of the algorithm. The resulting evidence-based fall prevention guideline consists of a three-step factor assessment and a three-step intervention approach. The resulting guideline was based on the literature and clinical experts. Further research is required to test the guideline's feasibility in across long term care facilities. This guideline can be used by nurses to screen patients who are at a high risk of falling to provide patient interventions to help prevent falls. Considering the high rate of falls at long-term care facilities and the absence of evidence-based guidelines to prevent them, additional studies on falls at long-term care facilities are necessary. Meanwhile, given prior research that indicates the importance of human resources in the application of such guidelines, continuous investigations are needed as to whether the research outcomes are actually conveyed to nurses. © 2014 International Council of Nurses.
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Knowledge of and Adherence to Hygiene Guidelines among Medical Students in Austria
Directory of Open Access Journals (Sweden)
Verena G. Herbert
2013-01-01
Full Text Available Background. Adherence to hygiene guidelines is of utmost importance for healthcare professionals. The aim of this study was to evaluate the knowledge on and the adherence to hygiene guidelines among medical students in Austria. Additionally, a possible difference between female and male students was investigated. Methods. An open paper-based survey among third-year medical students at the Medical University of Graz was conducted. The questionnaire consisted of 20 single-choice questions covering compliance with basic hygiene standards, self-rated knowledge of hygiene guidelines, and satisfaction with current hygiene education, equipment, and quality standards. Results. Of 192 medical students, 70% judged their knowledge of hygiene standards as “excellent” or “good”; however, only 49% reported adherence to hygiene guidelines and only 43% performed hygienic hand disinfection according to WHO guidelines. Of the respondents, 79% voted for a mandatory course on hygiene standards in medical education. No significant gender differences were observed. Conclusion. While the knowledge on hygiene guidelines appears to be good among medical students, adherence is limited and requires improvement. The need for an optimum education in hygiene is high.
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Guidelines for radiological monitoring of the environment
International Nuclear Information System (INIS)
1990-11-01
This Standard provides criteria to be used in deciding whether an environmental monitoring program is required for a given nuclear facility. It also sets out a systematic approach to monitoring the environment, which is considered to be outside the facility boundary. It provides guidelines for establishing an environmental program covering sampling and analysis protocols, analytical techniques and sensitivity, statistical treatment of monitoring results, quality assurance, methods for expressing results, and record keeping. The standard applies to the environment of a nuclear facility operating mainly under normal conditions; in addition, certain of these requirements may also apply to situations involving abnormal releases
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International Nuclear Information System (INIS)
Koch, W.; Rosa, F.; Knesewitsch, P.; Hahn, K.
2005-01-01
The lately updated German guideline on radiation protection in medicine (Richtlinie Strahlenschutz in der Medizin) requires the physician who administers radioactive substances for therapy, to perform and document follows-up. In order to decrease the administrative burden, an electronic database was developed that interfaces with a word processing software to generate written reports and statistic analysis. Methods: Based on Microsoft registered Access and Microsoft registered Visual Basic a database was created to monitor patients with benign and malignant thyroid disorders after radioiodine therapy. It permits automatic creation of therapy documents and necessary patient reports in Microsoft registered Word. Intuitive handling, third level of normalization in database architecture and automatic plausibility checks guarantee integrity of the data and the efficacy of the database. Results, conclusion: The new software has been a success in over 1500 patients and over 3800 in- and outpatient therapies and visits. The effort of data entry is easily offset by the automatic generation of the necessary patient reports. The required supervision of the follow-up appointments is now also user-friendly and efficient. (orig.)
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[Guidelines for Trainings in Inter-/Transcultural Competence for Psychotherapists].
von Lersner, Ulrike; Baschin, Kirsten; Wormeck, Imke; Mösko, Mike Oliver
2016-02-01
The ongoing globalization leads to the fact that intercultural aspects are becoming more important in recent years. Unfortunately, the psychosocial sector in general as well as psychotherapists in particular are not sufficiently trained for those issues. In the German speaking countries so far there were no guidelines for the conceptualization of intercultural trainings for psychotherapists. In the present study guidelines for trainings of inter-/transcultural competence of medical and psychological psychotherapists have been developed. An extensive data base was collected including a systematic international literature research, qualitative expert interviews, a quantitative survey among therapists and 8 focus groups with clients as well as therapists from different cultural backgrounds. The guidelines for trainings were then extracted in a 2-step consensus procedure. The guidelines define learning objectives which should be achieved in a training. They also describe the structural as well as substantive requirements which should be met in such a training. In addition to knowledge on cultural issues that should be acquired in a training the guidelines put high emphasis on the self reflection of training participants on their own cultural embededness as well as on the aquisition of culturally sensitive skills. Regarding demographic trends in Germany trainings for intercultural competence should become an obligatory element in the training of psychotherapists. The guidelines represent a high-quality base for the conceptualization as well as the evaluation of such trainings. The guidelines developed here represent an instrument for the improvement of the training of therapists in Germany in the field of transcultural psychology. In the long term they could contribute to the intercultural opening of the German mental health system and improve the quality of psychotherapeutical treatment of migrants in Germany. © Georg Thieme Verlag KG Stuttgart · New York.
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2010-01-01
... 7 Agriculture 6 2010-01-01 2010-01-01 false Guidelines. 622.5 Section 622.5 Agriculture... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... Environmental Principles and Guidelines for Water and Related Land Resources Implementation Studies issued by...
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Energy Technology Data Exchange (ETDEWEB)
Dietlein, M.; Schicha, H. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany); Eschner, W. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Allgemeines Krankenhaus St. Georg, Hamburg (Germany). Abt. fuer Nuklearmedizin; Reiners, C. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin
2007-07-01
The version 3 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline previously published in 2003. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of the TSH-level. As a consequence of the improved alimentary iodine supply the {sup 99m}Tc-uptake has decreased; 100 000 counts per scintigraphy should be acquired. For this, an imaging time of 10 minutes is generally needed using a high resolution collimator for thyroid imaging. (orig.)
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Requirements and Design Guidelines for a Trusted Hypervisor Interface
Weber, Dirk; Weber, Arnd; Presti, Stéphane Lo
Hypervisor technology in combination with tamper-resistant hardware such as Trusted Platform Modules has the potential of providing a significant new level of security for computers. These new systems will be able to protect legacy applications from applications such as malware, and they will enable the creation of new secure applications. This paper analyses the requirements for the graphical user interface (GUI) of such a system. First, application scenarios are presented to illustrate how extended Trusted Computing (TC) systems might be used in the future. Requirements for a trusted GUI are then derived from the analysis of articles on TC found in the media and from a survey of experts in information technology. These requirements are compared to existing proposals, showing how some of them are either inconvenient or insecure in the hands of end users. Based on this analysis, proposals are derived for the design of a trusted GUI suitable for laypersons and administrators, which uses familiar patterns, and yet protects against visual mimicry attacks. These proposals pave the way for hypervisors’ security-enhanced GUI.
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Development of cancer treatment guidelines
African Journals Online (AJOL)
Krystyna Kiel
2011-05-26
May 26, 2011 ... KEYWORDS. Cancer;. Therapy;. Guidelines. Contents. 1. Why develop guidelines? ... Widely available guideline resources in cancer care. ... The use of guidelines in medicine has a long history. Many .... She has a negative family history. ... The patient has 1 cm grade 3 infiltrating ductal carcinoma.
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2010-07-01
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidelines. 42.306 Section 42.306... PROCEDURES Equal Employment Opportunity Program Guidelines § 42.306 Guidelines. (a) Recipient agencies are... guidelines under their equal employment opportunity program which will correct, in a timely manner, any...
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2010-07-01
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidelines. 42.404 Section 42.404... Guidelines. (a) Federal agencies shall publish title VI guidelines for each type of program to which they extend financial assistance, where such guidelines would be appropriate to provide detailed information...
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Visitor's Computer Guidelines | CTIO
Visitor's Computer Guidelines Network Connection Request Instruments Instruments by Telescope IR Instruments Guidelines Library Facilities Outreach NOAO-S EPO Program team Art of Darkness Image Gallery EPO/CADIAS â¹âº You are here CTIO Home » Astronomers » Visitor's Computer Guidelines Visitor's Computer
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Burwash, Ian G; Basmadjian, Arsene; Bewick, David; Choy, Jonathan B; Cujec, Bibiana; Jassal, Davinder S; MacKenzie, Scott; Nair, Parvathy; Rudski, Lawrence G; Yu, Eric; Tam, James W
2011-01-01
Guidelines for the provision of echocardiography in Canada were jointly developed and published by the Canadian Cardiovascular Society and the Canadian Society of Echocardiography in 2005. Since their publication, recognition of the importance of echocardiography to patient care has increased, along with the use of focused, point-of-care echocardiography by physicians of diverse clinical backgrounds and variable training. New guidelines for physician training and maintenance of competence in adult echocardiography were required to ensure that physicians providing either focused, point-of-care echocardiography or comprehensive echocardiography are appropriately trained and proficient in their use of echocardiography. In addition, revision of the guidelines was required to address technological advances and the desire to standardize echocardiography training across the country to facilitate the national recognition of a physician's expertise in echocardiography. This paper summarizes the new Guidelines for Physician Training and Maintenance of Competency in Adult Echocardiography, which are considerably more comprehensive than earlier guidelines and address many important issues not previously covered. These guidelines provide a blueprint for physician training despite different clinical backgrounds and help standardize physician training and training programs across the country. Adherence to the guidelines will ensure that physicians providing echocardiography have acquired sufficient expertise required for their specific practice. The document will also provide a framework for other national societies to standardize their training programs in echocardiography and will provide a benchmark by which competency in adult echocardiography may be measured. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
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Requirements and Guidelines for Dental Hygiene Education Programs.
American Dental Association, Chicago, IL. Council on Dental Education.
The purpose of this report is to serve as a guide for dental hygiene education program development, and to serve as a stimulus for improving established programs. The first section of the report discusses the function of the Council on Dental Education and the trends in hygiene program development. In section II the requirements for an accredited…
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Nurses' experiences of guideline implementation
DEFF Research Database (Denmark)
Alanen, Seija; Välimäki, Marita; Kaila, Minna
2009-01-01
AIMS: The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines? BACKGROUND: The implementation of clinical guidelines seems...... to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning guideline implementation. DESIGN: Qualitative interview. METHODS: Data were generated by four focus group interviews involving nurses working in out-patient services in primary...... to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses' awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines...
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Virtual reality verification of workplace design guidelines for the process plant control room
International Nuclear Information System (INIS)
Droeivoldsmo, Asgeir; Nystad, Espen; Helgar, Stein
2001-02-01
Early identification of potential human factors guideline-violations and corrective input into the design process is desired for efficient and cost-effective control room design. Virtual reality (VR) technology makes it possible to perform evaluation of the design of the control room at an early stage of the design process, but can we trust the results from such evaluations? This paper describes an experimental validation of a VR model against the real world in five different guideline verification tasks. Results indicate that guideline verification in the VR model can be done with satisfactory accuracy for a number of evaluations. However, some guideline categories require further development of measurement tools and use of a model with higher resolution than the model used in this study. (Author). 30 refs., 4 figs., 1 tab
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Review and comparison of quality standards, guidelines and regulations for laboratories
Directory of Open Access Journals (Sweden)
Tjeerd A.M. Datema
2011-12-01
Full Text Available Background: The variety and number of laboratory quality standards, guidelines and regulations (hereafter: quality documents makes it difficult to choose the most suitable one for establishing and maintaining a laboratory quality management system. Objectives: There is a need to compare the characteristics, suitability and applicability of quality documents in view of the increasing efforts to introduce quality management in laboratories, especially in clinical diagnostic laboratories in low income and middle income countries. This may provide valuable insights for policy makers developing national laboratory policies, and for laboratory managers and quality officers in choosing the most appropriate quality document for upgrading their laboratories. Method: We reviewed the history of quality document development and then selected a subset based on their current use. We analysed these documents following a framework for comparison of quality documents that was adapted from the Clinical Laboratory Standards Institute guideline GP26 Quality management system model for clinical laboratory services. Results: Differences were identified between national and international, and non-clinical and clinical quality documents. The most salient findings were the absence of provisions on occurrence management and customer service in almost all non-clinical quality documents, a low number of safety requirements aimed at protecting laboratory personnel in international quality documents and no requirements regarding ethical behaviour in almost all quality documents. Conclusion: Each laboratory needs to investigate whether national regulatory standards are present. These are preferred as they most closely suit the needs of laboratories in the country. A laboratory should always use both a standard and a guideline: a standard sums up the requirements to a quality management system, a guideline describes how quality management can be integrated in the laboratory
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International Nuclear Information System (INIS)
Rhodes, M.; Kwong, A.
2011-01-01
The Canadian Standards Association (CSA) guideline N292.5, Guideline for the exemption or clearance from regulatory control of materials that contain, or potentially contain, nuclear substances, was recently developed to address a need for guidance on approaches for clearance of materials from facilities licensed by the Canadian Nuclear Safety Commission (CNSC) consistent with Canadian and international recommendations. This guideline is also applicable to determining if an activity associated with materials that contain nuclear substances is exempt from requiring a CNSC licence. The guideline summarizes the regulatory requirements associated with the exemption and clearance of materials and provides a graded approach to designing a survey based on the risk of residual contamination being present. (author)
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Simons, M; King, S; Edgar, D
2003-01-01
Clinical practice guidelines are a tool to assist with clinical decision making. They provide information about the care for a condition and make recommendations based on research evidence, which can be adapted locally. A focus group within the Allied Health Interest Group of the Australian and New Zealand Burn Association has compiled the "Occupational Therapy and Physiotherapy for the Patient with Burns--Principles and Management Guidelines." These guidelines are designed as a practical guide to the relevant clinical knowledge and therapy intervention techniques required for effective patient management. Content areas include respiratory management, edema management, splinting and positioning, physical function (mobility, function, exercise), scar management, and psychosocial and mutual elements. The document has undergone extensive review by members of the Australian and New Zealand Burn Association to ensure clarity, internal consistency, and acceptability. The guidelines have been endorsed by the Australian and New Zealand Burn Association. An abridged version of the guidelines is included in this article, with the full document available from www.anzba.org.au.
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2011-09-28
... Conference on Penalty Guidelines; Notice of Technical Conference on Penalty Guidelines The staff of the... the Penalty Guidelines, which the Commission issued on September 17, 2010.\\1\\ The conference will be... impact of the Penalty Guidelines on compliance and enforcement matters. More information on the topics to...
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... use this site. health.gov Physical Activity Guidelines Physical Activity Physical activity is key to improving the health of the Nation. Based on the latest science, the Physical Activity Guidelines for Americans is an essential resource for ...
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Guidelines for producing commercial nuclear power plant decommissioning cost estimates
International Nuclear Information System (INIS)
La Guardia, T.S.
1986-01-01
The guidelines are not intended to be a ''cookbook'' or a ''standard''. Their purpose is to ensure all decomissioning cost elements are properly included and to provide guidance on the detail required. Other methodologies may be used if they accomplish this objective
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Assessing the readiness of a school system to adopt food allergy management guidelines.
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.
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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
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Seibert, J Anthony; Clements, Jessica B; Halvorsen, Per H; Herman, Michael G; Martin, Melissa C; Palta, Jatinder; Pfeiffer, Douglas E; Pizzutiello, Robert J; Schueler, Beth A; Shepard, S Jeff; Fairobrent, Lynne A
2015-05-08
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.
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Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M
2016-10-01
In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.
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Testing post-editing guidelines
DEFF Research Database (Denmark)
Flanagan, Marian; Christensen, Tina Paulsen
2014-01-01
guidelines to use in translator training programmes. Recently, the first set of publicly available industry-focused PE guidelines (for ‘good enough’ and ‘publishable’ quality) were developed by Translation Automation User Society (TAUS) in partnership with the Centre for Global Intelligent Content (CNGL......), which can be used as a basis on which to instruct post-editors in professional environments. This paper reports on a qualitative study that investigates how trainee translators on an MA course, which is aimed at preparing the trainees for the translation industry, interpret these PE guidelines...... for publishable quality. The findings suggest trainees have difficulties interpreting the guidelines, primarily due to trainee competency gaps, but also due to the wording of the guidelines. Based on our findings we propose training measures to address these competency gaps. Furthermore, we provide post...
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van der Wees, Philip J; Zagers, Cor A M; de Die, Sara E; Hendriks, Erik J M; Nijhuis-van der Sanden, Maria W G; de Bie, Rob A
2013-05-01
Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments. An overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach's alpha. Barriers and facilitators were assessed using descriptive statistics. Some 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach's alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints. The construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in
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Towards guidelines for informed consent for prospective stem cell ...
African Journals Online (AJOL)
2015-08-02
Aug 2, 2015 ... of genes that reactivate the embryonic genetic programme.[5,6]. We, and many ... ever more complex and multifaceted ethical issues, many of which require new guidelines, consent protocols and even change in legislation, since they do not ..... Progress and prospects in stem cells therapy. Acta. Pharmacol ...
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Clinical imaging guidelines part 2: Risks, benefits, barriers, and solutions.
Malone, James; del Rosario-Perez, Maria; Van Bladel, Lodewijk; Jung, Seung Eun; Holmberg, Ola; Bettmann, Michael A
2015-02-01
A recent international meeting was convened by two United Nations bodies to focus on international collaboration on clinical appropriateness/referral guidelines for use in medical imaging. This paper, the second of 4 from this technical meeting, addresses barriers to the successful development/deployment of clinical imaging guidelines and means of overcoming them. It reflects the discussions of the attendees, and the issues identified are treated under 7 headings: ■ Practical Strategy for Development and Deployment of Guidelines; ■ Governance Arrangements and Concerns with Deployment of Guidelines; ■ Finance, Sustainability, Reimbursement, and Related Issues; ■ Identifying Benefits and Radiation Risks from Radiological Examinations; ■ Information Given to Patients and the Public, and Consent Issues; ■ Special Concerns Related to Pregnancy; and ■ The Research Agenda. Examples of topics identified include the observation that guideline development is a global task and there is no case for continuing it as the project of the few professional organizations that have been brave enough to make the long-term commitment required. Advocacy for guidelines should include the expectations that they will facilitate: (1) better health care delivery; (2) lower cost of that delivery; with (3) reduced radiation dose and associated health risks. Radiation protection issues should not be isolated; rather, they should be integrated with the overall health care picture. The type of dose/radiation risk information to be provided with guidelines should include the uncertainty involved and advice on application of the precautionary principle with patients. This principle may be taken as an extension of the well-established medical principle of "first do no harm." Copyright © 2015. Published by Elsevier Inc.
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Japanese Guideline for Atopic Dermatitis
Directory of Open Access Journals (Sweden)
Ichiro Katayama
2011-01-01
The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2009 (ADGL2009” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle.
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Guidelines for preclinical animal research in ALS/MND: A consensus meeting.
Ludolph, Albert C; Bendotti, Caterina; Blaugrund, Eran; Chio, Adriano; Greensmith, Linda; Loeffler, Jean-Philippe; Mead, Richard; Niessen, Heiko G; Petri, Susanne; Pradat, Pierre-Francois; Robberecht, Wim; Ruegg, Markus; Schwalenstöcker, Birgit; Stiller, Detlev; van den Berg, Leonard; Vieira, Fernando; von Horsten, Stephan
2010-01-01
The development of therapeutics for ALS/MND is largely based on work in experimental animals carrying human SOD mutations. However, translation of apparent therapeutic successes from in vivo to the human disease has proven difficult and a considerable amount of financial resources has been apparently wasted. Standard operating procedures (SOPs) for preclinical animal research in ALS/MND are urgently required. Such SOPs will help to establish SOPs for translational research for other neurological diseases within the next few years. To identify the challenges and to improve the research methodology, the European ALS/MND group held a meeting in 2006 and published guidelines in 2007 (1). A second international conference to improve the guidelines was held in 2009. These second and improved guidelines are dedicated to the memory of Sean F. Scott.
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Guidelines for earthquake ground motion definition for the eastern United States
International Nuclear Information System (INIS)
Gwaltney, R.C.; Aramayo, G.A.; Williams, R.T.
1985-01-01
Guidelines for the determination of earthquake ground-motion definition for the eastern United States are established in this paper. Both far-field and near-field guidelines are given. The guidelines were based on an extensive review of the current procedures for specifying ground motion in the United States. Both empirical and theoretical procedures were used in establishing the guidelines because of the low seismicity in the eastern United States. Only a few large to great (M > 7.5) sized earthquakes have occurred in this region, no evidence of tectonic surface ruptures related to historic or Holocene earthquakes have been found, and no currently active plate boundaries of any kind are known in this region. Very little instrumented data has been gathered in the East. Theoretical procedures are proposed so that in regions of almost no data a reasonable level of seismic ground motion activity can be assumed. The guidelines are to be used to develop the Safe Shutdown Earthquake, SSE. A new procedure for establishing the Operating Basis Earthquake, OBE, is proposed, in particular for the eastern United States. The OBE would be developed using a probabilistic assessment of the geological conditions and the recurrence of seismic events at a site. These guidelines should be useful in development of seismic design requirements for future reactors. 17 refs., 2 figs., 1 tab
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The right care, every time: improving adherence to evidence-based guidelines.
Runnacles, Jane; Roueché, Alice; Lachman, Peter
2018-02-01
Guidelines are integral to reducing variation in paediatric care by ensuring that children receive the right care, every time. However, for reasons discussed in this paper, clinicians do not always follow evidence-based guidelines. Strategies to improve guideline usage tend to focus on dissemination and education. These approaches, however, do not address some of the more complex factors that influence whether a guideline is used in clinical practice. In this article, part of the Equipped Quality Improvement series, we outline the literature on barriers to guideline adherence and present practical solutions to address these barriers. Examples outlined include the use of care bundles, integrated care pathways and quality improvement collaboratives. A sophisticated information technology system can improve the use of evidence-based guidelines and provide organisations with valuable data for learning and improvement. Key to success is the support of an organisation that places reliability of service delivery as the way business is done. To do this requires leadership from clinicians in multidisciplinary teams and a system of continual improvement. By learning from successful approaches, we believe that all healthcare organisations can ensure the right care for each patient, every time. © 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.
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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.
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10 CFR 960.3 - Implementation guidelines.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...
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[The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review].
Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika
2007-01-15
In Germany, the first national consensus on evidence-based recommendations for COPD prevention and disease management was reached in spring 2006. After a development period of 9 months, the National Disease Management Guideline COPD was finalized by nominal group process under the authorship of the scientific societies for pneumology (DGP and Atemwegsliga), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the NICE COPD Guideline 2004, the GOLD Recommendations as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline COPD 2006 (www.copd.versorgungsleitlinien.de).
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Reporting Guidelines and Checklists Improve the Reliability and Rigor of Research Reports.
Abbott, J Haxby
2016-03-01
The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) requires the use of robust research reporting guidelines for all research report submissions, including the newly adopted RECORD (REporting of studies Conducted using Observational Routinely-collected health Data) statement. We remind authors submitting research to JOSPT to identify the appropriate guideline and checklist for their study design, and to submit a completely and accurately completed checklist with their manuscript. J Orthop Sports Phys Ther 2016;46(3):130. doi:10.2519/jospt.2016.0105.
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International Nuclear Information System (INIS)
James, R.W.; Shank, J.W.; Yoder, C.
1996-01-01
Historically, nuclear power plants installing digital equipment have been required to conduct expensive, site-specific electromagnetic interference (EMI) surveys to demonstrate that EMI will not affect the operation of sensitive electronic equipment. Consequently, EPRI formed a Utility Working Group which developed a set of generic EMI susceptibility testing guidelines, which were published as an EPRI report in September 1994. These guidelines are based upon EMI survey data obtained from several different plants and include criteria for determining their applicability. The Working Group interacted with NRC staff to obtain NRC approval. In April 1996, the NRC issued a Safety Evaluation Report (SER) endorsing the guidelines as a valid means of demonstrating EMI compatibility. The issuance of this SER was conditional on issuing a revision to the EPRI EMI Guidelines. This paper summarizes the guidelines, the NRC SER, and the current status of Revision 1 to the report
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Selection of low-risk design guidelines for energetic events
International Nuclear Information System (INIS)
Ferguson, D.; Marchaterre, J.; Graham, J.
1982-01-01
This paper recommends the establishment of specific design guidelines for protection against potential, but low-probability, energetic events. These guidelines recognize the plant protective features incorporated to prevent such events, as well as the inherent capability of the plant to accommodate a certain level of energy release. Further, their application is recommended within the context of necessary standardized and agreed-upon acceptance criteria which are less restrictive than ASME code requirements. The paper provides the background upon which the selection of the design is made, including the characterization of energetic events dependent on various core-design parameters, and including the necessity of a low-risk design balanced between prevention of accidents and the mitigation of consequences
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Weidner, Theodore J.
2008-01-01
In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…
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10 CFR 960.5 - Preclosure guidelines.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Preclosure guidelines. 960.5 Section 960.5 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5 Preclosure guidelines. The guidelines in this subpart specify the...
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10 CFR 960.4 - Postclosure guidelines.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Postclosure guidelines. 960.4 Section 960.4 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4 Postclosure guidelines. The guidelines in this subpart specify the...
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Tabbers, M.M.; Boluyt, N.; Offringa, M.
2010-01-01
There is little experience with the nationwide implementation of an evidence-based pediatric guideline on first-choice fluid for resuscitation in hypovolemia. We investigated fluid prescribing behavior at (1) guideline development, (2) after guideline development, and (3) after active implementation
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New cardiopulmonary resuscitation guidelines 2010: managing the newly born in delivery room.
Biban, Paolo; Filipovic-Grcic, Boris; Biarent, Dominique; Manzoni, Paolo
2011-03-01
Most newborns are born vigorous and do not require neonatal resuscitation. However, about 10% of newborns require some type of resuscitative assistance at birth. Although the vast majority will require just assisted lung aeration, about 1% requires major interventions such as intubation, chest compressions, or medications. Recently, new evidence has prompted modifications in the international cardiopulmonary resuscitation (CPR) guidelines for both neonatal, paediatric and adult patients. Perinatal and neonatal health care providers must be aware of these changes in order to provide the most appropriate and evidence-based emergency interventions for newborns in the delivery room. The aim of this article is to provide an overview of the main recommended changes in neonatal resuscitation at birth, according to the publication of the international Liaison Committee on Resuscitation (ILCOR) in the CoSTR document (based on evidence of sciences) and the new 2010 guidelines released by the European Resuscitation Council (ERC), the American Heart Association (AHA), and the American Academy of Pediatrics (AAP). Copyright © 2010 Elsevier Ltd. All rights reserved.
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A review of clinical guidelines.
LENUS (Irish Health Repository)
Andrews, E J
2012-02-03
BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.
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Using "get with the guidelines" to improve cardiovascular secondary prevention.
LaBresh, Kenneth A; Gliklich, Richard; Liljestrand, James; Peto, Randolph; Ellrodt, A Gray
2003-10-01
"Get With The Guidelines (GWTG)" was developed and piloted by the American Heart Association (AHA), New England Affiliate; MassPRO, Inc.; and other organizations to reduce the gap in the application of secondary prevention guidelines in hospitalized cardiovascular disease patients. Collaborative learning programs and technology solutions were created for the project. The interactive Web-based patient management tool (PMT) was developed using quality measures derived from the AHA/American College of Cardiology secondary prevention guidelines. It provided data entry, embedded reminders and guideline summaries, and online reports of quality measure performance, including comparisons with the aggregate performance of all hospitals. Multidisciplinary teams from 24 hospitals participated in the 2000-2001 pilot. Four collaborative learning sessions and monthly conference calls supported team interaction. Best-practices sharing and the use of an Internet tool enabled hospitals to change systems and collect data on 1,738 patients. The GWTG program, a template of learning sessions with didactic presentations, best-practices sharing, and collaborative multidisciplinary team meetings supported by the Internet-based data collection and reporting system, can be extended to multiple regions without requiring additional development. Following the completion of the pilot, the AHA adopted GWTG as a national program.
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Short rotation coppice for energy production: hydrological guidelines
Energy Technology Data Exchange (ETDEWEB)
Hall, R.L.
2003-07-01
This report provides hydrological guidelines for growers, land and water resource managers, environmental groups and other parties interested in utilising short rotation coppice (SRC) for energy production. The aim of the report is to help interested parties decide if a location is suitable for SRC planting by considering whether potential hydrological impacts will have an adverse effect on crop productivity and yield. The guidelines consider: the water use of SRC compared with other crops; the factors governing water use; the water requirements for a productive crop; and the likely impacts on the availability and quantity of water. The report points out that there are still gaps in our knowledge of the processes controlling the water use and growth of SRC and notes that, in some situations, there will be considerable uncertainty in predictions.
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Support for reporting guidelines in surgical journals needs improvement: A systematic review.
Agha, Riaz A; Barai, Ishani; Rajmohan, Shivanchan; Lee, Seon; Anwar, Mohammed O; Fowler, Alexander J; Orgill, Dennis P; Altman, Douglas G
2017-09-01
Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047-8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the 73 (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
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From Clinical Practice Guidelines to Computer-interpretable Guidelines. A Literature Overview
Latoszek-Berendsen, A.; Tange, H.; van den Herik, H. J.; Hasman, A.
2010-01-01
Background: Guidelines are among us for over 30 years. Initially they were used as algorithmic protocols by nurses and other ancillary personnel. Many physicians regarded the use of guidelines as cookbook medicine. However, quality and patient safety issues have changed the attitude towards
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DOE guidelines for management of radioactive waste - historical perspectives
International Nuclear Information System (INIS)
Kluk, A.F.; Neal, R.M.
1996-01-01
From the beginning of the Manhattan Project in 1942 through the signing of the Atomic Energy Act (AEA) in 1946 and its reenactment in 1954, new policies and techniques began to evolve for managing waste produced in the manufacture of nuclear weapons. Even in the early days of war-time urgency, public health and safety were the major considerations in managing waste from this new technology. The Atomic Energy Commission (AEC), which took over from the Manhattan Engineer District (MED) in 1947, established initial waste category management guidelines (high level waste stored in tanks, solid low level waste disposed of primarily in trenches, and liquid waste released to ponds, cribs, and pits) based on the management concepts developed by the MED. The AEC and its successor agencies managed radioactive waste in a manner consistent with existing industrial health and safety requirements of that era. With the formation of the Department of Energy (DOE) in September 1977, techniques and internal requirements were already in place or being established that, in some cases, were more protective of human health and the environment than existing legislation and environmental standards. With the transition to environmental cleanup of former DOE weapons production facilities, new and revised guidelines were created to address hazardous and radioactive mixed waste, waste minimization, and recycling. This paper reviews the waste management guidelines as they have evolved from the MED through the resent time
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Guidelines for radiological interventions
International Nuclear Information System (INIS)
Kauffmann, G.W.
1998-01-01
The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)
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Gress, Dustin A; Dickinson, Renee L; Erwin, William D; Jordan, David W; Kobistek, Robert J; Stevens, Donna M; Supanich, Mark P; Wang, Jia; Fairobent, Lynne A
2017-07-01
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. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.
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Managing care pathways combining SNOMED CT, archetypes and an electronic guideline system.
Bernstein, Knut; Andersen, Ulrich
2008-01-01
Today electronic clinical guideline systems exist, but they are not well integrated with electronic health records. This paper thus proposes that the patient's "position" in the pathway during the patient journey should be made visible to all involved healthcare parties and the patient. This requires that the generic knowledge, which is represented in the guidelines, is combined with the patient specific information - and then made accessible for all relevant parties. In addition to the decision support provided by the guideline system documentation support can be provided by templates based on archetypes. This paper provides a proposal for how the guideline system and the EHR can be integrated by the use of archetypes and SNOMED CT. SNOMED CT provides the common reference terminology and the semantic links between the systems. The proposal also includes the use of a National Patient Index for storing data about the patient's position in the pathway and for sharing this information by all involved parties.
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Sullivan, Jane O'; Blake, Kevin; Berntgen, Michael; Salmonson, Tomas; Welink, Jan
2017-12-05
The European Medicines Agency's (EMA) product-specific bioequivalence guidelines outline harmonized regulatory requirements for studies to demonstrate bioequivalence for products that may have particular needs due to their pharmacokinetics, in addition to those outlined in general guidance. As such they are potentially very useful to the pharmaceutical industry in the development of generic medicinal products and to regulatory authorities for harmonized decision-making. Since their introduction in 2013, EMA product-specific bioequivalence guidelines continue to increase in number, and as of June 2017, encompass a number of different pharmacotherapeutic groups and pharmaceutical forms. This article further elucidates the processes involved for stakeholders and reviews the Agency's experience with the development of these guidelines, including the scientific issues witnessed with their advancement. A comparison with the United States Food and Drug Administration approach to similar guidelines is also provided. © 2017 The Authors Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.
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International Nuclear Information System (INIS)
Kainberger, Franz; Pokieser, Peter; Imhof, Herwig; Czembirek, Heinrich; Fruehwald, Franz
2002-01-01
Guidelines can be regarded as special forms of algorithms and have been shown to be useful tools for supporting medical decision making. With the Council Directive 97/43/Euratom recommendations concerning referral criteria for medical exposure have to be implemented into national law of all EU member states. The time- and cost-consuming efforts of developing, implementing, and updating such guidelines are balanced by the acceptance in clinical practice and eventual better health outcomes. Clearly defined objectives with special attention drawn on national and regional differences among potential users, support from organisations with expertise in evidence-based medicine, separated development of the evidence component and the recommendations component, and large-scale strategies for distribution and implementation are necessary. Editors as well as users of guidelines for referral criteria have to be aware which expectations can be met and which cannot be fulfilled with this instrument; thus, dealing with guidelines requires a new form of ''diagnostic reasoning'' based on medical ethics. (orig.)
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Event reporting guidelines 10 CFR 50.72 and 50.73. Revision 1
Energy Technology Data Exchange (ETDEWEB)
Allison, D P; Harper, M R; Jones, W R; MacKinnon, J B; Sandin, S S
1998-01-01
Revision 1 to NUREG-1022 clarifies the immediate notification requirements of Title 10 of the Code of Federal Regulations, Part 50, Section 50.72 (10 CFR 50.72), and the 30-day written licensee event report (LER) requirements of 10 CFR 50.73 for nuclear power plants. This revision was initiated to improve the reporting guidelines related to 10 CFR 50.72 and 50.73 and to consolidate these guidelines into a single reference document. A first draft of this document was noticed for public comment in the Federal Register on october 7, 1991 (56 FR 50598). A second draft was noticed for comment in the Federal Register on February 7, 1994 (59 FR 5614). This document updates and supersedes NUREG-1022 and its Supplements 1 and 2 (published in September 1983, February 1984, and September 1985, respectively). It does not change the reporting requirements of 10 CFR 50.72 and 50.73.
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Event reporting guidelines 10 CFR 50.72 and 50.73. Revision 1
International Nuclear Information System (INIS)
Allison, D.P.; Harper, M.R.; Jones, W.R.; MacKinnon, J.B.; Sandin, S.S.
1998-01-01
Revision 1 to NUREG-1022 clarifies the immediate notification requirements of Title 10 of the Code of Federal Regulations, Part 50, Section 50.72 (10 CFR 50.72), and the 30-day written licensee event report (LER) requirements of 10 CFR 50.73 for nuclear power plants. This revision was initiated to improve the reporting guidelines related to 10 CFR 50.72 and 50.73 and to consolidate these guidelines into a single reference document. A first draft of this document was noticed for public comment in the Federal Register on october 7, 1991 (56 FR 50598). A second draft was noticed for comment in the Federal Register on February 7, 1994 (59 FR 5614). This document updates and supersedes NUREG-1022 and its Supplements 1 and 2 (published in September 1983, February 1984, and September 1985, respectively). It does not change the reporting requirements of 10 CFR 50.72 and 50.73
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Guidelines for Bacteriophage Product Certification.
Fauconnier, Alan
2018-01-01
Following decades in the wilderness, bacteriophage therapy is now appearing as a credible antimicrobial strategy. However, this reemerging therapy does not rekindle without raising sensitive regulatory concerns. Indeed, whereas the European regulatory framework has been basically implemented to tackle ready-to-use pharmaceuticals produced on a large scale, bacteriophage therapy relies on a dynamic approach requiring a regulation on personalized medicine, nonexistent at present. Because of this, no guideline are currently available for addressing the scientific and regulatory issues specifically related to phage therapy medicinal products (PTMP).Pending to the implementation of an appropriate regulatory framework and to the development of ensuing guidelines, several avenues which might lead to PTMP regulatory compliance are explored here. Insights might come from the multi-strain dossier approach set up for particular animal vaccines, from the homologous group concept developed for the allergen products or from the licensing process for veterinary autogenous vaccines. Depending on national legislations, customized preparations prescribed as magistral formulas or to be used on a named-patient basis are possible regulatory approaches to be considered. However, these schemes are not optimal and should thus be regarded as transitional.
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2010-04-01
... FOR HUMAN CONSUMPTION FOOD LABELING Specific Nutrition Labeling Requirements and Guidelines § 101.43 Substantial compliance of food retailers with the guidelines for the voluntary nutrition labeling of raw fruit... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Substantial compliance of food retailers with the...
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Japanese Guideline for Atopic Dermatitis 2014
Directory of Open Access Journals (Sweden)
Ichiro Katayama
2014-01-01
The basics of treatment discussed in this guideline are based on the "Guidelines for the Treatment of Atopic Dermatitis 2008" prepared by the Health and Labour Sciences Research and the "Guidelines for the Management of Atopic Dermatitis 2012 (ADGL2012" prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the "Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2013" together with those for other allergic diseases.
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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.
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Evaluation of Crew-Centric Onboard Mission Operations Planning and Execution Tool: Year 2
Hillenius, S.; Marquez, J.; Korth, D.; Rosenbaum, M.; Deliz, Ivy; Kanefsky, Bob; Zheng, Jimin
2018-01-01
Currently, mission planning for the International Space Station (ISS) is largely affected by ground operators in mission control. The task of creating a week-long mission plan for ISS crew takes dozens of people multiple days to complete, and is often created far in advance of its execution. As such, re-planning or adapting to changing real-time constraints or emergent issues is similarly taxing. As we design for future mission operations concepts to other planets or areas with limited connectivity to Earth, more of these ground-based tasks will need to be handled autonomously by the crew onboard.There is a need for a highly usable (including low training time) tool that enables efficient self-scheduling and execution within a single package. The ISS Program has identified Playbook as a potential option. It already has high crew acceptance as a plan viewer from previous analogs and can now support a crew self-scheduling assessment on ISS or on another mission. The goals of this work, a collaboration between the Human Research Program and the ISS Program, are to inform the design of systems for more autonomous crew operations and provide a platform for research on crew autonomy for future deep space missions. Our second year of the research effort have included new insights on the crew self-scheduling sessions performed by the crew through use on the HERA (Human Exploration Research Analog) and NEEMO (NASA Extreme Environment Mission Operations) analogs. Use on the NEEMO analog involved two self-scheduling strategies where the crew planned and executed two days of EVAs (Extra-Vehicular Activities). On HERA year two represented the first HERA campaign where we were able to perform research tasks. This involved selected flexible activities that the crew could schedule, mock timelines where the crew completed more complex planning exercises, usability evaluation of the crew self-scheduling features, and more insights into the limit of plan complexity that the crew
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Directory of Open Access Journals (Sweden)
Burgers Jako S
2007-11-01
Full Text Available Abstract Background Dutch guideline-developing organizations do not focus systematically on differences between men and women when developing guidelines, even though there is increasing evidence that being male or female may have an effect on health and health outcomes. In collaboration with two prominent Dutch guideline-developing organizations, we designed a training course to encourage systematic attention to sex differences in guideline development procedures. Methods The course is targeted towards guideline developers. Its aims are to improve awareness concerning the relevance of considering sex differences in the guideline development process, as well as the competence and skills necessary for putting this into practice. The design and teaching methods of the course are based on adult learning styles and principles of changing provider behaviour. It was adjusted to the working methods of guideline organizations. The course was taught to, and evaluated by, a group of staff members from two guideline organizations in the Netherlands. Results The course consists of five modules, each of which corresponds to a key step in the guideline development process. The participants rated the training course positively on content, programme, and trainers. Their written comments suggest that the course met its objectives. Conclusion The training course is the first to address sex differences in guideline development. Results from the pilot test suggest that the course achieved its objectives. Because its modules and teaching methods of the course are widely transferable, the course could be useful for many organizations that are involved in developing guidelines. Follow-up studies are needed to assess the long-term effect of the course on the actions of guideline developers and its utility in other settings.
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Guidelines in electrodiagnostic medicine. American Association of Electrodiagnostic Medicine.
1992-02-01
The American Association of Electrodiagnostic Medicine (AAEM) is committed to the development of sound and clinically relevant guidelines through review of literature, expert opinion and consensus. In 1979, with the assistance of its Professional Practice Committee and association leaders, the association published its initial guidelines, Guidelines in Electrodiagnostic Medicine, covering the practice of electrodiagnostic medicine. The committee is charged with ongoing revision of the document, as needed, and the current version includes standards of practice in clinical electromyography, risks in electrodiagnostic medicine, basic equipment requirements, and the role of paramedical support. In 1988, Educational Guidelines for Electrodiagnostic Training Programs (Appendix A) was prepared by the AAEM Training Program Committee and added to aid training program directors in establishing new training programs or in reviewing the current status of the educational aspects of existing programs. In 1986, the AAEM charged its Quality Assurance Committee with the responsibility for the development of guidelines pertinent to electrodiagnostic medical consultations. The impetus for the charge was the requests received from members of the AAEM and other interested parties for educational material on indications for and conduct of electrodiagnostic medical consultations. As a result of the committee's efforts, Suggested Guidelines for Electrodiagnostic Medical Consultations (Appendix D), was published in 1989 and additional sections added subsequently. The current document includes (1) general indications for an electrodiagnostic medical consultation for patients with suspected myopathies, neuromuscular junction disorders, polyneuropathies, mononeuropathies, plexopathies, radiculopathies, neuronopathies and central nervous system disorders, (2) specific indications for patients with suspected lumbosacral or cervical radiculopathies, (3) general principles of electrodiagnostic
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Guideline concordance of treatment for depressive disorders in Canada.
Duhoux, Arnaud; Fournier, Louise; Nguyen, Cat Tuong; Roberge, Pasquale; Beveridge, Rachelle
2009-05-01
Depression is one of the most prevalent mental health problems worldwide with considerable social and economic burdens. While practice guidelines exist, their adherence is inconsistent in clinical practice. To provide up-to-date national estimates of the adequacy of treatment received by Canadians having suffered a major depressive disorder (MDD) and examine factors associated with this adequacy. To evaluate the impact of different definitions of guideline-concordant treatment on the results. Data were drawn from the Canadian Community Health Survey, cycle 1.2: Mental Health and Well-Being (CCHS 1.2), a nationally representative survey conducted in 2002 and targetting persons aged 15 years or older living in private dwellings. In order to calculate the prevalence of treatment adequacy, we used a sample of 1,563 individuals meeting the criteria for MDD in the 12 months preceding the survey. A subset of 831 subjects who reported having used health services for mental health purposes at least once during that time served to identify the factors associated with treatment adequacy. Four definitions of minimally adequate treatment were considered and covariates were selected according to a well-known behavioral model. The analyses consisted of prevalence estimates and logistic regression models. Among selected subjects, 55% received guideline-concordant treatment according to the Canadian guidelines. Inadequacy was more prevalent in rural settings, for less complex cases, and in the general medical sector. Depending on the definition, prevalence of guideline-concordant treatment ranged between 48 and 71%, and factors associated with guideline-concordant treatment were mainly need factors and sector of care. A large proportion of people with a depressive disorder do not receive minimally adequate treatment. Improved access to and quality of treatment is required, especially in primary care settings.
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European trauma guideline compliance assessment: the ETRAUSS study.
Hamada, Sophie Rym; Gauss, Tobias; Pann, Jakob; Dünser, Martin; Leone, Marc; Duranteau, Jacques
2015-12-08
available resources. Deviations from guidelines are frequent, differ from region to region and are dependent upon specialty training. Further efforts are required to provide consensus guidelines and to improve their implementation across European countries.
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[The German Program for Disease Management Guidelines: CHD Guideline 2006. Short review].
Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina
2006-12-15
In Germany, the first national consensus on evidence-based recommendations for disease management in patients with chronic coronary heart disease was reached in summer 2006. After a development period of 4 years, the National Disease Management Guideline Chronic Coronary Heart Disease was finalized by nominal group process under the authorship of the scientific associations for cardiac rehabilitation (DGPR), cardiac surgery (DGTHG), cardiology (DGK), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the ACC/AHA guidelines 2002 updates as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Chronic Coronary Heart Disease 2006 (www.khk.versorgungsleitlinie.de).
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Japanese guidelines for atopic dermatitis 2017
Directory of Open Access Journals (Sweden)
Ichiro Katayama
2017-04-01
The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2015 (ADGL2015” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the “Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2016” together with those for other allergic diseases.
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Heuristic guidelines for making effective augmented-reality based training instruction
International Nuclear Information System (INIS)
Yim, Ho Bin
2009-02-01
As industrial plants and factories age, their maintenance requirements increase. Because maintenance mistakes directly increase the operating costs of a power plant, maintenance quality is of significant concern to plant management. By law, all personnel working with nuclear technology must be re-trained every three years; however, as the statistical data show, the number of shutdown accidents at nuclear power plants (NPPs) due to maintenance failure is still high and needs to be reduced. Industries have started to adopt various technologies to increase the speed and accuracy of maintenance. Among those technologies, augmented reality (AR) is the latest multimedia presentation technology to be applied to plant maintenance, and it offers superior intuitiveness and user interactivity over other conventional multimedia. The objectives of this empirical study are to measure the optimum amounts of information to be delivered at a time and to identify what types of information enhance the learning ability of novices and to suggest heuristic guidelines by which to make effective AR training instructions. In addition, AR training instructions will be composed based on the suggested heuristic guidelines and on the Cognitive Theory of Multimedia Learning, which provides guidelines for multimedia instructions, and the efficiency of those guidelines will be compared with that of other AR instructions. Cognitive Load Theory addresses how working memory is structured. Intrinsic cognitive load refers to the cognitive load that is inherent in information to be learned. It depends on the basic amount of processing required for understanding a presentation. Intrinsic cognitive load is determined by the complexity of the learning material. Extraneous cognitive load refers to the cognitive load created through the presentation, format and delivery of the instruction. Germane cognitive load is the remaining part of the cognitive load, and it helps the learner transfer information from
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Heuristic guidelines for making effective augmented-reality based training instruction
Energy Technology Data Exchange (ETDEWEB)
Yim, Ho Bin
2009-02-15
As industrial plants and factories age, their maintenance requirements increase. Because maintenance mistakes directly increase the operating costs of a power plant, maintenance quality is of significant concern to plant management. By law, all personnel working with nuclear technology must be re-trained every three years; however, as the statistical data show, the number of shutdown accidents at nuclear power plants (NPPs) due to maintenance failure is still high and needs to be reduced. Industries have started to adopt various technologies to increase the speed and accuracy of maintenance. Among those technologies, augmented reality (AR) is the latest multimedia presentation technology to be applied to plant maintenance, and it offers superior intuitiveness and user interactivity over other conventional multimedia. The objectives of this empirical study are to measure the optimum amounts of information to be delivered at a time and to identify what types of information enhance the learning ability of novices and to suggest heuristic guidelines by which to make effective AR training instructions. In addition, AR training instructions will be composed based on the suggested heuristic guidelines and on the Cognitive Theory of Multimedia Learning, which provides guidelines for multimedia instructions, and the efficiency of those guidelines will be compared with that of other AR instructions. Cognitive Load Theory addresses how working memory is structured. Intrinsic cognitive load refers to the cognitive load that is inherent in information to be learned. It depends on the basic amount of processing required for understanding a presentation. Intrinsic cognitive load is determined by the complexity of the learning material. Extraneous cognitive load refers to the cognitive load created through the presentation, format and delivery of the instruction. Germane cognitive load is the remaining part of the cognitive load, and it helps the learner transfer information from
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Energy Technology Data Exchange (ETDEWEB)
Neudecker, Denise [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Conlin, Jeremy Lloyd [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gray, Mark Girard [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); McCartney, Austin Paul [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Parsons, Donald Kent [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); White, Morgan Curtis [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
2017-04-12
This memo contains general guidelines on what documentation and tools need to be in place as well as format and data testing requirements such that evaluated nuclear data sets or entire libraries can be adopted by the nuclear data team. Additional requirements beyond this memo might apply for specific nuclear data observables. These guidelines were established based on discussions between J.L. Conlin, M.G. Gray, A.P. McCartney, D. Neudecker, D.K. Parsons and M.C. White.
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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
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36 CFR 1191.1 - Accessibility guidelines.
2010-07-01
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accessibility guidelines... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR BUILDINGS AND FACILITIES; ARCHITECTURAL BARRIERS ACT (ABA) ACCESSIBILITY GUIDELINES § 1191.1 Accessibility guidelines. (a) The...
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Poitras, Stéphane; Avouac, Jérôme; Rossignol, Michel; Avouac, Bernard; Cedraschi, Christine; Nordin, Margareta; Rousseaux, Chantal; Rozenberg, Sylvie; Savarieau, Bernard; Thoumie, Philippe; Valat, Jean-Pierre; Vignon, Éric; Hilliquin, Pascal
2007-01-01
Clinical practice guidelines have been elaborated to summarize evidence related to the management of knee osteoarthritis and to facilitate uptake of evidence-based knowledge by clinicians. The objectives of the present review were summarizing the recommendations of existing guidelines on knee osteoarthritis, and assessing the quality of the guidelines using a standardized and validated instrument – the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Internet medical literature databases from 2001 to 2006 were searched for guidelines, with six guidelines being identified. Thirteen clinician researchers participated in the review. Each reviewer was trained in the AGREE instrument. The guidelines were distributed to four groups of three or four reviewers, each group reviewing one guideline with the exception of one group that reviewed two guidelines. One independent evaluator reviewed all guidelines. All guidelines effectively addressed only a minority of AGREE domains. Clarity/presentation was effectively addressed in three out of six guidelines, scope/purpose and rigour of development in two guidelines, editorial independence in one guideline, and stakeholder involvement and applicability in none. The clinical management recommendation tended to be similar among guidelines, although interventions addressed varied. Acetaminophen was recommended for initial pain treatment, combined with exercise and education. Nonsteroidal anti-inflammatory drugs were recommended if acetaminophen failed to control pain, but cautiously because of gastrointestinal risks. Surgery was recommended in the presence of persistent pain and disability. Education and activity management interventions were superficially addressed in most guidelines. Guideline creators should use the AGREE criteria when developing guidelines. Innovative and effective methods of knowledge translation to health professionals are needed. PMID:18062805
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International standardization of safety requirements for fast reactors
International Nuclear Information System (INIS)
2011-06-01
Japan Atomic Energy Agency (JAEA) is conducting the FaCT (Fast Reactor Cycle Technology Development) project in cooperation with Japan Atomic Power Company (JAPC) and Mitsubishi FBR systems inc. (MFBR), where an advanced loop-type fast reactor named JSFR (Japan Sodium-cooled Fast Reactor) is being developed. It is important to develop software technologies (a safety guideline, safety design criteria, safety design standards etc.) of FBRs as well as hardware ones (a reactor plant itself) in order to address prospective worldwide utilization of FBR technology. Therefore, it is expected to establish a rational safety guideline applicable to the JSFR and harmonized with national nuclear-safety regulations as well, including Japan, the United States and the European Union. This report presents domestic and international status of safety guideline development for sodium-cooled fast reactors (SFRs), results of comparative study for safety requirements provided in existing documents and a proposal for safety requirements of future SFRs with a roadmap for their refinement and worldwide utilization. (author)
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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....
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DEFF Research Database (Denmark)
Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar
2015-01-01
diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...
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Guidelines for use of fishes in research: revised and expanded
Jenkins, Jill A.; Bart, Henry L.; Bowker, James D.; Bowser, Paul R.; MacMillan, J. Randy; Nickum, John G.; Rachlin, Joseph W.; Rose, James D.; Sorensen, Peter W.; Warkentine, Barbara E.; Whitledge, Greg W.
2014-01-01
The Guidelines for the Use of Fishes in Research (2014; 2014 Guidelines), now available through the American fisheries Society (AFS) website and in print from the AFS bookstore, is a resource to aid researchers and regulatory authorities regarding responsible, scientifically valid research on fish and aquatic wildlife. The Guidelines for the Use of Fishes in Field Research (American Society of Ichthyologists and Herpetologists [ASIH] et al. 1987, 1988) emphasized field research and was followed by the 2004 Guidelines including laboratory research topics. Each version of the Guidelines has been jointly endorsed and/or published by the ASIH, the American Institute of Fishery Research Biologists (AIFRB), and AFS--each focusing on the scientific understanding, global conservation, and sustainability of aquatic animals, fisheries, and ecosystems. Changes with time necessitate revisions to make the Guidelines consistent with contemporary practices and scientific literature so to remain relevant as a technical resource. This document provides not only general principles relevant for field and laboratory research endeavors but includes specific requirements for researchers working within the United States and outside of the country. Within the scope of their expertise, the 2014 Uses of Fishers in Research (UFR) Committee members updated and revised sections, resulting in a 90-page 2014 Guidelines having undergone through peer review. As before, topical areas were addressed (see Table of Contents on page 416). Expanded coverage was provided on U.S. and international agencies and programs relevant to research with fishes. The Surgical Procedures and the Marking and Tagging section received special focus by a UFR Subcommittee. Feeds and Feeding and the Administration of Drugs, Biologics and Other Chemicals are just some of the newly added topics. The 2014 Guidelines is user-friendly by way of hyperlinks to external Internet sites, intradocument sections, and tables of
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Adopting preoperative fasting guidelines.
Anderson, Megan; Comrie, Rhonda
2009-07-01
In 1999, the American Society of Anesthesiologists adopted preoperative fasting guidelines to enhance the quality and efficiency of patient care. Guidelines suggest that healthy, non-pregnant patients should fast six hours from solids and two hours from liquids. Although these guidelines are in place, studies suggest that providers are still using the blanket statement "NPO after midnight" without regard to patient characteristics, the procedure, or the time of the procedure. Using theory to help change provider's beliefs may help make change more successful. Rogers' Theory of Diffusion of Innovations can assist in changing long-time practice by laying the groundwork for an analysis of the benefits and disadvantages of proposed changes, such as changes to fasting orders, while helping initiate local protocols instead of additional national guidelines.
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Okamoto, Etsuji
2003-11-01
"Ethical Guidelines for Epidemiological Research" took effect in July 2002, with a moral duty of all researchers to comply when conducting epidemiological studies although it is not legally binding. Public health research entails various forms of studies including not only epidemiological studies but also attention to psychological, societal and economic aspects, which are outside of the jurisdiction of the guidelines. Hence, confusion may arise among members of Japanese Society of Public Health as to whether the study they conduct falls within the definition of epidemiological research. The author discusses legal interpretations of the guidelines arising in the course of translation work as part of government-funded project, "Dissemination of the 'Ethical Guidelines for Epidemiological Research' via Internet (principal investigator: Toru Doi)" and argues that a case-method approach would be best suited to enhance understanding by researchers with diverse, non-legal backgrounds. The author proposes an algorithm for classification of studies as to whether the guideline applies, and applies it to all original articles published in the Japanese Journal of Public Health (JJPH) in one year (March 2002 thru February 2003). The rationale for classification is discussed from the strict legal viewpoint in each case. Sixteen out of 46 original articles published in JJPH for one year were classified as epidemiological studies to which the guidelines apply. Those classified otherwise were psychological studies (10), epidemiological studies not targeting specific diseases and are exempt form the guidelines (3), purely methodological studies (4), economics studies (3), fact-finding or opinion surveys with no hypothesis testing (2), as well as studies authorized by law (4) or using unlinkable anonymous data only (4), all of which are exempt from the guidelines. Reference to ethical considerations in the methodology section as required by the instructions for authors was generally
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Energy Technology Data Exchange (ETDEWEB)
NONE
1998-09-01
This Department of Energy (DOE) is approved for use by all components of DOE. It contains guidelines that should be followed when preparing Criticality Safety Evaluations that will be used to demonstrate the safety of operations performed at DOE Non-Reactor Nuclear Facilities. Adherence with these guidelines will provide consistency and uniformity in Criticality Safety Evaluations (CSEs) across the complex and will document compliance with DOE Order 5480.24 requirements as they pertain to CSEs.
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International Nuclear Information System (INIS)
1998-09-01
This Department of Energy (DOE) is approved for use by all components of DOE. It contains guidelines that should be followed when preparing Criticality Safety Evaluations that will be used to demonstrate the safety of operations performed at DOE Non-Reactor Nuclear Facilities. Adherence with these guidelines will provide consistency and uniformity in Criticality Safety Evaluations (CSEs) across the complex and will document compliance with DOE Order 5480.24 requirements as they pertain to CSEs
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2010-07-01
... 32 National Defense 2 2010-07-01 2010-07-01 false Guidelines. 231.11 Section 231.11 National... PROCEDURES GOVERNING BANKS, CREDIT UNIONS AND OTHER FINANCIAL INSTITUTIONS ON DOD INSTALLATIONS Guidelines for Application of the Privacy Act to Financial Institution Operations § 231.11 Guidelines. (a) The...
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Methodological quality of guidelines in gastroenterology.
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.
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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)
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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)
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2002-03-01
In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax. The study's aim was to determine the level of adherence to these guidelines at a London teaching hospital. A retrospective case note audit of 59 episodes was performed. In patients undergoing intervention, the initial procedure was simple aspiration in 32 (73 per cent) and chest tube insertion in 12 (27 per cent) cases, contrasting with the BTS recommendation that aspiration should be attempted first in all such patients. Simple aspiration was successful on 34 per cent of occasions. Successful aspiration was associated with a significantly shorter hospital stay (median 3, range 1-11 days) than either failed aspiration (7, 3-66 days) or chest tube insertion without aspiration (9, 3-16 days). Other areas where practice differed from the BTS guidelines were clamping of chest tubes and use of a pursestring suture for wound closure. A follow up questionnaire suggested a lack of familiarity with the guidelines. These findings indicate that current management of spontaneous pneumothorax deviates from the BTS guidelines in potentially important respects.
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36 CFR 910.67 - Square guidelines.
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...
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28 CFR 2.36 - Rescission guidelines.
2010-07-01
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Rescission guidelines. 2.36 Section 2.36... guidelines. (a) The following guidelines shall apply to the sanctioning of disciplinary infractions or new... such period of confinement has resulted from initial parole to a detainer). These guidelines specify...
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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
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2011-12-08
... benefits and costs, and recommended alternatives. The Board also invites the public to identify any gaps in... guidelines, alternative policies to those presented, and information on benefits and costs. After reviewing... with considerable potential cost in relation to the benefit. Because this requirement potentially would...
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2010-04-01
... 23 Highways 1 2010-04-01 2010-04-01 false Guidelines. 650.211 Section 650.211 Highways FEDERAL..., STRUCTURES, AND HYDRAULICS Erosion and Sediment Control on Highway Construction Projects § 650.211 Guidelines. (a) The FHWA adopts the AASHTO Highway Drainage Guidelines, Volume III, “Erosion and Sediment Control...
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2010-01-01
... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Guidelines. 1170.4 Section 1170.4... ADMINISTRATION, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES § 1170.4 Guidelines. Each... agency actions, activities or programs undertaken in compliance with these guidelines or other laws or...
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Efficient clinical evaluation of guideline quality: development and testing of a new tool
2014-01-01
Background Evaluating the methodological quality of clinical practice guidelines is essential before deciding which ones which could best inform policy or practice. One current method of evaluating clinical guideline quality is the research-focused AGREE II instrument. This uses 23 questions scored 1–7, arranged in six domains, which requires at least two independent testers, and uses a formulaic weighted domain scoring system. Following feedback from time-poor clinicians, policy-makers and managers that this instrument did not suit clinical need, we developed and tested a simpler, shorter, binary scored instrument (the iCAHE Guideline Quality Checklist) designed for single users. Methods Content and construct validity, inter-tester reliability and clinical utility were tested by comparing the new iCAHE Guideline Quality Checklist with the AGREE II instrument. Firstly the questions and domains in both instruments were compared. Six randomly-selected guidelines on a similar theme were then assessed by three independent testers with different experience in guideline quality assessment, using both instruments. Per guideline, weighted domain and total AGREE II scores were calculated, using the scoring rubric for three testers. Total iCAHE scores were calculated per guideline, per tester. The linear relationship between iCAHE and AGREE II scores was assessed using Pearson r correlation coefficients. Score differences between testers were assessed for the iCAHE Guideline Quality Checklist. Results There were congruent questions in each instrument in four domains (Scope & Purpose, Stakeholder involvement, Underlying evidence/Rigour, Clarity). The iCAHE and AGREE II scores were moderate to strongly correlated for the six guidelines. There was generally good agreement between testers for iCAHE scores, irrespective of their experience. The iCAHE instrument was preferred by all testers, and took significantly less time to administer than the AGREE II instrument. However
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Calcium and vitamin D requirements for optimal bone mass during adolescence
There remains very strong interest in the calcium and vitamin D requirements of adolescents related to bone health. The Institute of Medicine (IOM) released new dietary guidelines in late 2010 for these nutrients. These guidelines were primarily based on literature published in 2009 and earlier and ...
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Influence of Planetary Protection Guidelines on Waste Management Operations
Hogan, John A.; Fisher, John W.; Levri, Julie A.; Wignarajah, Kanapathipi; Race, Margaret S.; Stabekis, Perry D.; Rummel, John D.
2005-01-01
Newly outlined missions in the Space Exploration Initiative include extended human habitation on Mars. During these missions, large amounts of waste materials will be generated in solid, liquid and gaseous form. Returning these wastes to Earth will be extremely costly, and will therefore likely remain on Mars. Untreated, these wastes are a reservoir of live/dead organisms and molecules considered to be "biomarkers" i.e., indicators of life). If released to the planetary surface, these materials can potentially confound exobiology experiments and disrupt Martian ecology indefinitely (if existent). Waste management systems must therefore be specifically designed to control release of problematic materials both during the active phase of the mission, and for any specified post-mission duration. To effectively develop waste management requirements for Mars missions, planetary protection guidelines must first be established. While previous policies for Apollo lunar missions exist, it is anticipated that the increased probability of finding evidence of life on Mars, as well as the lengthy mission durations will initially lead to more conservative planetary protection measures. To facilitate the development of overall requirements for both waste management and planetary protection for future missions, a workshop was conducted to identify how these two areas interface, and to establish a preliminary set of planetary protection guidelines that address waste management operations. This paper provides background regarding past and current planetary protection and waste management issues, and their interactions. A summary of the recommended planetary protection guidelines, anticipated ramifications and research needs for waste management system design for both forward (Mars) and backward (Earth) contamination is also provided.
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The selection of low-risk design guidelines for energetic events
International Nuclear Information System (INIS)
Fergusson, Donald; Marchaterre, John; Graham, John
1982-01-01
This paper recommends the establishment of specific design guidelines for protection against potential, but low probability, energetic events. These guidelines recognize the plant protective features incorporated to prevents such events, as well as the inherent capability of the plant to accommodate a certain level of energy release. Further, their application is recommended within the context of necessary standardized and agreed upon acceptance criteria which are less restrictive than ASME code requirements. The paper provides the background upon which the selection of the design is made, including the characterization of energetic events dependent on various core-design parameters, and including the necessity of a low-risk design balanced between prevention of accidents and the mitigation of consequences
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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
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2010-07-01
... 32 National Defense 1 2010-07-01 2010-07-01 false Guidelines. 143.8 Section 143.8 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN DOD POLICY ON... BARGAINING § 143.8 Guidelines. The guidelines for making certain factual determinations are as follows: (a...
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Brüggemann, S; Korsukéwitz, C
2004-10-01
Clinical practice guidelines - seen as an aggregation of scientific evidence - and evidence based medicine are of relevance and importance for everybody involved in health care. Nevertheless, the discussion of their pros and cons is controversial. Major criticisms concern methodological aspects, a disregard of the patients' perspective, potentially increasing costs and the limitation of doctors' autonomy possibly caused by streamlining therapy. Supporters emphasize the improvement of care that comes with using proven therapies, patients' empowerment, cost reduction and equity in the distribution of resources. Following medical practice guidelines the liability for medical malpractice may be limited, but non-adherence to guidelines does not entail liability per se. Clinical practice guidelines in the rehabilitative sector differ from those in curative medicine by being required to achieve more complex goals than maintenance, recovery and improvement of health. Activities in the rehabilitation sector address two main topics: The integration of rehabilitation into curative guidelines, e. g. by participating in the German clearing process for guidelines, and the development of guidelines specific to rehabilitation. There are a number of guideline initiatives, e. g. with the Association of the Scientific Medical Societies (AWMF), the Federation of German Pension Insurance Institutes (VDR) and the Federal Insurance Institute for Salaried Employees (BfA). The BfA project is the first to allow integration of evidence based medicine into the quality assurance programme of the German Pension Insurance complementing it with differentiated criteria for the assessment of therapeutic processes. Taking evidence based medicine increasingly into consideration and the continuous process of introducing rehabilitative clinical practice guidelines are going to improve health care for people with chronic diseases.
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A structured record to implement the national guidelines for diabetes ...
African Journals Online (AJOL)
A draft of the structured record was developed at a single-pilot CHC in the Western Cape. Focus group discussions established the core requirements for a structured record. Process, result and structural indicators in line with the national Guidelines were considered for inclusion in the draft record. This draft record was then ...
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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...
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International Nuclear Information System (INIS)
Idriss, A.; Spurrell, F.
2009-06-01
Alberta Environment has developed a guidelines for operations and proposed operations that require approvals under the province's Environmental Protection and Enhancement Act or that operate under a code of practice for emissions to the atmosphere. In an effort to ensure consistency in the use of dispersion models for regulatory applications in Alberta, this document provided detailed guidance on suitable methods and approaches that should be employed to assess air quality from emission sources, specifically, information required to demonstrate that a source meets the Alberta ambient air quality objectives. The document outlined the statutory authority and provided an overview of the approach. It provided detailed advice on the types and uses of dispersion models with particular reference to the modelling protocol, input data, and output interpretation. Guidance on the application of regulatory models were also presented. Various models were described and their intended uses were explained. Internet addresses for different modelling resources were also offered. Last, some information about regional modelling in the province of Alberta was discussed. 40 refs., 4 tabs., 7 figs., 3 appendices.
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Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E
2015-01-22
Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study
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AsMA Medical Guidelines for Air Travel: In-Flight Medical Care.
Thibeault, Claude; Evans, Anthony D; Pettyjohn, Frank S; Alves, Paulo M
2015-06-01
Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. All airlines are required to provide first aid training for cabin crew, and the crew are responsible for managing any in-flight medical events. There are also regulatory requirements for the carriage of first aid and medical kits. AsMA has developed recommendations for first aid kits, emergency medical kits, and universal precaution kits.
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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.
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Workplace mental health: An international review of guidelines.
Memish, Kate; Martin, Angela; Bartlett, Larissa; Dawkins, Sarah; Sanderson, Kristy
2017-08-01
The aim of this systematic review was to determine the quality and comprehensiveness of guidelines developed for employers to detect, prevent, and manage mental health problems in the workplace. An integrated approach that combined expertise from medicine, psychology, public health, management, and occupational health and safety was identified as a best practice framework to assess guideline comprehensiveness. An iterative search strategy of the grey literature was used plus consultation with experts in psychology, public health, and mental health promotion. Inclusion criteria were documents published in English and developed specifically for employers to detect, prevent, and manage mental health problems in the workplace. A total of 20 guidelines met these criteria and were reviewed. Development documents were included to inform quality assessment. This was performed using the AGREE II rating system. Our results indicated that low scores were often due to a lack of focus on prevention and rather a focus on the detection and treatment of mental health problems in the workplace. When prevention recommendations were included they were often individually focused and did not include practical tools or advice to implement. An inconsistency in language, lack of consultation with relevant population groups in the development process and a failure to outline and differentiate between the legal/minimum requirements of a region were also observed. The findings from this systematic review will inform translation of scientific evidence into practical recommendations to prevent mental health problems within the workplace. It will also direct employers, clinicians, and policy-makers towards examples of best-practice guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.
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Mike Drummond
1991-01-01
In the summer of 1990, the Australian government took a major step by requiring evidence of cost-effectiveness of new medicines prior to reimbursement by the public health care system. This paper assesses whether the methodological principles behind the guidelines are sound and whether they raise important new logistical and policy implications. It is concluded that, whilst the guidelines may represent ‘the thin end of the wedge’ for the pharmaceutical industry, in that other countries may fo...
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1999-01-01
The attached guidelines on "Commercial Support of Continuing Nursing Education" have been developed by the American Nurses Association (ANA) to assist/guide nursing continuing educators who wish to utilize the resources of corporations to provide continuing education programs. These guidelines enable the provider to maintain a balance between the need for industry-supported dissemination of scientific information and promotional activities which meet the requirements of law, as well as professional standards of the American Nurses Association.
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Radiation protection. Factors influencing compliance to referral guidelines in minor chest trauma
International Nuclear Information System (INIS)
Tack, Denis; Louage, Fabian; Muylem, Alain van; Howarth, Nigel; Gevenois, Pierre Alain
2018-01-01
To test the hypothesis that referral guidelines are not sufficiently known by prescribers and that medico-legal concerns could influence the prescription of radiographs in minor chest trauma. We submitted a questionnaire including a typical clinical history and questions on reasons for prescribing radiographs of the ribs in minor chest trauma to 112 prescriptors (33 residents, 18 surgeons, 7 internists, 24 general practitioners and 30 ER physicians). All accepted to participate. Comparisons were performed by Fisher's exact test followed by a post-hoc analysis and by a McNemar test. Fifty-eight percent of prescriptors proposed rib radiographs, most (89%) being unaware of the guidelines. Only 11% of them changed their intention to order radiographs after information on referral guidelines and radiation dose (P=0.057). The mean dose delivered by rib radiographs was 38 times higher than that of a chest X-ray. Legal and medico-legal concerns (requirements from insurance policies and avoidance of lawsuits) were the main reasons for requesting radiographs. Unsharpness of guidelines in addition to social and medico-legal issues, rather than medical reasons or the lack of knowledge of the guidelines, strongly influence the prescription of radiographs of the ribs in minor chest trauma. (orig.)
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Standards and guidelines applicable for the validation of programmable automation systems
International Nuclear Information System (INIS)
Haapanen, P.; Maskuniitty, M.
1993-02-01
The validation of programmable automation system for an application important to safety in a nuclear power plant requires a comprehensive view about the system quality and reliability. One central point is to get assured that proper international guidelines and standards have been followed in the design, construction and maintenance of the system. The study was directed to locate international standards and guidelines which can support the validation of programmable systems and to evaluate their applicability for the validation of systems on different levels of requirement during their life cycle. The publication reviews the most important international standards (IAEA, ISO, IEC, IEEE) and their basic principles both for system and application program. Several nuclear standards, which have drawn the main attention, and some general programmable automation standards have been examined. In addition one practical automation system has been examined in order to find essential questions. Based on these studies a set of important items for the qualification have been identified
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Post-traumatic stress disorder--best practice GP guidelines.
Forbes, David; Wolfgang, Bronwyn; Cooper, John; Creamer, Mark; Barton, David
2009-03-01
Approximately 50-65% of Australians are exposed to a traumatic event during their lifetime. Approximately 250 000 Australians suffer from post-traumatic stress disorder (PTSD) at any given time, making it one of the most common anxiety disorders. In May 2007, the Australian guidelines for the treatment of adults with acute stress disorder and posttraumatic stress disorder was published. In order to facilitate translation of evidence regarding PTSD into busy clinical practice, and particularly for general practitioners, a more succinct version of the guidelines has been developed. This article describes a brief algorithm based on the Australian guidelines and outlines key recommendations. General practitioners are often the first point of contact with the health care system for someone who has experienced a traumatic event. Patients experiencing trauma within the past 2 weeks require psychological first aid, and monitoring and assessment for the development of acute stress disorder and symptoms of PTSD. If the patient wishes to talk about the event with you, support them in doing so. However, it is important not to push those who prefer not to talk about the event. Trauma focused psychological treatment is the first line of treatment for PTSD, although antidepressant medication may have an adjuvant role in some patients or in those with comorbidities.
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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
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Ecologo guidelines spark disagreement
International Nuclear Information System (INIS)
Anon.
1999-01-01
Defining what renewable means has been a challenge, but the authors of a new set of guidelines for the Ecologo certification of renewable low-impact electrcity expect after some delay to have the new rules on the street by March 2000.. There was contention in developing the guideline, according to Terra Choice Environmental Services, the company that created and applied criteria for Ecologo certification under the federal government's Environmetal Choice Program. Interim guidleines were developed and have been in place for renewable power since 1996, and have since been used to certify wood-waste biomass, landfill gas, small hydro and wind power plants, in addition to three green power marketing programs. The first draft of the revised guidelines was issued in March. It was one of the harder guidelines to have been worked on because Canadian power producers did not readily agree on what should qualify as renewable, particularly around the whole area of hydro. While small run-of-river hydro plants will continue to fit within the Ecologo guidelines, larger projects will not. Wind power producers are relatively happy with the latest version of TerraChoice's draft guidelines, released at the end of November. A significant revision of the original rules is a limit on the amount of older generation green power marketers who want to promote the green power Ecologo electricity can sell. At least 50% of their capacity must originate from plants installed after January 1, 1991
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Web Accessibility and Guidelines
Harper, Simon; Yesilada, Yeliz
Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.
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Addington, Donald; Anderson, Elizabeth; Kelly, Martina; Lesage, Alain; Summerville, Chris
2017-09-01
The objective of this review is to identify the features and components of a comprehensive system of services for people living with schizophrenia. A comprehensive system was conceived as one that served the full range of people with schizophrenia and was designed with consideration of the incidence and prevalence of schizophrenia. The system should provide access to the full range of evidence-based services, should be recovery oriented, and should provide patient-centred care. A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted were primarily drawn from the National Institute for Clinical Excellence (2014) Guideline on Psychosis and Schizophrenia in adults and the Scottish Intercollegiate Guidelines Network guidelines on management of schizophrenia. The recommendations adapted for Canada cover the range of services required to provide comprehensive services. Comprehensive services for people with schizophrenia can be organized and delivered to improve the quality of life of people with schizophrenia and their carers. The services need to be organized in a system that provides access to those who need them.
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Soft Tissue Sarcoma, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology.
von Mehren, Margaret; Randall, R Lor; Benjamin, Robert S; Boles, Sarah; Bui, Marilyn M; Ganjoo, Kristen N; George, Suzanne; Gonzalez, Ricardo J; Heslin, Martin J; Kane, John M; Keedy, Vicki; Kim, Edward; Koon, Henry; Mayerson, Joel; McCarter, Martin; McGarry, Sean V; Meyer, Christian; Morris, Zachary S; O'Donnell, Richard J; Pappo, Alberto S; Paz, I Benjamin; Petersen, Ivy A; Pfeifer, John D; Riedel, Richard F; Ruo, Bernice; Schuetze, Scott; Tap, William D; Wayne, Jeffrey D; Bergman, Mary Anne; Scavone, Jillian L
2018-05-01
Soft tissue sarcomas (STS) are rare solid tumors of mesenchymal cell origin that display a heterogenous mix of clinical and pathologic characteristics. STS can develop from fat, muscle, nerves, blood vessels, and other connective tissues. The evaluation and treatment of patients with STS requires a multidisciplinary team with demonstrated expertise in the management of these tumors. The complete NCCN Guidelines for STS provide recommendations for the diagnosis, evaluation, and treatment of extremity/superficial trunk/head and neck STS, as well as intra-abdominal/retroperitoneal STS, gastrointestinal stromal tumors, desmoid tumors, and rhabdomyosarcoma. This portion of the NCCN Guidelines discusses general principles for the diagnosis, staging, and treatment of STS of the extremities, superficial trunk, or head and neck; outlines treatment recommendations by disease stage; and reviews the evidence to support the guidelines recommendations. Copyright © 2018 by the National Comprehensive Cancer Network.
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A service oriented approach for guidelines-based clinical decision support using BPMN.
Rodriguez-Loya, Salvador; Aziz, Ayesha; Chatwin, Chris
2014-01-01
Evidence-based medical practice requires that clinical guidelines need to be documented in such a way that they represent a clinical workflow in its most accessible form. In order to optimize clinical processes to improve clinical outcomes, we propose a Service Oriented Architecture (SOA) based approach for implementing clinical guidelines that can be accessed from an Electronic Health Record (EHR) application with a Web Services enabled communication mechanism with the Enterprise Service Bus. We have used Business Process Modelling Notation (BPMN) for modelling and presenting the clinical pathway in the form of a workflow. The aim of this study is to produce spontaneous alerts in the healthcare workflow in the diagnosis of Chronic Obstructive Pulmonary Disease (COPD). The use of BPMN as a tool to automate clinical guidelines has not been previously employed for providing Clinical Decision Support (CDS).
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10 CFR 960.4-2 - Technical guidelines.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.4-2 Section 960.4-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4-2 Technical guidelines. The technical guidelines in this subpart...
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Guidelines for CPR Training in Louisiana Schools. Bulletin No. 1638.
Louisiana State Dept. of Education, Baton Rouge.
Completion of a course in cardiopulmonary resuscitation (CPR) is required for graduation from high school in Louisiana. This bulletin presents the guidelines for a course in CPR and was prepared with the cooperation of the American Red Cross (ARC) and the American Heart Association (AHA). At the conclusion of the course, students will be prepared…
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International Variation in Asthma and Bronchiolitis Guidelines.
Bakel, Leigh Anne; Hamid, Jemila; Ewusie, Joycelyne; Liu, Kai; Mussa, Joseph; Straus, Sharon; Parkin, Patricia; Cohen, Eyal
2017-11-01
Guideline recommendations for the same clinical condition may vary. The purpose of this study was to determine the degree of agreement among comparable asthma and bronchiolitis treatment recommendations from guidelines. National and international guidelines were searched by using guideline databases (eg, National Guidelines Clearinghouse: December 16-17, 2014, and January 9, 2015). Guideline recommendations were categorized as (1) recommend, (2) optionally recommend, (3) abstain from recommending, (4) recommend against a treatment, and (5) not addressed by the guideline. The degree of agreement between recommendations was evaluated by using an unweighted and weighted κ score. Pairwise comparisons of the guidelines were evaluated similarly. There were 7 guidelines for asthma and 4 guidelines for bronchiolitis. For asthma, there were 166 recommendation topics, with 69 recommendation topics given in ≥2 guidelines. For bronchiolitis, there were 46 recommendation topics, with 21 recommendation topics provided in ≥2 guidelines. The overall κ for asthma was 0.03, both unweighted (95% confidence interval [CI]: -0.01 to 0.07) and weighted (95% CI: -0.01 to 0.10); for bronchiolitis, it was 0.32 unweighted (95% CI: 0.16 to 0.52) and 0.15 weighted (95% CI: -0.01 to 0.5). Less agreement was found in national and international guidelines for asthma than for bronchiolitis. Additional studies are needed to determine if differences are based on patient preferences and values and economic considerations or if other recommendation-level, guideline-level, and condition-level factors are driving these differences. Copyright © 2017 by the American Academy of Pediatrics.
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Duda, Stephanie; Fahim, Christine; Szatmari, Peter; Bennett, Kathryn
2017-07-01
Innovative strategies that facilitate the use of high quality practice guidelines (PG) are needed. Accordingly, repositories designed to simplify access to PGs have been proposed as a critical component of the network of linked interventions needed to drive increased PG implementation. The National Guideline Clearinghouse (NGC) is a free, international online repository. We investigated whether it is a trustworthy source of child and youth anxiety and depression PGs. English language PGs published between January 2009 and February 2016 relevant to anxiety or depression in children and adolescents (≤ 18 years of age) were eligible. Two trained raters assessed PG quality using Appraisal of Guidelines for Research and Evaluation (AGREE II). Scores on at least three AGREE II domains (stakeholder involvement, rigor of development, and editorial independence) were used to designate PGs as: i) minimum quality (≥ 50%); and ii) high quality (≥ 70%). Eight eligible PGs were identified (depression, n=6; anxiety and depression, n=1; social anxiety disorder, n=1). Four of eight PGs met minimum quality criteria; three of four met high quality criteria. At present, NGC users without the time and special skills required to evaluate PG quality may unknowingly choose flawed PGs to guide decisions about child and youth anxiety and depression. The recent NGC decision to explore the inclusion of PG quality profiles based on Institute of Medicine standards provides needed leadership that can strengthen PG repositories, prevent harm and wasted resources, and build PG developer capacity.
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Surfing the best practice guidelines: national clinical guideline clearinghouse in development.
1997-08-01
The growth in development and usage of clinical guidelines during the last five years has been remarkable. Not only are health care practitioners reaching for what's deemed to be the best in protocols and practice, consumers, too, are looking toward standards and guidelines as they become more educated about the quality and quantity of health care services they should be receiving.
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International Nuclear Information System (INIS)
Anon.
1979-01-01
Requirements and guidelines are provided for the control of activities to be exercised during procurement of items and services which affect the quality of nuclear facilities. These requirements and guidelines apply to procurement activities for items and services such as designing, purchasing, fabricating, handling, shipping, storing, cleaning, constructing, erecting, installing, inspecting, texting, maintaining and modifying
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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.
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10 CFR 960.5-2 - Technical guidelines.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.5-2 Section 960.5-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-2 Technical guidelines. The technical guidelines in this subpart set...
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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
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Development of evidence-based clinical practice guidelines (CPGs: comparing approaches
Directory of Open Access Journals (Sweden)
Harris Claire
2008-10-01
Full Text Available Abstract Background While the potential of clinical practice guidelines (CPGs to support implementation of evidence has been demonstrated, it is not currently being achieved. CPGs are both poorly developed and ineffectively implemented. To improve clinical practice and health outcomes, both well-developed CPGs and effective methods of CPG implementation are needed. We sought to establish whether there is agreement on the fundamental characteristics of an evidence-based CPG development process and to explore whether the level of guidance provided in CPG development handbooks is sufficient for people using these handbooks to be able to apply it. Methods CPG development handbooks were identified through a broad search of published and grey literature. Documents published in English produced by national or international organisations purporting to support development of evidence-based CPGs were included. A list of 14 key elements of a CPG development process was developed. Two authors read each handbook. For each handbook a judgement was made as to how it addressed each element; assigned as: 'mentioned and clear guidance provided', 'mentioned but limited practical detail provided ', or 'not mentioned'. Results Six CPG development handbooks were included. These were produced by the Council of Europe, the National Health and Medical Research Council of Australia, the National Institute for Health and Clinical Excellence in the UK, the New Zealand Guidelines Group, the Scottish Intercollegiate Guideline Network, and the World Health Organization (WHO. There was strong concordance between the handbooks on the key elements of an evidence-based CPG development process. All six of the handbooks require and provide guidance on establishment of a multidisciplinary guideline development group, involvement of consumers, identification of clinical questions or problems, systematic searches for and appraisal of research evidence, a process for drafting
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Metric Guidelines Inservice and/or Preservice
Granito, Dolores
1978-01-01
Guidelines are given for designing teacher training for going metric. The guidelines were developed from existing guidelines, journal articles, a survey of colleges, and the detailed reactions of a panel. (MN)
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Energy Technology Data Exchange (ETDEWEB)
Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States); Chen, Chen [Argonne National Lab. (ANL), Argonne, IL (United States); Lu, Xiaonan [Argonne National Lab. (ANL), Argonne, IL (United States)
2015-08-01
This guideline focuses on the integration of DMS with DERMS and microgrids connected to the distribution grid by defining generic and fundamental design and implementation principles and strategies. It starts by addressing the current status, objectives, and core functionalities of each system, and then discusses the new challenges and the common principles of DMS design and implementation for integration with DERMS and microgrids to realize enhanced grid operation reliability and quality power delivery to consumers while also achieving the maximum energy economics from the DER and microgrid connections.
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What of guidelines for osteoarthritis?
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.
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The appraisal of clinical guidelines in dentistry.
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.
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Guidelines for reporting quantitative mass spectrometry based experiments in proteomics.
Martínez-Bartolomé, Salvador; Deutsch, Eric W; Binz, Pierre-Alain; Jones, Andrew R; Eisenacher, Martin; Mayer, Gerhard; Campos, Alex; Canals, Francesc; Bech-Serra, Joan-Josep; Carrascal, Montserrat; Gay, Marina; Paradela, Alberto; Navajas, Rosana; Marcilla, Miguel; Hernáez, María Luisa; Gutiérrez-Blázquez, María Dolores; Velarde, Luis Felipe Clemente; Aloria, Kerman; Beaskoetxea, Jabier; Medina-Aunon, J Alberto; Albar, Juan P
2013-12-16
Mass spectrometry is already a well-established protein identification tool and recent methodological and technological developments have also made possible the extraction of quantitative data of protein abundance in large-scale studies. Several strategies for absolute and relative quantitative proteomics and the statistical assessment of quantifications are possible, each having specific measurements and therefore, different data analysis workflows. The guidelines for Mass Spectrometry Quantification allow the description of a wide range of quantitative approaches, including labeled and label-free techniques and also targeted approaches such as Selected Reaction Monitoring (SRM). The HUPO Proteomics Standards Initiative (HUPO-PSI) has invested considerable efforts to improve the standardization of proteomics data handling, representation and sharing through the development of data standards, reporting guidelines, controlled vocabularies and tooling. In this manuscript, we describe a key output from the HUPO-PSI-namely the MIAPE Quant guidelines, which have developed in parallel with the corresponding data exchange format mzQuantML [1]. The MIAPE Quant guidelines describe the HUPO-PSI proposal concerning the minimum information to be reported when a quantitative data set, derived from mass spectrometry (MS), is submitted to a database or as supplementary information to a journal. The guidelines have been developed with input from a broad spectrum of stakeholders in the proteomics field to represent a true consensus view of the most important data types and metadata, required for a quantitative experiment to be analyzed critically or a data analysis pipeline to be reproduced. It is anticipated that they will influence or be directly adopted as part of journal guidelines for publication and by public proteomics databases and thus may have an impact on proteomics laboratories across the world. This article is part of a Special Issue entitled: Standardization and
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Guideline for the proof of expert knowledge of nuclear power station personnel
International Nuclear Information System (INIS)
1987-01-01
The guideline allows the examination of particulars on the state of knowledge and instruction of persons responsible for the erection, management and monitoring of a plant which applicants in accordance with section 7, sub-section (2) No. 1 AtG are required to provide. They apply uniformly to all of the Federal Republic of Germany. They comprise principles, evidence of expert knowledge, rules for the conduct of examinations and instructions for updating knowledge. This guideline supersedes the version of April 4, 1984 (GMBl. A (May 25, 1984) v. 35(12) p. 192-197). (orig./HP) [de
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Atrial fibrillation in a primary care population: how close to NICE guidelines are we?
LENUS (Irish Health Repository)
Loo, Bryan
2009-06-01
The National Institute for Health and Clinical Excellence (NICE) guidelines for the management of atrial fibrillation were published in June 2006. It was anticipated that they would potentially lead to increased demand for echocardiography (ECHO), increased access to secondary care services (for example for cardioversion), and require additional resources for monitoring anticoagulation. A primary care survey was therefore initiated in South Devon, in advance of publication of the guidelines as a snapshot of existing practice, to determine any additional resources and education required to meet the new standards. The main aim was to determine what proportion of patients were managed exclusively in primary care, how frequently patients were investigated by ECHO and whether anticoagulation was being appropriately targeted at patients at high risk of thromboembolic events.
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Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A
2007-11-23
Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common
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The design guidelines of mobile augmented reality for tourism in Malaysia
Shukri, Saidatul A'isyah Ahmad; Arshad, Haslina; Abidin, Rimaniza Zainal
2017-10-01
Recent data shows that one in every five people in the world owns a Smartphone and spends most of their time on the phone using apps. Visitors prefer this type of portable, convenient, practical and simple technology when travelling, especially geo location-enabled applications such as the GPS. The aim of this paper is to develop design guidelines for Mobile Augmented Reality (MAR) for tourism. From the analysis of existing design guidelines of Mobile Augmented Reality (MAR) for tourism, an application design guidelines are proposed based on Human-computer interaction principle and usability design that would fulfils the user's requirement in a better way. Six design principles were examined in this analysis. The analysis identified eleven suggestions for design principles. These recommendations are offered towards designing principles and developing prototype app for tourist in Malaysia. This paper identifies design principles to reduce cognitive overhead of tourist, learn ability and suitable context for providing content whiles their travel in Malaysia.
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Syrogiannis, Andreas; Rotchford, Alan P; Agarwal, Pankaj Kumar; Kumarasamy, Manjula; Montgomery, Donald; Burr, Jennifer; Sanders, Roshini
2015-01-01
To describe the pattern of glaucoma-service delivery in Scotland and identify areas for improvement, taking into account Scottish General Ophthalmic Services (GOS) arrangements and the Eye Care Integration project, and to design Scottish Intercollegiate Guidelines Network (SIGN) guidelines to refine the primary and secondary interface of glaucoma care. A glaucoma-survey questionnaire was sent to all consultant glaucomatologists in Scotland. The design of SIGN guidelines was based on the results of the questionnaire using SIGN methodology. Over 90% of Scottish glaucoma care is triaged and delivered within hospital services. Despite GOS referral, information is variable. There are no consistent discharge practices to the community. These results led to defined research questions that were answered, thus formulating the content of the SIGN guidelines. The guideline covers the assessment of patients in primary care, referral criteria to hospital, discharge criteria from hospital to community, and monitoring of patients at risk of glaucoma. With increasing age and limitations to hospital resources, refining glaucoma pathways between primary and secondary care has become a necessity. Scotland has unique eye care arrangements with both the GOS and Eye Care Integration project. It is hoped that implementation of SIGN guidelines will identify glaucoma at the earliest opportunity and reduce the rate of false-positive referrals to hospital.
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Guidelines for Self-assessment of Research Reactor Safety
International Nuclear Information System (INIS)
2018-01-01
Self-assessment is an organization’s internal process to review its current status, processes and performance against predefined criteria and thereby to provide key elements for the organization’s continual development and improvement. Self-assessment helps the organization to think through what it is expected to do, how it is performing in relation to these expectations, and what it needs to do to improve performance, fulfil the expectations and achieve better compliance with the predefined criteria. This publication provides guidelines for a research reactor operating organization to perform a self-assessment of the safety management and the safety of the facility and to identify gaps between the current situation and the IAEA safety requirements for research reactors. These guidelines also provide a methodology for Member States, regulatory bodies and operating organizations to perform a self-assessment of their application of the provisions of the Code of Conduct on the Safety of Research Reactors. This publication also addresses planning, implementation and follow-up of actions to enhance safety and strengthen application of the Code. The guidelines are applicable to all types of research reactor and critical and subcritical assemblies, at all stages in their lifetimes, and to States, regulatory bodies and operating organizations throughout all phases of research reactor programmes. Research reactor operating organizations can use these guidelines at any time to support self-assessments conducted in accordance with the organization’s integrated management system. These guidelines also serve as a tool for an organization to prepare to receive an IAEA Integrated Safety Assessment of Research Reactors (INSARR) mission. An important result of this is the opportunity for an operating organization to identify focus areas and make safety improvements in advance of an INSARR mission, thereby increasing the effectiveness of the mission and efficiency of the
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A proposal to prove compliance of ESD with EU-guidelines
International Nuclear Information System (INIS)
Tschurlovits, M.
2001-01-01
The question of compliance with the diagnostic reference levels issued as European Guidelines is discussed based upon measurements of entrance surface dose in four selected projections. The projections were chosen either for the higher dose associated with the investigation or the high frequency of the investigation. The results for the high dose projections lumbar spine and iv pyelography were found to be well below the guidelines. The results for the low dose projections chest pa and chest lat show a mean at about the guidance level. The parameters of the measurements are shown and possible reasons for the scattering of data are discussed. The parameters of the measurements are compared with the proposal of the EU. The main conclusion was a) that even when not all parameters are consistent with EU-guides, the dose is frequently much lower than required. In addition, the ranking in ESD was different for different techniques and different radiologists. Because an approved method to indicate compliance is not yet available, a proposal is given in order to make the guidelines executable. (author)
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Yamazaki, Kentaro; Taniguchi, Hiroya; Yoshino, Takayuki; Akagi, Kiwamu; Ishida, Hideyuki; Ebi, Hiromichi; Nakatani, Kaname; Muro, Kei; Yatabe, Yasushi; Yamaguchi, Kensei; Tsuchihara, Katsuya
2018-06-01
The Japanese Society of Medical Oncology (JSMO) previously published 2 editions of the clinical guidelines: "Japanese guidelines for testing of KRAS gene mutation in colorectal cancer" in 2008 and "Japanese Society of Medical Oncology Clinical Guidelines: RAS (KRAS/NRAS) mutation testing in colorectal cancer patients" in 2014. These guidelines have contributed to the proper use of KRAS and RAS mutation testing, respectively. Recently, clinical utility, particularly for colorectal cancer (CRC) patients with BRAF V600E mutation or DNA mismatch-repair (MMR) deficiency, has been established. Therefore, the guideline members decided these genetic alterations should also be involved. The aim of this revision is to properly carry out testing for BRAF V600E mutation and MMR deficiency in addition to RAS mutation. The revised guidelines include the basic requirements for testing for these genetic alterations based on recent scientific evidence. Furthermore, because clinical utility of comprehensive genetic testing using next-generation sequencing and somatic gene testing of analyzing circulating tumor DNA has increasingly evolved with recent advancements in testing technology, we noted the current situation and prospects for these testing technologies and their clinical implementation in the revised guidelines. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.
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Foda, Hussein D; Brehm, Anthony; Goldsteen, Karen; Edelman, Norman H
2017-01-01
Prescriber disagreement is among the reasons for poor adherence to COPD treatment guidelines; it is yet not clear whether this leads to adverse outcomes. We tested whether undertreatment according to the original Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines led to increased exacerbations. Records of 878 patients with spirometrically confirmed COPD who were followed from 2005 to 2010 at one Veterans Administration (VA) Medical Center were analyzed. Analysis of variance was performed to assess differences in exacerbation rates between severity groups. Logistic regression analysis was performed to assess the relationship between noncompliance with guidelines and exacerbation rates. About 19% were appropriately treated by guidelines; 14% overtreated, 44% under-treated, and in 23% treatment did not follow any guideline. Logistic regression revealed a strong inverse relationship between undertreatment and exacerbation rate when severity of obstruction was held constant. Exacerbations per year by GOLD stage were significantly different from each other: mild 0.15, moderate 0.27, severe 0.38, very severe 0.72, and substantially fewer than previously reported. The guidelines were largely not followed. Undertreatment predominated but, contrary to expectations, was associated with fewer exacerbations. Thus, clinicians were likely advancing therapy primarily based upon exacerbation rates as was subsequently recommended in revised GOLD and other more recent guidelines. In retrospect, a substantial lack of prescriber adherence to treatment guidelines may have been a signal that they required re-evaluation. This is likely to be a general principle regarding therapeutic guidelines. The identification of fewer exacerbations in this cohort than has been generally reported probably reflects the comprehensive nature of the VA system, which is more likely to identify relatively asymptomatic (ie, nonexacerbating) COPD patients. Accordingly, these rates may
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International Nuclear Information System (INIS)
Pfob, H.; Heinemann, G.
1992-01-01
Corresponding dose equivalent rate factors for various radionuclides are now available for determining the skin dose caused by skin contamination. These dose equivalent rate factors take into account all contributions from the types of radiation emitted. Any limits for skin decontamination measures are nowhere contained or determined yet. However, radiological protection does in practice require at least guideline values in order to prevent unsuitable or detrimental measures that can be noticed quite often. New calculations of dose equivalent rate factors for the skin now make the recommendation of guideline values possible. (author)
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Heins, M.J.; Jong, J.D. de; Spronk, I.; Ho, V.K.; Brink, M.; Korevaar, J.C.
2017-01-01
Background: Guideline adherence remains a challenge in clinical practice, despite guidelines’ ascribed potential to improve patient outcomes. We studied the level of adherence to recommendations from Dutch national cancer treatment guidelines, and the influence of general and
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DEFF Research Database (Denmark)
Burcharth, Hans F.; Lamberti, Alberto
The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...
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Rausch, Christopher M; Phillips, George C
2009-10-01
We compared the content of the cardiac screening questions on US state high school athletic association preparticipation evaluation forms with current consensus recommendations. We reviewed the high school athletic association's approved, recommended, or required sports preparticipation form from each of the 50 US states and the District of Columbia, and compared the content of the personal and family history components with current recommendations for cardiac screening questions. We found that 85% of the preparticipation forms in current use contain all elements of the formerly recommended guidelines, but only 17% contain all elements of the new consensus guidelines. We conclude that although there appears to be some improvement in the content of the preparticipation forms in current use compared with previous studies, the vast majority of these forms are incomplete compared with current consensus guidelines.
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Nutrition guidelines for undergraduate medical curricula: a six-country comparison
Directory of Open Access Journals (Sweden)
Crowley J
2015-02-01
of nutrition in health, interdisciplinary teamwork, and the provision of nutrition counseling. Notable differences exist regarding the scope and detail of curriculum guidelines for the reviewed countries. Conclusion: There are promising developments in nutrition curriculum guidelines for medical schools within the reviewed countries. Differences in the scope and detail of nutrition curriculum guidelines may influence the nutrition education provided to medical students, and the subsequent nutrition care provided by doctors in these countries. Consideration is required as to how to monitor and evaluate the nutrition competence of doctors in relation to routine health care practices, as well as the impact of their competency levels on patients’ nutrition behavior and health outcomes. Keywords: medical education, nutrition, undergraduate, doctors, curriculum guidelines
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Public safety around dams guidelines
Energy Technology Data Exchange (ETDEWEB)
Bennett, T [Canadian Dam Association, Edmonton, AB (Canada)
2010-07-01
This presentation discussed Canadian and international initiatives for improving dam safety and described some of the drivers for the development of new Canadian Dam Association (CDA) public safety guidelines for dams. The CDA guidelines were divided into the following 3 principal sections: (1) managed system elements, (2) risk assessment and management, and (3) technical bulletins. Public and media responses to the drownings have called for improved safety guidelines. While the public remains unaware of the hazards of dams, public interaction with dams is increasing as a result of interest in extreme sports and perceived rights of access. Guidelines are needed for dam owners in order to provide due diligence. Various organizations in Canada are preparing technical and public safety dam guidelines. CDA guidelines have also been prepared for signage, booms and buoys, and audible and visual alerts bulletins. Working groups are also discussing recommended practices for spill procedures, spillways and the role of professional engineers in ensuring public safety. Methods of assessing risk were also reviewed. Managed system elements for risk assessment and public interactions were also discussed, and stepped control measures were presented. tabs., figs.
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International Nuclear Information System (INIS)
2014-01-01
The IAEA fundamental safety principles provide the basis for IAEA safety standards and IAEA related programmes. IAEA safety standards reflect an international consensus on what constitutes a high level of safety for protecting people and the environment, and therefore represent what all regulators should achieve. These standards, in particular IAEA Safety Standards Series No. GSR Part 1, Governmental, Legal and Regulatory Framework for Safety, provide the basics for establishing, maintaining and continuously improving the governmental, legal and regulatory framework for safety. Additional IAEA requirements and guidance, such as the IAEA Safety Standards Series No. GSR Part 3 (Interim), Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards, and IAEA Safety Standards Series No. GS-R-3, The Management System for Facilities and Activities, are also used to establish and develop the national infrastructure for safety and for establishing and implementing a management system. Assessment of the regulatory framework for safety with respect to the IAEA safety standards can be made either through an external review or through internal self-assessment. Self-assessment offers a mechanism by which an organization can assess its performance against established standards and models and thereby identify areas for improvement. The IAEA has developed a methodology and tool for Self-assessment of the Regulatory Infrastructure for Safety (SARIS), to assist States in undertaking self-assessment of their national safety framework in accordance with the requirements and recommendations of the IAEA safety standards, and to develop an action plan for improvement. The IAEA self-assessment methodology and the associated tools are fully compatible with the IAEA safety standards and are also used in the preparation for regulatory review missions, such as the Integrated Regulatory Review Service and advisory missions. These guidelines have been developed to
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18 CFR 153.8 - Required exhibits.
2010-04-01
... such LNG, including a report containing detailed engineering and design information. The Commission staff's “Guidance Manual for Environmental Report Preparation” may be obtained from the Commission's..., a report on earthquake hazards and engineering. Guidelines are contained in “Data Requirements for...
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40 CFR 425.06 - Monitoring requirements.
2010-07-01
... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Monitoring requirements. 425.06 Section 425.06 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY General Provisions § 425.06...
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How GPs value guidelines applied to patients with multimorbidity: a qualitative study.
Luijks, Hilde; Lucassen, Peter; van Weel, Chris; Loeffen, Maartje; Lagro-Janssen, Antoine; Schermer, Tjard
2015-10-26
To explore and describe the value general practitioner (GPs) attribute to medical guidelines when they are applied to patients with multimorbidity, and to describe which benefits GPs experience from guideline adherence in these patients. Also, we aimed to identify limitations from guideline adherence in patients with multimorbidity, as perceived by GPs, and to describe their empirical solutions to manage these obstacles. Focus group study with purposive sampling of participants. Focus groups were guided by an experienced moderator who used an interview guide. Interviews were transcribed verbatim. Data analysis was performed by two researchers using the constant comparison analysis technique and field notes were used in the analysis. Data collection proceeded until saturation was reached. Primary care, eastern part of The Netherlands. Dutch GPs, heterogeneous in age, sex and academic involvement. 25 GPs participated in five focus groups. GPs valued the guidance that guidelines provide, but experienced shortcomings when they were applied to patients with multimorbidity. Taking these patients' personal circumstances into account was regarded as important, but it was impeded by a consistent focus on guideline adherence. Preventative measures were considered less appropriate in (elderly) patients with multimorbidity. Moreover, the applicability of guidelines in patients with multimorbidity was questioned. GPs' extensive practical experience with managing multimorbidity resulted in several empirical solutions, for example, using their 'common sense' to respond to the perceived shortcomings. GPs applying guidelines for patients with multimorbidity integrate patient-specific factors in their medical decisions, aiming for patient-centred solutions. Such integration of clinical experience and best evidence is required to practise evidence-based medicine. More flexibility in pay-for-performance systems is needed to facilitate this integration. Several improvements in
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Directory of Open Access Journals (Sweden)
Johnson Lorraine
2010-06-01
Full Text Available Abstract Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA. Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future.
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76 FR 1630 - Supplemental Guidelines for Sex Offender Registration and Notification
2011-01-11
... posting, pursuant to the KIDS Act, 42 U.S.C. 16915a. (3) Require jurisdictions to have sex offenders... on the sex offender does not have to be disclosed to these entities. B. Internet Identifiers The KIDS...] RIN 1105-AB36 Supplemental Guidelines for Sex Offender Registration and Notification AGENCY...
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Bazin, S.
2012-04-01
Landslide monitoring means the comparison of landslide characteristics like areal extent, speed of movement, surface topography and soil humidity from different periods in order to assess landslide activity. An ultimate "universal" methodology for this purpose does not exist; every technology has its own advantages and disadvantages. End-users should carefully consider each one to select the methodologies that represent the best compromise between pros and cons, and are best suited for their needs. Besides monitoring technology, there are many factors governing the choice of an Early Warning System (EWS). A people-centred EWS necessarily comprises five key elements: (1) knowledge of the risks; (2) identification, monitoring, analysis and forecasting of the hazards; (3) operational centre; (4) communication or dissemination of alerts and warnings; and (5) local capabilities to respond to the warnings received. The expression "end-to-end warning system" is also used to emphasize that EWSs need to span all steps from hazard detection through to community response. The aim of the present work is to provide guidelines for establishing the different components for landslide EWSs. One of the main deliverables of the EC-FP7 SafeLand project addresses the technical and practical issues related to monitoring and early warning for landslides, and identifies the best technologies available in the context of both hazard assessment and design of EWSs. This deliverable targets the end-users and aims to facilitate the decision process by providing guidelines. For the purpose of sharing the globally accumulated expertise, a screening study was done on 14 EWSs from 8 different countries. On these bases, the report presents a synoptic view of existing monitoring methodologies and early-warning strategies and their applicability for different landslide types, scales and risk management steps. Several comprehensive checklists and toolboxes are also included to support informed
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Directory of Open Access Journals (Sweden)
Burgers Jako S
2007-11-01
Full Text Available Abstract Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes
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Type 1 diabetes guidelines: Are they enough?
Directory of Open Access Journals (Sweden)
Abdul Abdul Zargar
2015-01-01
Full Text Available The discovery of insulin by Banting and Best in 1922 changed the landscape of type 1 diabetes mellitus (T1DM. Guidelines on T1DM should be evidence based and should emphasize comprehensive risk management. Guidelines would improve awareness amongst governments, state health care providers and the general public about the serious long-term implications of poorly managed diabetes and of the essential resources needed for optimal care. T1DM requires lifelong daily medication, regular control as well as access to facilities to manage acute and chronic complications. American Diabetes Association 2014 guidelines recommends annual nephropathy screening for albumin levels; random spot urine sample for albumin-to-creatinine ratio at start of puberty or age ≥10 years, whichever is earlier, once the child has had diabetes for 5 years. Hypertension should be screened for in T1DM patients by measuring blood pressure at each routine visit. Dyslipidemia in T1DM patients is important and patients should be screened if there is a family history of hypercholesterolemia or a cardiovascular event before the age of 55 years exists or if family history is unknown. Retinopathy is another important complication of diabetes and patients should be subjected to an initial dilated and comprehensive eye examination. Basic diabetes training should be provided for school staff, and they should be assigned with responsibilities for the care of diabetic children. Self-management should be allowed at all school settings for students.
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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.
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The Saudi Guidelines for the Diagnosis and Management of COPD
Khan, Javed H.; Lababidi, Hani M. S.; Al-Moamary, Mohamed S.; Zeitouni, Mohammed O.; AL-Jahdali, Hamdan H.; Al-Amoudi, Omar S.; Wali, Siraj O.; Idrees, Majdy M.; Al-Shimemri, Abdullah A.; Al Ghobain, Mohammed O.; Alorainy, Hassan S.; Al-Hajjaj, Mohamed S.
2014-01-01
The Saudi Thoracic Society (STS) launched the Saudi Initiative for Chronic Airway Diseases (SICAD) to develop a guideline for the diagnosis and management of chronic obstructive pulmonary disease (COPD). This guideline is primarily aimed for internists and general practitioners. Though there is scanty epidemiological data related to COPD, the SICAD panel believes that COPD prevalence is increasing in Saudi Arabia due to increasing prevalence of tobacco smoking among men and women. To overcome the issue of underutilization of spirometry for diagnosing COPD, handheld spirometry is recommended to screen individuals at risk for COPD. A unique feature about this guideline is the simplified practical approach to classify COPD into three classes based on the symptoms as per COPD Assessment Test (CAT) and the risk of exacerbations and hospitalization. Those patients with low risk of exacerbation (COPD patients, as manifested with ≥2 exacerbation or hospitalization in the past year irrespective of the baseline symptoms, are classified as Class III. Class I and II patients require bronchodilators for symptom relief, while Class III patients are recommended to use medications that reduce the risks of exacerbations. The guideline recommends screening for co-morbidities and suggests a comprehensive management approach including pulmonary rehabilitation for those with a CAT score ≥10. The article also discusses the diagnosis and management of acute exacerbations in COPD. PMID:24791168
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FDG PET/CT : EANM procedure guidelines for tumour imaging: version 2.0
Boellaard, Ronald; Delgado-Bolton, Roberto; Oyen, Wim J. G.; Giammarile, Francesco; Tatsch, Klaus; Eschner, Wolfgang; Verzijlbergen, Fred J.; Barrington, Sally F.; Pike, Lucy C.; Weber, Wolfgang A.; Stroobants, Sigrid; Delbeke, Dominique; Donohoe, Kevin J.; Holbrook, Scott; Graham, Michael M.; Testanera, Giorgio; Hoekstra, Otto S.; Zijlstra, Josee; Visser, Eric; Hoekstra, Corneline J.; Pruim, Jan; Willemsen, Antoon; Arends, Bertjan; Kotzerke, Joerg; Bockisch, Andreas; Beyer, Thomas; Chiti, Arturo; Krause, Bernd J.
The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA)
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Berger, R
1986-04-30
The Sun article, "Employers finding that AIDS in the workplace is a managerial nightmare" (April 3), did not accurately portray the status of AIDS in the workplace. The AIDS virus, HTLV III, is transmitted by body fluids, primarily semen and blood, and there is no known risk of transmitting the virus by casual contact in the workplace. The Center for Disease Control (CDC) released guidelines for child care workers last August. Guidelines on preventing transmission of AIDS in the workplace were issued by CDC in November 1985. These guidelines specifically discussed health care, personal service, and food service workers. The recommendations were against routine screening. Furthermore, employment should not be restricted on the basis of a positive HTLV III antibody test. A person with HTLV III infection should be exempt from the workplace only if there are circumstances interfering with job performance. In Maryland, the Governor's Task Force on AIDS has gone on record as endorsing CDC guidelines related to employment. Furthermore, the task force condemns discrimination based on the disease AIDS, AIDS Related Complex (ARC), or HTLV III infection. Increasingly AIDS patients are being considered legally disabled and therefore are protected by federal and state laws prohibiting discrimination on the basis of a handicap. Marylanders who are subjected to mandatory HTLV III screening in the workplace, or if discriminated against on the basis of HTLV III inefction, should contact the Maryland Commission on Human Relations, the Maryland Department of Health and Mental Hygiene, or the Health Education Resource Organization (HERO). All 3 of these resources guarantee confidentiality. It is only by employees reporting incidents that a nightmare in the workplace can be avoided in Maryland. full text
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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.
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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
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2011-04-15
... and comment are not required and need not be employed to make future changes to the guidelines. [[Page..., including the materiality of guarantees and franchise value. Commenters on the proposed large bank pricing...
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In Defense of a Social Value Requirement for Clinical Research.
Wendler, David; Rid, Annette
2017-02-01
Many guidelines and commentators endorse the view that clinical research is ethically acceptable only when it has social value, in the sense of collecting data which might be used to improve health. A version of this social value requirement is included in the Declaration of Helsinki and the Nuremberg Code, and is codified in many national research regulations. At the same time, there have been no systematic analyses of why social value is an ethical requirement for clinical research. Recognizing this gap in the literature, recent articles by Alan Wertheimer and David Resnik argue that the extant justifications for the social value requirement are unpersuasive. Both authors conclude, contrary to almost all current guidelines and regulations, that it can be acceptable across a broad range of cases to conduct clinical research which is known prospectively to have no social value. The present article assesses this conclusion by critically evaluating the ethical and policy considerations relevant to the claim that clinical research must have social value. This analysis supports the standard view that social value is an ethical requirement for the vast majority of clinical research studies and should be mandated by applicable guidelines and policies. © 2017 John Wiley & Sons Ltd.
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Chan, Leighton; Heinemann, Allen W; Roberts, Jason
2014-01-01
Note from the AJOT Editor-in-Chief: Since 2010, the American Journal of Occupational Therapy (AJOT) has adopted reporting standards based on the Consolidated Standards of Reporting Trials (CONSORT) Statement and American Psychological Association (APA) guidelines in an effort to publish transparent clinical research that can be easily evaluated for methodological and analytical rigor (APA Publications and Communications Board Working Group on Journal Article Reporting Standards, 2008; Moher, Schulz, & Altman, 2001). AJOT has now joined 28 other major rehabilitation and disability journals in a collaborative initiative to enhance clinical research reporting standards through adoption of the EQUATOR Network reporting guidelines, described below. Authors will now be required to use these guidelines in the preparation of manuscripts that will be submitted to AJOT. Reviewers will also use these guidelines to evaluate the quality and rigor of all AJOT submissions. By adopting these standards we hope to further enhance the quality and clinical applicability of articles to our readers. Copyright © 2014 by the American Occupational Therapy Association, Inc.
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Incremental guideline formalization with tool support
Serban, Radu; Puig-Centelles, Anna; ten Teije, Annette
2006-01-01
Guideline formalization is recognized as an important component in improving computerized guidelines, which in turn leads to better informedness, lower inter-practician variability and, ultimately, to higher quality healthcare. By means of a modeling exercise, we investigate the role of guideline
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Quality of evidence-based pediatric guidelines
Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin
2005-01-01
Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified
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Guidelines for the adaptation to floods in changing climate
Doroszkiewicz, Joanna; Romanowicz, Renata J.
2017-08-01
A decrease of flood damages in the future requires not only adaptation to flood caused by present day climate, but also climate change effects on floods should be taken into account. The paper illustrates the need to take into account changing climate conditions in flood adaptation strategies and to apply in practice the concept of integrated water resource management (IWRM). IWRM is based on a number of policy instruments, economic instruments, political signals, and also, on the effects of climate change on floods and collaboration across national, regional and local administrative units. The guidelines for a country adaptation to floods in a changing climate are outlined. A comparison of the adaptive capacities in Poland and Norway is used to illustrate the need for the implementation of proposed guidelines to assure flood risk management under climate change in a sustainable way.
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Vitamin D: Current Guidelines and Future Outlook.
Pilz, Stefan; Trummer, Christian; Pandis, Marlene; Schwetz, Verena; Aberer, Felix; Grübler, Martin; Verheyen, Nicolas; Tomaschitz, Andreas; März, Winfried
2018-02-01
Vitamin D is of public health interest because its deficiency is common and is associated with musculoskeletal diseases, as well as extraskeletal diseases, such as cancer, cardiovascular diseases, and infections. Several health authorities have reviewed the existing literature and published nutritional vitamin D guidelines for the general population. There was a wide consensus that serum 25-hydroxyvitamin D [25(OH)D] concentration should be used to assess vitamin D status and intake, and that musculoskeletal, and not extraskeletal, effects of vitamin D should be the basis for nutritional vitamin D guidelines. Recommended target levels for 25(OH)D range from 25 to 50 nmol/l (10 to 20 ng/ml), corresponding to a vitamin D intake of 400 to 800 International Units (10 to 20 μg) per day. It is of concern that significant sections of the general population do not meet these recommended vitamin D levels. This definitely requires action from a public health perspective. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Lin, Ching-Heng; Lo, Ying-Chih; Hung, Pei-Yuan; Liou, Der-Ming
2016-12-07
As a result of the disease's high prevalence, chronic kidney disease (CKD) has become a global public health problem. A clinical decision support system that integrates with computer-interpretable guidelines (CIGs) should improve clinical outcomes and help to ensure patient safety. The openEHR guideline definition language (GDL) is a formal language used to represent CIGs. This study explores the feasibility of using a GDL approach for CKD; it also attempts to identify any potential gaps between the ideal concept and reality. Using the Kidney Disease Improving Global Outcomes (KDIGO) anemia guideline as material, we designed a development workflow in order to establish a series of GDL guidelines. Focus group discussions were conducted in order to identify important issues related to GDL implementation. Ten GDL guidelines and 37 archetypes were established using the KDIGO guideline document. For the focus group discussions, 16 clinicians and 22 IT experts were recruited and their perceptions, opinions and attitudes towards the GDL approach were explored. Both groups provided positive feedback regarding the GDL approach, but raised various concerns about GDL implementation. Based on the findings of this study, we identified some potential gaps that might exist during implementation between the GDL concept and reality. Three directions remain to be investigated in the future. Two of them are related to the openEHR GDL approach. Firstly, there is a need for the editing tool to be made more sophisticated. Secondly, there needs to be integration of the present approach into non openEHR-based hospital information systems. The last direction focuses on the applicability of guidelines and involves developing a method to resolve any conflicts that occur with insurance payment regulations.
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Dizon, Janine Margarita; Machingaidze, Shingai; Grimmer, Karen
2016-09-13
Developing new clinical practice guidelines (CPGs) can be time-consuming and expensive. A more efficient approach could be to adopt, adapt or contextualise recommendations from existing good quality CPGs so that the resultant guidance is tailored to the local context. The first steps are to search for international CPGs that have a similar purpose, end-users and patients to your situation. The second step is to critically appraise the methodological quality of the CPGs to ensure that your guidance is based on credible evidence. Then the decisions begin. Can you simply 'adopt' this (parent) clinical practice guidelines, and implement the recommendations in their entirety, without any changes, in your setting? If so, then no further work is required. However this situation is rare. What is more likely, is that even if recommendations from the parent clinical practice guidelines can be adopted, how they are implemented needs to address local issues. Thus you may need to 'contextualise' the guidance, by addressing implementation issues such as local workforce, training, health systems, equipment and/or access to services. Generally this means that additional information is required (Practice/Context Points) to support effective implementation of the clinical practice guidelines recommendations. In some cases, you may need to 'adapt' the guidance, where you will make changes to the recommendations so that care is relevant to your local environments. This may involve additional work to search for local research, or obtain local consensus, regarding how best to adapt recommendations. For example, adaptation might reflect substituting one drug for another (drugs have similar effects, but the alternative drug to the recommended one may be cheaper, more easily obtained or more culturally acceptable). There is lack of standardisation of clinical practice guidelines terminology, leading clinical practice guideline activities often being poorly conceptualised or reported. We
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International Nuclear Information System (INIS)
Anon.
1983-01-01
In accordance with the requirements of the Nuclear Waste Policy Act of 1982 (Pub. L. 97-425), hereinafter referred to as the Act, the Department of Energy is proposing general guidelines for the recommendation of sites for repositories for disposal of high-level radioactive waste and spent nuclear fuel in geologic formations. These guidelines are based on the criteria that the Department has used in its National Waste Terminal Storage program, the criteria proposed by the Nuclear Regulatory Commission (NRC), and the environmental standards proposed by the Environmental Protection Agency. These guidelines establish the performance requirements for a geologic repository system, specify how the Department will implement its site-selection program, and define the technical qualifications that candidate sites must meet in the various steps of the site-selection process mandated by the Act. After considering comments from the public; consulting with the Council on Environmental Quality, the Administrator of the Environmental Protection Agency, the Director of the Geological Survey, and interested Governors; and obtaining NRC concurrence, the Department will issue these guidelines in final form as a new Part 960 to Title 10 of the Code of Federal Regulations (10 CFR Part 960)
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Whitebark pine planting guidelines
Ward McCaughey; Glenda L. Scott; Kay L. Izlar
2009-01-01
This article incorporates new information into previous whitebark pine guidelines for planting prescriptions. Earlier 2006 guidelines were developed based on review of general literature, research studies, field observations, and standard US Forest Service survival surveys of high-elevation whitebark pine plantations. A recent study of biotic and abiotic factors...
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Measure Guideline: Ventilation Cooling
Energy Technology Data Exchange (ETDEWEB)
Springer, D. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), David, CA (United States)
2012-04-01
The purpose of this measure guideline is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.
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Directory of Open Access Journals (Sweden)
Carmel Jacobs
consistently lower than the others over both domains. No journals adhered to all the items related to the transparency of document development. One journal's consensus statements endorsed a product made by the sponsoring pharmaceutical company in 64% of cases.Guidance documents are an essential part of oncology care and should be subjected to a rigorous and validated development process. Consensus statements had lower methodological quality than clinical practice guidelines using AGREE II. At a minimum, journals should ensure that that all consensus statements and clinical practice guidelines adhere to AGREE II criteria. Journals should consider explicitly requiring guidelines to declare pharmaceutical company sponsorship and to identify the sponsor's product to enhance transparency.
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Guidelines for Stretch Flanging Advanced High Strength Steels
International Nuclear Information System (INIS)
Sriram, S.; Chintamani, J.
2005-01-01
Advanced High Strength Steels (AHSS) are currently being considered for use in closure and structural panels in the automotive industry because of their high potential for affordable weight reduction and improved performance. AHSS such as dual phase steels are currently being used in some vehicle platforms. From a manufacturing perspective, stretch flanging during stamping is an important deformation mode requiring careful consideration of geometry and the die process. This paper presents some geometric and process guidelines for stretch flanging AHSS. Hole expansion experiments were conducted to determine the failure limit for a sheared edge condition. Effects of punching clearance, prestrain and prior strain path on hole expansion were explored in these experiments. In addition, dynamic explicit FE calculations using LS-DYNA were also conducted for a typical stretch flange by varying some key geometric parameters. The experimental and FEA results were then analyzed to yield process and geometric guidelines to enable successful stretch flanging of AHSS
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Comparing an Unstructured Risk Stratification to Published Guidelines in Acute Coronary Syndromes.
Beck, Ann-Jean C C; Hagemeijer, Anouk; Tortolani, Bess; Byrd, Bethany A; Parekh, Amisha; Datillo, Paris; Birkhahn, Robert
2015-09-01
at correctly placing patients with underlying ACS into a high-risk category. A small percentage of patients were considered low risk when applying AHA/ACC/ACEP guidelines, which demonstrates how clinical insight is often required to make an efficient assessment of cardiac risk and established criteria may be overly conservative when applied to an acute care population.
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Standards and Guidelines in Telemedicine and Telehealth
Krupinski, Elizabeth A.; Bernard, Jordana
2014-01-01
The development of guidelines and standards for telemedicine is an important and valuable process to help insure effective and safe delivery of quality healthcare. Some organizations, such as the American Telemedicine Association (ATA), have made the development of standards and guidelines a priority. The practice guidelines developed so far have been well received by the telemedicine community and are being adopted in numerous practices, as well as being used in research to support the practice and growth of telemedicine. Studies that utilize published guidelines not only help bring them into greater public awareness, but they also provide evidence needed to validate existing guidelines and guide the revision of future versions. Telemedicine will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of forms not just in the traditional clinical environments, and practice guidelines will be a key factor in fostering this growth. Creation of guidelines is important to payers and regulators as well as increasingly they are adopting and integrating them into regulations and policies. This paper will review some of the recent ATA efforts in developing telemedicine practice guidelines, review the role of research in guidelines development, review data regarding their use, and discuss some of areas where guidelines are still needed. PMID:27429261
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Graham, Tanya; Alderson, Phil; Stokes, Tim
2015-01-01
There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence). Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE's guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis. Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take "on trust" the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills. We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice.
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Directory of Open Access Journals (Sweden)
Tanya Graham
Full Text Available There is international concern that conflicts of interest (COI may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence.Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE's guideline development centres and 6 chairs of guideline development groups (GDGs. We conducted a thematic analysis.Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take "on trust" the information they receive, certain types of COI (non-financial are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills.We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice.
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Hesketh, Kylie D; Downing, Katherine L; Campbell, Karen; Crawford, David; Salmon, Jo; Hnatiuk, Jill A
2017-11-20
Little information is available on the movement behaviours of infants, despite evidence that these are important for development. The release of new Australian 24-hour Movement Guidelines provides an opportunity to document the current state of movement behaviours in infants relative to these guidelines. The aim of this study was to report the prevalence of 4 month old Australian infants meeting the 24-hour Movement Guidelines, individually, and in combination, and to describe associations with individual characteristics. Maternal report baseline data from the Melbourne Infant Feeding, Activity and Nutrition Trial Program were used to determine prevalence of infants meeting physical activity (30 min of tummy time per day), sedentary behaviour (no more than 1 h at a time kept restrained; zero screen time), and sleep guidelines (14-17 h for 0-3 month olds or 12-16 h for 4-11 month olds). Prevalence of infants meeting combined guidelines was also described. The odds of meeting guidelines based on infant and family characteristics was determined. Data are reported for 455 infants with a mean age of 3.6 months (SD = 1.0). The proportion of infants meeting each of the guidelines was 29.7% for tummy time, 56.9% for kept restrained, 27.9% for screen time, 58.7% for sleep and 3.5% for the combined guidelines (i.e. meeting all four guidelines). A significantly higher proportion of girls than boys met the screen time guideline (32.5% versus 24.0%, p = 0.04) and the combined guidelines (5.7% versus 1.6%, p = 0.01). Few associations were observed between infant and family characteristics and proportion of infants meeting individual guidelines. Very few infants met all of the guidelines contained in the new Australian 24-hour Movement Guidelines suggesting there is much room for improvement in movement behaviours from early life. Fewer infants met the tummy time and screen time guidelines hence these appear to be the behaviours requiring most attention. Parents and
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Human Engineering Guidelines for Management Information Systems. Change 1,
1983-06-09
beginner . chapter offers guidelines concerning training. 0 A brief review available for the infrequent user. Major training factors * A program for a...the training include a program specifically designed L Li LL for the beginner or naive user? 8. Is there a brief review for the intermittent user? Ei Li...250 pages of text. Flowchart - A graphic representation, using standard symbols, which portrays logical data and process- ing requirements. Formatting
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Radiation processing of flue gases: Guidelines for feasibility studies
Energy Technology Data Exchange (ETDEWEB)
NONE
2000-12-01
The aim of this publication is to facilitate the performance of feasibility studies for Electron Beam flue gas cleanup projects by providing guidelines to conduct these studies and compiling information on the state of the art. This document summarizes the contents of a feasibility study; discusses the main items in plant construction, measurement and control systems, radiation safety and building construction; and lists the required economic data for internationally funded projects.
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Radiation processing of flue gases: Guidelines for feasibility studies
International Nuclear Information System (INIS)
2000-12-01
The aim of this publication is to facilitate the performance of feasibility studies for Electron Beam flue gas cleanup projects by providing guidelines to conduct these studies and compiling information on the state of the art. This document summarizes the contents of a feasibility study; discusses the main items in plant construction, measurement and control systems, radiation safety and building construction; and lists the required economic data for internationally funded projects
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Raising the Bar with Trades Staffing Guidelines.
Weidner, Theodore J.
2000-01-01
Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)
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78 FR 38102 - Passenger Vessels Accessibility Guidelines
2013-06-25
... Costs and Benefits The primary estimates of the costs and benefits of the proposed guidelines are shown... quantify the benefits of the proposed guidelines due to the nature of the benefits. The proposed guidelines..., transportation, public accommodation, and leisure. The proposed guidelines would enable these individuals to...
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Revised DTI Guidelines for Petroleum Measurement
Energy Technology Data Exchange (ETDEWEB)
Griffin, D.; Philip, L.N.
1997-07-01
The DTI's guidelines on petroleum measurement have been extensively revised and enlarged. The new guidelines cover a much wider scope of measurement situations than before. Included in the new issue is guidance on allocation measurement, well testing, multiphase flow measurement, new technology acceptance procedures and operating procedures for different types of measurement systems. Significant changes have taken place in recent years both in the way the oil and gas industry conducts its business and in the fiscal regime operated by the UK government. New developments in flow measurement have progressed to such an extent that they have now been adopted by the industry or are close to being adopted as beneficial methods of the measurement of hydrocarbons in whatever form they present themselves for measurement. The rapid pace of development has left the standards-making bodies behind and in some cases there is insufficient quality data to enable the standards makers to produce guidance of the generic type appropriate for national or international standards. The case-by-case approach of the DTI in approving methods of measurement lends itself better to consideration of new technology where there may be no existing standards. These, amongst other considerations, make it appropriate for the DTI to extend the scope of its guidance into these new areas. The policy developments behind the changes in the new guidelines are not static and this new document has been produced in response to an evolutionary process which is still continuing but it is right to collate and make defining statements from time to time to put on record the current status of measurement requirements for the purpose of attaining DTI approval. (author)
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28 CFR 23.30 - Funding guidelines.
2010-07-01
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Funding guidelines. 23.30 Section 23.30 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL INTELLIGENCE SYSTEMS OPERATING POLICIES § 23.30 Funding guidelines. The following funding guidelines shall apply to all Crime Control Act funded...
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5 CFR 724.403 - Advisory guidelines.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Advisory guidelines. 724.403 Section 724.403 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... RETALIATION ACT OF 2002 Best Practices § 724.403 Advisory guidelines. OPM will issue advisory guidelines to...
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Energy Technology Data Exchange (ETDEWEB)
1993-09-01
The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.
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Inspector qualification guidelines
International Nuclear Information System (INIS)
Batty, A.C.; Van Binnebeek, J.J.; Ericsson, P.O.; Fisher, J.C.; Geiger, P.; Grandame, M.; Grimes, B.K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.
1994-07-01
The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied
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Inspector qualification guidelines
Energy Technology Data Exchange (ETDEWEB)
Batty, A. C.; Van Binnebeek, J. J.; Ericsson, P. O.; Fisher, J. C.; Geiger, P.; Grandame, M.; Grimes, B. K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.
1994-07-15
The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied.
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Guidelines for Posting Soil Contamination Areas
Energy Technology Data Exchange (ETDEWEB)
Mcnaughton, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Eisele, William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
2016-02-01
All soil guidelines were determined using RESRAD, version 6.1. All offsite guidelines are based on 15 mrem/year. This dose rate is sufficiently low to protect human health and is in accordance with DOE guidance and the proposed EPA 40-CFR-196 regulations for members of the public (never promulgated). For those onsite areas where general employees (non-radiological workers) could have routine access, soil concentrations should be based on a dose rate of 30 mrem/year (approximately one-third of the onsite LANL non-radiological worker dose of 100 mrem/year). In this case, soil concentration guidelines may be obtained by doubling the 15 mrem/year guidelines. Several scenarios were developed to provide maximum flexibility for application of the guidelines. The offsite guidelines were developed using: residential scenarios for both adults and children; a construction worker scenario; a resource user (e.g., a hunter) scenario; a child playing within canyon reaches scenario, a trail using jogger within canyon reaches scenario, and a trail using hiker within canyon reaches scenario. The residential guidelines represent the lowest values from both the adult residential scenario and the child residential scenario.
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Incident reviews in UK maternity units: a systematic appraisal of the quality of local guidelines.
Shah, Anjali; Mohamed-Ahmed, Olaa; Peirsegaele, Philippe; McClymont, Charlotte; Knight, Marian
2015-03-14
Maternity care is recognised as a particularly high-risk speciality that is subject to investigation and inquiry, and improvements in risk management have been recommended. However, the quality of guidelines for local reviews of maternity incidents is unknown. The aim of the study is to appraise the quality of local guidance on conducting reviews of severe maternity incidents in the National Health Service. Guidelines for incident reviews were requested from all 211 consultant-led maternity units in the UK during 2012. The Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) was used to evaluate the quality of guidelines. The methods used for reviewing an incident, the people involved in the review and the methods for disseminating the outcomes of the reviews were also examined. Guidelines covering 148 (70%) of all NHS maternity units in the UK were received for evaluation. Most guidelines (55%) received were of good or high quality. The median score on 'scope and purpose' (86%), concerned with the aims and target population of the guideline, was higher than for other domains. Median scores were: 'stakeholder involvement' (representation of users' views) 56%, 'rigour of development' (process used to develop guideline) 34%, 'clarity of presentation' 78%, 'applicability' (organisational and cost implications of applying guideline) 56% and 'editorial independence' 0%. Most guidelines (81%) recommended a range of health professionals review serious maternity incidents using root cause analysis. Findings were most often disseminated at meetings, in reports and in newsletters. Many guidelines (69%) stated lessons learnt from incidents would be audited. Overall, local guidance for the review of maternity incidents was mostly of good or high quality. Stakeholder participation in guideline development could be widened, and editorial independence more clearly stated. It was unclear in over a quarter of guidelines whether changes in practice in response
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International Nuclear Information System (INIS)
1992-01-01
A pulp and paper company in St. George, New Brunswick, is proposing to redevelop an existing hydroelectric plant built around 1900. The redevelopment proposal consists of decommissioning the existing powerhouse, constructing a new powerhouse containing a 12-MW Kaplan turbine, excavating a tailrace channel, and installing a new penstock. Other design considerations include improvements to gates in the main dam for improved flood control and modifications to the trash racks to prevent potential fish mortality. The provincial environment ministry has determined that an environmental impact assessment of the potential impacts of the redevelopment was required. Guidelines to be used in the assessment process are presented, including definition of the study boundaries, prediction of environmental effects, description of methods of mitigating and compensating for anticipated impacts, a commitment to monitoring and public consultation, and submittal of terms of reference in response to final assessment guidelines. Requirements for conducting the assessment study and content of the report are also listed. 1 fig
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40 CFR 766.12 - Testing guidelines.
2010-07-01
... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Testing guidelines. 766.12 Section 766... DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.12 Testing guidelines. Analytical test methods must be developed using methods equivalent to those described or reviewed in Guidelines for the...
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76 FR 63565 - Event Reporting Guidelines
2011-10-13
...-2011-0237] Event Reporting Guidelines AGENCY: Nuclear Regulatory Commission. ACTION: Draft NUREG... comments on Draft NUREG-1022, Revision 3, ``Event Reporting Guidelines: 10 CFR 50.72 and 50.73''. The NUREG-1022 contains guidelines that the NRC staff considers acceptable for use in meeting the event reporting...
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Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin
2016-08-15
Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors' FCOI declarations in guidelines from the Canadian Medical Association (CMA) Infobase. We also assess the financial relationships between guideline-affiliated organizations and drug companies. Using a population approach, we extracted first-line drug recommendations and authors' FCOI disclosures in guidelines from the CMA Infobase. We contacted the corresponding authors on guidelines when FCOI disclosures were missing for some or all authors. We also extracted guideline-affiliated organizations and searched each of their websites to determine if they had financial relationships with drug companies. We analyzed 350 authors from 28 guidelines. Authors were named on one, two, or three guidelines, yielding 400 FCOI statements. In 75.0 % of guidelines at least one author, and in 21.4 % of guidelines all authors, disclosed FCOI with drug companies. In 54.0 % of guidelines at least one author, and in 28.6 % of guidelines over half of the authors, disclosed FCOI with manufacturers of drugs that they recommended. Twenty of 48 authors on multiple guidelines reported different FCOI in their disclosures. Eight guidelines identified affiliated organizations with financial relationships with manufacturers of drugs recommended in those guidelines. This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by
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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.
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Strengthening the Enforcement of CSR Guidelines
DEFF Research Database (Denmark)
Olsen, Birgitte Egelund; Sørensen, Karsten Engsig
2014-01-01
the extensive right to refer complaints to them, the broad scope of the recommendations in the Guidelines and especially the use of naming and shaming in cases of breaches of the Guidelines, has changed the original character of the Guidelines as a purely soft law instrument. Furthermore, it is shown...... that the use of very broad and vague terminology in the Guidelines makes it very difficult for enterprises to comply with them. This is further complicated by the fact that many of the terms, which lay down when the NCPs have jurisdiction, are not clearly defined or explained. The three NCPs examined have...... implemented the Guidelines very differently. In particular the Danish NCP stands out. It has a jurisdiction which in many respects goes far beyond that envisioned in the Guidelines. This may put in question the legitimacy and effectiveness of the Danish NCP, but at the same time it can also be viewed...
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10 CFR 960.5-1 - System guidelines.
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false System guidelines. 960.5-1 Section 960.5-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-1 System guidelines. (a) Qualifying conditions—(1) Preclosure...
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[Preoperative fasting guidelines: an update].
López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J
2015-03-01
Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.
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At Northern Illinois U., Leaders Grapple with a Tragedy
Sander, Libby
2008-01-01
At even the best-prepared universities, there is no playbook for handling the crush of tough decisions that comes after a mass shooting rocks an otherwise quiet campus. While colleges and universities have always had tragedies, recent occurences like the shootings at Northern Illinois University and Virginia Tech have fundamentally changed the way…
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Hahn, H.
2011-01-01
There are many good reasons to implement a biogas plant ranging from environmental protection and waste reduction to renewable energy production. It can also include financial and non-financial incentives. Nevertheless, investors of biogas projects should be well informed about different legal requirements and financing possibilities. The guideline will help to analyse a potential biogas investment by describing its most important steps. The guideline starts with the project idea and a first ...
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Water chemistry guidelines for BWRs
International Nuclear Information System (INIS)
Bilanin, W.J.; Jones, R.L.; Welty, C.S.
1984-01-01
Guidelines for BWR water chemistry control have been prepared by a committee of experienced utility industry personnel sponsored by the BWR Owners Group on IGSCC Research and coordinated by the Electric Power Research Institute. The guidelines are based on extensive plant operational experience and laboratory research data. The purpose of the guidelines is to provide guidance to the electric utility industry on water chemistry control to help reduce corrosion, especially stress corrosion cracking, in boiling water reactors
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5 CFR 1310.1 - Policy guidelines.
2010-01-01
... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Policy guidelines. 1310.1 Section 1310.1 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES OMB CIRCULARS § 1310.1 Policy guidelines. In carrying out its responsibilities, the Office of Management and Budget issues policy guidelines to...
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Guidelines for the use of cell lines in biomedical research.
Geraghty, R J; Capes-Davis, A; Davis, J M; Downward, J; Freshney, R I; Knezevic, I; Lovell-Badge, R; Masters, J R W; Meredith, J; Stacey, G N; Thraves, P; Vias, M
2014-09-09
Cell-line misidentification and contamination with microorganisms, such as mycoplasma, together with instability, both genetic and phenotypic, are among the problems that continue to affect cell culture. Many of these problems are avoidable with the necessary foresight, and these Guidelines have been prepared to provide those new to the field and others engaged in teaching and instruction with the information necessary to increase their awareness of the problems and to enable them to deal with them effectively. The Guidelines cover areas such as development, acquisition, authentication, cryopreservation, transfer of cell lines between laboratories, microbial contamination, characterisation, instability and misidentification. Advice is also given on complying with current legal and ethical requirements when deriving cell lines from human and animal tissues, the selection and maintenance of equipment and how to deal with problems that may arise.
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Design Guidelines for Low Crested Structures
DEFF Research Database (Denmark)
Burcharth, H. F.; Lamberti, Alberto
2004-01-01
1998-2002. The Guidelines comprise engineering aspects related to morphological impact and structure stability, biological aspects related to ecological impact, and socio-economical aspects related to the implementation of LCS-schemes. The guidelines are limited to submerged and regularly overtopped......The paper presents an overview of the design guidelines for low crested structures (LCS's) to be applied in coastal protection schemes. The design guidelines are formulated as a part of the research project: Environmental Design of Low Crested Coastal Defence Structures (DELOS) within the EC 5FP...
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Methodological Quality of Consensus Guidelines in Implant Dentistry.
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.
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Medford, Andrew Rl; Pepperell, Justin Ct
2007-10-01
In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. To determine adherence to the 2003 BTS SP guidelines in a district general hospital. An initial retrospective audit of 52 episodes of acute SP was performed. Subsequent intervention involved a junior doctor educational update on both the 2003 BTS guidelines and the initial audit results, and the setting up of an online guideline hyperlink. After the educational intervention a further prospective re-audit of 28 SP episodes was performed. Management of SP deviated considerably from the 2003 BTS guidelines in the initial audit - deviation rate 26.9%. After the intervention, a number of clinical management deviations persisted (32.1% deviation rate); these included failure to insert a chest drain despite unsuccessful aspiration, and attempting aspiration of symptomatic secondary SPs. Specific tools to improve standards might include a pneumothorax proforma to improve record keeping and a pneumothorax care pathway to reduce management deviations compared to BTS guidelines. Successful change also requires identification of the total target audience for any educational intervention.
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Nachamkin, Irving; Kirn, Thomas J; Westblade, Lars F; Humphries, Romney
2017-11-01
As part of the American Society for Microbiology (ASM) Evidence-Based Laboratory Medicine Practice Guidelines Committee of the Professional Practice Committee, an ad hoc committee was formed in 2014 to assess guidelines published by the committee using an assessment tool, Appraisal of Guidelines for Research Evaluation II (AGREE II). The AGREE II assessment helps reviewers determine whether published guidelines are robust, transparent, and clear in presenting practice recommendations in a standardized manner. Identifying strengths and weaknesses of practice guidelines by ad hoc assessments helps with improving future guidelines through the participation of key stakeholders. This minireview describes the development of the ad hoc committee and results from their review of several ASM best practices guidelines and a non-ASM practice guideline from the Emergency Nurses Association. Copyright © 2017 American Society for Microbiology.
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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
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Guidelines for Learning Stations.
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…
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The Use of a Well-Designed Instructional Guideline in Online MBA Teaching
Duesing, Robert J.; Ling, Juan; Yang, Jiaqin
2016-01-01
This study investigated the positive impact of a teaching practice on student learning outcomes in an online MBA program. An instructional project guideline was developed to help online students enhance their achieving required learning objectives corresponding to five categories of Bloom's Taxonomy. The course learning objectives are based on…
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International Nuclear Information System (INIS)
Anon.
1978-01-01
Present knowledge of the relevant physical, chemical, and biological properties of radiocerium as a basis for establishing radiation protection guidelines is summarized. The first section of the report reviews the chemical and physical properties of radiocerium relative to the biological behavior of internally-deposited cerium and other lanthanides. The second section of the report gives the sources of radiocerium in the environment and the pathways to man. The third section of the report describes the metabolic fate of cerium in several mammalian species as a basis for predicting its metabolic fate in man. The fourth section of the report considers the biomedical effects of radiocerium in light of extensive animal experimentation. The last two sections of the report describe the history of radiation protection guidelines for radiocerium and summarize data required for evaluating the adequacy of current radiation protection guidelines. Each section begins with a summary of the most important findings that follow
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Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines
Min, Seung-Kee; Kim, Young Hwan; Joh, Jin Hyun; Kang, Jin Mo; Park, Ui Jun; Kim, Hyung-Kee; Chang, Jeong-Hwan; Park, Sang Jun; Kim, Jang Yong; Bae, Jae Ik; Choi, Sun Young; Kim, Chang Won; Park, Sung Il; Yim, Nam Yeol; Jeon, Yong Sun; Yoon, Hyun-Ki; Park, Ki Hyuk
2016-01-01
Lower extremity deep vein thrombosis is a serious medical condition that can result in death or major disability due to pulmonary embolism or post-thrombotic syndrome. Appropriate diagnosis and treatment are required to improve symptoms and salvage the affected limb. Early thrombus clearance rapidly resolves symptoms related to venous obstruction, restores valve function and reduces the incidence of post-thrombotic syndrome. Recently, endovascular treatment has been established as a standard method for early thrombus removal. However, there are a variety of views regarding the indications and procedures among medical institutions and operators. Therefore, we intend to provide evidence-based guidelines for diagnosis and treatment of lower extremity deep vein thrombosis by multidisciplinary consensus. These guidelines are the result of a close collaboration between interventional radiologists and vascular surgeons. The goals of these guidelines are to improve treatment, to serve as a guide to the clinician, and consequently to contribute to public health care. PMID:27699156
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Fertility and pregnancy in thalassaemia and sickle cell disease. The UK guidelines
Directory of Open Access Journals (Sweden)
Bernard Davis
2014-12-01
Full Text Available Progressive improvements in the health and survival of patients with thalassaemia and sickle cell disease have increased the reproductive prospects of affected individuals. However, pregnancy in these disorders is associated with significant maternal and fetal risks and expert management is required to ensure good outcomes. In the United Kingdom, it is recognised that the patchy geographical distribution of these conditions poses challenges for access to specialist care, including specialist obstetric services. Guidelines on the pregnancy management of thalassaemia and sickle cell disease in the UK have been published by the Royal College of Obstetricians and Gynaecologists. These guidelines describe the preconceptual, antenatal, intrapartum and postpartum aspects of care. They highlight the high-risk status of pregnancy in these conditions and emphasise the vital importance of specialist multidisciplinary care to the achievement of favourable maternal and fetal outcomes. The guidelines are a valuable resource to healthcare professionals, especially those working in low prevalence areas.
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Computer system validation: an overview of official requirements and standards.
Hoffmann, A; Kähny-Simonius, J; Plattner, M; Schmidli-Vckovski, V; Kronseder, C
1998-02-01
A brief overview of the relevant documents for companies in the pharmaceutical industry, which are to be taken into consideration to fulfil computer system validation requirements, is presented. We concentrate on official requirements and valid standards in the USA, European Community and Switzerland. There are basically three GMP-guidelines. their interpretations by the associations of interests like APV and PDA as well as the GAMP Suppliers Guide. However, the three GMP-guidelines imply the same philosophy about computer system validation. They describe more a what-to-do approach for validation, whereas the GAMP Suppliers Guide describes a how-to-do validation. Nevertheless, they do not contain major discrepancies.
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42 CFR 438.236 - Practice guidelines.
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Practice guidelines. 438.236 Section 438.236 Public... Improvement Standards § 438.236 Practice guidelines. (a) Basic rule: The State must ensure, through its...) Adoption of practice guidelines. Each MCO and, when applicable, each PIHP and PAHP adopts practice...
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22 CFR 214.42 - Uniform pay guidelines.
2010-04-01
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Uniform pay guidelines. 214.42 Section 214.42... Advisory Committees § 214.42 Uniform pay guidelines. (a) A.I.D. follows OMB/CSC guidelines in section 11 of... experts, their compensation shall be fixed in accordance with CSC guidelines and regulations, and the...
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National synchrotron light source guidelines for the conduct of operations
International Nuclear Information System (INIS)
Buckley, M.
1998-01-01
To improve the quality and uniformity of operations at the Department of Energy's facilities, the DOE issued Order 5480.19 ''Conduct of Operations Requirements at DOE facilities.'' This order recognizes that the success of a facility's mission critically depends upon a high level of performance by its personnel and equipment. This performance can be severely impaired if the facility's Conduct of Operations pays inadequate attention to issues of organization, safety, health, and the environment. These guidelines are Brookhaven National Laboratory's and the National Synchrotron Light Source's acknowledgement of the principles of Conduct of Operations and the response to DOE Order 5480.19. These guidelines cover the following areas: (1) operations organization and administration; (2) shift routines and operating practices; (3) control area activities; (4) communications; (5) control of on-shift training; (6) investigation of abnormal events; (7) notifications; (8) control of equipment and system studies; (9) lockouts and tagouts; (10) independent verification; (11) log-keeping; (12) operations turnover; (13) operations aspects of facility process control (14) required reading; (15) timely orders to operators; (16) operations procedures; (17) operator aid posting; and (18) equipment sizing and labeling
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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.
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Analysis of the 2015 American and European guidelines for the management of infective endocarditis.
Tattevin, P; Mainardi, J-L
2016-12-01
The optimal management of infective endocarditis requires a broad range of expertise (infectious disease specialists, cardiologists, microbiologists, cardiac surgeons, and intensivists). Given the low level of evidence currently available to support the management of infective endocarditis, international guidelines have always been particularly awaited and rather well implemented. Their cautious analysis of the medical literature and the range of expertise combined within the groups in charge of these guidelines are usually broadly acknowledged and respected. The publications, a few weeks apart, of the 2015 updates of the American and European guidelines, was quite disturbing. Indeed, several discrepancies on major therapeutic propositions were observed, including empirical treatment (penicillin M+penicillin A+gentamicin for Europeans in acutely ill patients; penicillin A+beta-lactamase inhibitor+gentamicin for Americans), or first-line treatment for the most common pathogen responsible for endocarditis in 2016, Staphylococcus aureus (trimethoprim-sulfamethoxazole+clindamycin as an alternative in the European guidelines, while this regimen is not even mentioned in the American guidelines). Other discrepancies were observed, although less significant: the role of positron emission tomography labelled with 18 F-fluorodeoxyglucose and administration modalities for aminoglycosides. We aimed to detail the main changes brought upon by these guidelines, their discrepancies, and the 'pros' and 'cons' that may help you select the best treatment regimen for your patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
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Fayed, Reham; Hamza, Dina; Abdallah, Heba; Kelany, Mohamed; Tahseen, Amira; Aref, Adel T
2017-01-01
region. Creating a national breast screening programme and a reliable database is essential. A regional guideline is required to establish the best possible management of breast cancer according to the patients and disease specification as well as the regional socioeconomic factors and facilities available. There is also a need to improve clinical research that meets the region's needs.
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Clinical practice guidelines in patient management
Directory of Open Access Journals (Sweden)
Santosh Kumar
2001-01-01
Full Text Available Efforts have always been made to evolve certain prin-ciples to reduce the variability in the management of patients and make medical care more appropriate. These efforts have become almost a movement since 1980s as evidenced in the development of clinical practice guide-lines in all medical disciplines. This article describes the need for clinical practice guidelines and their de-velopment methods and qualities. Advantages and limi-tations of clinical practice guidelines are enumerated. The salient features of various available clinical prac-tice guidelines in urology are also described.
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2010-04-01
Distribution centers (DC) have become more common in Texas over the past decade. As : major generators of large truck traffic, DCs can increase design and maintenance requirements of : Texas highway facilities. This handbook contains guidelines for u...
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Japanese encephalitis: a review of clinical guidelines and vaccine availability in Asia
Batchelor, Patricia; Petersen, Kyle
2015-01-01
Travelers to Asia are at risk for acquiring Japanese Encephalitis (JEV), an arbovirus with high rates of morbidity and mortality. Recent advances in vaccination resulting in vaccines with low rates of side effects have strengthened the rationale to vaccinate more travelers to this region, as reflected in many updated national guidelines for prevention of disease in travelers. Vaccines however still require a complex pre-travel schedule and are costly, often leading to a requirement or desire ...
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Endoscopic training in gastroenterology fellowship: adherence to core curriculum guidelines.
Jirapinyo, Pichamol; Imaeda, Avlin B; Thompson, Christopher C
2015-12-01
The Gastroenterology Core Curriculum and American Society of Gastrointestinal Endoscopy provide guidelines for endoscopic training. Program adherence to these recommendations is unclear. This study aims to assess endoscopic training experience during fellowship. Questionnaire study. The questionnaire was circulated to US fellowship programs, with the assistance of the American Gastroenterological Association. Graduating third-year fellows. Seventy-three fellows returned the questionnaire. Nearly all fellows met the required numbers for esophagoduodenoscopy (98%) and colonoscopy (100%), with fewer meeting requirements for PEG (73%) and non-variceal hemorrhage (75%). The majority of fellows did not meet minimum numbers for variceal banding (40%), esophageal dilation (43%), capsule endoscopy (42%). Fellows rated training in cognitive aspects of endoscopy as 3.86 [1 (inadequate), 5 (excellent)] and reported greatest emphasis on interpreting endoscopic findings and least on virtual colonography. Quality indicators of endoscopy received little emphasis (rating of 3.04; p = 0.00001), with adenoma detection rate being least emphasized. Fifty-six percent of fellows reported having routine endoscopy conferences. Half of the programs have endoscopic simulators, with 15% of fellows being required to use simulation. Following direct hands-on experience, fellows rated external endoscopy courses (64%) as the next most useful experience. Many fellows do not meet required numbers for several endoscopic procedures, and quality indicators receive little emphasis during training. Most programs do not provide simulation training or hold regular endoscopy conferences. Fellowship programs should perform internal audits and make feasible adjustments. Furthermore, it may be time for professional societies to revisit training guidelines.
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Energy Technology Data Exchange (ETDEWEB)
Kawamura, Hirotaka, E-mail: kawamuh@criepi.denken.or.jp [Central Research Institute of Electric Power Industry (Japan); Hirano, Hideo [Central Research Institute of Electric Power Industry (Japan); Katsumura, Yousuke [University of Tokyo (Japan); Uchida, Shunsuke [Tohoku University (Japan); Mizuno, Takayuki [Mie University (Japan); Kitajima, Hideaki; Tsuzuki, Yasuo [Japan Nuclear Safety Institute (Japan); Terachi, Takumi [Institute of Nuclear Safety System, Inc. (Japan); Nagase, Makoto; Usui, Naoshi [Hitachi-GE Nuclear Energy, Ltd. (Japan); Takagi, Junichi; Urata, Hidehiro [Toshiba Corporation (Japan); Shoda, Yasuhiko; Nishimura, Takao [Mitsubishi Heavy Industry, Ltd. (Japan)
2016-12-01
Highlights: • Framework of BWR/PWR water chemistry Guidelines in Japan are presented. • Guideline necessity, definitions, philosophy and technical background are mentioned. • Some guideline settings for control parameters and recommendations are explaines. • Chemistry strategy is also mentioned. - Abstract: After 40 years of light water reactor (LWR) operations in Japan, the sustainable development of water chemistry technologies has aimed to ensure the highest coolant system component integrity and fuel reliability performance for maintaining LWRs in the world; additionally, it aimed to achieve an excellent dose rate reduction. Although reasonable control and diagnostic parameters are utilized by each boiling water reactor (BWR) and pressurized water reactor (PWR) owner, it is recognized that specific values are not shared among everyone involved. To ensure the reliability of BWR and PWR operation and maintenance, relevant members of the Atomic Energy Society of Japan (AESJ) decided to establish guidelines for water chemistry. The Japanese BWR and PWR water chemistry guidelines provide strategies to improve material and fuel reliability performance as well as to reduce dosing rates. The guidelines also provide reasonable “control values”, “diagnostic values” and “action levels” for multiple parameters, and they stipulate responses when these levels are exceeded. Specifically, “conditioning parameters” are adopted in the Japanese PWR primary water chemistry guidelines. Good practices for operational conditions are also discussed with reference to long-term experience. This paper presents the purpose, technical background and framework of the preliminary water chemistry guidelines for Japanese BWRs and PWRs. It is expected that the guidelines will be helpful as an introduction to achieve safety and reliability during operations.
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Mobile PHRs compliance with Android and iOS usability guidelines.
Cruz Zapata, Belén; Hernández Niñirola, Antonio; Idri, Ali; Fernández-Alemán, José Luis; Toval, Ambrosio
2014-08-01
Mobile Personal Health Records (PHRs) have achieved a particularly strong market share since the appearance of more powerful mobile devices and popular worldwide mobile application markets such as Apple's App Store and Android's Google Play. However, Android and Apple have a set of recommendations on design and usability targeted towards developers who wish to publish apps in their stores: Android Design Guidelines and iOS Human Interface Guidelines. This paper aims to evaluate compliance with these guidelines by assessing the usability recommendations of a set of 24 selected mobile PHR applications. An analysis process based on a well-known Systematic Literature Review (SLR) protocol was used. The results show that the 24 mobile PHR applications studied are not suitably structured. 46 % of these applications do not use any of the recommended patterns, using instead lists or springboards, which are deprecated patterns for top-level menus. 70 % of the PHRs require a registration to be able to test the application when these interactions should be delayed. Our study will help both PHR users to select user-friendly mobile PHRs and PHR providers and developers to identify the good usability practices implemented by the applications with the highest scores.
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Guidelines for Better Heart Health
Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...
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2012 Guidelines for Water Reuse
This manual is a revision of the "2004 Water Reuse Guidelines." This document is a summary of reuse guidelines, with supporting information, for the benefit of utilities of utilities and regulatory agencies, particularly EPA.
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40 CFR 413.03 - Monitoring requirements.
2010-07-01
... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Monitoring requirements. 413.03 Section 413.03 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND... for total toxic organics (TTO), I certify that, to the best of my knowledge and belief, no dumping of...
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Burgers, Jako S.; Bailey, Julia V.; Klazinga, Niek S.; van der Bij, Akke K.; Grol, Richard; Feder, Gene
2002-01-01
OBJECTIVE: To compare guidelines on diabetes from different countries in order to examine whether differences in recommendations could be explained by use of different research evidence. RESEARCH DESIGN AND METHODS: We analyzed 15 clinical guidelines on type 2 diabetes from 13 countries using
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Non-transfusion dependent thalassemia: translating evidence to guidelines
Directory of Open Access Journals (Sweden)
Afif R. Harb
2014-12-01
Full Text Available The thalassemias are a group of inherited disorders of hemoglobin synthesis characterized by various degrees of defective production of the α- or β-globin chains of adult hemoglobin A. Non-transfusion- dependent thalassemia (NTDT includes a group of thalassemia patients who do not require regular RBC transfusions for survival, but may require occasional transfusions due to infection or pregnancy or may require more regular transfusions later in life due to splenomegaly or other complications. Due to the rising phenomenon of global migration, this previously well-localized entity is currently spreading more and more worldwide reaching Northern America and Northern Europe. The clinical picture of NTDT is governed by the severity of the ineffective erythropoiesis and the chronic hemolytic anemia, which, in turn, lead to iron overload, hypercoagulability, and an array of clinical complications involving almost every organ system. Patients with NTDT suffer from complications that are distinct from those encountered in patients with transfusion- dependent thalassemia (TDT in addition to the complications shared by both TDT and NTDT. As a consequence, patients with NTDT deserve a care specifically tailored to their needs. In the care of patients with NTDT, aiming at a standardized yet personalized care is not an easy task especially that NTDT patients lie on a heterogeneous spectrum with a wide variability in their clinical presentation and response to therapy. Therefore, guidelines emerge as a necessity to answer the specific needs of NTDT patients and the clinicians caring for them. In this article, we summarize the complications most commonly associated with NTDT and the recommendations of the guidelines for the management of patients with NTDT, based on the best available evidence.
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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
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Total quality management implementation guidelines
Energy Technology Data Exchange (ETDEWEB)
1993-12-01
These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.
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PROPOSAL OF GUIDELINE FOR CLINICAL TRIAL PROTOCOLS WITH HERBAL DRUGS
Directory of Open Access Journals (Sweden)
Migdacelys Arboláez Estrada.
2007-04-01
Full Text Available SUMMARYCuba has extensive experience about herbal drugs, however only a few products get to the clinical phase of drug development. Our objective was to design new guidelines for clinical trials with herbal drugs.A detailed bibliographic search about regulatory aspects about clinical trials in Cuba and the world was done for development of the guideline. The guideline's proposed format includes: 1 Index, including the classification of the content. 2 Summary, 3 Fifteen chapters, related to the clinical trials. The guideline also propose the inclusion of annexes.A new guideline containing 15 chapters allows for writing more clear and detailed clinical trial protocols. The guideline contains the information required to guide the research staff who is interested in the validation of herbal drugs pharmacological activations from the perspective of clinical trials. RESUMEN Cuba tiene experiencia extensa sobre plantas medicinales, aunque solo algunos productos llegan a una fase clínica del desarrollo. Nuestro objetivo fué diseñar una nueva guía para ensayos clínicos con plantas medicinales.Hemos realizado una detallada búsqueda bibliográfica sobre aspectos reguladores de ensayos clínicos en Cuba y el resto del mundo para el desarrollo de la guía. El formato propuesto de la guia incluye: 1 Índice, incluyendo la clasificación de los contenidos. 2 Resumen, 3 Quince capítulos, relacionados con los ensayos clínicos. La guía también propone la inclusión de anexos.La nueva guía que contiene 15 capítulos que orientan la redacción de protocolos de ensayos clínicos más claros y más detallados. La guía contiene la información requerida para orientar al personal investigador interesado en la validación de la actividad farmacológica de las plantas medicinales desde la perspectiva de los ensayos clínicos.
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2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats.
Epstein, Mark; Rodan, Ilona; Griffenhagen, Gregg; Kadrlik, Jamie; Petty, Michael; Robertson, Sheilah; Simpson, Wendy
2015-01-01
The robust advances in pain management for companion animals underlie the decision of AAHA and AAFP to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines for Dogs and Cats . The 2015 guidelines summarize and offer a discriminating review of much of this new knowledge. Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian-client-patient relationship. The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual-patient basis. The guidelines include both pharmacologic and nonpharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention, and treatment of pain in animals. Postsurgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Degenerative joint disease is one of the most significant and under-diagnosed diseases of cats and dogs. Degenerative joint disease is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats. These guidelines support veterinarians in incorporating pain management into practice, improving patient care.
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A Critical Review of Low Back Pain Guidelines.
Chetty, Laran
2017-09-01
Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17. Only five guidelines effectively addressed the AGREE scoring. On the basis of the appraisal and domain scores, only four guidelines were strongly recommended. Improved translation of research evidence from guidelines to clinical practice is needed.
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Librarian contributions to clinical practice guidelines.
Cruse, Peggy; Protzko, Shandra
2014-01-01
Librarians have become more involved in developing high quality systematic reviews. Evidence-based practice guidelines are an extension of systematic reviews and offer another significant area for librarian involvement. This column highlights opportunities and challenges for the librarian working on guideline panels and provides practical considerations for meaningful contributions to the guideline creation process.
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Main-coolant-pump shaft-seal guidelines. Volume 2. Operational 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 criteria for improving main coolant pump shaft seal operational reliability. The noted guidelines are developed from EPRI sponsored nuclear power plant seal operating experience studies. Usage procedures/practices and operational environment influence on seal life and reliability from the most recent such survey are summarized. The shaft seal and its auxiliary supporting systems are discussed both from technical and operational related viewpoints
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Singapore Paediatric Resuscitation Guidelines 2016.
Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong
2017-07-01
We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.
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In-service inspection guidelines for composite aerospace structures
International Nuclear Information System (INIS)
Heida, Jaap H.; Platenkamp, Derk J.
2012-01-01
The in-service inspection of composite aerospace structures is reviewed, using the results of a evaluation of promising, mobile non-destructive inspection (NDI) methods. The evaluation made use of carbon fibre reinforced specimens representative for primary composite aerospace structures, including relevant damage types such as impact damage, delaminations and disbonds. A range of NDI methods were evaluated such as visual inspection, vibration analysis, phased array ultrasonic inspection, shearography and thermography inspection. Important aspects of the evaluation were the capability for defect detection and characterization, portability of equipment, field of view, couplant requirements, speed of inspection, level of training required and the cost of equipment. The paper reviews the damage tolerance design approach for composites, and concludes with guidelines for the in-service inspection of composite aerospace structures.
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32 CFR Appendix F to Part 154 - Guidelines for Conducting Prenomination Personal Interviews
2010-07-01
...—Guidelines for Conducting Prenomination Personal Interviews A. Purpose. The purpose of the personal interview... for a position requiring an SBI. B. Scope. Questions asked during the course of a personal interview... into the personal interview. For example, religious beliefs and affiliations, beliefs and opinions...
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Sharing life-altering information: development of pediatric hospital guidelines and team training.
Wolfe, Adam D; Frierdich, Sharon A; Wish, Joel; Kilgore-Carlin, Joyce; Plotkin, Julie A; Hoover-Regan, Margo
2014-09-01
Abstract Background: Despite parent and physician reports of inadequate skill development, there are few guidelines for training the pediatric care team in sharing life-altering information (SLAI), i.e., "breaking bad news." The necessary skills for SLAI differ between pediatric and adult medical environments. We set out to establish evidence-based guidelines and multidisciplinary team training for SLAI in pediatrics, and to demonstrate an improvement in immediate self-efficacy of training participants. A multidisciplinary task force, which included parent participation and feedback, and which received input from parents of patients in multiple pediatric subspecialties, crafted children's hospitalwide guidelines for SLAI. A one-hour training module on the guidelines was presented to several multidisciplinary pediatric team audiences; 159 voluntary pre- and post-presentation self-efficacy surveys were collected. Responses were analyzed by paired t-test (within groups) and ANOVA (between groups). All evaluated groups of care team members reported significant improvements in self-efficacy among four learning objectives after the training. Medical trainees, newer physicians, and nonphysician (e.g., midlevel providers including nurses) team members reported the greatest improvements, regardless of whether they had received previous training in SLAI. We propose pediatric-focused SLAI guidelines based on a modified SPIKES protocol. Focus on patient- and family-centered, culturally sensitive pediatric practices should be the basis for development of training that can be periodically reinforced. Future comprehensive training will incorporate experiential learning. SLAI requires a skill set that benefits from lifelong learning.
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The International Rare Diseases Research Consortium: Policies and Guidelines to maximize impact.
Lochmüller, Hanns; Torrent I Farnell, Josep; Le Cam, Yann; Jonker, Anneliene H; Lau, Lilian Pl; Baynam, Gareth; Kaufmann, Petra; Dawkins, Hugh Js; Lasko, Paul; Austin, Christopher P; Boycott, Kym M
2017-12-01
The International Rare Diseases Research Consortium (IRDiRC) has agreed on IRDiRC Policies and Guidelines, following extensive deliberations and discussions in 2012 and 2013, as a first step towards improving coordination of research efforts worldwide. The 25 funding members and 3 patient umbrella organizations (as of early 2013) of IRDiRC, a consortium of research funders that focuses on improving diagnosis and therapy for rare disease patients, agreed in Dublin, Ireland in April 2013 on the Policies and Guidelines that emphasize collaboration in rare disease research, the involvement of patients and their representatives in all relevant aspects of research, as well as the sharing of data and resources. The Policies and Guidelines provide guidance on ontologies, diagnostics, biomarkers, patient registries, biobanks, natural history, therapeutics, models, publication, intellectual property, and communication. Most IRDiRC members-currently nearly 50 strong-have since incorporated its policies in their funding calls and some have chosen to exceed the requirements laid out, for instance in relation to data sharing. The IRDiRC Policies and Guidelines are the first, detailed agreement of major public and private funding organizations worldwide to govern rare disease research, and may serve as a template for other areas of international research collaboration. While it is too early to assess their full impact on research productivity and patient benefit, the IRDiRC Policies and Guidelines have already contributed significantly to improving transparency and collaboration in rare disease research.
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State Emergency Department Opioid Guidelines: Current Status.
Broida, Robert I; Gronowski, Tanner; Kalnow, Andrew F; Little, Andrew G; Lloyd, Christopher M
2017-04-01
The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM). We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP. We found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions for opioids with 67 total recommendations; preventing/diverting abuse with 56 total recommendations; addiction-related guidelines with 29 total recommendations; and a community resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion. This study highlights the 17 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this study will provide the basis for similar efforts in other states.
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Sadeghi-Demneh, Ebrahim; Forghany, Saeed; Onmanee, Pornsuree; Trinler, Ursula; Dillon, Michael P; Baker, Richard
2017-06-20
Standards and guidelines are an integral part of prosthetic and orthotic service delivery in the developed world underpinned by an assumption that they lead to improved services. Implementing them has a cost, however, and that cost needs to be justified, particularly in resource-limited environments. This scoping review thus asks the question, "What is the evidence of the impact of standards and guidelines on service delivery outcomes in prosthetics and orthotics?" A structured search of three electronic databases (Medline, Scopus and Web of Science) followed by manual searching of title, abstract and full text, yielded 29 articles. Four categories of papers were identified: Descriptions and Commentaries (17 papers), Guideline Development (7), Guideline Testing (2) and Standards implementation (3). No articles were explicitly designed to assess the impact of standards and guidelines on service delivery outcomes in prosthetics and orthotics. Studies tended to be commentaries on or descriptions of guideline development, testing or implementation of standards. The literature is not sufficiently well developed to warrant the cost and effort of a systematic review. Future primary research should seek to demonstrate whether and how guidelines and standards improve the outcomes for people that require prostheses, orthoses and other assistive devices. Implications for Rehabilitation International Standards and Clinical Guidelines are now an integral part of clinical service provision in prosthetics and orthotics in the developed world. Complying with standards and guidelines has a cost and, particularly in resource-limited environments, it should be possible to justify this in terms of the resulting benefits. This scoping review concludes that there have been no previous studies designed to directly quantify the effects of implementing standards and guidelines on service delivery.
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Guidelines for bone scintigraphy in children; Empfehlungen zur Knochenszintigraphie bei Kindern
Energy Technology Data Exchange (ETDEWEB)
Hahn, K.; Fischer, S. [LMU Muenchen (Germany). Klinik fuer Nuklearmedizin; Colarinha, P. [Instituto Portugues de Oncologia, Lisbon (Portugal); Gordon, I. [Great Osmond Street Hospital for Children, London (United Kingdom); Mann, M. [Red Cross Hospital, Cape Town (South Africa); Piepsz, A. [AZ VUB and CHU St. Pierre, Brussels (Belgium); Olivier, P. [CHU Vandoeuvre, Nancy (France); Sixt, R. [The Queen Silvia Children' s Hospital, Goeteborg (Sweden); Velzen, J. van
2000-11-01
The guidelines are intended to help nuclear medical teams in their daily routine. The guidelines give information relating to indications, performance of examinations, analysis and interpretation of the diagnostic results. The guidelines should be applied in the context of adopted basic quality criteria in nuclear medicine, requirements of the German radiation protection ordinance, as well as the regulatory codes for radiation protection in the medical field. The guidelines express the opinions of the Paediatric Committee of the EANM and hence focus on compliance with the relevant European standards in nuclear medicine. In order to enhance the specificity of results obtained with a bone scintigraphy, the interpretation of the results should be based on combined analysis with information drawn from X-rays. (orig./CB) [German] Zweck dieser Leitlinie ist es, dem nuklearmedizinischen Team eine Hilfe fuer die taegliche Praxis anzubieten. Diese Leitlinie enthaelt Informationen ueber die Indikationen, die Untersuchungsdurchfuehrung, Auswertung und Interpretation von Knochenszintigraphien bei Kindern. Sie sollte in Verbindung mit den ueblichen Qualitaetskriterien in der Nuklearmedizin und den Vorschriften der Strahlenschutzverordnung sowie der Richtlinie Strahlenschutz in der Medizin gesehen werden. Sie fasst die Meinung des Paediatric Committee der EANM zusammen und ist daher in einzelnen Bereichen mehr dem europaeischen Standard der Nuklearmedizin angepasst. Um die Spezifitaet der Knochenszintigraphie zu erhoehen, sollte immer eine gemeinsame Interpretation von Knochenszintigraphie und Roentgenbildern erfolgen. (orig.)
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A Dutch guideline for the treatment of scoliosis in neuromuscular disorders
Directory of Open Access Journals (Sweden)
Titarsolej PJ
2008-09-01
Full Text Available Abstract Background Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is considered the primary treatment option for correcting severe scoliosis in neuromuscular disorders. Surgery in this population requires a multidisciplinary approach, careful planning, dedicated surgical procedures, and specialized after care. Methods The guideline is based on scientific evidence and expert opinions. A multidisciplinary working group representing experts from all relevant specialties performed the research. A literature search was conducted to collect scientific evidence in answer to specific questions posed by the working group. Literature was classified according to the level of evidence. Results For most aspects of the treatment scientific evidence is scarce and only low level cohort studies were found. Nevertheless, a high degree of consensus was reached about the management of patients with scoliosis in neuromuscular disorders. This was translated into a set of recommendations, which are now officially accepted as a general guideline in the Netherlands. Conclusion In order to optimize the treatment for scoliosis in neuromuscular disorders a Dutch guideline has been composed. This evidence-based, multidisciplinary guideline addresses conservative treatment, the preoperative, perioperative, and postoperative care of scoliosis in neuromuscular disorders.