WorldWideScience

Sample records for prevention assessment guidance

  1. Pollution prevention opportunity assessments. Guidance for the Hanford Site

    International Nuclear Information System (INIS)

    Engel, J.A.

    1994-10-01

    The purpose of this document is to provide help to you, Hanford waste generators, in finding ways to reduce waste through Pollution Prevention (P2) and Pollution Prevention Opportunity Assessments (P2OAs). It is based on guidance from other sites, and serves to compliment the Hanford-specific training on P2OAs offered by the Pollution Prevention group at Westinghouse Hanford Company (WHC). The chapters of this document include help on how to choose major waste generating activities, how to conduct a P2OA, how to get results, and how to show progress. There is also a chapter on special situations and problems your facility may encounter. This first chapter tells you why you should consider conducting P2OAs and why they may be required

  2. 76 FR 81513 - Guidance for Industry: Prevention of Salmonella

    Science.gov (United States)

    2011-12-28

    ...] Guidance for Industry: Prevention of Salmonella Enteritidis in Shell Eggs During Production, Storage, and... ``Prevention of Salmonella Enteritidis in Shell Eggs During Production, Storage, and Transportation.'' The... final rule ``Prevention of Salmonella Enteritidis in Shell Eggs During Production, Storage, and...

  3. 75 FR 48973 - Draft Guidance for Industry: Prevention of Salmonella

    Science.gov (United States)

    2010-08-12

    ...] Draft Guidance for Industry: Prevention of Salmonella Enteritidis in Shell Eggs During Production... entitled ``Prevention of Salmonella Enteritidis in Shell Eggs During Production, Storage, and... on how to comply with certain provisions contained in FDA's final rule ``Prevention of Salmonella...

  4. Guidance for performing preliminary assessments under CERCLA

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1991-09-01

    EPA headquarters and a national site assessment workgroup produced this guidance for Regional, State, and contractor staff who manage or perform preliminary assessments (PAs). EPA has focused this guidance on the types of sites and site conditions most commonly encountered. The PA approach described in this guidance is generally applicable to a wide variety of sites. However, because of the variability among sites, the amount of information available, and the level of investigative effort required, it is not possible to provide guidance that is equally applicable to all sites. PA investigators should recognize this and be aware that variation from this guidance may be necessary for some sites, particularly for PAs performed at Federal facilities, PAs conducted under EPA`s Environmental Priorities Initiative (EPI), and PAs at sites that have previously been extensively investigated by EPA or others. The purpose of this guidance is to provide instructions for conducting a PA and reporting results. This guidance discusses the information required to evaluate a site and how to obtain it, how to score a site, and reporting requirements. This document also provides guidelines and instruction on PA evaluation, scoring, and the use of standard PA scoresheets. The overall goal of this guidance is to assist PA investigators in conducting high-quality assessments that result in correct site screening or further action recommendations on a nationally consistent basis.

  5. Assessment of the effectiveness of guidance services in senior ...

    African Journals Online (AJOL)

    Guidance Service Assessment Questionnaire for Teacher/Students (GSAQTS) was used to measure the extent of guidance services and their perception of it. ... to counsellor, and a misconception of the counsellors role has made guidance ...

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

    African Journals Online (AJOL)

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

  7. Image Guidance and Assessment of Radiation Induced Gene Therapy

    National Research Council Canada - National Science Library

    Pelizzari, Charles

    2004-01-01

    Image guidance and assessment techniques are being developed for combined radiation/gene therapy, which utilizes a radiation-inducible gene promoter to cause expression of tumor necrosis factor alpha...

  8. Guidance on Dependence Assessment in SPAR-H

    Energy Technology Data Exchange (ETDEWEB)

    April M. Whaley

    2012-06-01

    As part of the effort to develop the SPAR-H user guidance, particular attention was paid to the assessment of dependence in order to address user questions about proper application of dependence. This paper presents a discussion of dependence from a psychological perspective and provides guidance on applying this information during the qualitative analysis of dependence to ensure more realistic and appropriate dependence assessments with the SPAR-H method. While this guidance was developed with SPAR-H in mind, it may be informative to other human reliability analysis methods that also use a THERP-based dependence approach, particularly if applied at the human failure event level.

  9. Key performance indicators for the assessment of pediatric pharmacotherapeutic guidance.

    Science.gov (United States)

    Barrett, Jeffrey S; Patel, Dimple; Jayaraman, Bhuvana; Narayan, Mahesh; Zuppa, Athena

    2008-07-01

    Given the paucity of actual guidance provided for managing pediatric drug therapy, prescribing caregivers must be able to draw on the limited published information in pediatrics and/or guidance provided in adults with some account for expected pediatric response. Guidance for managing drug therapy in children is clearly desirable. Our objectives were to construct key performance indicators (KPIs) for pediatric pharmacotherapy guidance to identify drugs where pharmacotherapy guidance would be most beneficial. A pilot survey to assess variation in caregiver appreciation for pediatric dosing guidance has also been constructed to provide a complementary subjective assessment. Three KPI categories, drug utilization (based on hospital admission and billing data collected from 2001 through 2006), medical need, and guidance outcome value along with a KPI composite score have been proposed. Low scores are favored with respect to prioritization for pharmacotherapy guidance. The pilot survey consisted of 15 questions to assess 1) physician knowledge regarding dosing guidance, 2) attitudes toward dose modification and patient individualization, 3) the accessibility, ease of use and appropriateness of existing data stores, and 4) frequency of dosing modification, consultation of dosing compendiums and estimate of success rate in dosing guidance. Pilot results suggest that dosing guidance is generally viewed as important and that the existing resources are insufficient to guide recommendations for all drugs. While the majority of respondents check more than one resource less than 25% of the time, at least 25% of the respondents check more than one resource 25-50% of the time. The majority viewed the relevance of dosing guidance very important to the management of drug therapy. The questionnaire is being extended to the primary care centers, the Kids First Network and specialty care centers. Results will guide the development of decision support systems (DSS) that provide patient

  10. Laboratory Biosafety and Biosecurity Risk Assessment Technical Guidance Document

    Energy Technology Data Exchange (ETDEWEB)

    Astuto-Gribble, Lisa M; Caskey, Susan Adele

    2014-07-01

    The purpose of this document is threefold: 1) to describe the laboratory bio safety and biosecurity risk assessment process and its conceptual framework; 2) provide detailed guidance and suggested methodologies on how to conduct a risk assessment; and 3) present some practical risk assessment process strategies using realistic laboratory scenarios.

  11. Implementing DOE guidance for hazards assessments at Rocky Flats Plant

    International Nuclear Information System (INIS)

    Zimmerman, G.A.

    1993-01-01

    Hazards Assessments are performed for a variety of activities and facilities at Rocky Flats Plant. Prior to 1991, there was no guidance for performing Hazards Assessments. Each organization that performed Hazards Assessments used its own methodology with no attempt at standardization. In 1991, DOE published guidelines for the performance of Hazards Assessments for Emergency Planning (DOE-EPG-5500.1, ''Guidance for a Hazards Assessment Methodology''). Subsequently, in 1992, DOE published a standard for the performance of Hazards Assessments (DOE-STD-1027-92, ''Hazard Categorization and Accident Analysis, Techniques for Compliance with DOE Order 5480.23, Nuclear Safety Analysis Reports''). Although these documents are a step in the direction of standardization, there remains a great deal of interpretation and subjective implementation in the performance of Hazards Assessments. Rocky Flats Plant has initiated efforts to develop a uniform and standard process to be used for Hazards Assessments

  12. 77 FR 70167 - Draft Guidance for Industry on Vaginal Microbicides: Development for the Prevention of Human...

    Science.gov (United States)

    2012-11-23

    ...] Draft Guidance for Industry on Vaginal Microbicides: Development for the Prevention of Human...: The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry... Drug Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New...

  13. [International trend of guidance for nanomaterial risk assessment].

    Science.gov (United States)

    Hirose, Akihiko

    2013-01-01

    In the past few years, several kinds of opinions or recommendations on the nanomaterial safety assessment have been published from international or national bodies. Among the reports, the first practical guidance of risk assessment from the regulatory body was published from the European Food Safety Authorities in May 2011, which included the determination of exposure scenario and toxicity testing strategy. In October 2011, European Commission (EC) adopted the definition of "nanomaterial" for regulation. And more recently, Scientific Committee on Consumer Safety of EC released guidance for assessment of nanomaterials in cosmetics in June 2012. A series of activities in EU marks an important step towards realistic safety assessment of nanomaterials. On the other hand, the US FDA announced a draft guidance for industry in June 2011, and then published draft guidance documents for both "Cosmetic Products" and "Food Ingredients and Food Contact Substances" in April 2012. These draft documents do not restrictedly define the physical properties of nanomaterials, but when manufacturing changes alter the dimensions, properties, or effects of an FDA-regulated product, the products are treated as new products. Such international movements indicate that most of nanomaterials with any new properties would be assessed or regulated as new products by most of national authorities in near future, although the approaches are still case by case basis. We will introduce such current international activities and consideration points for regulatory risk assessment.

  14. Guidance on the environmental risk assessment of plant pests

    DEFF Research Database (Denmark)

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

    2011-01-01

    The European Food Safety Authority (EFSA) requested the Panel on Plant Health to develop a methodology for assessing the environmental risks posed by harmful organisms that may enter, establish and spread in the European Union. To do so, the Panel first reviewed the methods for assessing...... the environmental risks of plant pests that have previously been used in pest risk assessment. The limitations identified by the review led the Panel to define the new methodology for environmental risk assessment which is described in this guidance document. The guidance is primarily addressed to the EFSA PLH...... (biodiversity) and the functional (ecosystem services) aspects of the environment, this new approach includes methods for assessing both aspects for the first time in a pest risk assessment scheme. A list of questions has been developed for the assessor to evaluate the consequences for structural biodiversity...

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

    Science.gov (United States)

    Witton, R V; Moles, D R

    2015-06-01

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

  16. Remote assessment and guidance of liver harvesting for transplantation.

    OpenAIRE

    Eadie, L. H.

    2005-01-01

    The harvesting of livers for transplantation involves assessment of the liver's suitability, including an examination of the colour and general appearance of the liver. If the organ is to be split for transplantation into two recipients, the vasculature of the liver must be studied and recorded. Remote assessment of livers and telesurgical guidance could save time and money. This thesis highlights the importance of colour in liver diagnosis, using animal and human models to examine the colour...

  17. Guidance on the environmental risk assessment of genetically modified plants

    DEFF Research Database (Denmark)

    Bartsch, Detlef; Chueca, Cristina; De-Schrijver, Adinda

    risk evaluation. The scientific Panel on Genetically Modified Organisms (of the European Food Safety Authority (EFSA GMO Panel) considers seven specific areas of concern to be addressed by applicants and risk assessors during the ERA (1) persistence and invasiveness of the GM plant , or its compatible......This document provides guidance for the environmental risk assessment (ERA) of genetically modified (GM) plants submitted within the framework of Regulation (EC) No. 1829/2003 on GM food and feed or under Directive 2001/18/EC on the deliberate release into the environment of genetically modified...... organisms (GMOs). This document provides guidance for assessing potential effects of GM plants on the environment and the rationales for the data requirements for a comprehensive ERA of GM plants. The ERA should be carried out on a case-by-case basis, following a step-by-step assessment approach...

  18. 78 FR 27235 - Technical Guidance for Assessing Environmental Justice in Regulatory Analysis

    Science.gov (United States)

    2013-05-09

    ... Justice in Regulatory Analysis.'' The purpose of this guidance is to provide EPA analysts with technical...-566-2363. Mail: Technical Guidance for Assessing Environmental Justice in Regulatory Analysis... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OA-2013-0320; FRL-9810-5] Technical Guidance for Assessing...

  19. 77 FR 34390 - Draft Guidance for Industry: Amendment to “Guidance for Industry: Revised Preventive Measures To...

    Science.gov (United States)

    2012-06-11

    ... recommendations for plasma-derived products, including albumin and products containing plasma-derived albumin, in..., submit either electronic or written comments on the draft guidance by September 10, 2012. ADDRESSES... electronic access to the draft guidance document. Submit electronic comments on the draft guidance to http...

  20. Guidance on the Technology Performance Level (TPL) Assessment Methodology

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Jochem [National Renewable Energy Lab. (NREL), Golden, CO (United States); Roberts, Jesse D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Babarit, Aurelien [Ecole Centrale de Nantes (France). Lab. of Research in Hydrodynamics, Energetics and Atmospheric Environment (LHEEA); Costello, Ronan [Wave Venture, Penstraze (United Kingdom); Bull, Diana L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Neilson, Kim [Ramboll, Copenhagen (Denmark); Bittencourt, Claudio [DNV GL, London (United Kingdom); Kennedy, Ben [Wave Venture, Penstraze (United Kingdom); Malins, Robert Joseph [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Dykes, Katherine [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-09-01

    This document presents the revised Technology Performance Level (TPL) assessment methodology. There are three parts to this revised methodology 1) the Stakeholder Needs and Assessment Guidance (this document), 2) the Technical Submission form, 3) the TPL scoring spreadsheet. The TPL assessment is designed to give a technology neutral or agnostic assessment of any wave energy converter technology. The focus of the TPL is on the performance of the technology in meeting the customer’s needs. The original TPL is described in [1, 2] and those references also detail the critical differences in the nature of the TPL when compared to the more widely used technology readiness level (TRL). (Wave energy TRL is described in [3]). The revised TPL is particularly intended to be useful to investors and also to assist technology developers to conduct comprehensive assessments in a way that is meaningful and attractive to investors. The revised TPL assessment methodology has been derived through a structured Systems Engineering approach. This was a formal process which involved analyzing customer and stakeholder needs through the discipline of Systems Engineering. The results of the process confirmed the high level of completeness of the original methodology presented in [1] (as used in the Wave Energy Prize judging) and now add a significantly increased level of detail in the assessment and an improved more investment focused structure. The revised TPL also incorporates the feedback of the Wave Energy Prize judges.

  1. Assessment of Adaptive Guidance for Responsive Launch Vehicles and Spacecraft

    Science.gov (United States)

    2009-04-29

    Figures 1 Earth centered inertial and launch plumbline coordinate systems . . . . . . . 7 2 Geodetic and geocentric latitude...Dramatically reduced reoccurring costs related to guidance. The same features of the closed-loop ascent guidance that provide operational flexibility...also result in greatly reduced need for human intervention. Thus the operational costs related to ascent guidance could be reduced to minimum

  2. Guidance for addressing the Australian Weed Risk Assessment questions

    Czech Academy of Sciences Publication Activity Database

    Gordon, D. R.; Mitterdorfer, B.; Pheloung, P. C.; Ansari, S.; Buddehagen, C.; Chimera, C.; Daehler, C. C.; Dawson, G.; Denslow, J. S.; La Rosa, A. M.; Nishida, T.; Onderdonk, D. A.; Panetta, F. D.; Pyšek, Petr; Randall, R. P.; Richardson, D. M.; Tshidada, N. J.; Virtue, J. G.; Williams, P. A.

    2010-01-01

    Roč. 25, č. 2 (2010), s. 56-74 ISSN 0815-2195 R&D Projects: GA MŠk 7E09053 Institutional research plan: CEZ:AV0Z60050516 Keywords : plant invasions * risk assessment * prevention Subject RIV: EF - Botanics

  3. Social Impact Assessment : Guidance for assessing and managing the social impacts of projects

    NARCIS (Netherlands)

    Vanclay, Francis; Esteves, Ana Maria; Aucamp, Ilse; Franks, Daniel

    2015-01-01

    The purpose of this Guidance Note is to provide advice to various stakeholders about what is expected in good practice social impact assessment (SIA) and social impact management processes, especially in relation to project development. Project development refers to dams, mines, oil and gas

  4. 78 FR 70307 - Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy...

    Science.gov (United States)

    2013-11-25

    ...] Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy Products... Assessment of Investigational Cellular and Gene Therapy Products'' dated November 2013. The guidance document... products reviewed by the Office of Cellular, Tissue and Gene Therapies (OCTGT). The product areas covered...

  5. 77 FR 55510 - Guidance on Performing a Seismic Margin Assessment

    Science.gov (United States)

    2012-09-10

    ... Guidance for the Individual Plant Examination of External Events (IPEEE) for Severe Accident...-Term Task Force Review of Insights from the Fukushima Dai-ichi Accident,'' hereafter called the ``March...

  6. Career Guidance Books Assess the Value of Journalism Education.

    Science.gov (United States)

    Steiner, Linda

    1994-01-01

    Examines the advice given about journalism preparation and education in 100 career guidance books and general inventories of careers published over the last century. Discusses educating journalists, the special case of women, and shifting assumptions. (SR)

  7. 77 FR 71194 - Draft Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy...

    Science.gov (United States)

    2012-11-29

    ...] Draft Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy... Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy Products,'' dated November... Evaluation (CBER), Office of Cellular, Tissue, and Gene Therapies (OCTGT). The product areas covered by this...

  8. Global guidance on environmental life cycle impact assessment indicators: Progress and case study

    DEFF Research Database (Denmark)

    Frischknecht, Rolf; Fantke, Peter; Tschümperlin, Laura

    2016-01-01

    Purpose The life cycle impact assessment (LCIA) guidance flagship project of the United Nations Environment Programme (UNEP)/Society of Environmental Toxicology and Chemistry (SETAC) Life Cycle Initiative aims at providing global guidance and building scientific consensus on environmental LCIA in...

  9. 78 FR 39284 - Technical Guidance for Assessing Environmental Justice in Regulatory Analysis

    Science.gov (United States)

    2013-07-01

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OA-2013-0320; FRL-9830-1] Technical Guidance for Assessing Environmental Justice in Regulatory Analysis AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... Environmental Protection Agency (EPA) issued for public comment a document entitled, ``Technical Guidance for...

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Guidance Manual for Conducting Screening Level Ecological Risk Assessments at the INEL

    Energy Technology Data Exchange (ETDEWEB)

    R. L. VanHorn; N. L. Hampton; R. C. Morris

    1995-06-01

    This document presents reference material for conducting screening level ecological risk assessments (SLERAs)for the waste area groups (WAGs) at the Idaho National Engineering Laboratory. Included in this document are discussions of the objectives of and processes for conducting SLERAs. The Environmental Protection Agency ecological risk assessment framework is closely followed. Guidance for site characterization, stressor characterization, ecological effects, pathways of contaminant migration, the conceptual site model, assessment endpoints, measurement endpoints, analysis guidance, and risk characterization are included.

  12. Stakeholder views of ethical guidance regarding prevention and care in HIV vaccine trials

    Science.gov (United States)

    2014-01-01

    Background South Africa is a major hub of HIV prevention trials, with plans for a licensure trial to start in 2015. The appropriate standards of care and of prevention in HIV vaccine trials are complex and debated issues and ethical guidelines offer some direction. However, there has been limited empirical exploration of South African stakeholders’ perspectives on ethical guidance related to prevention and care in HIV vaccine trials. Methods Site staff, Community Advisory Board members and Research Ethics Committee members involved with current HIV vaccine trials in South Africa were invited to participate in an exploration of their views. A questionnaire listed 10 care and 10 prevention recommendations drawn from two widely available sets of ethical guidelines for biomedical HIV prevention trials. Respondents (n = 98) rated each recommendation on five dimensions: “Familiarity with”, “Ease of Understanding”, “Ease of Implementing”, “Perceived Protection”, and “Agreement with” each ethical recommendation. The ratings were used to describe stakeholder perspectives on dimensions for each recommendation. Dimension ratings were averaged across the five dimensions and used as an indication of overall merit for each recommendation. Differences were explored across dimensions, between care-oriented and prevention-oriented recommendations, and between stakeholder groups. Results Both care and prevention recommendations were rated highly overall, with median ratings well above the scale midpoint. In general, informed consent recommendations were most positively rated. Care-related recommendations were rated significantly more positively than prevention-related recommendations, with the five lowest-rated recommendations being prevention-related. The most problematic dimension across all recommendations was “Ease of Implementing,” and the least problematic was “Agreement with,” suggesting the most pressing stakeholder concerns are practical

  13. Stakeholder views of ethical guidance regarding prevention and care in HIV vaccine trials.

    Science.gov (United States)

    Moorhouse, Rika; Slack, Catherine; Quayle, Michael; Essack, Zaynab; Lindegger, Graham

    2014-06-30

    South Africa is a major hub of HIV prevention trials, with plans for a licensure trial to start in 2015. The appropriate standards of care and of prevention in HIV vaccine trials are complex and debated issues and ethical guidelines offer some direction. However, there has been limited empirical exploration of South African stakeholders' perspectives on ethical guidance related to prevention and care in HIV vaccine trials. Site staff, Community Advisory Board members and Research Ethics Committee members involved with current HIV vaccine trials in South Africa were invited to participate in an exploration of their views. A questionnaire listed 10 care and 10 prevention recommendations drawn from two widely available sets of ethical guidelines for biomedical HIV prevention trials. Respondents (n = 98) rated each recommendation on five dimensions: "Familiarity with", "Ease of Understanding", "Ease of Implementing", "Perceived Protection", and "Agreement with" each ethical recommendation. The ratings were used to describe stakeholder perspectives on dimensions for each recommendation. Dimension ratings were averaged across the five dimensions and used as an indication of overall merit for each recommendation. Differences were explored across dimensions, between care-oriented and prevention-oriented recommendations, and between stakeholder groups. Both care and prevention recommendations were rated highly overall, with median ratings well above the scale midpoint. In general, informed consent recommendations were most positively rated. Care-related recommendations were rated significantly more positively than prevention-related recommendations, with the five lowest-rated recommendations being prevention-related. The most problematic dimension across all recommendations was "Ease of Implementing," and the least problematic was "Agreement with," suggesting the most pressing stakeholder concerns are practical rather than theoretical; that is, respondents agree with

  14. 77 FR 24722 - Draft Guidance for Industry: Assessing the Effects of Significant Manufacturing Process Changes...

    Science.gov (United States)

    2012-04-25

    ...] Draft Guidance for Industry: Assessing the Effects of Significant Manufacturing Process Changes... Manufacturing Process Changes, Including Emerging Technologies, on the Safety and Regulatory Status of Food... determining whether changes in manufacturing process, including the intentional reduction in particle size to...

  15. Assessment of a personalized and distributed patient guidance system.

    Science.gov (United States)

    Peleg, Mor; Shahar, Yuval; Quaglini, Silvana; Broens, Tom; Budasu, Roxana; Fung, Nick; Fux, Adi; García-Sáez, Gema; Goldstein, Ayelet; González-Ferrer, Arturo; Hermens, Hermie; Hernando, M Elena; Jones, Val; Klebanov, Guy; Klimov, Denis; Knoppel, Daniel; Larburu, Nekane; Marcos, Carlos; Martínez-Sarriegui, Iñaki; Napolitano, Carlo; Pallàs, Àngels; Palomares, Angel; Parimbelli, Enea; Pons, Belén; Rigla, Mercedes; Sacchi, Lucia; Shalom, Erez; Soffer, Pnina; van Schooten, Boris

    2017-05-01

    The MobiGuide project aimed to establish a ubiquitous, user-friendly, patient-centered mobile decision-support system for patients and for their care providers, based on the continuous application of clinical guidelines and on semantically integrated electronic health records. Patients would be empowered by the system, which would enable them to lead their normal daily lives in their regular environment, while feeling safe, because their health state would be continuously monitored using mobile sensors and self-reporting of symptoms. When conditions occur that require medical attention, patients would be notified as to what they need to do, based on evidence-based guidelines, while their medical team would be informed appropriately, in parallel. We wanted to assess the system's feasibility and potential effects on patients and care providers in two different clinical domains. We describe MobiGuide's architecture, which embodies these objectives. Our novel methodologies include a ubiquitous architecture, encompassing a knowledge elicitation process for parallel coordinated workflows for patients and care providers; the customization of computer-interpretable guidelines (CIGs) by secondary contexts affecting remote management and distributed decision-making; a mechanism for episodic, on demand projection of the relevant portions of CIGs from a centralized, backend decision-support system (DSS), to a local, mobile DSS, which continuously delivers the actual recommendations to the patient; shared decision-making that embodies patient preferences; semantic data integration; and patient and care provider notification services. MobiGuide has been implemented and assessed in a preliminary fashion in two domains: atrial fibrillation (AF), and gestational diabetes Mellitus (GDM). Ten AF patients used the AF MobiGuide system in Italy and 19 GDM patients used the GDM MobiGuide system in Spain. The evaluation of the MobiGuide system focused on patient and care providers

  16. Quality assurance guidance for laboratory assessment plates in support of EM environmental sampling and analysis activities

    International Nuclear Information System (INIS)

    1994-05-01

    This document is one of several guidance documents developed to support the EM (DOE Environmental Restoration and Waste Management) Analytical Services program. Its purpose is to introduce assessment plates that can be used to conduct performance assessments of an organization's or project's ability to meet quality goals for analytical laboratory activities. These assessment plates are provided as non-prescriptive guidance to EM-support organizations responsible for collection of environmental data for remediation and waste management programs at DOE facilities. The assessments evaluate objectively all components of the analytical laboratory process to determine their proper selection and use

  17. 77 FR 48989 - Draft Guidance for Industry on Suicidal Ideation and Behavior: Prospective Assessment of...

    Science.gov (United States)

    2012-08-15

    ...] Draft Guidance for Industry on Suicidal Ideation and Behavior: Prospective Assessment of Occurrence in... ``Suicidal Ideation and Behavior: Prospective Assessment of Occurrence in Clinical Trials.'' The purpose of... suicidal ideation and behavior in clinical trials of drug and biological products, including drugs for...

  18. Needs Assessment of Guidance Services in Schools as A Method

    African Journals Online (AJOL)

    Emeka Egbochuku

    Key Words: Academic programme evaluation; counselling; educational standards ... good success in a needs assessment study of any educational programme. ..... technology colleges in Ontario: Jones and Geis, 1995; and for physical.

  19. Self-Assessment of Nuclear Security Culture in Facilities and Activities. Technical Guidance

    International Nuclear Information System (INIS)

    2017-01-01

    The IAEA has developed a comprehensive methodology for evaluating nuclear security culture. When implemented by a State, this methodology will help to make nuclear security culture sustainable. It will also promote cooperation and the sharing of good practices related to nuclear security culture. This publication is the first guidance for assessing nuclear security culture and analysing its strengths and weaknesses within a facility or activity, or an organization. It reflects, within the context of assessment, the nuclear security culture model, principles and criteria set out in the Implementing Guide, IAEA Nuclear Security Series No. 7. This guidance will be useful for organizations and operating facilities in conducting the self-assessment of nuclear security culture by providing practical methods and tools. It will also help regulatory bodies and other competent authorities to understand the self-assessment methodology used by operators, encourage operators to start the self-assessment process or, if appropriate, conduct independent assessments of nuclear security culture.

  20. Guidance on assessing the methodological and reporting quality of toxicologically relevant studies: A scoping review.

    Science.gov (United States)

    Samuel, Gbeminiyi O; Hoffmann, Sebastian; Wright, Robert A; Lalu, Manoj Mathew; Patlewicz, Grace; Becker, Richard A; DeGeorge, George L; Fergusson, Dean; Hartung, Thomas; Lewis, R Jeffrey; Stephens, Martin L

    2016-01-01

    Assessments of methodological and reporting quality are critical to adequately judging the credibility of a study's conclusions and to gauging its potential reproducibility. To aid those seeking to assess the methodological or reporting quality of studies relevant to toxicology, we conducted a scoping review of the available guidance with respect to four types of studies: in vivo and in vitro, (quantitative) structure-activity relationships ([Q]SARs), physico-chemical, and human observational studies. Our aims were to identify the available guidance in this diverse literature, briefly summarize each document, and distill the common elements of these documents for each study type. In general, we found considerable guidance for in vivo and human studies, but only one paper addressed in vitro studies exclusively. The guidance for (Q)SAR studies and physico-chemical studies was scant but authoritative. There was substantial overlap across guidance documents in the proposed criteria for both methodological and reporting quality. Some guidance documents address toxicology research directly, whereas others address preclinical research generally or clinical research and therefore may not be fully applicable to the toxicology context without some translation. Another challenge is the degree to which assessments of methodological quality in toxicology should focus on risk of bias - as in clinical medicine and healthcare - or be broadened to include other quality measures, such as confirming the identity of test substances prior to exposure. Our review is intended primarily for those in toxicology and risk assessment seeking an entry point into the extensive and diverse literature on methodological and reporting quality applicable to their work. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Guidance on internal dose assessments from monitoring data (Project IDEAS)

    International Nuclear Information System (INIS)

    Doerfel, H.; Andrasi, A.; Bailey, M.; Berkovski, V.; Castellani, M.; Hurtgen, C.; Jourdain, R.; Le Guen, B.

    2003-01-01

    Several international intercomparison exercises on intake and internal dose assessments from monitoring data led to the conclusion that the results calculated by different participants varied significantly mainly to the broad variety of methods and assumptions applied in the assessment procedure. Based on these experiences the need of harmonisation of the procedures has been formulated as an EU research project under the 5th Framework Programme, with the aim of developing general guidelines for standardising assessments of intakes and internal doses. In the IDEAS project, eight institutions from seven European countries are participating, also using inputs from internal dosimetry professionals from across Europe to ensure broad consensus in the outcome of the project. To ensure that the guidelines are applicable to a wide range of practical situations, the first step will be to compile a database on well documented cases of internal contamination. In parallel, an improved version of existing software will be developed and distributed to the partners for further use. Many cases from the database will be evaluated independently by more partners using the same software and the results will be discussed and the draft guidelines prepared. The guidelines will then be revised and refined on the basis of the experiences and discussions of two workshops, and an inter-comparison exercise organised in the frame of the project which will be open to all internal dosimetry professionals. (author)

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

    DEFF Research Database (Denmark)

    Kørnøv, Lone

    2009-01-01

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

  3. 78 FR 9702 - Draft Guidance for Industry on Immunogenicity Assessment for Therapeutic Protein Products...

    Science.gov (United States)

    2013-02-11

    ... approach in both the preclinical and clinical phases of the development of therapeutic protein products to... you can comment on any guidance at any time (see 21 CFR 10.115(g)(5)), to ensure that the Agency... entitled ``Immunogenicity Assessment for Therapeutic Protein Products.'' The purpose of this document is to...

  4. 77 FR 60124 - Draft Guidance for Industry on Initial Completeness Assessments for Type II Active Pharmaceutical...

    Science.gov (United States)

    2012-10-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1010] Draft Guidance for Industry on Initial Completeness Assessments for Type II Active Pharmaceutical... certain drug master files, namely, Type II active pharmaceutical ingredient (API) drug master files (DMFs...

  5. Guidance for treatment of variability and uncertainty in ecological risk assessments of contaminated sites

    International Nuclear Information System (INIS)

    1998-06-01

    Uncertainty is a seemingly simple concept that has caused great confusion and conflict in the field of risk assessment. This report offers guidance for the analysis and presentation of variability and uncertainty in ecological risk assessments, an important issue in the remedial investigation and feasibility study processes. This report discusses concepts of probability in terms of variance and uncertainty, describes how these concepts differ in ecological risk assessment from human health risk assessment, and describes probabilistic aspects of specific ecological risk assessment techniques. The report ends with 17 points to consider in performing an uncertainty analysis for an ecological risk assessment of a contaminated site

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

    Science.gov (United States)

    Xia, Wenyao; Breen, Stephen L

    2018-04-01

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

  7. Pollution prevention opportunity assessment benchmarking: Recommendations for Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Engel, J.A.

    1994-05-01

    Pollution Prevention Opportunity Assessments (P2OAs) are an important first step in any pollution prevention program. While P2OAs have been and are being conducted at Hanford, there exists no standard guidance, training, tracking, or systematic approach to identifying and addressing the most important waste streams. The purpose of this paper then is to serve as a guide to the Pollution Prevention group at Westinghouse Hanford in developing and implementing P2OAs at Hanford. By searching the literature and benchmarks other sites and agencies, the best elements from those programs can be incorporated and pitfalls more easily avoided. This search began with the 1988 document that introduces P2OAs (then called Process Waste Assessments, PWAS) by the Environmental Protection Agency. This important document presented the basic framework of P20A features which appeared in almost all later programs. Major Department of Energy programs were also examined, with particular attention to the Defense Programs P20A method of a graded approach, as presented at the Kansas City Plant. The graded approach is a system of conducting P2OAs of varying levels of detail depending on the size and importance of the waste stream. Finally, private industry programs were examined briefly. While all the benchmarked programs had excellent features, it was determined that the size and mission of Hanford precluded lifting any one program for use. Thus, a series of recommendations were made, based on the literature review, in order to begin an extensive program of P2OAs at Hanford. These recommendations are in the areas of: facility Pollution Prevention teams, P20A scope and methodology, guidance documents, training for facilities (and management), technical and informational support, tracking and measuring success, and incentives.

  8. Independent Orbiter Assessment (IOA): Assessment of the guidance, navigation, and control subsystem FMEA/CIL

    Science.gov (United States)

    Trahan, W. H.; Odonnell, R. A.; Pietz, K. C.; Drapela, L. J.

    1988-01-01

    The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Guidance, Navigation, and Control System (GNC) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. A resolution of each discrepancy from the comparison is provided through additional analysis as required. The results of that comparison for the Orbiter GNC hardware is documented. The IOA product for the GNC analysis consisted of 141 failure mode worksheets that resulted in 24 potential critical items being identified. Comparison was made to the NASA baseline which consisted of 148 FMEAs and 36 CIL items. This comparison produced agreement on all but 56 FMEAs which caused differences in zero CIL items.

  9. Supplementary guidance for the investigation and risk-assessment of potentially contaminated sediments

    Energy Technology Data Exchange (ETDEWEB)

    Baker, K.; Spadaro, P.; Starr, J.; Thomas, J. [Arcadis, Arnhem (Netherlands); Hildenbrand, B. [Energy Institute, London (United Kingdom); Smith, J.W.N.; Dunk, M.; Grosjean, T.; De Ibarra, M.; Medve, A.; Den Haan, K.

    2013-11-15

    This report provides guidance on the investigation and assessment of potentially contaminated sediments, focusing on the inland, estuarine and coastal environments. It is designed as a complementary, technical companion document to Energy Institute and CONCAWE (2013) report 'Guidance on characterising, assessing and managing risks associated with potentially contaminated sediments' (Report E1001). It highlights a number of significant challenges associated with assessing the aquatic and water bottom environment, which means that a sediment assessment should not be undertaken lightly. Where a decision is taken to undertake a site assessment, this report promotes the use of an iterative process of Conceptual Site Model (CSM) development, data collection, data evaluation and a continuous CSM refinement, taking into account the results obtained. Risk-based assessment is described throughout the report, entailing four tiers of assessment, which progress from a qualitative assessment (Tier 0) through to a detailed cause-attribution assessment (Tier 3), in which the decrease in uncertainty in the assessment process is balanced against the increased costs and timescales with progress to a higher tier assessment. The application of this evidence-driven risk-based approach to sediment site management, including remedial control measures, should help to overcome at least some of the challenges associated with contaminants in sediment sites in Europe, and promote a sustainable approach to sediment management on a case-by-case basis.

  10. 78 FR 44483 - Draft Guidance for Industry: Questions and Answers Regarding the Final Rule, Prevention of...

    Science.gov (United States)

    2013-07-24

    ... written requests for single copies of the draft guidance to the Division of Plant and Dairy Food Safety/Office of Food Safety, Center for Food Safety and Applied Nutrition (HFS-315), Food and Drug..., Center for Food Safety and Applied Nutrition (HFS-316), Food and Drug Administration, 5100 Paint Branch...

  11. Assessing impact of blanket interventions for MAM prevention

    International Nuclear Information System (INIS)

    Grais, Rebecca F.; Isanaka, I; Langendorf, C; Roederer, T

    2014-01-01

    Full text: Blanket interventions for MAM prevention (Blanket supplementary feeding programming (BSFP)) provide a supplementary food ration often accompanied by a basic medical treatment and prevention package to a vulnerable population for a defined period in a defined geographic location. There is little strong evidence on the impact of BSFP on rates of malnutrition and mortality, and scare guidance on program monitoring and evaluation to improve the implementation of specific programs. Assessing the impact of BSFP has been fraught with difficulty. Their isolated impact is difficult, if not often impossible to disentangle from larger care and prevention packages, the objectives of BSFP may vary by context, implementing agency, time and geography. Various and often multiple co-morbidities among children in the targeted group complicate matters further with respect to impact assessment. This leads to difficulties in generalizing results from one context to another and the need for more complex metrics to guide operational decision-making. Ideally, impact or effectiveness of BSFP should be addressed in a research framework where appropriate and complete data is collected in order to address specific questions. The gold standard is the conduct of randomized studies including a control group. These studies have been scarce as they may be perceived as either rarely feasible or not ethical or both. However, as generating evidence on impact of BSFP is essential to provide operational guidance, these studies should be encouraged through a diversity of robust, yet creative and pragmatic, methodological approaches. As a case study, a series of studies conducted over the past decade are reviewed in the same location in Niger highlighting the lessons learned. (author)

  12. Pollution prevention opportunity assessment for Technical Art

    International Nuclear Information System (INIS)

    Torres, H.M.

    1995-09-01

    This pollution prevention opportunity assessment was conducted to evaluate Technical Art, which is part of the Technical Communications Department at Sandia National Laboratories/California. It is located in Building 912, Room 138. This assessment documents the processes, identifies the hazardous chemical waste streams generated by these processes, and recommends possible ways to minimize waste

  13. Probabilistic risk assessment (PRA): status report and guidance for regulatory application. Draft report for comment

    International Nuclear Information System (INIS)

    1984-02-01

    This document describes the current status of the methodologies used in probabilistic risk assessment (PRA) and provides guidance for the application of the results of PRAs to the nuclear reactor regulatory process. The PRA studies that have been completed or are underway are reviewed. The levels of maturity of the methodologies used in a PRA are discussed. Insights derived from PRAs are listed. The potential uses of PRA results for regulatory purposes are discussed

  14. Track 2 sites: Guidance for assessing low probability hazard sites at the INEL. Revision 6

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-01

    This document presents guidance for assessment of Track 2 low probability hazard sites (LPHS) at the Idaho National Engineering Laboratory (INEL). The Track 2 classification was developed specifically for the INEL to streamline the implementation of Comprehensive Environmental Response, Compensation, and Liability Act. Track 2 LPHSs are described as sites where insufficient data are available to make a decision concerning the risk level or to select or design a remedy. As such, these types of sites are not described in the National Contingency Plan or existing regulatory guidance. The goal of the Track 2 process is to evaluate LPHSs using existing qualitative and quantitative data to minimize the collection of new environmental data. To this end, this document presents a structured format consisting of a series of questions and tables. A qualitative risk assessment is used. The process is iterative, and addresses an LPHS from multiple perspectives (i.e., historical, empirical, process) in an effort to generate a reproducible and defensible method. This rigorous approach follows the data quality objective process and establishes a well organized, logical approach to consolidate and assess existing data, and set decision criteria. If necessary, the process allows for the design of a sampling and analysis strategy to obtain new environmental data of appropriate quality to support decisions for each LPHS. Finally, the guidance expedites consensus between regulatory parties by emphasizing a team approach to Track 2 investigations.

  15. Track 2 sites: Guidance for assessing low probability hazard sites at the INEL

    International Nuclear Information System (INIS)

    1994-01-01

    This document presents guidance for assessment of Track 2 low probability hazard sites (LPHS) at the Idaho National Engineering Laboratory (INEL). The Track 2 classification was developed specifically for the INEL to streamline the implementation of Comprehensive Environmental Response, Compensation, and Liability Act. Track 2 LPHSs are described as sites where insufficient data are available to make a decision concerning the risk level or to select or design a remedy. As such, these types of sites are not described in the National Contingency Plan or existing regulatory guidance. The goal of the Track 2 process is to evaluate LPHSs using existing qualitative and quantitative data to minimize the collection of new environmental data. To this end, this document presents a structured format consisting of a series of questions and tables. A qualitative risk assessment is used. The process is iterative, and addresses an LPHS from multiple perspectives (i.e., historical, empirical, process) in an effort to generate a reproducible and defensible method. This rigorous approach follows the data quality objective process and establishes a well organized, logical approach to consolidate and assess existing data, and set decision criteria. If necessary, the process allows for the design of a sampling and analysis strategy to obtain new environmental data of appropriate quality to support decisions for each LPHS. Finally, the guidance expedites consensus between regulatory parties by emphasizing a team approach to Track 2 investigations

  16. 76 FR 41157 - Guidance for Industry: Questions and Answers Regarding the Final Rule, Prevention of Salmonella...

    Science.gov (United States)

    2011-07-13

    ..., Prevention of Salmonella Enteritidis in Shell Eggs During Production, Storage, and Transportation... Industry: Questions and Answers Regarding the Final Rule, Prevention of Salmonella Enteritidis in Shell... Salmonella Enteritidis in Shell Eggs During Production, Storage, and Transportation'' (the final rule). The...

  17. 77 FR 50372 - Guidance for Industry: Questions and Answers Regarding the Final Rule, Prevention of Salmonella...

    Science.gov (United States)

    2012-08-21

    ..., Prevention of Salmonella Enteritidis in Shell Eggs During Production, Storage, and Transportation... Industry: Questions and Answers Regarding the Final Rule, Prevention of Salmonella Enteritidis in Shell... 33030), we issued a final rule requiring shell egg producers to implement measures to prevent Salmonella...

  18. EFSA Guidance Document on the risk assessment of plant protection products on bees (Apis mellifera, Bombus spp. and solitary bees)

    NARCIS (Netherlands)

    Arnold, G.; Boesten, J.J.T.I.; Clook, M.

    2013-01-01

    The Guidance Document is intended to provide guidance for notifiers and authorities in the context of the review of plant protection products (PPPs) and their active substances under Regulation (EC) 1107/2009. The scientific opinion on the science behind the development of a risk assessment of plant

  19. 78 FR 78822 - Draft Guidance for Assessing the Effects of Anthropogenic Sound on Marine Mammals-Acoustic...

    Science.gov (United States)

    2013-12-27

    ... Guidance for Assessing the Effects of Anthropogenic Sound on Marine Mammals--Acoustic Threshold Levels for... available in electronic form via the Internet at http://www.nmfs.noaa.gov/pr/acoustics/ . You may submit...: Acoustic Guidance. Instructions: All comments received are a part of the public record and will generally...

  20. Ecological risk assessment guidance for preparation of remedial investigation/feasibility study work plans

    International Nuclear Information System (INIS)

    Pentecost, E.D.; Vinikour, W.S.

    1993-08-01

    This guidance document (1) provides instructions on preparing the components of an ecological work plan to complement the overall site remedial assessment investigation/feasibility study (RI/FS) work plan and (2) directs the user on how to implement ecological tasks identified in the plan. Under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), as amended by the Superfired Amendments and Reauthorization Act of 1986 (SARA), an RI/FS work plan win have to be developed as part of the site-remediation scoping the process. Specific guidance on the RI/FS process and the preparation of work plans has been developed by the US Environmental Protection Agency (EPA 1988a). This document provides guidance to US Department of Energy (DOE) staff and contractor personnel for incorporation of ecological information into environmental remediation planning and decision making at CERCLA sites. An overview analysis of early ecological risk assessment methods (i.e., in the 1980s) at Superfund sites was conducted by the EPA (1989a). That review provided a perspective of attention given to ecological issues in some of the first RI/FS studies. By itself, that reference is of somewhat limited value; it does, however, establish a basis for comparison of past practices in ecological risk with current, more refined methods

  1. EMP Attachment 3 DOE-SC PNNL Site Dose Assessment Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, Sandra F.

    2011-12-21

    This Dose Assessment Guidance (DAG) describes methods to use to determine the Maximally-Exposed Individual (MEI) location and to estimate dose impact to that individual under the U.S. Department of Energy Office of Science (DOE-SC) Pacific Northwest National Laboratory (PNNL) Site Environmental Monitoring Plan (EMP). This guidance applies to public dose from radioactive material releases to the air from PNNL Site operations. This document is an attachment to the Pacific Northwest National Laboratory (PNNL) Environmental Monitoring Plan (EMP) and describes dose assessment guidance for radiological air emissions. The impact of radiological air emissions from the U.S. Department of Energy Office of Science (DOE-SC) PNNL Site is indicated by dose estimates to a maximally exposed member of the public, referred to as the maximally exposed individual (MEI). Reporting requirements associated with dose to members of the public from radiological air emissions are in 40 CFR Part 61.94, WAC 246-247-080, and DOE Order 458.1. The DOE Order and state standards for dose from radioactive air emissions are consistent with U.S. Environmental Protection Agency (EPA) dose standards in 40 CFR 61.92 (i.e., 10 mrem/yr to a MEI). Despite the fact that the current Contract Requirements Document (CRD) for the DOE-SC PNNL Site operations does not include the requirement to meet DOE CRD 458.1, paragraph 2.b, public dose limits, the DOE dose limits would be met when EPA limits are met.

  2. Communication Services and Supports for Individuals with Severe Disabilities: Guidance for Assessment and Intervention

    Science.gov (United States)

    Brady, Nancy C.; Bruce, Susan; Goldman, Amy; Erickson, Karen; Mineo, Beth; Ogletree, Bill T.; Paul, Diane; Romski, Mary Ann; Sevcik, Rose; Siegel, Ellin; Schoonover, Judith; Snell, Marti; Sylvester, Lorraine; Wilkinson, Krista

    2015-01-01

    The National Joint Committee for the Communication Needs of People with Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities. PMID:26914467

  3. 78 FR 22269 - International Conference on Harmonisation; Draft Guidance on M7 Assessment and Control of DNA...

    Science.gov (United States)

    2013-04-15

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance entitled ``M7 Assessment and Control of DNA Reactive (Mutagenic) Impurities in Pharmaceuticals to Limit Potential Carcinogenic Risk.'' The draft guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The draft guidance emphasizes considerations of both safety and quality risk management in establishing levels of mutagenic impurities that are expected to pose negligible carcinogenic risk. It outlines recommendations for assessment and control of mutagenic impurities that reside or are reasonably expected to reside in a final drug substance or product, taking into consideration the intended conditions of human use. The draft guidance is intended to provide guidance for new drug substances and new drug products during their clinical development and subsequent applications for marketing.

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

    OpenAIRE

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

    2007-01-01

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

  5. Clarification of the Use of Biological Data and Information in the 2002 Integrated Water Quality Monitoring and Assessment Report Guidance

    Science.gov (United States)

    The memorandum modifies the 2002 Integrated Water Quality Monitoring and Assessment Report Guidance to provide clarity and promote consistency in the manner in which states use biological data and information in developing their 2002 submissions.

  6. Physician Performance Assessment: Prevention of Cardiovascular Disease

    Science.gov (United States)

    Lipner, Rebecca S.; Weng, Weifeng; Caverzagie, Kelly J.; Hess, Brian J.

    2013-01-01

    Given the rising burden of healthcare costs, both patients and healthcare purchasers are interested in discerning which physicians deliver quality care. We proposed a methodology to assess physician clinical performance in preventive cardiology care, and determined a benchmark for minimally acceptable performance. We used data on eight…

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

    International Nuclear Information System (INIS)

    Kornov, Lone

    2009-01-01

    A wide range of factors within spatial planning can affect health. There is therefore an important scope for Strategic Environmental Assessment (SEA) of spatial plans to protect and improve human health. Due to the EU Directive 2001/42/EC on SEA, health has been made explicit in Danish legislation and guidance. This paper examines the inclusion of health as a formal component in impact assessment of spatial plans. Based upon a documentary study of 100 environmental reports, the paper analyses and discusses how health impact considerations are incorporated in SEA practice. It is found that health impacts are included in SEA practice and are being interpreted in a broader sense than what the national guidance exemplifies. The frequent included health aspects are noise, drinking water, air pollution, recreation/outdoor life and traffic safety. The primary determinant for health is transport-whether it is at the overall or local planning level. The main conclusion is that SEA shows a potential to catalyse healthier spatial planning. Despite the broad inclusion of health in SEA practice the examination shows potential improvements, hereunder qualification of assessments by better explaining the nature and significance of impacts and by including the distributional aspects of human health impacts. Inclusion from the health sector is put forward as an important institutional mean to secure cross disciplinarily and higher quality assessment

  8. Interim guidance risk assessment of the device assembly facility at the Nevada test site

    International Nuclear Information System (INIS)

    Altenbach, T.J.

    1996-05-01

    The risks of plutonium dispersal and/or high explosive detonation from nuclear explosive operations at the Device Assembly Facility were examined in accordance with DOE Order 5610.11 and the Interim Guidance. The assessment consisted of a qualitative task and hazards analysis, and a quantitative risk screening. Results are displayed on risk matrices for the major types of operations. Most accident scenarios were considered to have Low risk; a few scenarios have Moderate risk; and none have High risk. The highest risk scenarios (Moderate category) consist of a high explosive detonation during assembly operations in a cell, with bare conventional high explosive surrounding the pit

  9. Safety assessment guidance in the International Atomic Energy Agency RADWASS Program

    Energy Technology Data Exchange (ETDEWEB)

    Vovk, I.F.; Seitz, R.R.

    1995-12-31

    The IAEA RADWASS programme is aimed at establishing a coherent and comprehensive set of principles and standards for the safe management of waste and formulating the guidelines necessary for their application. A large portion of this programme has been devoted to safety assessments for various waste management activities. Five Safety Guides are planned to be developed to provide general guidance to enable operators and regulators to develop necessary framework for safety assessment process in accordance with international recommendations. They cover predisposal, near surface disposal, geological disposal, uranium/thorium mining and milling waste, and decommissioning and environmental restoration. The Guide on safety assessment for near surface disposal is at the most advanced stage of preparation. This draft Safety Guide contains guidance on description of the disposal system, development of a conceptual model, identification and description of relevant scenarios and pathways, consequence analysis, presentation of results and confidence building. The set of RADWASS publications is currently undergoing in-depth review to ensure a harmonized approach throughout the Safety Series.

  10. 75 FR 4400 - Draft Guidance for Industry on Assessment of Abuse Potential of Drugs; Availability

    Science.gov (United States)

    2010-01-27

    ... draft guidance before it begins work on the final version of the guidance, submit written or electronic..., prescribing, advertising, manufacturing, promotion, marketing, and use in the practice of medicine. Not...

  11. A New Approach to Lane Guidance Systems

    OpenAIRE

    Eidehall, Andreas; Pohl, Jochen; Gustafsson, Fredrik

    2005-01-01

    This paper presents a new automotive safety function called Emergency Lane Assist (ELA). ELA combines conventional lane guidance systems with a threat assessment module that tries to activate and deactivate the lane guidance interventions according to the actual risk level of lane departure. The goal is to only prevent dangerous lane departure manoeuvres. Such a threat assessment algorithm is dependent on detailed information about the vehicle surroundings, i.e., positions and motion of other...

  12. Criteria for guidance in the safety assessment of nuclear installations in the United Kingdom

    International Nuclear Information System (INIS)

    Gausden, R.; Fryer, D.R.H.

    1977-01-01

    There is an increasing appreciation of the need for a consistent approach to nuclear safety between various groups having an interest in safety and between various types of installation. Licensing for construction and ultimate approval to operate any nuclear installation depend in the United Kingdom upon a searching assessment of the design, construction and operation of the proposed plant. Criteria of the kind discussed in this paper have been used by the Nuclear Installations Inspectorate in this assessment process. From time to time they are subject to comments from other bodies in the U.K. One aim of the criteria is to set out the broad objectives that should be met regarding the magnitude of radiological consequences of accidents or normal operation. In addition, the criteria give guidance on the design philosophy for nuclear safety and the principles of fault evaluation. Criteria must be conceived so that while maintaining safety standards their application does not frustrate design and development. It is also important that undue formalism is not induced in the assessment process at the expense of inhibiting the judgement of safety assessors. A balance must, therefore, be struck between detailed and generalised guidance. It is also accepted that experience in the use and interpretation of criteria will indicate a need for improvement and additions: the criteria are, therefore, regarded as living rather than fixed statements which are expected to develop in response to any need for change in a safe direction that may arise. In developing them, the Inspectorate has drawn heavily upon the experience accumulated during its 16 years of operation and has also referred to criteria published by other organisations. The paper deals specifically with certain of the most important sections of the criteria and indicates the total range of subjects which need to be included in such criteria

  13. Pollution prevention opportunity assessments at Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Betsch, M.D., Westinghouse Hanford

    1996-06-26

    The Pollution Prevention Opportunity Assessment (PPOA) is a pro- active way to look at a waste generating activity and identify opportunities to minimize wastes through a cost benefit analysis. Hanford`s PPOA process is based upon the graded approach developed by the Kansas City Plant. Hanford further streamlined the process while building in more flexibility for the individual users. One of the most challenging aspects for implementing the PPOA process at Hanford is one overall mission which is environmental restoration, Now that the facilities are no longer in production, each has a different non- routine activity making it difficult to quantify the inputs and outputs of the activity under consideration.

  14. A systematic review on status of lead pollution and toxicity in Iran; Guidance for preventive measures

    Directory of Open Access Journals (Sweden)

    Abdollahi Mohammad

    2012-07-01

    Full Text Available Abstract Lead is an old environmental metal which is presented everywhere and lead poisoning is an important health issue in many countries in the world including Iran. It is known as a silent environmental disease which can have life-long adverse health effects. In children, the most vulnerable population, mental development of children health effects is of the greatest influence. Low level lead exposure can significantly induce motor dysfunctions and cognitive impairment in children. The sources of lead exposure vary among countries. Occupational lead exposure is an important health issue in Iran and mine workers, employees of paint factories, workers of copying centers, drivers, and tile making factories are in higher risk of lead toxicity. Moreover lead processing industry has always been a major of concern which affects surface water, drinking waters, and ground waters, even water of Caspian Sea, Persian Gulf and rivers due to increasing the number of industries in vicinity of rivers that release their waste discharges into river or sea. In addition, lead contamination of soil and air especially in vicinity of polluted and industrialized cities is another health problem in Iran. Even foods such as rice and fishes, raw milk, and vegetables which are the most common food of Iranian population are polluted to lead in some area of Iran. Adding lead to the opium is a recently health hazard in Iran that has been observed among opium addicts. There are few studies evaluated current status of lead exposure and toxicity in the Iranian children and pregnant women which should be taken into account of authorities. We recommend to identify sources, eliminate or control sources, and monitor environmental exposures and hazards to prevent lead poisoning.

  15. A Systematic Review on Status of Lead Pollution and Toxicity in Iran; Guidance for Preventive Measures

    Directory of Open Access Journals (Sweden)

    Parissa Karrari

    2012-07-01

    Full Text Available Lead is an old environmental metal which is presented everywhere and lead poisoning is an important health issue in many countries in the world including Iran. It is known as a silent environmental disease which can have life-long adverse health effects. In children, the most vulnerable population, mental development of children health effects is of the greatest influence. Low level lead exposure can significantly induce motor dysfunctions and cognitive impairment in children. The sources of lead exposure vary among countries. Occupational lead exposure is an important health issue in Iran and mine workers, employees of paint factories, workers of copying centers, drivers,and tile making factories are in higher risk of lead toxicity. Moreover lead processing industry has always been amajor of concern which affects surface water, drinking waters, and ground waters, even water of Caspian Sea,Persian Gulf and rivers due to increasing the number of industries in vicinity of rivers that release their waste discharges into river or sea. In addition, lead contamination of soil and air especially in vicinity of polluted andindustrialized cities is another health problem in Iran. Even foods such as rice and fishes, raw milk, and vegetables which are the most common food of Iranian population are polluted to lead in some area of Iran. Adding lead to the opium is a recently health hazard in Iran that has been observed among opium addicts. There are few studiesevaluated current status of lead exposure and toxicity in the Iranian children and pregnant women which should be taken into account of authorities. We recommend to identify sources, eliminate or control sources, and monitor environmental exposures and hazards to prevent lead poisoning.

  16. HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)'s 2010 HIV testing guidance.

    Science.gov (United States)

    Sullivan, Ann K; Sperle, Ida; Raben, Dorthe; Amato-Gauci, Andrew J; Lundgren, Jens Dilling; Yazdanpanah, Yazdan; Jakobsen, Stine Finne; Tavoschi, Lara

    2017-11-01

    An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015-January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. Data sources were two surveys: one for the primary target audience (health policymakers and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions  (17 participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very important to have an EU/EEA-level HIV testing guidance (23/28 and 46/51, respectively). The guidance has been widely used to develop policies, guidelines, programmes and strategies in the EU/EEA and should be regularly updated due to continuous developments in the field in order to continue to serve as an important reference guidance in the region.

  17. Pollution prevention opportunity assessments, a training and resource guide

    Energy Technology Data Exchange (ETDEWEB)

    VALERO, O.J.

    1998-11-03

    The intention of the ''Pollution Prevention Opportunity Assessment Training and Resource Guide'' is to help Hanford waste generators identify ways to reduce waste through the Pollution Prevention Opportunity Assessment (P20A) process. This document presents pollution prevention tools and provides a step-by-step approach for conducting assessments.

  18. Guidance Document on Anaerobic Digester Foaming Prevention and Control Methods (WERF Report INFR1SG10a)

    Science.gov (United States)

    The development of this anaerobic digester (AD) foaming guidance document is based on the need for a specific detailed methodology that water resource recovery facilities (WRRF) personnel can follow and implement to manage or mitigate AD foam incidents. This guidance manual is th...

  19. 75 FR 29768 - Guidance for Industry: Revised Preventive Measures to Reduce the Possible Risk of Transmission of...

    Science.gov (United States)

    2010-05-27

    ... manufacturers of plasma derivatives with comprehensive FDA recommendations intended to minimize the possible...CJD) by Blood and Blood Products''' dated August 2006 (2006 draft guidance). DATES: Submit electronic... the SUPPLEMENTARY INFORMATION section for electronic access to the guidance document. Submit...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  1. Psycho-Educational Assessment of Specific Learning Disabilities: Views and Practices of Australian Psychologists and Guidance Counsellors

    Science.gov (United States)

    Meteyard, John D.; Gilmore, Linda

    2015-01-01

    This article reports an investigation of the views and practices of 203 Australian psychologists and guidance counsellors with respect to psycho-educational assessment of students with specific learning disabilities (SLDs). Results from an online survey indicated that practitioners draw upon a wide range of theoretical perspectives when…

  2. 75 FR 8412 - Office of New Reactors: Interim Staff Guidance on Assessing Ground Water Flow and Transport of...

    Science.gov (United States)

    2010-02-24

    ... NUCLEAR REGULATORY COMMISSION [NRC-2010-0047] Office of New Reactors: Interim Staff Guidance on Assessing Ground Water Flow and Transport of Accidental Radionuclide Releases; Solicitation of Public... ground water flow and transport of accidental radionuclide releases necessary to demonstrate compliance...

  3. Human exposure assessment for biocides in the EU development of step by step guidance and worked examples

    NARCIS (Netherlands)

    Gerritsen-Ebben, R.M.G.; Hemmen, J.J. van

    2007-01-01

    Directive 98/8/EC(1) concerns EU harmonisation of placing biocidal products on the market. In the present short paper the preliminary results of an ongoing project are presented in which step by step guidance on human exposure assessment with worked examples is developed. For all 23 biocidal product

  4. Understanding the implementation of 'sick day guidance' to prevent acute kidney injury across a primary care setting in England: a qualitative evaluation.

    Science.gov (United States)

    Martindale, Anne-Marie; Elvey, Rebecca; Howard, Susan J; McCorkindale, Sheila; Sinha, Smeeta; Blakeman, Tom

    2017-11-08

    The study sought to examine the implementation of sick day guidance cards designed to prevent acute kidney injury (AKI), in primary care settings. Qualitative semistructured interviews were conducted and comparative analysis informed by normalisation process theory was undertaken to understand sense-making, implementation and appraisal of the cards and associated guidance. A single primary care health setting in the North of England. 29 participants took part in the qualitative evaluation: seven general practitioners, five practice nurses, five community pharmacists, four practice pharmacists, two administrators, one healthcare assistant and five patients. The sick day guidance intervention was rolled out (2015-2016) in general practices (n=48) and community pharmacies (n=60). The materials consisted of a 'medicine sick day guidance' card, provided to patients who were taking the listed drugs. The card provided advice about medicines management during episodes of acute illness. An information leaflet was provided to healthcare practitioners and administrators suggesting how to use and give the cards. Implementation of sick day guidance cards to prevent AKI entailed a new set of working practises across primary care. A tension existed between ensuring reach in administration of the cards to at risk populations while being confident to ensure patient understanding of their purpose and use. Communicating the concept of temporary cessation of medicines was a particular challenge and limited their administration to patient populations at higher risk of AKI, particularly those with less capacity to self-manage. Sick day guidance cards that focus solely on medicines management may be of limited patient benefit without adequate resourcing or if delivered as a standalone intervention. Development and evaluation of primary care interventions is urgently warranted to tackle the harm associated with AKI. © Article author(s) (or their employer(s) unless otherwise stated in the

  5. Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control

    Directory of Open Access Journals (Sweden)

    A. P. Magiorakos

    2017-11-01

    Full Text Available Abstract Background Infections with carbapenem-resistant Enterobacteriaceae (CRE are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are “at-risk” may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E. The purpose of this guidance is to raise awareness and identify the “at-risk” patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE. Methods The guidance was created by a group of experts who were functioning independently of their organisations, during two meetings hosted by the European Centre for Disease Prevention and Control. A list of epidemiological risk factors placing patients “at-risk” for carriage with CRE was created by the experts. The conclusions of a systematic review on the prevention of spread of CRE, with the addition of expert opinion, were used to construct lists of core and supplemental infection prevention and control measures to be implemented for “at-risk” patients upon admission to healthcare settings. Results Individuals with the following profile are “at-risk” for carriage of CRE: a a history of an overnight stay in a healthcare setting in the last 12 months, b dialysis-dependent or cancer chemotherapy in the last 12 months, c known previous carriage of CRE in the last 12 months and d epidemiological linkage to a known carrier of a CRE. Core infection prevention and control measures that should be considered for all patients in healthcare settings were compiled. Preliminary supplemental measures to be implemented for “at-risk” patients on admission are: pre-emptive isolation, active screening for CRE, and contact precautions. Patients who are confirmed positive for CRE will need additional supplemental measures. Conclusions Strengthening the microbiological

  6. Patient-reported outcome (PRO assessment in clinical trials: a systematic review of guidance for trial protocol writers.

    Directory of Open Access Journals (Sweden)

    Melanie Calvert

    Full Text Available Evidence suggests there are inconsistencies in patient-reported outcome (PRO assessment and reporting in clinical trials, which may limit the use of these data to inform patient care. For trials with a PRO endpoint, routine inclusion of key PRO information in the protocol may help improve trial conduct and the reporting and appraisal of PRO results; however, it is currently unclear exactly what PRO-specific information should be included. The aim of this review was to summarize the current PRO-specific guidance for clinical trial protocol developers.We searched the MEDLINE, EMBASE, CINHAL and Cochrane Library databases (inception to February 2013 for PRO-specific guidance regarding trial protocol development. Further guidance documents were identified via Google, Google scholar, requests to members of the UK Clinical Research Collaboration registered clinical trials units and international experts. Two independent investigators undertook title/abstract screening, full text review and data extraction, with a third involved in the event of disagreement. 21,175 citations were screened and 54 met the inclusion criteria. Guidance documents were difficult to access: electronic database searches identified just 8 documents, with the remaining 46 sourced elsewhere (5 from citation tracking, 27 from hand searching, 7 from the grey literature review and 7 from experts. 162 unique PRO-specific protocol recommendations were extracted from included documents. A further 10 PRO recommendations were identified relating to supporting trial documentation. Only 5/162 (3% recommendations appeared in ≥50% of guidance documents reviewed, indicating a lack of consistency.PRO-specific protocol guidelines were difficult to access, lacked consistency and may be challenging to implement in practice. There is a need to develop easily accessible consensus-driven PRO protocol guidance. Guidance should be aimed at ensuring key PRO information is routinely included in

  7. Climate Change Effects and Impacts Assessment. A guidance manual for Local Government in New Zealand

    International Nuclear Information System (INIS)

    Wratt, D.; Mullan, B.; Salinger, J.; Allan, S.; Morgan, T.; Kenny, G.

    2004-05-01

    Climate change is a real and internationally recognised outcome of increased amounts of greenhouse gases in the atmosphere. It will have effects over the next decades that are predictable with some level of certainty, but which will vary from place to place throughout New Zealand. The climate will also change from year to year and decade to decade due to natural processes. For example, some parts of the country often have dry summers and autumns when an El Nino climate pattern is present. Both natural fluctuations and human-induced climate changes need to be considered when developing adaptation plans and policies, rather than just 'greenhouse warming' effects on their own. Councils already address extreme weather events and climate variations as they develop plans and provide services. Climate change effects need also to be considered as part of these regulatory, assessment and planning activities. It is not necessary to develop a set of procedures for dealing separately with effects and impacts of climate change - they can be built into existing practices. Over time, climate change responses will involve iterative planning processes, keeping up-to-date with new information, monitoring changes, and reviewing the effectiveness of responses. The response to climate change involves international, national, regional, district and community consideration and action. The Guidance Manual aims to assist local government in working with its communities and making appropriate decisions.

  8. Assessment guidance of carbohydrate counting method in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Martins, Michelle R; Ambrosio, Ana Cristina T; Nery, Marcia; Aquino, Rita de Cássia; Queiroz, Marcia S

    2014-04-01

    We evaluated the application of the method of carbohydrate counting performed by 21 patients with type 2 diabetes, 1 year later attending a guidance course. Participants answered a questionnaire to assess patients' adhesion to carbohydrate counting as well as to identify habit changes and the method's applicability, and values of glycated hemoglobin were also analyzed. Most participants (76%) were females, and 25% of them had obesity degree III. There was a statistically significant decrease in glycated hemoglobin from 8.42±0.02% to 7.66±0.01% comparing values before and after counseling. We observed that although patients stated that the method was difficult they understood that carbohydrate counting could allow them make choices and have more freedom in their meals; we also verified if they understood accurately how to replace some foods used regularly in their diets and most patients correctly chose replacements for the groups of bread (76%), beans (67%) and noodles (67%). We concluded that participation in the course led to improved blood glucose control with a significant reduction of glycated hemoglobin, better understanding of food groups and the adoption of healthier eating habits. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  9. UK guidance for assessing the impact of radioactive substances on wildlife inhabiting Natura 2000 sites

    International Nuclear Information System (INIS)

    Merrill, P.; Copplestone, D.; Zinger, I.; Allot, R.; Williams, C.

    2004-01-01

    concept of reference organisms into the context of protecting feature species present in Natura 2000 sites. Feature species are named species, usually of conservation value, that have been identified as requiring protection. The derivation of concentration factors has been conservative, due to the lack of data for those protected feature species. In light of the lack of data, and given the assumptions and uncertainties that underlay the assessment methodology, a precautionary approach has been adopted. The derived guidance allows assessors to derive dose-rates to biota based on discharge limits (Bq/yr). The paper will outline the Stage 3 Assessment approach and provide a practical example of its application in England and Wales to demonstrate the use of this methodology as part of the UK regulatory framework. (Author)

  10. Eating nanomaterials: cruelty-free and safe? the EFSA guidance on risk assessment of nanomaterials in food and feed.

    Science.gov (United States)

    Sauer, Ursula G

    2011-12-01

    Nanomaterials are increasingly being added to food handling and packaging materials, or directly, to human food and animal feed. To ensure the safety of such engineered nanomaterials (ENMs), in May 2011, the European Food Safety Authority (EFSA) published a guidance document on Risk assessment of the application of nanoscience and nanotechnologies in the food and feed chain. It states that risk assessment should be performed by following a step-wise procedure. Whenever human or animal exposure to nanomaterials is expected, the general hazard characterisation scheme requests information from in vitro genotoxicity, toxicokinetic and repeated dose 90-day oral toxicity studies in rodents. Numerous prevailing uncertainties with regard to nanomaterial characterisation and their hazard and risk assessment are addressed in the guidance document. This article discusses the impact of these knowledge gaps on meeting the goal of ensuring human safety. The EFSA's guidance on the risk assessment of ENMs in food and animal feed is taken as an example for discussion, from the point of view of animal welfare, on what level of uncertainty should be considered acceptable for human safety assessment of products with non-medical applications, and whether animal testing should be considered ethically acceptable for such products.

  11. Teen Dating Violence Prevention Program Assessment

    Science.gov (United States)

    Lucas, Quincy Arrianna Rose

    2013-01-01

    The American Psychological Association (APA) has identified the prevention of and intervention in relationship violence as a top priority (APA, n.d.). According to the Center for Disease Control and Prevention's 2012 Teen Dating Violence Fact Sheet, dating violence is a serious problem in the United States. In accordance with Foshee et al. (1998):…

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

    Science.gov (United States)

    Kawakami, Ryoko; Miyachi, Motohiko

    2010-10-01

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

  13. Assessment of severe accident prevention and mitigation features: PWR, large dry containment design

    International Nuclear Information System (INIS)

    Perkins, K.R.; Hsu, C.J.; Lehner, J.R.; Luckas, W.J.; Cho, N.; Fitzpatrick, R.G.; Pratt, W.T.; Eltawila, F.; Maly, J.A.

    1988-07-01

    Plant features and operator actions which have been found to be important in either preventing or mitigating severe accidents in PWRs with large dry containments have been identified. These features and actions were developed from insights derived from reviews of risk assessments performed specifically for the Zion plant and from assessments of other relevant studies. Accident sequences that dominate the core-damage frequency and those accident sequences that are of potentially high consequence were identified. Vulnerabilities of the large dry containment to severe accident containment loads were also identified. In addition, those features of a PWR with a large dry containment, which are important for preventing core damage and are available for mitigating fission-product release to the environment were identified. The report is issued to provide focus to the analyst examining an individual plant. The report calls attention to plant features and operator actions and provides a list of deterministic tributes for assessing those features and actions found to be helpful in reducing the overall risk for Zion and other PWRs with large dry containments. Thus, the guidance is offered as a resource in examining the subject plant to determine if the same, or similar, plant features and operator actions will be of value in reducing overall plant risk. This report is intended to serve solely as guidance

  14. Assessment of severe accident prevention and mitigation features: PWR, ice-condenser containment design

    International Nuclear Information System (INIS)

    Hsu, C.J.; Perkins, K.R.; Luckas, W.J.; Fitzpatrick, R.G.; Cho, N.; Lehner, J.R.; Pratt, W.T.; Eltawila, F.; Maly, J.A.

    1988-07-01

    Plant features and operator actions which have been found to be important in either preventing and mitigating severe accidents in PWRs with ice-condenser containments have been identified. Thus features and actions were developed from insights derived from reviews of risk assessments performed specifically for the Sequoyah plant and from assessments of other relevant studies. Accident sequences that dominate the core-damage frequency and those accident sequences that are of potentially high consequence were identified. Vulnerabilities of the ice-condenser containment to sever accident containment loads were also identified. In addition, those features of a PWR with an ice-condenser containment, which are important for preventing core damage and are available for mitigating fission-product release to the environment were identified. This report is issued to provide focus to an analyst examining an individual plant. The report calls attention to plant features and operator actions and provides a list of deterministic attributes for assessing those features and actions found to be helpful in reducing the overall risk for Sequoyah and other PWRs with ice-condenser containments. Thus, the guidance is offered as a resource in examining the subject plant to determine if the same, or similar, plant features and operator actions will be of value in reducing overall plant risk. This report is intended to serve solely as guidance. 14 tabs

  15. Guidance documents: Continued support to improve operations of fish hatcheries and field sites to reduce the impact or prevent establishment of New Zealand Mudsnails and other invasive mollusks

    Science.gov (United States)

    Moffitt, Christine M.

    2017-01-01

    This project tested and revised a risk assessment/management tool authored by Moffitt and Stockton designed to provide hatchery biologists and others a structure to measure risk and provide tools to control, prevent or eliminate invasive New Zealand mudsnails (NZMS) and other invasive mollusks in fish hatcheries and hatchery operations. The document has two parts: the risk assessment tool, and an appendix that summarizes options for control or management.The framework of the guidance document for risk assessment/hatchery tool combines approaches used by the Hazard Analysis and Critical Control Points (HACCP) process with those developed by the Commission for Environmental Cooperation (CEC), of Canada, Mexico, and the United States, in the Tri-National Risk Assessment Guidelines for Aquatic Alien Invasive Species. The framework approach for this attached first document assesses risk potential with two activities: probability of infestation and consequences of infestation. Each activity is treated equally to determine the risk potential. These two activities are divided into seven basic elements that utilize scientific, technical, and other relevant information in the process of the risk assessment. To determine the probability of infestation four steps are used that have scores reported or determined and averaged. This assessment follows a familiar HACCP process to assess pathways of entry, entry potential, colonization potential, spread potential. The economic, environmental and social consequences are considered as economic impact, environmental impact, and social and cultural influences.To test this document, the Principal Investigator worked to identify interested hatchery managers through contacts at regional aquaculture meetings, fish health meetings, and through the network of invasive species managers and scientists participating in the Western Regional Panel on Aquatic Nuisance Species and the 100th Meridian Initiative's Columbia River Basin Team, and the

  16. Assessment of severe accident prevention and mitigation features: BWR, Mark II containment design

    International Nuclear Information System (INIS)

    Lehner, J.R.; Hsu, C.J.; Eltawila, F.; Perkins, K.R.; Luckas, W.J.; Fitzpatrick, R.G.; Pratt, W.T.

    1988-07-01

    Plant features and operator actions, which have been found to be important in either preventing or mitigating severe accidents in BWRs with Mark II containments (BWR Mark II's) have been identified. These features and actions were developed from insights derived from reviews of in-depth risk assessments performed specifically for the Limerick and Shoreham plants and from other relevant studies. Accident sequences that dominate the core-damage frequency and those accident sequences that are of potentially high consequence were identified. Vulnerabilities of the BWR Mark II to severe-accident containment loads were also noted. In addition, those features of a BWR Mark II, which are important for preventing core damage and are available for mitigating fission-product release to the environment were also identified. This report is issued to provide focus to an analyst examining an individual plant. This report calls attention to plant features and operator actions and provides a list of deterministic attributes for assessing those features and actions found to be helpful in reducing the overall risk for Mark II plants. Thus, the guidance is offered as a resource in examining the subject plant to determine if the same, or similar, plant features and operator actions will be of value in reducing overall plant risk. This report is intended to serve solely as guidance

  17. Radiation induced cancer: risk assessment and prevention

    International Nuclear Information System (INIS)

    Shore, R.E.

    1984-01-01

    A number of factors have to be considered in defining the cancer risk from ionizing radiation. These include the radiation sensitivity of the target tissue(s), the temporal pattern of risk, the shape of the dose-incidence curve, the effects of low dose rates, host susceptibility factors, and synergism with other environmental exposures. For the population as a whole the largest sources of radiation exposure are natural background radiation and medical/dental radiation. Radiation exposures in the medical field make up the largest volume of occupational exposures as well. Although new technologies offer opportunities to lower exposures, worker training, careful exposure monitoring with remedial feedback, and monitoring to prevent unnecessary radiodiagnostic procedures may be even more important means of reducing radiation exposure. Screening of irradiated populations can serve a useful preventive function, but only for those who have received very high doses

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2018-03-20

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

  20. Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society & Infection Prevention Society.

    Science.gov (United States)

    Price, E; Weaver, G; Hoffman, P; Jones, M; Gilks, J; O'Brien, V; Ridgway, G

    2016-03-01

    A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing & Allied Health Literature, Midwifery & Infant Care and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources much of the guidance represents good practice based on the consensus view of the Working Group. Breast pump milk collection kits should not be reused by different mothers unless they have been sterilized in a Sterile Services Department between these different users.When used by the same mother, a detergent wash followed by thorough rinsing and drying after each use gives acceptable decontamination for most circumstances, as long as it is performed correctly.Additional decontamination precautions to washing, rinsing and drying may be used if indicated by local risk assessments and on advice from the departmental clinicians and Infection Prevention and Control Teams. The microbiological quality of the rinse water is an important consideration, particularly for infants on neonatal units.If bottle brushes or breast/nipple shields are used, they should be for use by one mother only. Decontamination should be by the processes used for breast pump milk collection kits.Dummies (soothers, pacifiers or comforters) needed for non-nutritive sucking by infants on neonatal units, should be for single infant use. Manufacturers should provide these dummies ready-to-use and individually packaged. They must be discarded at least every 24 hours

  1. Use of toxicity assessment to develop site specific remediation criteria for oil and gas facilities : guidance manual

    International Nuclear Information System (INIS)

    1996-01-01

    The results of a two year study into the evaluation of toxicity-based methods to develop site-specific, risk-based cleanup objectives for the decommissioning of oil and gas facilities were compiled into a manual of guidance. The two basic approaches used in determining remediation criteria for contaminated sites are: (1) comparison of the concentrations of chemicals found on-site with broad regional or national soil and water quality objectives developed for the chemicals involved, and (2) site-specific risk assessment. Toxicity tests are used to test organisms such as earthworms, lettuce seeds, or larval fish directly in the soil, water or sediment suspected of being contaminated. The effects of any contamination on the survival, growth, reproduction, and behaviour of the test organisms are then evaluated. The manual provides guidance in: (1) using toxicity assessments within the regulatory framework of site decommissioning, (2) performing a toxicity assessment, and (3) developing site-specific criteria for a risk assessment. 18 refs., 3 tabs., 5 figs

  2. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - GEOCHEMISTRY LABORATORY AT SANDIA NATIONAL LABORATORIES

    Science.gov (United States)

    These reports summarize pollution prevention opportunity assessments conducted jointly by EPA and DOE at the Geochemistry Laboratory and the Manufacturing and Fabrication Repair Laboratory at the Department of Energy's Sandia National Laboratories facility in Albuquerque, New Mex...

  3. Data requirement comparison between the fixed site upgrade rule guidance compendium and the Structured Assessment Approach Licensee Submittal Document

    Energy Technology Data Exchange (ETDEWEB)

    Parziale, A.A.; Sacks, I.J.

    1980-12-01

    We compared the Structured Assessment Approach's (SAA) Licensee Submittal Document (LSD) with the Fixed Site Physical Protection Upgrade Rule Guidance Compendium Standard Format and Content (SFC) Guide using correlation matrices to see how well the data requirements of the SFC Guide coincided with those of a specific automated vulnerability assessment technique for fixed-site nuclear fuel cycle facilities, namely, SAA. We found that a limited SAA assessment is possible using the SFC Guide, but significant and critical safeguards vulnerabilities might be missed. Also, it was found that in some cases the organization and format of the SFC Guide input data and information made the preparation of data for the SAA somewhat awkward. 2 refs., 2 tabs.

  4. Dental student perception and assessment of their clinical knowledge in educating patients about preventive dentistry.

    Science.gov (United States)

    Metz, M J; Miller, C J; Lin, W S; Abdel-Azim, T; Zandinejad, A; Crim, G A

    2015-05-01

    In today's dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman (D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case-based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior (D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content-specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content-specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Campania preventability assessment committee: a focus on the preventability of the contrast media adverse drug reactions.

    Science.gov (United States)

    Sessa, Maurizio; Rossi, Claudia; Rafaniello, Concetta; Mascolo, Annamaria; Cimmaruta, Daniela; Scavone, Cristina; Fiorentino, Sonia; Grassi, Enrico; Reginelli, Alfonso; Rotondo, Antonio; Sportiello, Liberata

    2016-12-01

    The current study aims to assess the preventability of the contrast media adverse drug reactions reported through the Campania spontaneous reporting system, identifying the possible limitations emerged in this type of evaluation. All the individual case safety reports validated by the Campania Pharmacovigilance Regional Centre from July 2012 to September 2015 were screened to select those that reported contrast media as suspected drug. Campania Preventability Assessment Committee, in collaboration with clinicians specialized in Radiology, assessed the preventability according to the P-Method, through a case-by-case approach. From July 2012 to September 2015, 13798 cases were inserted by pharmacovigilance managers in the Italian Pharmacovigilance Network database (in the geographical contest of the Campania Region), of which 67 reported contrast media as suspected drug. Five preventable cases were found. The most reported causes for preventability were the inappropriate drug use for the case clinical conditions and the absence of the preventive measure administrated prior to the contrast media administration. Several limitations were found in the evaluation of the critical criteria for the preventability assessment. Educational initiatives will be organized directly to the healthcare professionals involved in the contrast media administration, to promote an appropriate use of the contrast media.

  6. Assessment of Dermatoglyphics Multiple Intelligence Test (DMIT Reports: Implication to Career Guidance Program Enhancement of Academic Institutions

    Directory of Open Access Journals (Sweden)

    Dr. Maria Luisa A. Valdez

    2014-04-01

    Full Text Available This research aims to assess the reports generated from the Dermatoglyphics Multiple Intelligence Test (DMIT administered by selected DMIT resource companies and consultancy firms in India with the end view of identifying its implication to career guidance program enhancement of academic institutions. This paper employed the descriptive research method which involved the use of documentary analysis, questionnaires and interviews with purposively selected respondents supported by the researchers’ analysis and insights with reference to the content of the data. Findings of this research revealed that the dermatoglyphics, as a scientific discipline, began with the publication of Purkinje’s thesis (1823 and Galton’s classic book, Fingerprints (1892; DMIT is a remarkable offshoot of Howard Gardner’s Theory of Multiple Intelligences which has the following salient features: Overview of the Dermatoglyphics and the Dermatoglyphics Multiple Intelligence Test/Analysis; Personality Assessment; Profile based on Gardner’s Multiple Intelligences and Dunn’s Brain Lateralization Theories; Learning Styles; Competency and Compatibility Profiles; Working Style; Leadership Style; Management Style; Report Interpretation; and Customized Academic and Relationship Advises; the respondents of this study gave their perceptions with reference to the beneficial results of the DMIT; and the foregoing findings have some implications that may be used by academic institutions to enhance their career guidance program.

  7. Training Needs Assessment in Occupational Risk Prevention into Schools

    Science.gov (United States)

    Burgos-Garcia, Antonio; Alonso-Morillejo, Enrique; Pozo-Munoz, Carmen

    2011-01-01

    The assessment of needs plays a relevant role in the training for preventing of risks at work into school, as it is a scientific procedure to identify and prioritise problems existing within an educative context. This type of assessment is the starting point for a subsequent planning of the educative interventions that will enable pupils and…

  8. Preventive effectiveness of pre-employment medical assessments

    NARCIS (Netherlands)

    de Kort, W.; van Dijk, F.

    1997-01-01

    Health gain, prevention of health loss, and avoidance of financial risk all seem to be driving forces for the use of pre-employment medical assessment. An attempt is made to measure the effect of implementing the pre-employment medical assessment on these end points. The anticipated maximum

  9. Preventive risk assessment in forensic child and youth care

    NARCIS (Netherlands)

    Assink, M.

    2017-01-01

    Risk assessment is central to the work of forensic mental health professionals, since it serves as a guide for prevention and intervention strategies. For effective risk assessment, knowledge on risk factors and their effects as well as the availability of valid and reliable instruments for risk

  10. Application of environmental accounting to pollution prevention assessments

    International Nuclear Information System (INIS)

    Del Mar, R.A.

    1997-08-01

    Environmental accounting represents a major paradigm shift in the way most companies account for costs and benefits. However, it is a change that must be made if pollution prevention is to become institutionalized into the corporate and government mainstream. Pollution prevention investments must be justified on an economic basis; without environmental accounting tools, pollution prevention investments cannot show their true profitability. This is because traditional accounting methods only track billable costs, thus ignoring some of the major benefits of pollution prevention investments, which are indirect savings resulting from a lessening of a company's regulatory compliance burden and present and future liabilities. This paper discusses how to apply environmental accounting principles to pollution prevention assessments to improve the outcome of profitability analyses

  11. Accelerator production of tritium pollution prevention design assessment

    International Nuclear Information System (INIS)

    Reynolds, R.; Nowacki, P.; Sheetz, S.O.; Lanik, P.

    1997-01-01

    This Pollution Prevention Design Assessment (PPDA) provides data for cost-benefit analysis of the potential environmental impact of the APT, is an integral part of pollution prevention/waste minimization, and is required by DOE for any activity generating radioactive, hazardous, and mixed wastes. It will also better position the APT to meet future requirements, since it is anticipated that regulatory and other requirements will continue to become more restrictive and demanding

  12. Early chronic obstructive pulmonary disease: definition, assessment, and prevention.

    Science.gov (United States)

    Rennard, Stephen I; Drummond, M Bradley

    2015-05-02

    Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. COPD, however, is a heterogeneous collection of diseases with differing causes, pathogenic mechanisms, and physiological effects. Therefore a comprehensive approach to COPD prevention will need to address the complexity of COPD. Advances in the understanding of the natural history of COPD and the development of strategies to assess COPD in its early stages make prevention a reasonable, if ambitious, goal. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Accelerator production of tritium pollution prevention design assessment

    Energy Technology Data Exchange (ETDEWEB)

    Reynolds, R.; Nowacki, P.; Sheetz, S.O. [Westinghouse Savannah River Co., Aiken, SC (United States); Lanik, P. [Burns and Roe Engineering Inc. (United States)

    1997-09-18

    This Pollution Prevention Design Assessment (PPDA) provides data for cost-benefit analysis of the potential environmental impact of the APT, is an integral part of pollution prevention/waste minimization, and is required by DOE for any activity generating radioactive, hazardous, and mixed wastes. It will also better position the APT to meet future requirements, since it is anticipated that regulatory and other requirements will continue to become more restrictive and demanding.

  14. Assessment of compliance costs resulting from implementation of the proposed Great Lakes water quality guidance

    International Nuclear Information System (INIS)

    Fenner, K.; Podar, M.; Snyder, B.

    1993-01-01

    The primary purpose of the study was to develop an estimate of the incremental cost to direct dischargers resulting from the implementation of the proposed Great Lakes Water Quality Guidance (GLWQG). This estimate reflects the incremental cost of complying with permit requirements developed using the Implementation Procedures and water quality criteria proposed in the GLWQG versus permit requirements based on existing State water quality standards. Two secondary analyses were also performed, one to develop a preliminary estimate of the costs that would be incurred by indirect dischargers to publicly owned treatment works (POTWs), and another to evaluate the cost-effectiveness of the GLWQG. Finally, several sensitivity analyses were performed to evaluate the impact of several major assumptions on the estimated compliance costs. To estimate compliance costs, permit limitations and conditions based on existing State water quality standards were compared to water quality-based limitations and conditions based on the proposed GLWQG criteria and Implementation Procedures for a sample of plants. The control measures needed to comply with the proposed GLWQG-based effluent limitations were evaluated. Individual plant compliance costs were estimated for these control measures based on information on treatment technology and cost analyses available in the literature. An overall compliance cost was projected from the sample based on statistical methods

  15. European Primary Care Cardiovascular Society (EPCCS) consensus guidance on stroke prevention in atrial fibrillation (SPAF) in primary care

    NARCIS (Netherlands)

    Hobbs, Fd Richard; Taylor, Clare J; Jan Geersing, Geert; Rutten, FH; Brouwer, Judith R

    BACKGROUND: Atrial fibrillation affects 1-2% of the general population and 10% of those over 75, and is responsible for around a quarter of all strokes. These strokes are largely preventable by the use of anticoagulation therapy, although many eligible patients are not treated. Recent large clinical

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

    Science.gov (United States)

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

    2018-04-01

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

  17. Evaluation Methods for Prevention Education.

    Science.gov (United States)

    Blue, Amy V.; Barnette, J. Jackson; Ferguson, Kristi J.; Garr, David R.

    2000-01-01

    Discusses the importance of assessing medical students' competence in prevention knowledge, skills, and attitudes. Provides general guidance for programs interested in evaluating their prevention instructional efforts, and gives specific examples of possible methods for evaluating prevention education. Stresses the need to tailor assessment…

  18. An assessment of option B implementation for the prevention of ...

    African Journals Online (AJOL)

    An assessment of option B implementation for the prevention of mother to child transmission in Dschang, Cameroon: results from the DREAM (Drug Resource ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader).

  19. original article assessment of effective coverage of hiv prevention of ...

    African Journals Online (AJOL)

    Abrham

    BACKGROUND: Coverage assessment of prevention of Pregnant Mother to Child Transmission. (PMTCT) of HIV service is useful to measure the health system effort or performance of health service delivery function and ... anti retroviral drugs, breast-feeding counseling and ... care service coverage to develop appropriate.

  20. An assessment of option B implementation for the prevention of ...

    African Journals Online (AJOL)

    An assessment of option B implementation for the prevention of mother to child transmission in Dschang, Cameroon: results from the DREAM (Drug Resource Enhancement against AIDS and ... Those with a CD4 count <350 cells/mm3 during pregnancy had the highest mortality risk (RR 2.53; 95% CL= 1.86-3.44). The HIV ...

  1. Image Guidance

    Science.gov (United States)

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

  2. Risk assessment guidance document for the UMTRA project groundwater remediation phase

    International Nuclear Information System (INIS)

    1992-05-01

    The purpose of the groundwater remedial activities at the Uranium Mill Tailings Remedial Action (UMTRA) sites is to reduce, control, or eliminate risks to human health and the environment. This is in accordance with Subpart B of 40 CFR 192. According to this regulation, the need for groundwater restoration is based upon US Environmental Protection Agency (EPA)-defined groundwater cleanup standards and must be consistent with the National Environmental Policy Act (NEPA) process. Risk assessments will be used in the UMTRA Groundwater Program to aid in the evaluation of sites. Risk assessments are conducted for four purposes: (1) Preliminary risk assessments are used to aid in prioritizing sites, scope data collection, end determine if a site presents immediate health risks. (2) Baseline risk assessments provide a comprehensive integration and interpretation of demographic, geographic, physical, chemical, and biological factors at a site to determine the extent of actual or potential harm. This information Is used to determine the need for remedial action. (3) Risk evaluation of remedial alternatives is performed to evaluate risks to humans or the environment associated with the various remedial strategies. (4) After remediation, an evaluation of residual risks is conducted. The information gathered for each of these risk evaluations is used to determine the need for subsequent evaluation. Several sites may be eliminated after a preliminary risk assessment if there is no current or future threat to humans or the environment. Likewise, much of the data from a baseline risk assessment can be used to support alternate concentration limits or supplemental standards demonstrations, or identify sensitive habitats or receptors that may be of concern in selecting a remedy

  3. Guidance on the safety assessment methodology for storage of radioactive waste

    International Nuclear Information System (INIS)

    Kinyanjui, M.N.

    2014-04-01

    This project on safety assessment on storage was carried out with the main objective of ensuring safety of human life and our environment. This is the fundamental principle of radiation protection. Safety assessment has been evaluated as a tool in the safety case in the pre-construction, operational and the post closure phase of storage. In particular the iterative process of evaluating and predicting safety scenarios at each stage of the process has proved to be prudent. It is important that this concept be adopted for this type of facility to ensure safety of mankind and the environment now and in the future.

  4. Supporting Situation Assessment through Attention Guidance: A Cost-Benefit and Depth of Processing Analysis

    National Research Council Canada - National Science Library

    Horrey, William J; Wickens, Christopher D

    2001-01-01

    ...). For half the trials, an automated system guided their attention to high-threat units. On two trials a memory probe was administered to assess the depth of processing of information, and on the final trial an automation failure was presented...

  5. Career writing : a creative, expressive and reflective approach to qualitative assessment and guidance

    NARCIS (Netherlands)

    dr. Frans Meijers; Reinekke Lengelle

    2015-01-01

    Career Writing is a narrative approach to qualitative career assessment whereby client (or student) groups use creative, reflective, and expressive forms of writing to foster an internal dialogue about career. It is intended to help individuals construct a career identity by uncovering life themes,

  6. Developing guidance in the nuclear criticality safety assessment for fuel cycle facilities

    International Nuclear Information System (INIS)

    Galet, C.; Evo, S.

    2012-01-01

    In this poster IRSN (Institute for radiation protection and nuclear safety) presents its safety guides whose purpose is to transmit the safety assessment know-how to any 'junior' staff or even to give a view of the safety approach on the overall risks to any staff member. IRSN has written a first version of such a safety guide for fuel cycle facilities and laboratories. It is organized into several chapters: some refer to types of assessments, others concern the types of risks. Currently, this guide contains 13 chapters and each chapter consists of three parts. In parallel to the development of criticality chapter of this guide, the IRSN criticality department has developed a nuclear criticality safety guide. It follows the structure of the three parts fore-mentioned, but it presents a more detailed first part and integrates, in the third part, the experience feedback collected on nuclear facilities. The nuclear criticality safety guide is online on the IRSN's web site

  7. Guidance for Large-scale Implementation of Alternate Wetting and Drying: A Biophysical Suitability Assessment

    Science.gov (United States)

    Sander, B. O.; Wassmann, R.; Nelson, A.; Palao, L.; Wollenberg, E.; Ishitani, M.

    2014-12-01

    The alternate wetting and drying (AWD) technology for rice production does not only save 15-30% of irrigation water, it also reduces methane emissions by up to 70%. AWD is defined by periodic drying and re-flooding of a rice field. Due to its high mitigation potential and its simplicity to execute this practice AWD has gained a lot of attention in recent years. The Climate and Clean Air Coalition (CCAC) has put AWD high on its agenda and funds a project to guide implementation of this technology in Vietnam, Bangladesh and Colombia. One crucial activity is a biophysical suitability assessment for AWD in the three countries. For this, we analyzed rainfall and soil data as well as potential evapotranspiration to assess if the water balance allows practicing AWD or if precipitation is too high for rice fields to fall dry. In my talk I will outline key factors for a successful large-scale implementation of AWD with a focus on the biophysical suitability assessment. The seasonal suitability maps that we generated highlight priority areas for AWD implementation and guide policy makers to informed decisions about meaningful investments in infrastructure and extension work.

  8. Using Technology and Assessment to Personalize Instruction: Preventing Reading Problems.

    Science.gov (United States)

    Connor, Carol McDonald

    2017-09-15

    Children who fail to learn to read proficiently are at serious risk of referral to special education, grade retention, dropping out of high school, and entering the juvenile justice system. Accumulating research suggests that instruction regimes that rely on assessment to inform instruction are effective in improving the implementation of personalized instruction and, in turn, student learning. However, teachers find it difficult to interpret assessment results in a way that optimizes learning opportunities for all of the students in their classrooms. This article focuses on the use of language, decoding, and comprehension assessments to develop personalized plans of literacy instruction for students from kindergarten through third grade, and A2i technology designed to support teachers' use of assessment to guide instruction. Results of seven randomized controlled trials demonstrate that personalized literacy instruction is more effective than traditional instruction, and that sustained implementation of personalized literacy instruction first through third grade may prevent the development of serious reading problems. We found effect sizes from .2 to .4 per school year, which translates into about a 2-month advantage. These effects accumulated from first through third grade with a large effect size (d = .7) equivalent to a full grade-equivalent advantage on standardize tests of literacy. These results demonstrate the efficacy of technology-supported personalized data-driven literacy instruction to prevent serious reading difficulties. Implications for translational prevention research in education and healthcare are discussed.

  9. Bridging the divide between theory and guidance in strategic environmental assessment: A path for Italian regions

    International Nuclear Information System (INIS)

    Baresi, Umberto; Vella, Karen J.; Sipe, Neil G.

    2017-01-01

    Clear and effective legislation is a requisite to bring sustainable development from theory into practice. This paper develops a methodology to investigate how Italian regional legislation disciplines the use of Strategic Environmental Assessment (SEA), the procedure used in the European Union (EU) to pursue sustainable development of policies, plans, and programs (PPPs). Our case study is the Italian regional level, examined to identify eventual flaws and areas for improvement for each regional legislative framework. For this purpose, this study refers to a selection of analytical criteria recurring in the international debate on sustainability assessments. Statistical multi-dimensional analysis is used to identify Italian regions with similar SEA legislation. We recognize four taxonomies, depending on the way regional legislation provides information about i) legislation and guidelines, ii) integration between SEA and PPPs, iii) sustainability goals, iv) technical organization, v) participatory organization, and vi) monitoring. The results suggest that Italian administrators should cooperate to improve legislation at the regional level. Acknowledging the institution-centred nature of SEA, this methodology could drive the EU to better support SEA development in countries with diversified traditions.

  10. Bridging the divide between theory and guidance in strategic environmental assessment: A path for Italian regions

    Energy Technology Data Exchange (ETDEWEB)

    Baresi, Umberto, E-mail: u.baresi@uq.edu.au [School of Geography, Planning and Environmental Management, The University of Queensland, Level 5, Building 35, The University of Queensland, Brisbane 4072 (Australia); Vella, Karen J., E-mail: karen.vella@qut.edu.au [School of Civil Engineering and Built Environment, Queensland University of Technology, Level 8, Block S, Queensland University of Technology, Brisbane 4000 (Australia); Sipe, Neil G., E-mail: n.sipe@uq.edu.au [School of Geography, Planning and Environmental Management, The University of Queensland, Level 5, Building 35, The University of Queensland, Brisbane 4072 (Australia)

    2017-01-15

    Clear and effective legislation is a requisite to bring sustainable development from theory into practice. This paper develops a methodology to investigate how Italian regional legislation disciplines the use of Strategic Environmental Assessment (SEA), the procedure used in the European Union (EU) to pursue sustainable development of policies, plans, and programs (PPPs). Our case study is the Italian regional level, examined to identify eventual flaws and areas for improvement for each regional legislative framework. For this purpose, this study refers to a selection of analytical criteria recurring in the international debate on sustainability assessments. Statistical multi-dimensional analysis is used to identify Italian regions with similar SEA legislation. We recognize four taxonomies, depending on the way regional legislation provides information about i) legislation and guidelines, ii) integration between SEA and PPPs, iii) sustainability goals, iv) technical organization, v) participatory organization, and vi) monitoring. The results suggest that Italian administrators should cooperate to improve legislation at the regional level. Acknowledging the institution-centred nature of SEA, this methodology could drive the EU to better support SEA development in countries with diversified traditions.

  11. CO{sub 2}MPARE. CO2 Model for Operational Programme Assessment in EU Regions. Technical background and guidance for deployment in EU regions

    Energy Technology Data Exchange (ETDEWEB)

    Hekkenberg, M. [ECN Policy Studies, Amsterdam (Netherlands); Le Pierres, S. [Energies Demain, Montreuil Sous Bois (France); Del Ciello, R. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development ENEA, Rome (Italy); Keppo, I. [University College London UCL, London (United Kingdom); Papagianni, S. [Centre for Renewable Energy Sources and Saving CRES, Pikermi Attiki (Greece); Harnych, J. [ENVIROS, Prague (Czech Republic)

    2013-03-15

    The CO2MPARE model enables national and regional authorities to assess the carbon impacts of Operational Programmes co-financed through the European Regional Development Fund (ERDF). This document provides technical background information and guidance for deploying the model in additional EU regions.

  12. Guidance on a harmonised framework for pest risk assessment and the identification and evaluation of pest risk management options by EFSA

    DEFF Research Database (Denmark)

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

    2010-01-01

    The Scientific Panel on Plant Health was requested by EFSA to develop a guidance document on a harmonised framework for risk assessment of organisms harmful to plants and plant products and the identification and evaluation of risk management options. The document provides guiding principles on a...

  13. Pollution Prevention Opportunity Assessment for the SNL/NM cafeterias.

    Energy Technology Data Exchange (ETDEWEB)

    McCord, Samuel Adam

    2005-12-01

    This Pollution Prevention Opportunity Assessment (PPOA) was conducted for the two Sandia National Laboratories/New Mexico cafeteria facilities between May and August 2005. The primary purpose of this PPOA is to assess waste and resource reduction opportunities and issue Pollution Prevention (P2) recommendations for Sandia's food service facilities. This PPOA contains recommendations for energy, water and resource reduction, as well as material substitution based upon environmentally preferable purchasing. Division 3000 has requested the PPOA report as part of the Division's compliance effort to implement the Environmental Management System (EMS) per DOE Order 450.1. This report contains a summary of the information collected and analyses performed with recommended options for implementation. The SNL/NM P2 Group will work with Division 3000 and the respective cafeteria facilities to implement these options.

  14. The 2014 FDA assessment of commercial fish: practical considerations for improved dietary guidance.

    Science.gov (United States)

    McGuire, Jennifer; Kaplan, Jason; Lapolla, John; Kleiner, Rima

    2016-07-13

    The U.S. Food and Drug Administration (FDA) recently released its report: A Quantitative Assessment of the Net Effects on Fetal Neurodevelopment from Eating Commercial Fish (As Measured by IQ and also by Early Age Verbal Development in Children). By evaluating the benefits and potential concerns of eating fish during pregnancy and breastfeeding, the analysis suggests that pregnant women consuming two seafood meals (8-12 oz) per week could provide their child with an additional 3.3 IQ points by age 9. Recent insights from behavioral economics research indicate that other factors, such as concerns about price and methylmercury (MeHg) exposure, appear to reduce fish consumption in many individuals.To assess the net effects of eating commercial fish during pregnancy, we compared the consumption of select fish species necessary to achieve IQ benefits with the amount necessary to have adverse developmental effects due to MeHg exposure. For the species or market types evaluated, the number of servings necessary to reach MeHg exposure to observe an adverse effect was at least twice that the amount estimated to achieve peak developmental benefit. We then reported average costs of fresh and canned or pouched fish, and calculated the cost per week for pregnant women to achieve maximum IQ benefits for their gestating child. Canned light tuna was the least expensive option at $1.83 per week to achieve maximum IQ benefit.Due to their relatively low cost, canned and pouched fish products eaten with enough regularity are likely to provide peak cognitive benefits. Because of its popularity, canned and pouched tuna could provide some of the largest cognitive benefits from fish consumption in the U.S. Future FDA consumer advice and related educational initiatives could benefit from a broader perspective that highlights the importance of affordable and accessible fish choices. These observations underscore the importance of clear public health messaging that address both health

  15. Pollution prevention opportunity assessment: Foundation of pollution prevention for waste management

    International Nuclear Information System (INIS)

    Damewood, R.W.

    1994-01-01

    The objective of this paper is to promote the Pollution Prevention Opportunity Assessment (PPOA) technique as a fundamental of pollution prevention for waste management. All key elements of an effective PPOA program are presented. These key elements include impacts of environmental laws on pollution prevention, PPOA concepts and overview, waste minimization opportunities assessment, reporting and monitoring waste minimization progress, and PPOA program implementation. As environmental laws evolve the focus is shifting from end-of-pipe pollution control to front-end source reduction. Waste minimization was mistakenly interpreted to mean the reduction of hazardous waste after generation in the past. The Pollution Prevention Act of 1990 has clearly defined its requirement on resource reduction. Waste reduction can be viewed as a criterion to assess all industrial processes and operations. The fundamental approach of PPOA focuses on a mass balance concept. This concept deals with tracking of chemicals from the point of purchase, through storage, utilization in the process, and waste generation at the end of process. In other words, PPOA is a technique to analyze this input/output process. By applying PPOA techniques, the framework of applicable compliance requirements to the current operation process is established. Furthermore, documentation of PPOA itself can meet as documentation requirements for environmental compliance. In general, the PPOA process consists of two phases. The first phase involves input and output process description and waste characterization. The second phase is an opportunities assessment for waste minimization from input/output waste characterization. These two phases are explained in detail in the paper

  16. German competent authority guidance in FE methods applications for package design assessment

    International Nuclear Information System (INIS)

    Voelzke, H.; Wieser, G.; Zencker, U.; Qiao Linan; Ballheimer, V.

    2004-01-01

    The development of new methods in analysing package designs by using the finite element method (FEM) is of increasing importance. Package designers are more and more applying the growing opportunities of numerical methods to perform safety assessments for their products which requires suited methods also for competent authorities like BAM to verify the applicants' results. This presentation gives an topical overview of the experiences and tendencies within the complex field of finite element design testing. There are at first some general and more formal aspects concerning the correct finite element program selection and documentation of modelling, material properties, boundaries and calculation results including their interpretation. To give a reliable basis to the applicants in Germany BAM has drawn up and published a Finite Element Guideline recently. Secondly, the paper discusses actual technical questions which are of a wide interest and range from mechanical reflections on cask drop and extreme impact scenarios to thermal reflections on decay heat removal and fire scenarios. Examples from BAM work on FE-development activities are shown to demonstrate the great opportunities as well as the difficulties of using finite element methods for package safety analysis and design testing

  17. German competent authority guidance in FE methods applications for package design assessment

    Energy Technology Data Exchange (ETDEWEB)

    Voelzke, H.; Wieser, G.; Zencker, U.; Qiao Linan; Ballheimer, V. [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany)

    2004-07-01

    The development of new methods in analysing package designs by using the finite element method (FEM) is of increasing importance. Package designers are more and more applying the growing opportunities of numerical methods to perform safety assessments for their products which requires suited methods also for competent authorities like BAM to verify the applicants' results. This presentation gives an topical overview of the experiences and tendencies within the complex field of finite element design testing. There are at first some general and more formal aspects concerning the correct finite element program selection and documentation of modelling, material properties, boundaries and calculation results including their interpretation. To give a reliable basis to the applicants in Germany BAM has drawn up and published a Finite Element Guideline recently. Secondly, the paper discusses actual technical questions which are of a wide interest and range from mechanical reflections on cask drop and extreme impact scenarios to thermal reflections on decay heat removal and fire scenarios. Examples from BAM work on FE-development activities are shown to demonstrate the great opportunities as well as the difficulties of using finite element methods for package safety analysis and design testing.

  18. INKAS – a guidance tool to assess the impact of adaptation measures against urban heat

    Directory of Open Access Journals (Sweden)

    Saskia Buchholz

    2016-06-01

    Full Text Available Cities are particularly vulnerable to extreme weather events such as heat waves, which are expected to increase in frequency, duration and intensity by the end of this century. Hence, climate adaptation in cities is necessary to improve their resilience against climate change impacts and to secure their sustainability, quality of life and economic strength. Urban planners, practitioners and decision-makers require knowledge about the effectiveness of city-scale climate adaptation measures to prioritise their options for action and to push forward the political process for the implementation of climate adaptation strategies in cities. The Deutscher Wetterdienst's new Information Portal for Climate Adaptation in Cities, INKAS, enables its users to assess and compare the quantitative effect of different adaptation measures for varying degrees of implementation. The impact of different climate adaptation measures designed to reduce summertime air temperatures in cities is systematically investigated by means of the urban climate modelling of idealised cities. INKAS is based on about 2000 urban climate simulations of various combinations of nine urban settlement types typical for Germany and of four urban surrounding countrysides. The simplified assumptions of idealised cities with typical urban settlement types simulated with the 3‑dimensional urban climate model MUKLIMO_3 increases the transferability of complex urban interrelations to local decision-makers and urban planners. Simulated adaptation measures include the use of materials with high reflectivity, the installation of green roofs and the transformation of impervious surfaces between buildings into pervious surfaces.

  19. Socioeconomic assessment guidance report: Determining the effects of amenity characteristics on business location decisions

    International Nuclear Information System (INIS)

    Allison, T.

    1993-02-01

    Evaluating perception-based impacts of hazardous waste facilities has become an increasingly important part of socioeconomic impact assessments in recent years. One area of discussion has been the potential effect of risk perceptions on business location decision making. This report evaluates the importance of environmental amenities (broadly defined to include natural, cultural, and recreational features; environmental quality; and other indexes of quality of life) with respect to decisions on locating both manufacturing and business service activities. It discusses the major theoretical and empirical issues that arise in attempting to determine the effects of environmental amenities on the location choices for businesses and business activities. This discussion is followed by a survey of major findings from the academic literature and a review of research by the state of Nevada. A number of recommendations for further research are also provided to help the US Department of Energy's Office of Civilian Radioactive Waste Management better understand the importance of perception-based impacts in business location decision making and estimate the scale of socioeconomic impacts that would result from siting a high-level waste repository in Nevada

  20. Socioeconomic assessment guidance report: Determining the effects of amenity characteristics on business location decisions

    Energy Technology Data Exchange (ETDEWEB)

    Allison, T.

    1993-02-01

    Evaluating perception-based impacts of hazardous waste facilities has become an increasingly important part of socioeconomic impact assessments in recent years. One area of discussion has been the potential effect of risk perceptions on business location decision making. This report evaluates the importance of environmental amenities (broadly defined to include natural, cultural, and recreational features; environmental quality; and other indexes of quality of life) with respect to decisions on locating both manufacturing and business service activities. It discusses the major theoretical and empirical issues that arise in attempting to determine the effects of environmental amenities on the location choices for businesses and business activities. This discussion is followed by a survey of major findings from the academic literature and a review of research by the state of Nevada. A number of recommendations for further research are also provided to help the US Department of Energy`s Office of Civilian Radioactive Waste Management better understand the importance of perception-based impacts in business location decision making and estimate the scale of socioeconomic impacts that would result from siting a high-level waste repository in Nevada.

  1. MODARIA WG5: Towards a practical guidance for including uncertainties in the results of dose assessment of routine releases

    Energy Technology Data Exchange (ETDEWEB)

    Mora, Juan C. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas - CIEMAT (Spain); Telleria, Diego [International Atomic Energy Agency - IAEA (Austria); Al Neaimi, Ahmed [Emirates Nuclear Energy Corporation - ENEC (United Arab Emirates); Blixt Buhr, Anna Ma [Vattenfall AB (Sweden); Bonchuk, Iurii [Radiation Protection Institute - RPI (Ukraine); Chouhan, Sohan [Atomic Energy of Canada Limited - AECL (Canada); Chyly, Pavol [SE-VYZ (Slovakia); Curti, Adriana R. [Autoridad Regulatoria Nuclear - ARN (Argentina); Da Costa, Dejanira [Instituto de Radioprotecao e Dosimetria - IRD (Brazil); Duran, Juraj [VUJE Inc (Slovakia); Galeriu, Dan [Horia Hulubei National Institute of Physics and Nuclear Engineering - IFIN-HH (Romania); Haegg, Ann- Christin; Lager, Charlotte [Swedish Radiation Safety Authority - SSM (Sweden); Heling, Rudie [Nuclear Research and Consultancy Group - NRG (Netherlands); Ivanis, Goran; Shen, Jige [Ecometrix Incorporated (Canada); Iosjpe, Mikhail [Norwegian Radiation Protection Authority - NRPA (Norway); Krajewski, Pawel M. [Central Laboratory for Radiological Protection - CLOR (Poland); Marang, Laura; Vermorel, Fabien [Electricite de France - EdF (France); Mourlon, Christophe [Institut de Radioprotection et de Surete Nucleaire - IRSN (France); Perez, Fabricio F. [Belgian Nuclear Research Centre - SCK (Belgium); Woodruffe, Andrew [Federal Authority for Nuclear Regulation - FANR (United Arab Emirates); Zorko, Benjamin [Jozef Stefan Institute (Slovenia)

    2014-07-01

    MODARIA (Modelling and Data for Radiological Impact Assessments) project was launched in 2012 with the aim of improving the capabilities in radiation dose assessment by means of acquisition of improved data for model testing, model testing and comparison, reaching consensus on modelling philosophies, approaches and parameter values, development of improved methods and exchange of information. The project focuses on areas where uncertainties remain in the predictive capability of environmental models, emphasizing in reducing associated uncertainties or developing new approaches to strengthen the evaluation of the radiological impact. Within MODARIA, four main areas were defined, one of them devoted to Uncertainty and Variability. In this area four working groups were included, Working Group 5 dealing with the 'uncertainty and variability analysis for assessments of radiological impacts arising from routine discharges of radionuclides'. Whether doses are estimated by using measurement data, by applying models, or through a combination of measurements and calculations, the variability and uncertainty contribute to a distribution of possible values. The degree of variability and uncertainty is represented by the shape and extent of that distribution. The main objective of WG5 is to explore how to consider uncertainties and variabilities in the results of assessment of doses in planned situations for controlling the impact of routine releases from radioactive and nuclear installations to the environment. The final aim is to produce guidance for the calculation of uncertainties in these exposure situations and for the presentation of such results to the different stakeholders. To achieve that objective the main tasks identified were: to find tools and methods for uncertainty and variability analysis applicable to dose assessments in routine radioactive discharges, to define scenarios where information on uncertainty and variability of parameters is available

  2. Integrated Assessment of Prevention and Restoration Actions to Combat Desertification

    Science.gov (United States)

    Bautista, S.; Orr, B. J.; Vallejo, R.

    2009-12-01

    Recent advances in desertification and land degradation research have provided valuable conceptual and analytical frameworks, degradation indicators, assessment tools and surveillance systems with respect to desertification drivers, processes, and impacts. These findings, together with stakeholders’ perceptions and local/regional knowledge, have helped to define and propose measures and strategies to combat land degradation. However, integrated and comprehensive assessment and evaluation of prevention and restoration strategies and techniques to combat desertification is still lacking, and knowledge on the feasibility and cost-effectiveness of the proposed strategies over a wide range of environmental and socio-economic conditions is very scarce. To address this challenge, we have launched a multinational project (PRACTICE - Prevention and Restoration Actions to Combat Desertification. An Integrated Assessment), funded by the European Commission, in order to link S & T advances and traditional knowledge on prevention and restoration practices to combat desertification with sound implementation, learning and adaptive management, knowledge sharing, and dissemination of best practices. The key activities for pursuing this goal are (1) to establish a platform and information system of long-term monitoring sites for assessing sustainable management and actions to combat desertification, (2) to define an integrated protocol for the assessment of these actions, and (3) to link project assessment and evaluation with training and education, adaptive management, and knowledge sharing and dissemination through a participatory approach involving scientists, managers, technicians, financial officers, and members of the public who are/were impacted by the desertification control projects. Monitoring sites are distributed in the Mediterranean Europe (Greece, Italy, Spain, and Portugal), Africa (Morocco, Namibia, South Africa), Middle East (Israel), China, and South and North

  3. Pollution prevention and waste minimization opportunity assessment in environmental restoration

    International Nuclear Information System (INIS)

    Roybal, J.A.; Willison, C.P.

    1997-01-01

    The Environmental Restoration (ER) Project at Sandia National Laboratories implicitly subscribed to the philosophy of pollution prevention and waste minimization. As a result of a Department of Energy (DOE) offer, Pollution Prevention Opportunity Assessments (PPOA) were conducted at two ER sites and a decontamination and Demolition (D and D) site. The purpose of one of the PPOAs was to identify pollution prevention (P2) opportunities during environmental remediation at the Classified Waste Landfill located at Sandia National Laboratories, New Mexico (SNL/NM). The remediation activities at this site are scheduled to begin in the fall of 1997. The PPOA included presentations by the team members, a tour of the site, and a brainstorming session to list the waste streams, identify P2 opportunities and rank them in order of priority. Twenty-five P2 opportunities were identified during the brainstorming session of which twenty-two opportunities were selected for further investigation. Those twenty-two opportunities are discussed in this paper. A cost benefit analysis was performed for each P2 opportunity based on the estimated waste volume, feasibility, and cost. Pollution Prevention by Design (P2D) was incorporated into the PPOA to introduce waste minimization techniques that can be used during the planning phase of restoration projects

  4. Issuance of Final Guidance: Ecological Risk Assessment and Risk Management Principles for Superfund Sites, October 7, 1999

    Science.gov (United States)

    This guidance is intended to help Superfund risk managers make ecological risk management decisions that are based on sound science, consistent across Regions, and present a characterization of site risks that is transparent to the public.

  5. How Has CDER Prepared for the Nano Revolution? A Review of Risk Assessment, Regulatory Research, and Guidance Activities.

    Science.gov (United States)

    Tyner, Katherine M; Zheng, Nan; Choi, Stephanie; Xu, Xiaoming; Zou, Peng; Jiang, Wenlei; Guo, Changning; Cruz, Celia N

    2017-07-01

    The Nanotechnology Risk Assessment Working Group in the Center for Drug Evaluation and Research (CDER) within the United States Food and Drug Administration (FDA) was established to assess the potential impact of nanotechnology on drug products. One of the working group's major initiatives has been to conduct a comprehensive risk management exercise regarding the potential impact of nanomaterial pharmaceutical ingredients and excipients on drug product quality, safety, and efficacy. This exercise concluded that current review practices and regulatory guidance are capable of detecting and managing the potential risks to quality, safety, and efficacy when a drug product incorporates a nanomaterial. However, three risk management areas were identified for continued focus during the review of drug products containing nanomaterials: (1) the understanding of how to perform the characterization of nanomaterial properties and the analytical methods used for this characterization, (2) the adequacy of in vitro tests to evaluate drug product performance for drug products containing nanomaterials, and (3) the understanding of properties arising from nanomaterials that may result in different toxicity and biodistribution profiles for drug products containing nanomaterials. CDER continues to actively track the incorporation of nanomaterials in drug products and the methodologies used to characterize them, in order to continuously improve the readiness of our science- and risk-based review approaches. In parallel to the risk management exercise, CDER has also been supporting regulatory research in the area of nanotechnology, specifically focused on characterization, safety, and equivalence (between reference and new product) considerations. This article provides a comprehensive summary of regulatory and research efforts supported by CDER in the area of drug products containing nanomaterials and other activities supporting the development of this emerging technology.

  6. Guidance for Preventing Birth Defects

    Science.gov (United States)

    ... start in life will help you to have peace of mind. Before pregnancy » During pregnancy » To learn ... value="Submit" /> Information For… Media Policy Makers Language: English (US) Español (Spanish) File Formats Help: How ...

  7. The Future of Preschool Prevention, Assessment, and Intervention.

    Science.gov (United States)

    Hudziak, Jim; Archangeli, Christopher

    2017-07-01

    Preschoolers are in the most rapid period of brain development. Environment shapes the structure and function of the developing brain. Promoting brain health requires cultivation of healthy environments at home, school, and in the community. This improves the emotional-behavioral and physical health of all children, can prevent problems in children at risk, and can alter the trajectory of children already suffering. For clinicians, this starts with assessing and treating the entire family, equipping parents with the principles of parent management training, and incorporating wellness prescriptions for nutrition, physical activity, music, and mindfulness. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Researching Human Experience: video intervention/prevention assessment (VIA

    Directory of Open Access Journals (Sweden)

    Jennifer Patashnick

    2005-05-01

    Full Text Available Human experience is a critical subject for research. By discussing Video Intervention/Prevention Assessment (VIA, a patient-centered health research method where patients teach their clinicians about living with a chronic condition through the creation of visual illness narratives, this paper examines the value of qualitative inquiry and why human experience rarely is investigated directly. An analysis of a sample VIA data is presented to demonstrate how, by utilizing grounded theory and qualitative analysis, one can derive rich and unique information from human experience.

  9. Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society and Infection Prevention Society.

    Science.gov (United States)

    Price, E; Weaver, G; Hoffman, P; Jones, M; Gilks, J; O'Brien, V; Ridgway, G

    2016-03-01

    A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a Joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing and Allied Health Literature, Midwifery and Infant Care, and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources, much of the guidance represents good practice based on the consensus view of the Working Group. This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Developing an acceptability assessment of preventive dental treatments.

    Science.gov (United States)

    Hyde, Susan; Gansky, Stuart A; Gonzalez-Vargas, Maria J; Husting, Sheila R; Cheng, Nancy F; Millstein, Susan G; Adams, Sally H

    2009-01-01

    Early childhood caries (ECC) is very prevalent among young Hispanic children. ECC is amenable to a variety of preventive procedures, yet many Hispanic families underutilize dental services. Acceptability research may assist in health care planning and resource allocation by identifying patient preferences among efficacious treatments with the goal of improving their utilization. The purposes of this study were (a) to develop a culturally competent acceptability assessment instrument, directed toward the caregivers of young Hispanic children, for five preventive dental treatments for ECC and (b) to test the instrument's reliability and validity. An instrument of five standard treatments known to prevent ECC was developed, translated, reviewed by focus groups, and pilot tested, then tested for reliability The instrument included illustrated cards, brief video clips, and samples of the treatments and was culturally appropriate for low-income Hispanic caregivers. In addition to determining the acceptability of the five treatments individually, the treatments were also presented as paired comparisons. Focus groups and debriefing interviews following the pilot tests established that the instrument has good face validity. The illustrated cards, product samples, and video demonstrations of the five treatments resulted in an instrument possessing good content validity. The instrument has good to excellent test-retest reliability, with identical time 1-time 2 responses for each of the five treatments 92 percent of the time (range 87 to 97 percent), and the same treatment of the paired comparisons preferred 75 percent of the time (range 61 to 90 percent). The acceptability instrument described is reliable and valid and may be useful in program planning efforts to identify and increase the utilization of preferred ECC preventive treatments for target populations.

  11. Non-cable vehicle guidance

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-06-01

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

  12. Topic 8 Ecological Risk Assessment and regulatory guidance, radioecological assessment and radioprotection of the territory of Moscow

    Energy Technology Data Exchange (ETDEWEB)

    Polski, O.G.; Shmonov, M.G.; Lakaev, V.S. [Scientific-and-Industrial Association Radon, Moscow (Russian Federation)

    2004-07-01

    Moscow is the historical centre of the atom project of the former USSR. The radiation situation in Moscow has been regularly monitored by 'Radon' Scientific-and-Industrial Association (Moscow) since 1987. In pursuance of conception and Program of the Environmental Radiation Monitoring in Moscow the environmental activity and monitoring of radiation exposure doses in Moscow area have been carried out. The environmental radiation monitoring includes radiation measuring, classification and summarisation of the data file, creation of the data bank, assessment of the general and local radiation situation and it's forecasting. The system for environmental radiation monitoring consists of mobile and stationary monitoring equipment. The mobile equipment includes the automobile, water and aircraft means for monitoring. The stationary equipment includes means for periodical monitoring (134 sites), a network for stationary monitoring of air (4 sites), water areas (64 sites) and a network for automated monitoring of radiation background (MRB) ( 19 sites). MRB are disposed at highways, railroads, large enterprises, at densely populated localities, taking into account the regularity of encompassing all administrative regions. MRB represents a totally automated component for monitoring at the region. It permanently monitors the radiation background in automatic mode, providing for monitoring the preset threshold background values and informing the data processing centre of exceeding the above preset values. The equipment monitors and reports the radiation values twenty four hours a day. The information is provided for the population at indication boards. More than 3000 environmental samples are monitored and studied; about 2500 km of automatic gamma-survey is carried out annually and 300 thermoluminescent dosimeters have been used to monitor the absorbed radiation dose. The major radionuclides monitored in the environmental samples have been the decay products of

  13. A critical assessment of vector control for dengue prevention.

    Directory of Open Access Journals (Sweden)

    Nicole L Achee

    2015-05-01

    Full Text Available Recently, the Vaccines to Vaccinate (v2V initiative was reconfigured into the Partnership for Dengue Control (PDC, a multi-sponsored and independent initiative. This redirection is consistent with the growing consensus among the dengue-prevention community that no single intervention will be sufficient to control dengue disease. The PDC's expectation is that when an effective dengue virus (DENV vaccine is commercially available, the public health community will continue to rely on vector control because the two strategies complement and enhance one another. Although the concept of integrated intervention for dengue prevention is gaining increasingly broader acceptance, to date, no consensus has been reached regarding the details of how and what combination of approaches can be most effectively implemented to manage disease. To fill that gap, the PDC proposed a three step process: (1 a critical assessment of current vector control tools and those under development, (2 outlining a research agenda for determining, in a definitive way, what existing tools work best, and (3 determining how to combine the best vector control options, which have systematically been defined in this process, with DENV vaccines. To address the first step, the PDC convened a meeting of international experts during November 2013 in Washington, DC, to critically assess existing vector control interventions and tools under development. This report summarizes those deliberations.

  14. Opportunities for Prevention: Assessing Where Low-Income Patients Seek Care for Preventable Coronary Artery Disease.

    Science.gov (United States)

    Klaiman, Tamar A; Valdmanis, Vivian G; Bernet, Patrick; Moises, James

    2015-10-01

    The Affordable Care Act has many aspects that are aimed at improving health care for all Americans, including mandated insurance coverage for individuals, as well as required community health needs assessments (CHNAs), and reporting of investments in community benefit by nonprofit hospitals in order to maintain tax exemptions. Although millions of Americans have gained access to health insurance, many--often the most vulnerable--remain uninsured, and will continue to depend on hospital community benefits for care. Understanding where patients go for care can assist hospitals and communities to develop their CHNA and implementation plans in order to focus resources where the need for prevention is greatest. This study evaluated patient care-seeking behavior among patients with coronary artery disease (CAD) in Florida in 2008--analyzed in 2013--to assess whether low-income patients accessed specific safety net hospitals for treatment or received care from hospitals that were geographically closer to their residence. This study found evidence that low-income patients went to hospitals that treated more low-income patients, regardless of where they lived. The findings demonstrate that hospitals-especially public safety net hospitals with a tradition of treating low-income patients suffering from CAD-should focus prevention activities where low-income patients reside.

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

    Science.gov (United States)

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

    2010-03-01

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

  16. Environmental carcinogenic agents and cancer prevention. Risk assessment and management

    International Nuclear Information System (INIS)

    Tsugane, Shoichiro

    2013-01-01

    Many agents in our environment have been established as being carcinogenic, and in most cases, the carcinogenic properties of these agents were identified because of high-dose occupational or accidental exposure. Risk characterization, taking into account the dose-response relationship, and exposure assessment are essential for risk assessment and subsequent cancer prevention. Based on scientific risk assessment, risk management should be conducted practically by considering the economic, social, political, and other technical issues and by balancing the risks and benefits. Asbestos and environmental tobacco smoke are typical examples of established carcinogenic agents in the general environment, contributing to low-dose exposure. Further epidemiological studies are required to investigate the carcinogenicity of low-dose exposure to known carcinogenic agents such as arsenic and cadmium through dietary intake, radiation via medical and natural exposure, and air pollution due to diesel exhaust. In contrast, occupational chemical exposure to 1,2-dichloropropane and/or dichloromethane, whose carcinogenicity had not been established, was suggested to cause cholangiocarcinoma among workers involved in offset color proof-printing only after a rare situation of high-dose exposure was unveiled. Continuous monitoring of unusual cancer occurrences in target populations such as workers in occupational and regional settings as well as exposure reduction to suspected carcinogenic agents to levels as low as reasonably achievable is essential for reducing the risk of cancer due to environmental carcinogens. (author)

  17. Assessment of pollution prevention and control technology for plating operations

    Science.gov (United States)

    Chalmer, Paul D.; Sonntag, William A.; Cushnie, George C., Jr.

    1995-01-01

    The National Center for Manufacturing Sciences (NCMS) is sponsoring an on-going project to assess pollution prevention and control technology available to the plating industry and to make this information available to those who can benefit from it. Completed project activities include extensive surveys of the plating industry and vendors of technologies and an indepth literature review. The plating industry survey was performed in cooperation with the National Association of Metal Finishers. The contractor that conducted the surveys and prepared the project products was CAI Engineering. The initial products of the project were made available in April, 1994. These products include an extensive report that presents the results of the surveys and literature review and an electronic database. The project results are useful for all those associated with pollution prevention and control in the plating industry. The results show which treatment, recovery and bath maintenance technologies have been most successful for different plating processes and the costs for purchasing and operating these technologies. The project results also cover trends in chemical substitution, the identification of compliance-problem pollutants, sludge generation rates, off-site sludge recovery and disposal options, and many other pertinent topics.

  18. Guidance for the safety assessment of botanicals and botanical preparations for use in food and food supplements.

    Science.gov (United States)

    Schilter, B; Andersson, C; Anton, R; Constable, A; Kleiner, J; O'Brien, J; Renwick, A G; Korver, O; Smit, F; Walker, R

    2003-12-01

    There is a growing interest by both consumers and industry for the development of food products with 'functional' properties, or health benefits. These products may take the form of dietary supplements or of foods. The health benefits are given by particular ingredients, and in many cases these are derived from botanicals. The variety of plants providing these functions is large, ranging from staple food sources such as cereals, fruits and vegetables, to herbals as used in traditional medicine. The food or ingredient conferring health properties may consist of the plants themselves, extracts thereof, or more purified components. The scientific literature is abundant with articles not only on the beneficial properties, but also on possible adverse health effects of plants and their components. The present report discusses the data required to determine the safe use of these types of ingredients, and provides advice on the development of risk assessment strategies consistent with due diligence under existing food regulations. Product specifications, composition and characterisation of standardised and authentic materials, documented history of use and comparison to existing products (taking into account the effect of industrial processing), description of the intended use and consequent exposure are highlighted as key background information on which to base a risk evaluation. The extent of experimental investigation required, such as in vitro, animal, and/or human studies, depends on the adequacy of this information. A decision tree is presented as an aid to determine the extent of data requirements based on product comparison. The ultimate safety in use depends on the establishment of an adequate safety margin between expected exposure and identified potential hazards. Health hazards may arise from inherent toxicities or contaminants of the plant materials, including the mechanism of the intended beneficial effect. A lower safety margin may therefore be expected

  19. Exploration of the methodological quality and clinical usefulness of a cross-sectional sample of published guidance about exercise training and physical activity for the secondary prevention of coronary heart disease.

    Science.gov (United States)

    Abell, Bridget; Glasziou, Paul; Hoffmann, Tammy

    2017-06-13

    Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other

  20. Fall Prevention Self-Assessments Via Mobile 3D Visualization Technologies: Community Dwelling Older Adults' Perceptions of Opportunities and Challenges.

    Science.gov (United States)

    Hamm, Julian; Money, Arthur; Atwal, Anita

    2017-06-19

    In the field of occupational therapy, the assistive equipment provision process (AEPP) is a prominent preventive strategy used to promote independent living and to identify and alleviate fall risk factors via the provision of assistive equipment within the home environment. Current practice involves the use of paper-based forms that include 2D measurement guidance diagrams that aim to communicate the precise points and dimensions that must be measured in order to make AEPP assessments. There are, however, issues such as "poor fit" of equipment due to inaccurate measurements taken and recorded, resulting in more than 50% of equipment installed within the home being abandoned by patients. This paper presents a novel 3D measurement aid prototype (3D-MAP) that provides enhanced measurement and assessment guidance to patients via the use of 3D visualization technologies. The purpose of this study was to explore the perceptions of older adults with regard to the barriers and opportunities of using the 3D-MAP application as a tool that enables patient self-delivery of the AEPP. Thirty-three community-dwelling older adults participated in interactive sessions with a bespoke 3D-MAP application utilizing the retrospective think-aloud protocol and semistructured focus group discussions. The system usability scale (SUS) questionnaire was used to evaluate the application's usability. Thematic template analysis was carried out on the SUS item discussions, think-aloud, and semistructured focus group data. The quantitative SUS results revealed that the application may be described as having "marginal-high" and "good" levels of usability, along with strong agreement with items relating to the usability (P=.004) and learnability (Putility with regards to effectiveness, efficiency, accuracy, and reliability of measurements that are recorded using the application and to compare it with 2D measurement guidance leaflets. ©Julian Hamm, Arthur Money, Anita Atwal. Originally published in

  1. Preventing blood transfusion failures: FMEA, an effective assessment method.

    Science.gov (United States)

    Najafpour, Zhila; Hasoumi, Mojtaba; Behzadi, Faranak; Mohamadi, Efat; Jafary, Mohamadreza; Saeedi, Morteza

    2017-06-30

    Failure Mode and Effect Analysis (FMEA) is a method used to assess the risk of failures and harms to patients during the medical process and to identify the associated clinical issues. The aim of this study was to conduct an assessment of blood transfusion process in a teaching general hospital, using FMEA as the method. A structured FMEA was recruited in our study performed in 2014, and corrective actions were implemented and re-evaluated after 6 months. Sixteen 2-h sessions were held to perform FMEA in the blood transfusion process, including five steps: establishing the context, selecting team members, analysis of the processes, hazard analysis, and developing a risk reduction protocol for blood transfusion. Failure modes with the highest risk priority numbers (RPNs) were identified. The overall RPN scores ranged from 5 to 100 among which, four failure modes were associated with RPNs over 75. The data analysis indicated that failures with the highest RPNs were: labelling (RPN: 100), transfusion of blood or the component (RPN: 100), patient identification (RPN: 80) and sampling (RPN: 75). The results demonstrated that mis-transfusion of blood or blood component is the most important error, which can lead to serious morbidity or mortality. Provision of training to the personnel on blood transfusion, knowledge raising on hazards and appropriate preventative measures, as well as developing standard safety guidelines are essential, and must be implemented during all steps of blood and blood component transfusion.

  2. Development of a guidance manual for the identification and assessment of interactions as part of Environmental Impact Assessment; Entwicklung einer Arbeitsanleitung zur Beruecksichtigung der Wechselwirkungen in der Umweltvertraeglichkeitspruefung

    Energy Technology Data Exchange (ETDEWEB)

    Rassmus, J.; Bruening, H.; Kleinschmidt, V.; Reck, H.; Dierssen, K.; Bonk, A. [Kiel Univ. (Germany). Oekologie-Zentrum

    2001-03-01

    The objective of the project was the development of a practice-oriented guidance manual for the identification and assessment of interactions as part of EIA. The guidance manual is to assist developers and their consultants in identifying the effects of a project on interactions and adequately describing them in the application dossier and to support the authorities in subsequent assessment. Based inter alia on a review of relevant literature and through the performance of workshops, relevant legal principles and scientific knowledge (notably current knowledge from ecosystem research), guidelines, procedural instructions and similar documents from Germany and elsewhere as well as the approaches applied in EIA practice were evaluated and further developed. On this basis, a definition of 'interactions' was in the project, which defines interactions within the meaning of the Eu's EIA Directive and Art. 2 of the German Environmental Impact Assessment Act as processes which occur in the environment. The analysis of effect chains and webs, as often carried out in EIA practice to date, already enables an extensive identification and characterisation of processes/interactions, since the elements of the chains and webs are interlinked by processes. Here, the guidance manual developed in the project goes one step farther in that it recommends a procedure for the systematic analysis of effect chains and webs, with defined interfaces for data delivery from one specialist to another which are situated at the points where these chains or webs meet. The effects of a project on interactions, as identified using the above procedure, are described in chapters specific to individual protected assets and subsequently evaluated using the conventional approach which involves the application of assessment standards (e.g., limit values laid down in the various specialised laws, precautionary guide and threshold values) according to current knowledge. As an additional module

  3. PSD Increment Consumption Guidance

    Science.gov (United States)

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

  4. [Evaluation of the relapse prevention guidance for drug-dependent inmates: the intervention using self-teach workbook and group therapy in a "private finance initiative" prison--the first report].

    Science.gov (United States)

    Matsumoto, Toshihiko; Imamura, Fumie; Kobayashi, Ohji; Wada, Kiyoshi; Ozaki, Shiro; Takeuchi, Yoshio; Hasegawa, Masahiko; Imamura, Yoko; Tania, Yuko; Adachi, Yasumori

    2011-04-01

    In Japan, methamphetamine (MAP) abuse has been a serious problem for 60 years, and many of MAP abusers have been incarcerated in prisons as a violator of the Stimulant Control Law in Japan. The purpose of the present study is to evaluate effectiveness of the relapse prevention guidance for drug-dependent inmates using a self-teaching workbook for drug-abusing adolescents and group therapy, conducted in the Harima Rehabilitation Program Center, one of the new prisons which the Ministry of Justice founded cooperating private enterprises as a "Private Finance Initiative" project. We provided for 89 male drug-dependent inmates, incarcerated in the Harima Rehabilitation Program Center, with the relapse prevention guidance consisting of a self-teaching workbook and group therapy, and implement pre-and post-evaluations by the Self-efficacy Scale for Drug Dependence (SES) and the Stages of Change Readiness and Treatment Eagerness Scale, 8th version for Drug Dependence (SOCRATES-8D). After a waiting term, the participants were provided with a self-teaching program, subsequently with a group program. At the point of completing the waiting term, no significant changes were observed in the SES and SOCRATES-8D scores. However, at the point of completing the self-teaching program, the SES scores significantly fell, while the total SOCRATES-8D score and the scores of the two subscales, the "Recognition" and "Ambivalence," significantly rose. Further, at the point of completing the group program, the total scores of the SES and SOCRATES-8D, and the score of the two SOCRATES-8D subscales, the "Recognition" and "Taking Steps," significantly rose. The relapse prevention guidance consisting of a self-teaching workbook and group therapy, conducted in the Harima Rehabilitation Program Center, were supposed to bring same internal changes as the "Stage of Changes" model, proposed by Prochaska and DiClemente, to drug-dependent inmates.

  5. 77 FR 74194 - Issuance of Final Guidance Publication

    Science.gov (United States)

    2012-12-13

    ... NIOSH-238] Issuance of Final Guidance Publication AGENCY: National Institute for Occupational Safety and... Services (HHS). ACTION: Notice of issuance of final guidance publication. SUMMARY: The National Institute...), announces the availability of the following publication: NIOSH Alert entitled ``Preventing Occupational...

  6. 76 FR 14024 - Draft Guidance for Industry on Non-Penicillin Beta-Lactam Risk Assessment: A CGMP Framework...

    Science.gov (United States)

    2011-03-15

    ... appropriate steps during the manufacturing process to prevent cross-contamination of finished pharmaceuticals... implementing appropriate steps during the manufacturing process to prevent cross-contamination of finished... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0104...

  7. Global guidance on environmental life cycle impact assessment indicators: impacts of climate change, fine particulate matter formation, water consumption and land use

    DEFF Research Database (Denmark)

    Jolliet, Olivier; Antón, Assumpció; Boulay, Anne-Marie

    2018-01-01

    of water consumption on human health assesses the DALYs from malnutrition caused by lack of water for irrigated food production. Land use impacts: CFs representing global potential species loss from land use are proposed as interim recommendation suitable to assess biodiversity loss due to land use......Purpose: Guidance is needed on best-suited indicators to quantify and monitor the man-made impacts on human health, biodiversity and resources. Therefore, the UNEP-SETAC Life Cycle Initiative initiated a global consensus process to agree on an updated overall life cycle impact assessment (LCIA...... are recommended: (a) The global warming potential 100 years (GWP 100) represents shorter term impacts associated with rate of change and adaptation capacity, and (b) the global temperature change potential 100 years (GTP 100) characterizes the century-scale long term impacts, both including climate-carbon cycle...

  8. [Assessment on the capacity for programs regarding chronic non-communicable diseases prevention and control, in China].

    Science.gov (United States)

    Si, Xiang; Zhai, Yi; Shi, Xiaoming

    2014-06-01

    To assess the policies and programs on the capacity of prevention and control regarding non-communicable diseases (NCDs) at the Centers for Disease Control and Prevention (CDCs) at all levels and grass roots health care institutions, in China. On-line questionnaire survey was adopted by 3 352 CDCs at provincial, city and county levels and 1 200 grass roots health care institutions. 1) On policies: 75.0% of the provincial governments provided special funding for chronic disease prevention and control, whereas 19.7% city government and 11.3% county government did so. 2) Infrastructure:only 7.1% county level CDCs reported having a department taking care of NCD prevention and control. 8 263 staff members worked on NCDs prevention and control, accounting for 4.2% of all the CDCs' personnel. 40.2% CDCs had special funding used for NCDs prevention and control. 3)Capacity on training and guidance:among all the CDCs, 96.9% at provincial level, 50.3% at city level and 42.1% at county level had organized training on NCDs prevention and control. Only 48.3% of the CDCs at county level provided technical guidance for grass-roots health care institutions. 4) Capacities regarding cooperation and participation: 20.2% of the CDCs had experience in collaborating with mass media. 5) Surveillance capacity: 64.6% of the CDCs at county level implemented death registration, compare to less than 30.0% of CDCs at county level implemented surveillance programs on major NCDs and related risk factors. In the grass roots health care institutions, 18.6% implemented new stroke case reporting system but only 3.0% implemented program on myocardial infarction case reporting. 6) Intervention and management capacity: 36.1% and 32.2% of the CDCs conducted individualized intervention on hypertension and diabetes, while less than another 20% intervened into other NCDs and risk factors. More than 50% of the grass roots health care institutions carried follow-up survey on hypertension and diabetes. Rates

  9. Career Guidance and Public Mental Health

    Science.gov (United States)

    Robertson, Peter J.

    2013-01-01

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

  10. Why Guidance Works Better than Punishment.

    Science.gov (United States)

    Gartrell, Dan

    1995-01-01

    Examines how guidance techniques address the full spectrum of intervention methods, from prevention to conflict resolution to long-term management strategies. Discusses how punishment affects both children and teachers. Suggests that to put guidance into practice teachers should: be realistic, tailor activities to each child, practice positive…

  11. Assessment of knowledge and attitude towards prevention among ...

    African Journals Online (AJOL)

    =64) of the two dental colleges in Jammu city using pretested questionnaire. The questionnaire obtained information regarding their demographic and professional attributes, preventive knowledge regarding dental caries, periodontal disease, ...

  12. NICE-Accredited Commissioning Guidance for Weight Assessment and Management Clinics: a Model for a Specialist Multidisciplinary Team Approach for People with Severe Obesity.

    Science.gov (United States)

    Welbourn, Richard; Dixon, John; Barth, Julian H; Finer, Nicholas; Hughes, Carly A; le Roux, Carel W; Wass, John

    2016-03-01

    Despite increasing prevalence of obesity, no country has successfully implemented comprehensive pathways to provide advice to all the severely obese patients that seek treatment. We aimed to formulate pathways for referral into and out of weight assessment and management clinics (WAMCs) that include internal medicine/primary care physicians as part of a multidisciplinary team that could provide specialist advice and interventions, including referral for bariatric surgery. Using a National Institute of Health and Care Excellence (NICE)-accredited process, a Guidance Development Group conducted a literature search identifying existing WAMCs. As very few examples of effective structures and clinical pathways existed, the current evidence base for optimal assessment and management of bariatric surgery patients was used to reach a consensus. The model we describe could be adopted internationally by health services to manage severely obese patients.

  13. Methods for assessing the preventability of adverse drug events: a systematic review.

    Science.gov (United States)

    Hakkarainen, Katja Marja; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan

    2012-02-01

    Preventable adverse drug events (ADEs) are common in both outpatient and inpatient settings. However, the proportion of preventable ADEs varies considerably in different studies, even when conducted in the same setting, and methods for assessing the preventability of ADEs are diverse. The aim of this article is to identify and systematically evaluate methods for assessing the preventability of ADEs. Seven databases (Cochrane, CINAHL, EMBASE, IPA, MEDLINE, PsycINFO and Web of Science) were searched in September 2010 utilizing the databases' index terms and other common terminology on preventable ADEs. No limits for the years of publication were set. Reference lists of included original articles and relevant review articles were also screened. After applying predetermined inclusion and exclusion criteria on 4161 unique citations, 142 (3.4%) original research articles were included in the review. One additional article was included from reference lists. Outcome measures of included studies had to include the frequency of ADEs and the assessment of their preventability. Studies were excluded if they focused on individuals with one specific type of treatment, medical condition, medical procedure or ADE. Measurement instruments for determining the preventability of ADEs in each article were extracted and unique instruments were compared. The process of assessing the preventability of ADEs was described based on reported actions taken to standardize and conduct the assessment, and on information about the reliability and validity of the assessment. Eighteen unique instruments for determining the preventability of ADEs were identified. They fell under the following four groups: (i) instruments using a definition of preventability only (n = 3); (ii) instruments with a definition of preventability and an assessment scale for determining preventability (n = 5); (iii) instruments with specific criteria for each preventability category (n = 3); and (iv) instruments

  14. The threat of nuclear terrorism: Assessment and preventive action

    International Nuclear Information System (INIS)

    Nilsson, A.

    2001-01-01

    In the light of the events of 11 September, the General Conference requested the IAEA Director General to review thoroughly the activities and programmes of the Agency with a view to strengthening the Agency's work relevant to preventing acts of terrorism involving nuclear materials and other radioactive materials. That review is ongoing and the results will be presented in March to the Board of Governors, including proposals for revisions and updates on relevant programmes. It is underlined that preventing nuclear terrorism requires cooperation between States and with international organizations. The problem must be addressed in a comprehensive manner. The international community should therefore strive for strong, comprehensive, internationally accepted security systems

  15. Risk assessment and management to prevent preterm birth

    NARCIS (Netherlands)

    Koullali, B.; Oudijk, M. A.; Nijman, T. A. J.; Mol, B. W. J.; Pajkrt, E.

    2016-01-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history

  16. An assessment of mine legacies and how to prevent them

    DEFF Research Database (Denmark)

    Pacheco Cueva, Vladimir

    in eastern El Salvador, compared the country’s mine closure legislation against world’s best practice standards and provided strategies for awareness, prevention and remediation. The most damaging legacy to the environment is that of Acid Mine Drainage (AMD) contamination of the local river. The impact...

  17. A Systematic Assessment of Smartphone Tools for Suicide Prevention.

    Science.gov (United States)

    Larsen, Mark Erik; Nicholas, Jennifer; Christensen, Helen

    2016-01-01

    Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps) to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies. Apps referring to suicide or deliberate self-harm (DSH) were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature. One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27) and safety planning (n = 14). Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13). All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1), although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9). Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified. Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive evidence

  18. A Systematic Assessment of Smartphone Tools for Suicide Prevention.

    Directory of Open Access Journals (Sweden)

    Mark Erik Larsen

    Full Text Available Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies.Apps referring to suicide or deliberate self-harm (DSH were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature.One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27 and safety planning (n = 14. Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13. All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1, although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9. Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified.Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive

  19. Assessing the effects of anti-homosexuality legislation in Uganda on HIV prevention, treatment, and care services.

    Science.gov (United States)

    Semugoma, Paul; Beyrer, Chris; Baral, Stefan

    2012-01-01

    Uganda's response to the HIV epidemic has been lauded for its robustness and achievements. However, a key component of HIV prevention programming has been missing, for men who have sex with men (MSM). The main reason cited has been criminalization of male homosexual behavior. In 2009, the Anti-Homosexuality Bill (AHB) was introduced in the parliament to enhance existing anti-homosexuality law. A multi-disciplinary team made a Health Impact Assessment of the proposed AHB. The bill as tabled would severely increase punishments, increased closeting. Social capital of MSM would be eroded by clauses mandating reporting by friends, relatives, and acquaintances. Health-care professionals would have to inform on homosexuals. Mandatory HIV testing would be a blow to programming. Probable disclosure of HIV status in a public space (court) would also be a deterrent. Heftier punishments for those testing positive increases stigma and hobbles subsequent care. The AHB argues for exclusion, and more discrimination targeting persons living with HIV and sexual minorities. It will exacerbate the negative public health consequences of the existing legislation. The government of Uganda should review guidance documents published by authoritative bodies including the World Bank, World Health Organization to develop and bring to scale Human rights-affirming HIV prevention, treatment, and care responses.

  20. Guidance for Facilities on Risk Management Programs (RMP)

    Science.gov (United States)

    Includes supplemental guidance specific to ammonia refrigeration, wastewater treatment, propane storage, warehouses, chemical distributors, offsite consequence analysis, retail agriculture, applicability of program levels, prevention, emergency response.

  1. Pandemic risk prevention in European countries: role of the ECDC in preparing for pandemics. Development and experience with a national self-assessment procedure, 2005-2008.

    Science.gov (United States)

    Nicoll, A

    2010-12-01

    To be effective risk prevention work takes place well before pandemics through the three Ps: Planning, Preparedness and Practise. Between 2005 and 2008 the European Centre for Disease Prevention and Control (ECDC) worked with the European Commission (EC) and the WHO Regional Office for Europe (WHO-Euro) to assist European countries in preparing themselves for a future influenza pandemic. All eligible countries in the European Union and European Economic Area participated with energy and commitment. Indicators of preparedness were developed based on WHO planning guidance and these were set within a simple assessment which included a formal country visit. The procedure evolved considerably with field experience. As the complexity of pandemic preparedness was appreciated it changed from being a classical short external assessment to longer national self-assessments with demonstrable impact, especially when self-assessments were published. There were essential supporting activities undertaken including a series of pan-European pandemic preparedness workshops organised by EC, WHO-Euro, ECDC and countries holding the European Union Presidency. The self-assessments highlighted additional work and documentation that was needed by national authorities from the ECDC. This work was undertaken and the document produced. The benefits of the self-assessments were seen in the 2009 pandemic in that EU/EEA countries performed better than some others. A number of the guidance documents were updated to fit the specific features of the pandemic. However the pandemic revealed many weaknesses and brought new challenges for European countries, notably over communication and vaccines, the need to prepare for a variety of scenarios and to factor severity estimates into preparedness, to improve surveillance for severe disease and to deliver seroepidemiology. Any revised self-assessment procedure will need to respond to these challenges.

  2. Applying probabilistic methods for assessments and calculations for accident prevention

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    The guidelines for the prevention of accidents require plant design-specific and radioecological calculations to be made in order to show that maximum acceptable expsoure values will not be exceeded in case of an accident. For this purpose, main parameters affecting the accident scenario have to be determined by probabilistic methods. This offers the advantage that parameters can be quantified on the basis of unambigious and realistic criteria, and final results can be defined in terms of conservativity. (DG) [de

  3. BENCHPAR PROJECT. How to Incorporate ThermaI-Hydro-Mechanical Coupled Processes into Performance Assessments and Design Studies for Radioactive Waste Disposal in Geological Formations. Guidance Document

    International Nuclear Information System (INIS)

    Stephansson, O.; Andersson, Johan

    2005-02-01

    The objective of this Guidance Document is to provide advice on how to incorporate thermo-hydro-mechanical (THM) coupled processes into Performance Assessments (PAS) and design studies for radioactive waste disposal in geological formations to be experienced in a European context. The document has been generated by the EU research project BENCHPAR: Benchmark Tests and Guidance on Coupled Processes for Performance Assessment of Nuclear Waste Repositories. The document starts in Section 1 with an explanation of why numerical analyses incorporating THM mechanisms are required for radioactive waste studies and provides background material on the subject. Then, the THM processes and their interactions are explained in Section 2. Three case examples of THM numerical analysis are presented in Section 3 to illustrate the type of work that can be conducted to study the near-field, upscaling, and the far-field. For the three cases, there is discussion on the main findings, the relevance to a safety case, the relative importance of the different couplings, and the uncertainties involved. The importance and priority of the THM couplings are then summarized in Section 4. It is especially important to be able to technically audit the numerical analyses in order to establish that all the relevant variables, parameters and mechanisms have been included in the modelling and hence that the numerical model adequately represents the rock and engineering reality. Accordingly, recommended soft and hard auditing procedures are presented in Section 5. In this Guidance Document, we emphasize especially that the most important step in numerical modelling is not executing the calculations per se, but the earlier conceptualization of the problem regarding the dominant processes, the material properties and parameters, the engineering perturbations, and their mathematical presentations. The associated modelling component of addressing the uncertainties and estimating their influence on the

  4. Risk assessment for prevention of morbidity and mortality: lessons for pressure ulcer prevention.

    Science.gov (United States)

    Reynolds, T M

    2008-11-01

    Medicine has changed from being a reactive process that attempts to alleviate disease only when it is clinically evident to a proactive one in which it is hoped that early intervention may reduce the impact of disease or even it developing at all. In moving the focus of treatment, this inevitably means that a greater number of individuals with lesser disease burdens are treated. The logical end-point of this process is to provide preventative measures for the entire population but this can only be done if the economic costs and negative effects of treatment are out-weighed by the benefits. In the case of pressure ulcers, it is self-evident that prevention is extremely beneficial to patients. However, the cost of some of the equipment used for prevention can be high, and therefore, the balance between the optimum level of provision, the purposes of prevention and the available funding becomes critical. Consequently a screening mechanism to better match susceptible patients with resources is essential. There are, however, many problems with such screening techniques. By looking at other specialties, we can see that it is vital to know the natural history of the disease: PSA testing reveals many men who would have died never having known they had prostate cancer, thus giving them years of worry and morbidity they would probably not previously have suffered; cardiovascular risk screening is so imprecise that risk estimates are of questionable utility; antenatal Down's syndrome risk screening is prone to data-related problems that can unexpectedly reduce the effectiveness of the test. In pressure ulcer screening, there are many tools currently in use, but few (possibly none) are really effective. Finally, this paper details some suggestions for future research to combine risk tests that may offer a prospect for improving ulcer risk screening tools.

  5. Damage, Loss, and Needs Assessment Guidance Notes : Volume 3. Estimation of Post-Disaster Needs for Recovery and Reconstruction

    OpenAIRE

    Jovel, Roberto J.; Mudahar, Mohinder

    2010-01-01

    This is a guideline for World Bank task team leaders (TTLs) entrusted with the design and execution of assessments to determine disaster impacts as well as post-disaster needs for recovery, reconstruction, and disaster risk reduction or management. Assessments estimate, first, the short-term government interventions required to initiate recovery and second, the financial requirements to ac...

  6. Bioenergy systems sustainability assessment & management (BIOSSAM) guidance portal for policy, decision and development support of integrated bioenergy supply interventions

    CSIR Research Space (South Africa)

    Stafford, WHL

    2010-08-01

    Full Text Available . There are several new bioenergy interventions (policies, projects, or programmes) that are being considered and these developments must be assessed in terms of their sustainability. Both public and private sector policy makers, decision makers, and technology...

  7. Assessing maintenance contracts when preventive maintenance is outsourced

    International Nuclear Information System (INIS)

    Wu Shaomin

    2012-01-01

    In some companies, corrective maintenance is conducted in-house but preventive maintenance might be outsourced. This raises a need to optimise some parameters such as the number of contracts from a perspective of the equipment owner. This paper considers a maintenance policy for such a situation, analyses the roles of the parameters in a PM model, proposes approaches to defining bonus functions, and finally discusses special cases of both the PM policy and the bonus function. Numerical examples are also given to explore the impact of parameters on the expected lifecycle cost rate.

  8. Risk assessment and management to prevent preterm birth.

    Science.gov (United States)

    Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

    2016-04-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Prevention of Human Trafficking in Ethiopia: Assessing The Legal Framework

    Directory of Open Access Journals (Sweden)

    Zelalem Shiferaw Woldemichael

    2017-12-01

    Full Text Available Recent findings have indicated that both in-country trafficking (trafficking of individuals from rural areas to relatively affluent towns and cities and external trafficking (trafficking of individuals from a given country to foreign countries are prevalent in Ethiopia. In 2012, the government acceded to the Protocol to Suppress and Punish Trafficking in Persons Especially Women and Children supplementing the United Nations Convention against Transnational Organized Crime (The UN Trafficking Protocol, here after. With a view to giving effect to the requirements of this instrument, the government passed in to law Proclamation No. 909/2015 (The Prevention and Suppression of Trafficking in Persons and Smuggling of Migrants Proclamation, which is the most comprehensive of all laws adopted in Ethiopia to deal with human trafficking. Taking in to account the fact that human trafficking is exacerbated by the absence of regulatory framework on the employment of Ethiopian nationals in foreign countries, the govern-ment has also brought in to practice Proclamation No. 923/2016 (Ethiopia’s Overseas Employment Proclamation. This article has examined whether the above-mentioned laws of Ethiopia comply with international standards in dealing with prevention strategies.

  10. Graphic Turbulence Guidance

    Data.gov (United States)

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

  11. Graphical Turbulence Guidance - Composite

    Data.gov (United States)

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

  12. Career guidance in communities

    DEFF Research Database (Denmark)

    Thomsen, Rie

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

  13. Risk Assessment and Prevention of Hypertension in Filipino Americans.

    Science.gov (United States)

    Ma, Grace X; Lee, Minsun; Bhimla, Aisha; Tan, Yin; Gadegbeku, Crystal A; Yeh, Ming Chin; Aczon, Hermie

    2017-08-01

    Despite that Filipino Americans represent an important target group for hypertension, health behaviors associated with hypertension in this population have not been well studied. Two hundred Filipino Americans from eight community-based organizations completed the study. Information was collected to determine whether modifiable behavioral factors, as well as acculturation and demographic characteristics, were associated with hypertension status in Filipino Americans. Approximately 67% of Filipino Americans were hypertensive. Logistic regression analysis showed that adding salt, physical inactivity, and old age were significantly associated with hypertension status after controlling for other covariates. The present study confirmed a high rate of hypertension among Filipino Americans and demonstrates the association of hypertension status with behavioral factors. These findings highlight the need for targeted interventions to prevent and manage hypertension in this high-risk community by facilitating health behaviors, particularly, salt reduction and physical activity.

  14. [Assessment of a preconception preventive program in a community].

    Science.gov (United States)

    Sánchez, B; Mendoza, M E; Avila Rosas, H

    2000-01-01

    Primary Health Care (PHC) is the basic health support that includes health promotion and disease prevention, considering social and developmental factors. It is the main axis to pregestational health programs with the basic elements for the women's self-care. This study evaluated the impact on health behavior and adherence to a community based pregestational preventive program in 224 women of reproductive age from Mexico City. The women were exposed to a health education intervention for twelve months, with free clinical examination every six months in a mobile screening unit close to their homes. Food and hygiene one to one orientation was offered, together with anthropometric, blood pressure and biochemical evaluations. Program adherence was 55%. Most of the women were less than 25 years of age, education above nine years, non-single, housework occupation as housewives, from an extended family, with social security and two or less live children and desire for more. No differences were found in the evaluated factors between those who continued and those who left the program. When comparing initial and final data, a significant larger proportion did breast self-examination, while this was not the case for the Pap smear test, no differences were found in prevalence of anemia or overweight. Drop-out was mainly due to a lack of interest, school or work problems and change of address. While breast self examination showed a positive effect, the negative or no effect on the other factors requires the intervention of other health professionals and implies more effort from the women. If one of the objectives of the PHC is health promotion, nurse intervention is a prominent role in the community.

  15. Assessing Implementation Fidelity and Adaptation in a Community-Based Childhood Obesity Prevention Intervention

    Science.gov (United States)

    Richards, Zoe; Kostadinov, Iordan; Jones, Michelle; Richard, Lucie; Cargo, Margaret

    2014-01-01

    Little research has assessed the fidelity, adaptation or integrity of activities implemented within community-based obesity prevention initiatives. To address this gap, a mixed-method process evaluation was undertaken in the context of the South Australian Obesity Prevention and Lifestyle (OPAL) initiative. An ecological coding procedure assessed…

  16. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - MANUFACTURING AND FABRICATION REPAIR LABORATORY AT SANDIA NATIONAL LABORATORIES

    Science.gov (United States)

    These reports summarize pollution prevention opportunity assessments conducted jointly by EPA and DOE at the Geochemistry Laboratory and the Manufacturing and Fabrication Repair Laboratory at the Department of Energy's Sandia National Laboratories facility in Albuquerque, New Mex...

  17. Comparison of the guidance documents in support of EU risk assessments with those for the derivation of EU water quality standards

    NARCIS (Netherlands)

    Vos JH; Janssen MPM; SEC

    2005-01-01

    Risks of both new and existing substances and of biocides in Europe are being evaluated using the Technical Guidance Document (TGD). The European Water Framework Directive refers to this document for establishing Environmental Quality Standards (EQSs) for water. Another guidance document for the

  18. Dual in vivo Photoacoustic and Fluorescence Imaging of HER2 Expression in Breast Tumors for Diagnosis, Margin Assessment, and Surgical Guidance

    Directory of Open Access Journals (Sweden)

    Azusa Maeda

    2015-01-01

    Full Text Available Biomarker-specific imaging probes offer ways to improve molecular diagnosis, intraoperative margin assessment, and tumor resection. Fluorescence and photoacoustic imaging probes are of particular interest for clinical applications because the combination enables deeper tissue penetration for tumor detection while maintaining imaging sensitivity compared to a single optical imaging modality. Here we describe the development of a human epidermal growth factor receptor 2 (HER2-targeting imaging probe to visualize differential levels of HER2 expression in a breast cancer model. Specifically, we labeled trastuzumab with Black Hole Quencher 3 (BHQ3 and fluorescein for photoacoustic and fluorescence imaging of HER2 overexpression, respectively. The dual-labeled trastuzumab was tested for its ability to detect HER2 overexpression in vitro and in vivo. We demonstrated an over twofold increase in the signal intensity for HER2-overexpressing tumors in vivo, compared to low–HER2-expressing tumors, using photoacoustic imaging. Furthermore, we demonstrated the feasibility of detecting tumors and positive surgical margins by fluorescence imaging. These results suggest that multimodal HER2-specific imaging of breast cancer using the BHQ3-fluorescein trastuzumab enables molecular-level detection and surgical margin assessment of breast tumors in vivo. This technique may have future clinical impact for primary lesion detection, as well as intraoperative molecular-level surgical guidance in breast cancer.

  19. Testing REACH draft technical guidance notes for conducting chemical safety assessments-the experience of a downstream user of a preparation.

    Science.gov (United States)

    Gade, Anne Lill; Ovrebø, Steinar; Hylland, Ketil

    2008-07-01

    The goal of REACH is the safe use of chemicals. This study examines the efficiency and usefulness of two draft technical guidance notes in the REACH Interim Project 3.2-2 for the development of the chemical safety report and exposure scenarios. A case study was carried out for a paint system for protection of structural steel. The focuses of the study were risk assessment of preparations based on Derived No Effect Level (DNEL) and Predicted No Effect Concentrations (PNEC) and on effective and accurate communication in the supply chain. Exposure scenarios and generic descriptions of uses, risk management measures, and exposure determinants were developed. The study showed that communication formats, software tools, and guidelines for chemical risk assessment need further adjustment to preparations and real-life situations. Web platforms may simplify such communication. The downstream formulator needs basic substance data from the substance manufacturer during the pre-registration phase to develop exposure scenarios for preparations. Default values need to be communicated in the supply chain because these were critical for the derivation of applicable risk management demands. The current guidelines which rely on the available toxicological knowledge are insufficient to advise downstream users on how to develop exposure scenarios for preparations.

  20. Design Guidance for New Windows | Efficient Windows Collaborative

    Science.gov (United States)

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  1. Design Guidance for Replacement Windows | Efficient Windows Collaborative

    Science.gov (United States)

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  2. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  3. Organizing and conducting career guidance and crime prevention among young people by means of physical culture and sports specialized university departments Internal Affairs of Ukraine.

    Directory of Open Access Journals (Sweden)

    Zakorko I.P

    2011-06-01

    Full Text Available At the present stage of social development takes on special urgency the problem of finding new means and methods of crime prevention among youth in the context of strengthening the nation's health. In our opinion, employees of the Ukrainian Interior Ministry must take a decisive role in solving these problems. One of the most effective ways to solve them is to organize youth sports schools and clubs to professionally-applied sports at the bases of relevant departments of higher educational institutions of Ministry of Internal Affairs of Ukraine, the involvement of the best specialists and trainers.

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

    Science.gov (United States)

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

    2017-01-01

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

  5. A quantitative integrated assessment of pollution prevention achieved by integrated pollution prevention control licensing.

    Science.gov (United States)

    Styles, David; O'Brien, Kieran; Jones, Michael B

    2009-11-01

    This paper presents an innovative, quantitative assessment of pollution avoidance attributable to environmental regulation enforced through integrated licensing, using Ireland's pharmaceutical-manufacturing sector as a case study. Emissions data reported by pharmaceutical installations were aggregated into a pollution trend using an Environmental Emissions Index (EEI) based on Lifecycle Assessment methodologies. Complete sectoral emissions data from 2001 to 2007 were extrapolated back to 1995, based on available data. Production volume data were used to derive a sectoral production index, and determine 'no-improvement' emission trends, whilst questionnaire responses from 20 industry representatives were used to quantify the contribution of integrated licensing to emission avoidance relative to these trends. Between 2001 and 2007, there was a 40% absolute reduction in direct pollution from 27 core installations, and 45% pollution avoidance relative to hypothetical 'no-improvement' pollution. It was estimated that environmental regulation avoided 20% of 'no-improvement' pollution, in addition to 25% avoidance under business-as-usual. For specific emissions, avoidance ranged from 14% and 30 kt a(-1) for CO(2) to 88% and 598 t a(-1) for SO(x). Between 1995 and 2007, there was a 59% absolute reduction in direct pollution, and 76% pollution avoidance. Pollution avoidance was dominated by reductions in emissions of VOCs, SO(x) and NO(x) to air, and emissions of heavy metals to water. Pollution avoidance of 35% was attributed to integrated licensing, ranging from between 8% and 2.9 t a(-1) for phosphorus emissions to water to 49% and 3143 t a(-1) for SO(x) emissions to air. Environmental regulation enforced through integrated licensing has been the major driver of substantial pollution avoidance achieved by Ireland's pharmaceutical sector - through emission limit values associated with Best Available Techniques, emissions monitoring and reporting requirements, and

  6. Guidance for the assessment of a chronic intake of workers in a nuclear fuel facility in Argentina

    International Nuclear Information System (INIS)

    Rojo, A.M.; Spinella, M.R.; Gomez Parada, I.

    2006-01-01

    Todays trend for the design of internal dose monitoring programmes of workers applying the ICRP respiratory tract model requires taking into account the specific absorption parameters of the compounds and the physical data of the workplace aerosols. The aim of this analysis is to determine the specific ALIs and to establish reference levels for the assessment of chronic intake of workers, using the data from individual monitoring (pulmonary burden and urinary and fecal excretion) for natural uranium and uranium with 3.5 % and 20 % enrichment. In this paper the I.M.B.A. and AIDE software were used applying the respiratory tract model and the uranium biokinetic model published by ICRP taking into consideration the specific parameters of the uranium compounds. On the basis of this analysis, the relevance of lung, urine and faeces measurements in the individual monitoring of workers for internal dosimetry purposes is discussed It is concluded that these monitoring methods are useful for confirming that ALIs have not been exceeded and to assure that daily intakes are below the toxicological limits (2 mg/d) but it is necessary considering practical limitations of each method. (authors)

  7. Multimedia Environmental Pollutant Assessment System (MEPAS) application guidance. Guidelines for evaluating MEPAS input parameters for Version 3.1

    International Nuclear Information System (INIS)

    Buck, J.W.; Whelan, G.; Droppo, J.G. Jr.; Strenge, D.L.; Castleton, K.J.; McDonald, J.P.; Sato, C.; Streile, G.P.

    1995-02-01

    The Multimedia Environmental Pollutant Assessment System (MEPAS) was developed by Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE) Office of Environment, Safety and Health and Office of Environmental Management and Environmental Restoration. MEPAS is a set of computer codes developed to provide decision makers with risk information integrated for hazardous, radioactive, and mixed-waste sites based on their potential hazard to public health. It is applicable to a wide range of environmental management and regulatory conditions, including inactive sites covered under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) and active air and water releases covered under the Clean Air Act, the Clean Water Act, and the Resource Conservation and Recovery Act. MEPAS integrates contaminant release, transport, and exposure models into a single system. An interactive user interface assists the investigator in defining problems, assembling data and entering input, and developing reports. PNL has compiled two documents that explain the methodology behind the MEPAS model and instruct the user in how to input, retrieve, and evaluate data. This report contains detailed guidelines for defining the input data required to conduct an analysis with MEPAS. Entries for each variable have a short definition, units, and text explaining what a variable is and how it can be quantified. As appropriate, ranges and typical values are given. This report also contains listings of the input screens (worksheets) that are used in the MEPAS user interface for these variables

  8. Automation of workplace lifting hazard assessment for musculoskeletal injury prevention.

    Science.gov (United States)

    Spector, June T; Lieblich, Max; Bao, Stephen; McQuade, Kevin; Hughes, Margaret

    2014-01-01

    such as task frequency in an automated fashion, although these findings should be confirmed in a larger study. Further work is needed to incorporate force assessments and address workplace feasibility challenges. We anticipate that this approach could ultimately be used to perform large-scale musculoskeletal exposure assessment not only for research but also to provide real-time feedback to workers and employers during work method improvement activities and employee training.

  9. Development and validation of measures to assess prevention and control of AMR in hospitals.

    Science.gov (United States)

    Flanagan, Mindy; Ramanujam, Rangaraj; Sutherland, Jason; Vaughn, Thomas; Diekema, Daniel; Doebbeling, Bradley N

    2007-06-01

    The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

  10. Hanford Site guide for preparing and maintaining generator group pollution prevention program documentation

    International Nuclear Information System (INIS)

    Place, B.G.

    1998-01-01

    This document provides guidance to generator groups for preparing and maintaining documentation of Pollution Prevention Waste Minimization (P2/WMin) Program activities. The guidance is one of a hierarchical series that includes the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan (DOE-RL, 1998a) and Prime contractor implementation plans describing programs required by Resource Conservation and Recovery Act of 1976 (RCRA) 3002(b) and 3005(h) (RCRA and EPA, 1994). Documentation guidance for the following five P2/WMin elements are discussed: Fiscal Year (FY) Goals; Budget and Staffing; Waste Minimization (WMin) Assessments (WMAs); Quarterly Pollution Prevention (P2) Reporting WMin Certification

  11. Hanford Site Guide for Preparing and Maintaining Fenerator Group Pollution Prevention Program Documentation

    International Nuclear Information System (INIS)

    PLACE, B.G.

    1999-01-01

    This document provides guidance to generator groups for preparing and maintaining documentation of Pollution Prevention/Waste Minimization (P2/WMin) Program activities. The guidance is one of a hierarchical series that includes the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan (DOE-RL, 1998a) and Prime Contractor implementation plans describing programs required by Resource Conservation and Recovery Act of 1976 (RCRA) 3002(b) and (300501) (RCRA and EPA, 1994). Documentation guidance for the following five P2/WMin elements are discussed: Fiscal Year (FY) Goals; Budget and Staffing; Waste Minimization (WMinn ) Assessments (WMAs); Pollution Prevention (P2) Reporting; WMin Certification

  12. Validity and reliability of the Turkish version of the pressure ulcer prevention knowledge assessment instrument.

    Science.gov (United States)

    Tulek, Zeliha; Polat, Cansu; Ozkan, Ilknur; Theofanidis, Dimitris; Togrol, Rifat Erdem

    2016-11-01

    Sound knowledge of pressure ulcers is important to enable good prevention. There are limited instruments assessing pressure ulcer knowledge. The Pressure Ulcer Prevention Knowledge Assessment Instrument is among the scales of which psychometric properties have been studied rigorously and reflects the latest evidence. This study aimed to evaluate the validity and reliability of the Turkish version of the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI-T), an instrument that assesses knowledge of pressure ulcer prevention by using multiple-choice questions. Linguistic validity was verified through front-to-back translation. Psychometric properties of the instrument were studied on a sample of 150 nurses working in a tertiary hospital in Istanbul, Turkey. The content validity index of the translated instrument was 0.94, intra-class correlation coefficients were between 0.37 and 0.80, item difficulty indices were between 0.21 and 0.88, discrimination indices were 0.20-0.78, and the Kuder Richardson for the internal consistency was 0.803. The PUPKAI-T was found to be a valid and reliable tool to evaluate nurses' knowledge on pressure ulcer prevention. The PUPKAI-T may be a useful tool for determining educational needs of nurses on pressure ulcer prevention. Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  13. Assessing the adequacy of pressure ulcer prevention in hospitals: a nationwide prevalence survey.

    Science.gov (United States)

    Vanderwee, Katrien; Defloor, Tom; Beeckman, Dimitri; Demarré, Liesbet; Verhaeghe, Sofie; Van Durme, Thérèse; Gobert, Micheline

    2011-03-01

    The development of a pressure ulcer is an adverse event and is often avoidable if adequate preventive measures are applied. No large-scale data, based on direct patient observations, are available regarding the pressure ulcer preventive interventions used in hospitals. The aim of this study was to obtain insight into the adequacy of interventions used to prevent pressure ulcers in Belgian hospitals. A cross-sectional, multi-centre pressure ulcer prevalence study was performed in Belgian hospitals. The methodology used to measure pressure ulcer prevalence was developed by the European Pressure Ulcer Advisory Panel. The data collection instrument includes five categories of data: general data, patient data, risk assessment, skin observation and prevention. The total sample consisted of 19,968 patients. The overall prevalence of pressure ulcers Category I-IV was 12.1%. Only 10.8% of the patients at risk received fully adequate prevention in bed and while sitting. More than 70% of the patients not at risk received some pressure ulcer prevention while lying or sitting. Generally, there is a limited use of adequate preventive interventions for pressure ulcers in hospitals, which reflects a rather low quality of preventive care. The implementation of pressure ulcer guidelines requires more attention. The pressure ulcer prevention used in practice should be re-evaluated on a regular basis.

  14. A systematic approach to injury policy assessment: introducing the assessment of child injury prevention policies (A-CHIPP).

    Science.gov (United States)

    Alonge, Olakunle; Agrawal, Priyanka; Meddings, David; Hyder, Adnan A

    2017-11-03

    This study presents a systematic approach-assessment of child injury prevention policies (A-CHIPP)-to assess and track policies on effective child injury interventions at the national level. Results from an initial pilot test of the approach in selected countries are presented. A literature review was conducted to identify conceptual models for injury policy assessment, and domains and indicators were proposed for assessing national injury policies for children aged 1-9 years. The indicators focused on current evidence-supported interventions targeting the leading external causes of child injury mortality globally, and were organised into a self-administered A-CHIPP questionnaire comprising 22 questions. The questionnaire was modified based on reviews by experts in child injury prevention. For an initial test of the approach, 13 countries from all six WHO regions were selected to examine the accuracy, usefulness and ease of understanding of the A-CHIPP questionnaire. Data on the A-CHIPP questionnaire were received from nine countries. Drowning and road traffic injuries were reported as the leading causes of child injury deaths in seven of these countries. Most of the countries lacked national policies on interventions that address child injuries; supportive factors such as finance and leadership for injury prevention were also lacking. All countries rated the questionnaire highly on its relevance for assessment of injury prevention policies. The A-CHIPP questionnaire is useful for national assessment of child injury policies, and such an assessment could draw attention of stakeholders to policy gaps and progress in child injury prevention in all countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Pollution prevention opportunity assessment approach, training, and technical assistance for DOE contractors. FY 1995 report

    Energy Technology Data Exchange (ETDEWEB)

    Pemberton, S.

    1996-02-01

    The Department of Energy and its contractors are faced with environmental concerns and large waste management costs. Federal legislation and DOE Orders require sites to develop waste minimization/pollution prevention programs. In response to these requirements, the Kansas City Plant developed a pollution prevention tool called a pollution prevention opportunity assessment (PPOA). Pilot assessments resulted in the development of a graded approach to reduce the amount of effort required for activities that utilized nonhazardous and/or low-volume waste streams. The project`s objectives in FY95 were to validate DOE`s PPOA Graded Approach methodology, provide PPOA training and technical assistance to interested DOE personnel and DOE contractors, enhance the methodology with energy analysis and tools for environmental restoration activities, implement a DOE-wide PPOA database, and provide support to DOE EM-334 in the completion of a report which estimates the future potential for pollution prevention and waste minimization in the DOE complex.

  16. Pollution prevention opportunity assessment approach, training, and technical assistance for DOE contractors. FY 1995 report

    International Nuclear Information System (INIS)

    Pemberton, S.

    1996-02-01

    The Department of Energy and its contractors are faced with environmental concerns and large waste management costs. Federal legislation and DOE Orders require sites to develop waste minimization/pollution prevention programs. In response to these requirements, the Kansas City Plant developed a pollution prevention tool called a pollution prevention opportunity assessment (PPOA). Pilot assessments resulted in the development of a graded approach to reduce the amount of effort required for activities that utilized nonhazardous and/or low-volume waste streams. The project's objectives in FY95 were to validate DOE's PPOA Graded Approach methodology, provide PPOA training and technical assistance to interested DOE personnel and DOE contractors, enhance the methodology with energy analysis and tools for environmental restoration activities, implement a DOE-wide PPOA database, and provide support to DOE EM-334 in the completion of a report which estimates the future potential for pollution prevention and waste minimization in the DOE complex

  17. Minimal intervention dentistry: part 3. Paediatric dental care--prevention and management protocols using caries risk assessment for infants and young children.

    Science.gov (United States)

    Ramos-Gomez, F J; Crystal, Y O; Domejean, S; Featherstone, J D B

    2012-11-01

    Recent increases in caries prevalence in young children throughout the world highlight the need for a simple but effective infant oral care programme. This programme needs to include a medical disease prevention management model with an early establishment of a dental home and a treatment approach based on individual patient risk. This article presents an updated approach with practical forms and tools based on the principles of caries management by risk assessment, CAMBRA. This method will aid the general practitioner to develop and maintain a comprehensive protocol adequate for infant and young children oral care visits. Perinatal oral health is vitally important in preventing early childhood caries (ECC) in young children. Providing dental treatment to expectant mothers and their young children in a 'dual parallel track' is an effective innovative strategy and an efficient practice builder. It promotes prevention rather than intervention, and this may be the best way to achieve long-lasting oral health for young patients. General dental practice can adopt easy protocols that will promote early preventive visits and anticipatory guidance/counselling rather than waiting for the need for restorative treatment.

  18. Development of the System on the Internet for Pre-Assessment of Child Abuse Prevention

    Science.gov (United States)

    Honma, Satoru; Wakamatsu, Hidetoshi; Ueda, Reiko

    Some assessments have been applied to find possible factors that might lead to child abuse. PACAP is a new method proposed by Ueda and others as a pre-assessment of the concerning child abuse, which reduces its false-positive misclassification. The Internet PACAP is developed to reduce the laborious work of nurses and health care workers for the necessary processing and classifying the scores of the pre-assessment. The present system is expected to prevent the child abuse more effectively.

  19. Evaluating and prioritizing technologies for adaptation to climate change. A hands on guidance to multi criteria analysis (MCA) and the identification and assessment of related criteria

    DEFF Research Database (Denmark)

    Trærup, Sara Lærke Meltofte; Bakkegaard, Riyong Kim

    The objective of this guidance is to guide consultants, decision makers and technical experts on how to facilitate discussions for prioritizing adaptation technologies, and to support the stakeholders in identifying appropriate criteria for this analysis.......The objective of this guidance is to guide consultants, decision makers and technical experts on how to facilitate discussions for prioritizing adaptation technologies, and to support the stakeholders in identifying appropriate criteria for this analysis....

  20. Media in guidance and counseling services: a tool and innovation for school counselor

    Directory of Open Access Journals (Sweden)

    Said Alhadi

    2016-12-01

    Full Text Available Guidance and counseling services is an element of education that aims to support the achievement of the objectives of education. Guidance and counseling can prevent students experience problems and may even alleviate student of his problems. One of the efforts that need to be done to improve the effectiveness of guidance and counseling services is the development of media guidance and counseling. Media guidance and counseling can make different colors of guidance and counseling services so that the interests of students increase when following the guidance and counseling services. Used media must be relevant with the objectives/ competency of the guidance and counseling and relevant with material guidance and counseling services. Media in guidance and counseling services plays an important role in the implementation of guidance and counseling so that student can better understand, understand, and internalize the material guidance and counseling services to the student.

  1. Latex allergy: assessment of knowledge, appropriate use of gloves and prevention practice among hospital healthcare workers.

    Science.gov (United States)

    Al-Niaimi, F; Chiang, Y Z; Chiang, Y N; Williams, J

    2013-01-01

    Healthcare workers and patients are often exposed to natural rubber latex (NRL) through contact with gloves and various healthcare products, which can potentially cause allergic reactions, with varying degrees of severity. In 2008, the Royal College of Physicians published their first evidence-based guidance on occupational health interventions for latex allergy, which emphasized the importance of healthcare workers having knowledge of latex allergy. This study aimed to survey the knowledge of healthcare workers (n = 156) about latex gloves and NRL allergy, routine prevention practice and the appropriate use of gloves in patient care. Healthcare workers in a large teaching hospital were surveyed using a standard questionnaire. We found that only 1% of healthcare workers were able to correctly match the appropriate gloves to the specifically designed procedure. More than half (n = 74.53%) were unable to recognize the presentation of type 1 allergy to NRL. Of the 156 participants, 131 (84%) considered that they would benefit from training about NRL allergy and the use of different types of gloves in clinical care. This survey indicates the importance of education regarding appropriate use of gloves and prevention of NRL allergy among healthcare workers, and dermatologists should play an important role in facilitating this. © The Author(s). CED © 2012 British Association of Dermatologists.

  2. Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

    2013-01-01

    Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

  3. The Needs Assessment in order to develop the Service of Psychological Lab and Counseling Center, Department of Educational Psychology and Guidance, the Faculty of Education, Mahasarakham University

    Directory of Open Access Journals (Sweden)

    Chaiporn Pongpisanrat

    2017-03-01

    Full Text Available The purpose of this study was to explore the needs assessment in order to develop the service of Psychological Lab and Counseling Center, Department of Educational Psychology and Guidance, the Faculty of Education, Mahasarakham University. This study aimed to compare the realistic service and the desirable service, as well as, to explore the directions to improve the service of Psychological Lab and Counseling Center among the service recipients based on their gender, age range, and field of studies. A total sample of 150 participants were service recipients; college students, lecturers, staff during the first semester academic year 2014 until the first semester academic year 2015. The instruments used included: the Questionnaire on needs assessment of the development of Psychological Lab and Counseling Center, and a focus group discussion. Frequency distribution, percentage, means, standard deviation, and variance were used to analyze the data. The needs assessment results showed as follows: 1 Overall the realistic basis of Psychological Lab and Counseling Center service was in an “above level of needs” while “the highest level of needs” was found in the desirable qualification. After having divided into categories, the result yielded an “above level” on the realistic basis of the counselor characteristics, task planning, and facility arrangement. For the desired qualification, the results showed that the needs on the counselors’ characteristics, task planning, and facility arrangement were identified as at a highest level of needs. 2 No differences were found on the realistic basis needs of the clients, the services provided, gender, and age range of the clients although they responded differently to the questionnaire. The clients who responded to the questionnaire from different field of studies showed the different needs of services provided in the realistic basis significantly at the level of .05 in which the General Sciences

  4. Quantitative assessment of safety barrier performance in the prevention of domino scenarios triggered by fire

    International Nuclear Information System (INIS)

    Landucci, Gabriele; Argenti, Francesca; Tugnoli, Alessandro; Cozzani, Valerio

    2015-01-01

    The evolution of domino scenarios triggered by fire critically depends on the presence and the performance of safety barriers that may have the potential to prevent escalation, delaying or avoiding the heat-up of secondary targets. The aim of the present study is the quantitative assessment of safety barrier performance in preventing the escalation of fired domino scenarios. A LOPA (layer of protection analysis) based methodology, aimed at the definition and quantification of safety barrier performance in the prevention of escalation was developed. Data on the more common types of safety barriers were obtained in order to characterize the effectiveness and probability of failure on demand of relevant safety barriers. The methodology was exemplified with a case study. The results obtained define a procedure for the estimation of safety barrier performance in the prevention of fire escalation in domino scenarios. - Highlights: • We developed a methodology for the quantitative assessment of safety barriers. • We focused on safety barriers aimed at preventing domino effect triggered by fire. • We obtained data on effectiveness and availability of the safety barriers. • The methodology was exemplified with a case study of industrial interest. • The results showed the role of safety barriers in preventing fired domino escalation

  5. A computer based system for prioritizing pollution prevention opportunity assessments at SNL/NM

    International Nuclear Information System (INIS)

    Custer, M.S.; Leishman, N.L.; Walsh, M.L.; Nelson, J.D.; Davis, R.L.; Bueno, N.C.

    1996-01-01

    Prioritizing waste generators is necessary to determine which are the best candidates for Pollution Prevention Opportunity Assessments (PPOAs). This paper describes the Sandia National Laboratories/New Mexico (SNL/NM) PPOA Ranking System. The system uses a multimedia approach that considers hazardous and radioactive waste disposal data, and hazardous chemical usage data (from which air emissions are extrapolated). Pollution prevention information is included, from the SNL Pollution Prevention Opportunities database that identifies waste streams that have readily apparent pollution prevention opportunities. The system also considers the relative costs of waste management and the chargeback fees paid for waste generation. From these data, organizations are ranked with an algorithm developed in Microsoft Access trademark on a personal computer. The concept could readily be transferred to other facilities needing to decide where to perform PPOAs

  6. Preventive Intervention: Assessing Its Effect on the Trajectories of Delinquency and Testing for Mediational Processes.

    Science.gov (United States)

    Vitaro, Frank; Brendgen, Mara; Tremblay, Richard E.

    2001-01-01

    This study assessed the impact of a prevention program on the growth of delinquency from 13 to 16 years of age and examined whether its impact operated through a chain of events compatible with many developmental models. Analysis showed that the program had an indirect effect on the growth of delinquency from 13 to 16 years of age. (Author)

  7. Cochrane Qualitative and Implementation Methods Group guidance series-paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings.

    Science.gov (United States)

    Noyes, Jane; Booth, Andrew; Flemming, Kate; Garside, Ruth; Harden, Angela; Lewin, Simon; Pantoja, Tomas; Hannes, Karin; Cargo, Margaret; Thomas, James

    2018-05-01

    The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method implementation evidence. Choice of appropriate methodologies, methods, and tools is essential when developing a rigorous protocol and conducting the synthesis. Cochrane authors who conduct qualitative evidence syntheses have thus far used a small number of relatively simple methods to address similarly written questions. Cochrane has invested in methodological work to develop new tools and to encourage the production of exemplar reviews to show the value of more innovative methods that address a wider range of questions. In this paper, in the series, we report updated guidance on the selection of tools to assess methodological limitations in qualitative studies and methods to extract and synthesize qualitative evidence. We recommend application of Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews to assess confidence in qualitative synthesized findings. This guidance aims to support review authors to undertake a qualitative evidence synthesis that is intended to be integrated subsequently with the findings of one or more Cochrane reviews of the effects of similar interventions. The review of intervention effects may be undertaken concurrently with or separate to the qualitative evidence synthesis. We encourage further development through reflection and formal testing. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Measuring trauma center injury prevention activity: an assessment and reporting tool.

    Science.gov (United States)

    Sise, Michael J; Sise, Carol Beth

    2006-02-01

    To develop an assessment and reporting tool for a trauma center's community partnership strategy to deliver injury prevention programs in a large metropolitan area. The tool was designed to track prevention activity and serve as a reporting format for the parent health system, county designating agency, and the American College of Surgeons' Trauma Center Verification Process. The tool collected data including trauma center paid and volunteer personnel time, equipment, resource, and financial costs, community group and public agency contributions, number of community members receiving prevention material or presentations, impact on public policy, and print and broadcast media coverage. These measurements were incorporated in a reporting grid format. Six youth injury prevention programs were evaluated over a recent 2-year interval to demonstrate the tool's usefulness. Of six programs, three focused on motor vehicle injuries, one on teen suicide, one on firearm injuries, and one on drug and alcohol abuse. Trauma Center personnel asset allocation included 3% full-time equivalent by the Trauma Medical Director, 30% by the Injury Prevention and Community Outreach Coordinator, and 473 person hours (both work and volunteer) by physicians, nurses, and other personnel. Trauma Center equipment and fixed asset expenses totaled $3,950 and monetary contribution totaled $4,430. Community groups and public agencies contributed 20,400 person hours with estimated in-kind costs exceeding $750,000. Five of the six programs continued during the 2-year period. A gun-lock giveaway program was suspended because of a product recall. A total of over 29,000 youth received prevention material and presentations. Four public policy initiatives and 18 Trauma Center media stories with over 50 mentions and 37 new community partnerships resulted. The reports generated were easily incorporated in the trauma center's reports to local and national organizations and agencies. This assessment tool

  9. Acute tier-1 and tier-2 effect assessment approaches in the EFSA Aquatic Guidance Diocument: are they sufficiently protective for insecticides?

    NARCIS (Netherlands)

    Wijngaarden, van R.P.A.; Maltby, L.; Brock, T.C.M.

    2015-01-01

    BACKGROUND The objective of this paper is to evaluate whether the acute tier-1 and tier-2 methods as proposed by the Aquatic Guidance Document recently published by the European Food Safety Authority (EFSA) are appropriate for deriving regulatory acceptable concentrations (RACs) for insecticides.

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Pollution prevention opportunity assessment for Sandia National Laboratories/California recycling programs.

    Energy Technology Data Exchange (ETDEWEB)

    Wrons, Ralph Jordan; Vetter, Douglas Walter

    2007-07-01

    This Pollution Prevention Opportunity Assessment (PPOA) was conducted for the Sandia National Laboratories/California (SNL/CA) Environmental Management Department between May 2006 and March 2007, to evaluate the current site-wide recycling program for potential opportunities to improve the efficiency of the program. This report contains a summary of the information collected and analyses performed with recommended options for implementation. The SNL/NM Pollution Prevention (P2) staff worked with the SNL/CA P2 Staff to arrive at these options.

  12. UV DISINFECTION GUIDANCE MANUAL FOR THE ...

    Science.gov (United States)

    Provides technical information on selection, design and operation of UV systems; provides regulatory agencies with guidance and the necessary tools to assess UV systems at the design, start-up, and routine operation phase; provides manufacturers with the testing and performance standards for UV components and systems for treating drinking water. Provide guidance to water systems, regulators and manufacturers on UV disinfection of drinking water.

  13. Optimal Aerocapture Guidance

    Data.gov (United States)

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

  14. Coral Reef Guidance

    Science.gov (United States)

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

  15. Laser Guidance Analysis Facility

    Data.gov (United States)

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

  16. 78 FR 78963 - Issuance of Final Guidance Publication

    Science.gov (United States)

    2013-12-27

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

  17. Wearable technology and ECG processing for fall risk assessment, prevention and detection.

    Science.gov (United States)

    Melillo, Paolo; Castaldo, Rossana; Sannino, Giovanna; Orrico, Ada; de Pietro, Giuseppe; Pecchia, Leandro

    2015-01-01

    Falls represent one of the most common causes of injury-related morbidity and mortality in later life. Subjects with cardiovascular disorders (e.g., related to autonomic dysfunctions and postural hypotension) are at higher risk of falling. Autonomic dysfunctions increasing the risk of falling in the short and mid-term could be assessed by Heart Rate Variability (HRV) extracted by electrocardiograph (ECG). We developed three trials for assessing the usefulness of ECG monitoring using wearable devices for: risk assessment of falling in the next few weeks; prevention of imminent falls due to standing hypotension; and fall detection. Statistical and data-mining methods are adopted to develop classification and regression models, validated with the cross-validation approach. The first classifier based on HRV features enabled to identify future fallers among hypertensive patients with an accuracy of 72% (sensitivity: 51.1%, specificity: 80.2%). The regression model to predict falls due to orthostatic dropdown from HRV recorded before standing achieved an overall accuracy of 80% (sensitivity: 92%, specificity: 90%). Finally, the classifier to detect simulated falls using ECG achieved an accuracy of 77.3% (sensitivity: 81.8%, specificity: 72.7%). The evidence from these three studies showed that ECG monitoring and processing could achieve satisfactory performances compared to other system for risk assessment, fall prevention and detection. This is interesting as differently from other technologies actually employed to prevent falls, ECG is recommended for many other pathologies of later life and is more accepted by senior citizens.

  18. Assessing and Mobilizing Faith Organizations to Implement Childhood Obesity Prevention Advocacy Strategies.

    Science.gov (United States)

    Bozlak, Christine T; Kenady, James M; Becker, Adam B

    2018-01-01

    Childhood obesity remains a public health problem requiring mobilization across diverse social and political sectors. The faith-based sector can contribute to obesity prevention advocacy when existing resources are supported and leveraged. This article describes an advocacy resource assessment conducted in six Chicago faith organizations. Key administrators and congregation members were surveyed to identify organizational resources that could be mobilized for childhood obesity prevention advocacy. Survey data were analyzed using SPSS and Excel. Descriptive statistics were calculated for each organization and for all combined. Organizational resources for advocacy were identified, with varying degrees of resources within organizations. Congregation members and faith leaders expressed interest in advocacy training and activities but acknowledged competing organizational priorities. Participating organizations received a stipend to pursue recommended action items based on their assessment. Faith organizations have unique resources and human capital and can be key partners in childhood obesity prevention. Conducting an assessment prior to planning interventions and advocacy approaches can strengthen partnerships, leverage assets among partners, and ensure efforts are relevant and beneficial for faith organizations. It may also be strategic to incorporate funding in grant budgets in order to empower faith organizations to act on findings from the assessment process.

  19. Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

    Science.gov (United States)

    Yazdani, Amin; Wells, Richard

    2012-01-01

    The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

  20. Assessing change in perceived community leadership readiness in the Obesity Prevention and Lifestyle program.

    Science.gov (United States)

    Kostadinov, Iordan; Daniel, Mark; Jones, Michelle; Cargo, Margaret

    2016-02-01

    Issue addressed The context of community-based childhood obesity prevention programs can influence the effects of these intervention programs. Leadership readiness for community mobilisation for childhood obesity prevention is one such contextual factor. This study assessed perceived community leadership readiness (PCLR) at two time points in a state-wide, multisite community-based childhood obesity prevention program. Methods PCLR was assessed across 168 suburbs of 20 intervention communities participating in South Australia's Obesity Prevention and Lifestyle (OPAL) program. Using a validated online PCLR tool, four key respondents from each community rated each suburb within their respective community on a nine-point scale for baseline and 2015. Average PCLR and change scores were calculated using the general linear model with suburbs nested in communities. Relationships between demographic variables and change in PCLR were evaluated using multiple regression. Ease of survey use was also assessed. Results Average PCLR increased between baseline (3.51, s.d.=0.82) and 2015 (5.23, s.d.=0.89). PCLR rose in 18 of 20 intervention communities. PCLR was inversely associated with suburb population size (r 2 =0.03, P=0.03, β=-0.25) and positively associated with intervention duration (r 2 change=0.08, P=0.00, β=0.29). Only 8% of survey respondents considered the online assessment tool difficult to use. Conclusions PCLR increased over the course of the OPAL intervention. PCLR varied between and within communities. Online assessment of PCLR has utility for multisite program evaluations. So what? Use of a novel, resource-efficient online tool to measure the key contextual factors of PCLR has enabled a better understanding of the success and generalisability of the OPAL program.

  1. RMP Guidance for Chemical Distributors - Appendix D: OSHA Guidance on PSM

    Science.gov (United States)

    Guidance on the Process Safety Management standard says information (including MSDS) about chemicals, including process intermediates, must enable accurate assessment of fire/explosion characteristics, reactivity hazards, and corrosing/erosion effects.

  2. Environmental Restoration Program waste minimization and pollution prevention self-assessment

    International Nuclear Information System (INIS)

    1994-10-01

    The Environmental Restoration (ER) Program within Martin Marietta Energy Systems, Inc. is currently developing a more active waste minimization and pollution prevention program. To determine areas of programmatic improvements within the ER Waste Minimization and Pollution Prevention Awareness Program, the ER Program required an evaluation of the program across the Oak Ridge K-25 Site, the Oak Ridge National Laboratory, the Oak Ridge Y-12 Plant, the Paducah Environmental Restoration and Waste Minimization Site, and the Portsmouth Environmental Restoration and Waste Minimization Site. This document presents the status of the overall program as of fourth quarter FY 1994, presents pollution prevention cost avoidance data associated with FY 1994 activities, and identifies areas for improvement. Results of this assessment indicate that the ER Waste Minimization and Pollution Prevention Awareness Program is firmly established and is developing rapidly. Several procedural goals were met in FY 1994 and many of the sites implemented ER waste minimization options. Additional growth is needed, however, for the ER Waste Minimization and Pollution Prevention Awareness Program

  3. Thinking about "Think Again" in Canada: assessing a social marketing HIV/AIDS prevention campaign.

    Science.gov (United States)

    Lombardo, Anthony P; Léger, Yves A

    2007-06-01

    The Canadian "Think Again" social marketing HIV/AIDS prevention campaign, adapted from an American effort, encourages gay men to rethink their assumptions about their partners' HIV statuses and the risks of unsafe sex with them. To improve future efforts, existing HIV/AIDS prevention initiatives require critical reflection. While a formal evaluation of this campaign has been carried out elsewhere, here we use the campaign as a social marketing case study to illustrate its strengths and weaknesses, as a learning tool for other campaigns. After describing the campaign and its key results, we assess how it utilized central tenets of the social marketing process, such as formative research and the marketing mix. We then speak to the importance of theoretical influence in campaign design and the need to account for social-contextual factors in safer sex decision making. We conclude with a summary of the lessons learned from the assessment of this campaign.

  4. Revising REACH guidance on information requirements and chemical safety assessment for engineered nanomaterials for aquatic ecotoxicity endpoints: recommendations from the EnvNano project

    DEFF Research Database (Denmark)

    Hansen, Steffen Foss; Sørensen, Sara Nørgaard; Skjolding, Lars Michael

    2017-01-01

    be made applicable to nanomaterials. European Research Council project EnvNano—Environmental Effects and Risk Evaluation of Engineered, which ran from 2011 to 2016, took another outset by assuming that: “The behaviour of nanoparticles in suspension is fundamentally different from that of chemicals......The European Chemical Agency (ECHA) is in the process of revising its guidance documents on how to address the challenges of ecotoxicological testing of nanomaterials. In these revisions, outset is taken in the hypothesis that ecotoxicological test methods, developed for soluble chemicals, can...... in solution”. The aim of this paper is to present the findings of the EnvNano project and through these provide the scientific background for specific recommendations on how ECHA guidance could be further improved. Key EnvNano findings such as the need to characterize dispersion and dissolution rates in stock...

  5. Assessment of a training programme for the prevention of ventilator-associated pneumonia

    OpenAIRE

    Jam Gatell, M Rosa; Santé Roig, Montserrat; Hernández Vian, Óscar; Carrillo Santín, Esther; Turégano Duaso, Concepción; Fernández Moreno, Inmaculada; Vallés Daunis, Jordi

    2012-01-01

    Background Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. Aim To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects complia...

  6. Assessment, mechanisms, prevention, and measures for quick recovery of military operation-associated fatigue

    OpenAIRE

    Zhao-shen LI; Wen HUANG

    2012-01-01

    Fatigue is a worldwide problem. Military members frequently feel fatigue in military operations, which hinders the successful completion of their tasks. In complicated international military environments, military fatigue has received great attention from the armed forces in all countries. The present paper elaborates the performances, assessment, and mechanism of fatigue in military operations. In addition, the current study discusses the prevention and rapid recovery of fatigue, aiming at p...

  7. Exercise for falls prevention in older people: assessing the knowledge of exercise science students.

    Science.gov (United States)

    Sturnieks, Daina L; Finch, Caroline F; Close, Jacqueline C T; Tiedemann, Anne; Lord, Stephen R; Pascoe, Deborah A

    2010-01-01

    Participation in appropriate exercise can help reduce the risk of falls and falls injury in older people. Delivery of population-level exercise interventions requires an expert workforce with skills in development and delivery of group exercise programs and prescription of individually targeted exercise. This study assessed the current knowledge of university exercise science students (as future exercise professionals) across different levels of study. A structured survey designed to assess knowledge in relation to falls in older people and exercise prescription for falls prevention was administered during second, third and fourth year lectures in seven Australian universities. Students' knowledge was assessed as the percent of correct responses. Overall, 566 students completed the survey and knowledge levels increased significantly with study year. Mean knowledge levels were significantly knowledge. They were lowest for falls risk factor questions and highest for issue/cost related questions in second and third year students. Fourth year students had best knowledge about falls interventions and this was the only group and topic with a mean score >70%. In conclusion, knowledge about falls and exercise prescription for falls prevention in current students does not meet a desired competency level of 70% and is therefore insufficient to ensure an adequately equipped future workforce in this area. There is a clear need for the development and widespread delivery of an evidence-based "exercise for falls prevention" curriculum module for exercise professionals. Copyright (c) 2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  8. The Use of Assessment Center Technology for the Prevention and Reduction of Professional Burnout

    Directory of Open Access Journals (Sweden)

    Stalnova I.A.,

    2014-08-01

    Full Text Available Dynamism of professional activity, increasing workload and working time shortage, high social responsibility for results and other factors increase the probability of formation of burnout in government employees. This actualizes the search for new forms and methods of professional qualification of government employees based on an assessment of their psychological qualities. We discuss the problem of professional and personal burnout in Rosreestr employees, reveal the symptoms of this syndrome. As a tool for preventing and reducing the negative impact of professional deformation in Rosreestr workers, we propose the use of assessment center technology successfully tested in the international practice and requiring adaptation to Russian realities.

  9. Preventive radioecological assessment of territory for optimization of monitoring and countermeasures after radiation accidents.

    Science.gov (United States)

    Prister, B S; Vinogradskaya, V D; Lev, T D; Talerko, M M; Garger, E K; Onishi, Y; Tischenko, O G

    2018-04-01

    A methodology of a preventive radioecological assessment of the territory has been developed for optimizing post-emergency monitoring and countermeasure implementation in an event of a severe radiation accident. Approaches and main stages of integrated radioecological zoning of the territory are described. An algorithm for the assessment of the potential radioecological criticality (sensitivity) of the area is presented. The proposed approach is validated using data of the dosimetric passportization in Ukraine after the Chernobyl accident for the test site settlements. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Automatic limb identification and sleeping parameters assessment for pressure ulcer prevention.

    Science.gov (United States)

    Baran Pouyan, Maziyar; Birjandtalab, Javad; Nourani, Mehrdad; Matthew Pompeo, M D

    2016-08-01

    Pressure ulcers (PUs) are common among vulnerable patients such as elderly, bedridden and diabetic. PUs are very painful for patients and costly for hospitals and nursing homes. Assessment of sleeping parameters on at-risk limbs is critical for ulcer prevention. An effective assessment depends on automatic identification and tracking of at-risk limbs. An accurate limb identification can be used to analyze the pressure distribution and assess risk for each limb. In this paper, we propose a graph-based clustering approach to extract the body limbs from the pressure data collected by a commercial pressure map system. A robust signature-based technique is employed to automatically label each limb. Finally, an assessment technique is applied to evaluate the experienced stress by each limb over time. The experimental results indicate high performance and more than 94% average accuracy of the proposed approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Assessing the quality of mental health promotion and prevention in Croatia: the case of Istria.

    Science.gov (United States)

    Mihic, Josipa; Novak, Miranda; Hosman, Clemens; Domitrovich, Celene

    2017-06-01

    While the availability of mental health promotion and prevention programs worldwide is growing, there is divergence in their level of effectiveness that has led to increasing interest in the development of 'effect management' strategies. Mental health promotion and prevention science and practice has a relatively young history in Croatia, but major investments towards its development have been made over the last decade. This paper reports on a research project that took place within the Istrian Region. The long-term goal of the initiative is to establish quality assurance indicators for mental health promotion and prevention interventions. The current study involved adapting the Dutch Preffi 2.0 instrument for use in Croatia. The content of the Preffi reflects the literature regarding research-based effect predictors. An instrument allows users to assess whether programs have been designed and implemented in ways that maximize their ability to be effective. The Preffi scores can be used for improving a program and the quality with which it is implemented. The first aim of the study is to determine if independent researchers can use the Preffi reliably as a quality assessment instrument. The second aim is to use the Preffi to describe the quality of one cohort of mental health promotion and prevention programs. The study represents the first steps toward developing a strategy for quality assurance that strengthens community capacity for effective service delivery and that could inform other countries whose mental health promotion and prevention efforts are in early stages of development. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Assessment of Meat and Poultry Product Recalls Due to Salmonella Contamination: Product Recovery and Illness Prevention.

    Science.gov (United States)

    Seys, Scott A; Sampedro, Fernando; Hedberg, Craig W

    2017-08-01

    Data from the recalls of meat and poultry products from 2000 through 2012 due to Salmonella contamination were used to assess the factors associated with the recovery of the recalled product and to develop quantitative models to estimate the number of illnesses prevented by recalls. The percentage of product recovered following a recall action was not dependent on establishment size, recall expansions, complexity of the distribution chain, type of distribution, amount of time between the production and recall dates, or number of pounds of product recalled. However, illness-related recalls were associated with larger amounts of recalled product, smaller percentages of recalled product recovered, a greater number of days between the production date and recall date, and nationwide distribution than were recalls that were not illness related. In addition, the detection of recall-associated illnesses appeared to be enhanced in states with strong foodborne illness investigation systems. The number of Salmonella illnesses prevented by recalls was based on the number of illnesses occurring relative to the number of pounds consumed, which was then extrapolated to the number of pounds of recalled product recovered. A simulation using a program evaluation and review technique probability distribution with illness-related recalls from 2003 through 2012 estimated that there were 19,000 prevented Salmonella illnesses, after adjusting for underdiagnosis. Recalls not associated with illnesses from 2000 through 2012 prevented an estimated additional 8,300 Salmonella illnesses, after adjusting for underdiagnosis. Although further improvements to ensure accurate and complete reporting should be undertaken, our study demonstrates that recalls are an important tool for preventing additional Salmonella illnesses. Moreover, additional training resources dedicated to public health agencies for enhancing foodborne illness detection, investigations, and rapid response and reporting would

  13. Oak Ridge K-25 Site chlorinated solvent pollution prevention opportunity assessment

    International Nuclear Information System (INIS)

    1994-08-01

    A pollution prevention opportunity assessment (PPOA) was conducted at the Oak Ridge K-25 Site to identify opportunities to reduce and better manage the use of chlorinated solvents. At the K-25 Site, 67 control areas were examined for their potential use of chlorinated solvents. Of these areas, 27 were found to be using (1) chlorinated solvents for cleaning, degreasing, and lubricating; (2) laboratory standards and solvents; and (3) test medium. Current management practices encourage the identification and use of nonhazardous chemicals, including the use of chlorinated solvents. The main pollution prevention principles are source reduction and recycling, and a number of pollution prevention options based on these principles were identified and evaluated as part of this chlorinated solvent PPOA. Source reduction options evaluated for the K-25 Site include the substitution of chlorinated solvents with nonchlorinated solvents. Recycling was identified for those areas that would benefit most from the reuse of the chlorinated solvents in use. The pollution prevention options that offer the greatest opportunity for success at the K-25 Site are the implementation of substitutes at the 10 control areas using chlorinated solvents for cleaning, degreasing, and lubrication. A change in the process may be all that is needed to eliminate the use of a chlorinated solvent. Once a decision is made to implement a substitution, the information should be communicated to all shops and laboratories. Another option to consider is the installation of recycling units to recycle the large amounts of methylene chloride used in the analytical sampling procedure

  14. Oak Ridge K-25 Site chlorinated solvent pollution prevention opportunity assessment

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-01

    A pollution prevention opportunity assessment (PPOA) was conducted at the Oak Ridge K-25 Site to identify opportunities to reduce and better manage the use of chlorinated solvents. At the K-25 Site, 67 control areas were examined for their potential use of chlorinated solvents. Of these areas, 27 were found to be using (1) chlorinated solvents for cleaning, degreasing, and lubricating; (2) laboratory standards and solvents; and (3) test medium. Current management practices encourage the identification and use of nonhazardous chemicals, including the use of chlorinated solvents. The main pollution prevention principles are source reduction and recycling, and a number of pollution prevention options based on these principles were identified and evaluated as part of this chlorinated solvent PPOA. Source reduction options evaluated for the K-25 Site include the substitution of chlorinated solvents with nonchlorinated solvents. Recycling was identified for those areas that would benefit most from the reuse of the chlorinated solvents in use. The pollution prevention options that offer the greatest opportunity for success at the K-25 Site are the implementation of substitutes at the 10 control areas using chlorinated solvents for cleaning, degreasing, and lubrication. A change in the process may be all that is needed to eliminate the use of a chlorinated solvent. Once a decision is made to implement a substitution, the information should be communicated to all shops and laboratories. Another option to consider is the installation of recycling units to recycle the large amounts of methylene chloride used in the analytical sampling procedure.

  15. Infection prevention needs assessment in Colorado hospitals: rural and urban settings.

    Science.gov (United States)

    Reese, Sara M; Gilmartin, Heather; Rich, Karen L; Price, Connie S

    2014-06-01

    The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training. Surveys were received from 62 hospitals (77.5% response); 33 rural (75.0% response) and 29 urban (80.6% response). Fifty-two percent of rural ICPs reported multiple job responsibilities compared with 17.2% of urban ICPs. Median length of experience for rural ICPs was 4.0 years compared with 11.5 years for urban ICPs (P = .008). Fifty-one percent of rural ICPs reported no access to infectious disease physicians (0.0% urban) and 81.8% of rural hospitals reported no antimicrobial stewardship programs (31.0% urban). Through the interviews it was revealed that priorities for rural ICPs were training and communication. Our study revealed numerous differences between infection prevention programs in rural versus urban hospitals. An infection prevention outreach program established in Colorado could potentially address the challenges faced by rural hospital infection prevention departments. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Method for screening prevention and control measures and technologies based on groundwater pollution intensity assessment

    Energy Technology Data Exchange (ETDEWEB)

    Li, Juan, E-mail: lijuan@craes.org.cn [College of Water Sciences, Beijing Normal University, Beijing 100875 (China); Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Yang, Yang [College of Environment, Beijing Normal University, Beijing 100875 (China); Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Huan, Huan; Li, Mingxiao [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Xi, Beidou, E-mail: xibd413@yeah.net [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Lanzhou Jiaotong University, Lanzhou 730070 (China); Lv, Ningqing [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Wu, Yi [Guizhou Academy of Environmental Science and Designing, Guizhou 550000 (China); Xie, Yiwen, E-mail: qin3201@126.com [School of Chemical and Environmental Engineering, Dongguan University of Technology, Dongguan, 523808 (China); Li, Xiang; Yang, Jinjin [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China)

    2016-05-01

    index-based methodology to assess the groundwater pollution intensity (GPI). • GPI assessment includes PSH assessment and GIV assessment. • Measures to prevent and control groundwater pollution based on GPI assessment. • An index-based methodology for prevention and control technologies (PCT) screening. • PCT screening based on GPI assessment results and TOPSIS method.

  17. Method for screening prevention and control measures and technologies based on groundwater pollution intensity assessment

    International Nuclear Information System (INIS)

    Li, Juan; Yang, Yang; Huan, Huan; Li, Mingxiao; Xi, Beidou; Lv, Ningqing; Wu, Yi; Xie, Yiwen; Li, Xiang; Yang, Jinjin

    2016-01-01

    index-based methodology to assess the groundwater pollution intensity (GPI). • GPI assessment includes PSH assessment and GIV assessment. • Measures to prevent and control groundwater pollution based on GPI assessment. • An index-based methodology for prevention and control technologies (PCT) screening. • PCT screening based on GPI assessment results and TOPSIS method.

  18. Guidance for the application of an assessment methodology for Innovative Nuclear Energy Systems. INPRO manual - Economics. Vol. 2 of the final report of phase 1 of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO)

    International Nuclear Information System (INIS)

    2008-11-01

    The International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) was initiated in the year 2000, based on a resolution of the IAEA General Conference (GC(44)/RES/21). The main objectives of INPRO are (1) to help to ensure that nuclear energy is available to contribute in fulfilling energy needs in the 21st century in a sustainable manner, (2) to bring together both technology holders and technology users to consider jointly the international and national actions required to achieve desired innovations in nuclear reactors and fuel cycles; and (3) to create a forum to involve all relevant stakeholders that will have an impact on, draw from, and complement the activities of existing institutions, as well as ongoing initiatives at the national and international level. This publication elaborates on the guidance given in the INPRO report 'Methodology for the assessment of innovative nuclear reactors and fuel cycles', IAEA-TECDOC-1434 (2004), and the previous INPRO report 'Guidance for the evaluation for innovative nuclear reactors and fuel cycles', IAEA-TECDOC-1362 (2003) in the area of economics. The information presented in Volume 1 of the INPRO manual should be considered to be an integral part of this volume and the user should be familiar with that information. The goal of the INPRO Manual for the area of economics (Volume 2) is to provide guidance for performing an INPRO assessment, as described in Volume 1 of the INPRO manual, in the area of economics. The manual is not intended to provide guidance on how to design an INS to meet the INPRO requirements in the area of economics: rather, the focus is on the assessment method and the evaluation of the INPRO criteria in the area of economics. The INPRO assessor, i.e. the individual or group of individuals carrying out the assessment, is assumed to be knowledgeable in the area of economics and financial analysis. The INPRO assessment will either confirm that the INPRO economic criteria are fulfilled

  19. Risk assessment and cost-benefit techniques as management tools for oil spill prevention

    International Nuclear Information System (INIS)

    Diller, S.

    1998-01-01

    In the last 15 years, and especially after remarkable large technological accidents like Bhopal, San Juanico, Tacoa, Piper Alpha, Exxon Valdez, Sea Empress, etc, the risk assessment tools have become a must for design engineers and also have been growing popular since more reliable oil spill accident analysis data has been gathered in the last ten years. On the other hand the large investments that have been necessary to execute in order to adequate and improve old facilities, equipment, etc., and the total loss control enhancements in new projects, have created some concern on how safe is safe and how much money is it necessary to spend in order to be sufficiently preventative without getting into financial trouble and being technologically sound according to the growing global concern about environmental issues. Concepts are presented in risk prevention and oil spill risk assessment, and examples are developed in order to understand the link between different oil spill risk prevention options and the management finance decision making process. (author)

  20. The design and development of a complex multifactorial falls assessment intervention for falls prevention: The Prevention of Falls Injury Trial (PreFIT).

    Science.gov (United States)

    Bruce, Julie; Ralhan, Shvaita; Sheridan, Ray; Westacott, Katharine; Withers, Emma; Finnegan, Susanne; Davison, John; Martin, Finbarr C; Lamb, Sarah E

    2017-06-01

    This paper describes the design and development of a complex multifactorial falls prevention (MFFP) intervention for implementation and testing within the framework of a large UK-based falls prevention randomised controlled trial (RCT). A complex intervention was developed for inclusion within the Prevention of Falls Injury Trial (PreFIT), a multicentre pragmatic RCT. PreFIT aims to compare the clinical and cost-effectiveness of three alternative primary care falls prevention interventions (advice, exercise and MFFP), on outcomes of fractures and falls. Community-dwelling adults, aged 70 years and older, were recruited from primary care in the National Health Service (NHS), England. Development of the PreFIT MFFP intervention was informed by the existing evidence base and clinical guidelines for the assessment and management of falls in older adults. After piloting and modification, the final MFFP intervention includes seven falls risk factors: a detailed falls history interview with consideration of 'red flags'; assessment of balance and gait; vision; medication screen; cardiac screen; feet and footwear screen and home environment assessment. This complex intervention has been fully manualised with clear, documented assessment and treatment pathways for each risk factor. Each risk factor is assessed in every trial participant referred for MFFP. Referral for assessment is based upon a screening survey to identify those with a history of falling or balance problems. Intervention delivery can be adapted to the local setting. This complex falls prevention intervention is currently being tested within the framework of a large clinical trial. This paper adheres to TIDieR and CONSORT recommendations for the comprehensive and explicit reporting of trial interventions. Results from the PreFIT study will be published in due course. The effectiveness and cost-effectiveness of the PreFIT MFFP intervention, compared to advice and exercise, on the prevention of falls and

  1. Noninvasive imaging in the assessment and prevention of coronary heart disease

    International Nuclear Information System (INIS)

    Llerena Rojas, Luis Roberto; Peix Gonzalez, Amalia; Valiente Mustelier, Juan

    2011-01-01

    Echocardiography, multidetector computed tomography, magnetic resonance imaging, and nuclear cardiology can all help prevent coronary heart disease. Echocardiography can identify asymptomatic individuals who are at risk of coronary disease and who should receive aggressive preventative therapy by providing data on the carotid intima-media thickness, arterial stiffness and flow-mediated dilatation of the brachial artery. The calcium score is an independent predictor of cardiac events that influences clinical risk scores such as the Framingham risk score. By using multidetector computed tomography or magnetic resonance imaging for coronary angiography, it is possible to visualize both the lumen and vessel walls of coronary arteries and to discriminate between calcified and noncalcified atherosclerotic plaque before invasive coronary angiography is performed. With nuclear cardiology, the functional effects of atherosclerotic lesions can be evaluated by assessing perfusion and ventricular function simultaneously

  2. Pressure ulcer risk assessment and prevention: what difference does a risk scale make? A comparison between Norway and Ireland.

    Science.gov (United States)

    Johansen, E; Moore, Z; van Etten, M; Strapp, H

    2014-07-01

    To explore similarities and differences in nurses' views on risk assessment practices and preventive care activities in a context where patients' risk of developing pressure ulcers is assessed using clinical judgment (Norway) and a context where patients' risk of developing pressure ulcers is assessed using a formal structured risk assessment combined with clinical judgement (Ireland). A descriptive, qualitative design was employed across two different care settings with a total of 14 health care workers, nine from Norway and five from Ireland. Regardless of whether risk assessment was undertaken using clinical judgment or formal structured risk assessment, identified risk factors, at risk patients and appropriate preventive initiatives discussed by participant were similar across care settings. Furthermore, risk assessment did not necessarily result in the planning and implementation of appropriate pressure ulcer prevention initiatives. Thus, in this instance, use of a formal risk assessment tool does not seem to make any difference to the planning, initiation and evaluation of pressure ulcer prevention strategies. Regardless of the method of risk assessment, patients at risk of developing pressure ulcers are detected, suggesting that the practice of risk assessment should be re-evaluated. Moreover, appropriate preventive interventions were described. However, the missing link between risk assessment and documented care planning is of concern and barriers to appropriate pressure ulcer documentation should be explored further. This work is partly funded by a research grant from the Norwegian Nurses Organisation (NNO) (Norsk Sykepleierforbund NSF) in 2012. The authors have no conflict of interest to declare.

  3. Threshold guidance update

    International Nuclear Information System (INIS)

    Wickham, L.E.

    1986-01-01

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

  4. Regulatory guidance document

    International Nuclear Information System (INIS)

    1994-05-01

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

  5. PIV Logon Configuration Guidance

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-04

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

  6. Blending Qualitative and Computational Linguistics Methods for Fidelity Assessment: Experience with the Familias Unidas Preventive Intervention.

    Science.gov (United States)

    Gallo, Carlos; Pantin, Hilda; Villamar, Juan; Prado, Guillermo; Tapia, Maria; Ogihara, Mitsunori; Cruden, Gracelyn; Brown, C Hendricks

    2015-09-01

    Careful fidelity monitoring and feedback are critical to implementing effective interventions. A wide range of procedures exist to assess fidelity; most are derived from observational assessments (Schoenwald and Garland, Psycholog Assess 25:146-156, 2013). However, these fidelity measures are resource intensive for research teams in efficacy/effectiveness trials, and are often unattainable or unmanageable for the host organization to rate when the program is implemented on a large scale. We present a first step towards automated processing of linguistic patterns in fidelity monitoring of a behavioral intervention using an innovative mixed methods approach to fidelity assessment that uses rule-based, computational linguistics to overcome major resource burdens. Data come from an effectiveness trial of the Familias Unidas intervention, an evidence-based, family-centered preventive intervention found to be efficacious in reducing conduct problems, substance use and HIV sexual risk behaviors among Hispanic youth. This computational approach focuses on "joining," which measures the quality of the working alliance of the facilitator with the family. Quantitative assessments of reliability are provided. Kappa scores between a human rater and a machine rater for the new method for measuring joining reached 0.83. Early findings suggest that this approach can reduce the high cost of fidelity measurement and the time delay between fidelity assessment and feedback to facilitators; it also has the potential for improving the quality of intervention fidelity ratings.

  7. Assessment of a training programme for the prevention of ventilator-associated pneumonia.

    Science.gov (United States)

    Jam Gatell, M Rosa; Santé Roig, Montserrat; Hernández Vian, Óscar; Carrillo Santín, Esther; Turégano Duaso, Concepción; Fernández Moreno, Inmaculada; Vallés Daunis, Jordi

    2012-01-01

    Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance. A prospective, quasiexperimental, pre- and post-study of the nursing team in a 16-bed medical/surgical ICU. Pre-intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post-intervention phase mirrored the pre-intervention phase. Nurses answered more questions correctly on the post-intervention questionnaire than on the pre-intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post-intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37). The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

  8. Assessment of a training programme for the prevention of ventilator-associated pneumonia

    Science.gov (United States)

    Jam Gatell, M Rosa; Santé Roig, Montserrat; Hernández Vian, Óscar; Carrillo Santín, Esther; Turégano Duaso, Concepción; Fernández Moreno, Inmaculada; Vallés Daunis, Jordi

    2012-01-01

    Background Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. Aim To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance. Method A prospective, quasiexperimental, pre- and post-study of the nursing team in a 16-bed medical/surgical ICU. Pre-intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post-intervention phase mirrored the pre-intervention phase. Findings Nurses answered more questions correctly on the post-intervention questionnaire than on the pre-intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post-intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37). Conclusion The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance. PMID:23061618

  9. Readability assessment of concussion and traumatic brain injury publications by Centers for Disease Control and Prevention

    Science.gov (United States)

    Gill, Preetinder S; Gill, Tejkaran S; Kamath, Ashwini; Whisnant, Billy

    2012-01-01

    Health literacy is associated with a person’s capacity to find, access, contextualize, and understand information needed for health care-related decisions. The level of health literacy thus has an influence on an individual’s health status. It can be argued that low health literacy is associated with poor health status. Health care literature (eg, pamphlets, brochures, postcards, posters, forms) are published by public and private organizations worldwide to provide information to the general public. The ability to read, use, and understand is critical to the successful application of knowledge disseminated by this literature. This study assessed the readability, suitability, and usability of health care literature associated with concussion and traumatic brain injury published by the United States Centers for Disease Control and Prevention. The Flesch–Kincaid Grade Level, Flesch Reading Ease, Gunning Fog, Simple Measure of Gobbledygook, and Suitability Assessment of Materials indices were used to assess 40 documents obtained from the Centers for Disease Control and Prevention website. The documents analyzed were targeted towards the general public. It was found that in order to be read properly, on average, these documents needed more than an eleventh grade/high school level education. This was consistent with the findings of other similar studies. However, the qualitative Suitability Assessment of Materials index showed that, on average, usability and suitability of these documents was superior. Hence, it was concluded that formatting, illustrations, layout, and graphics play a pivotal role in improving health care-related literature and, in turn, promoting health literacy. Based on the comprehensive literature review and assessment of the 40 documents associated with concussion and traumatic brain injury, recommendations have been made for improving the readability, suitability, and usability of health care-related documents. The recommendations are

  10. Preventative maintenance cycle of contact switches for nuclear power plants based on lifetime assessment and economic analysis

    International Nuclear Information System (INIS)

    Shi Jie

    2010-01-01

    An approach to determine the preventive maintenance cycle was proposed in consideration of the lifetime, optimal cost and economy. Two parameters Weibull distribution was used to calculate the lifetime of contact switch. The block replacement model and age replacement model were built with the objective of optimal cost, and the preventive replacement cycle was accounted. Eight proposals for preventive replacement cycle were given. Economy model was applied to assess those proposals and the optimal proposal was confirmed. (authors)

  11. Preventive child health care at elementary school age: The costs of routine assessments with a triage approach

    NARCIS (Netherlands)

    Bezem, J.; Ploeg, C. van der; Numans, M.; Buitendijk, S.; Kocken, P.; Akker, E. van der

    2017-01-01

    Background. Triage in Preventive Child Health Care (PCH) assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6

  12. Prevention of HPV-Related Oral Cancer by Dentists: Assessing the Opinion of Dutch Dental Students.

    Science.gov (United States)

    Poelman, Marcella R; Brand, Henk S; Forouzanfar, Thymour; Daley, Ellen M; Jager, Derk H Jan

    2017-07-24

    The aim of this study is to assess dental students' opinions of the dentists' role in primary prevention of human papillomavirus (HPV)-related oral cancer using a cross-sectional web-based survey. A questionnaire, containing questions about knowledge of HPV and oral cancer, confidence in head and neck examination and role of the dentist in preventing HPV-related oral cancer, was sent to all students of the Academic Centre of Dentistry Amsterdam (n = 912). One hundred and twenty-six (n = 126) students completed the questionnaire. Significantly, more master students (75%) than bachelor students (54.3%) were aware that HPV is a causative factor for oral cancer. Master students had more knowledge of HPV than bachelor students, but knowledge about HPV vaccination was irrespective of the study phase. The majority of dental students agreed that it is important to discuss HPV vaccination with patients. Eighty-nine percent of the students think that more education about symptoms of oral cancer will increase screening for oral cancer. Development of a protocol for screening in dental practices was considered even more important. According to dental students, dentists should discuss HPV as a risk factor for oral cancer with patients. Future dentists are willing to be involved in both primary and secondary prevention of HPV-related oral cancer. Therefore, screening for oral cancer and education about HPV vaccination should be integral elements of the dental curriculum.

  13. Failure to use routine prevention of disability (POD assessment resulting In permanent disability

    Directory of Open Access Journals (Sweden)

    Erika Zoulba

    2016-06-01

    Full Text Available Disability is one of problems in leprosy or Morbus Hansen (MH, which can cause the patient loose his autonomy and may affect his social relationship with family and community. Disability occurs due to neurological inflammation that can manifest as silent neuritis (which develops without any pain. Silent neuritis can be recognized early with a routine prevention of disability (POD assessment. A 19-year-old male patient was referred from a District General Hospital with a history of numbness and stiffness of his 4th and 5th fingers of his left hand since 1 month before admittance. The patient was refered by Community Health Center (CHC or PUSKESMAS after a one year treatment and RFT. During his treatment at the CHC, no assessment of peripheral nerve or POD had ever been performed. The POD assessment at our hospital demonstrated sensory deficit at some points of assessment on both palms and reduced muscle strength of the first and 5th fingers in both hands. Nerve conduction velocity (NCV performed at the outpatient of Neurology Department, showed multiple mononeuropathy MH with irreversible damage. Nerve damage is still considered reversible when it occurs less than 6 months. In this case, the silent neuritis was not detected early and there was delayed treatment; as showed by NCV which revealed a manifestation of irreversible nerve damage. Routine POD assessment may detect the condition and appropriate treatment may overcome the nerve damage.

  14. Legionella pneumophila: risk assessment and strategy for the prevention and control of nosocomial infections

    Directory of Open Access Journals (Sweden)

    Salvo Torrisi

    2012-06-01

    Full Text Available The term “Legionellosis” includes all forms of disease caused by microorganisms of the genus Legionella; it may manifest as a flu-like shape (Pontiac fever, or with severe pneumonia with high mortality (Legionnaires Disease. The causative agent was Legionella pneumophila in the literature although other strains of the genus Legionella are classified as pathogens, mode of transmission is through inhalation of aerosol particles produced by hot water or air conditioning systems: for this reason in community settings and nosocomial L. pneumophila represents a serious public health problem. In the light of epidemiological data since the year 2000 the Italian State has issued a series of provisions laws concerning the prevention and control of nosocomial Legionellosis environment and community.The present work aims to evaluate the presence of Legionella species and L. pneumophila comparing the different approaches proposed by the Guidelines of the regions of Lombardy and Piedmont in terms of assessment and prevention of risk “Legionellosis” in the field of nosocomial infection. The analytical methods used are those provided by the Regional Guidelines: the official method in the second CSR April 4 Method 2000 and UNI EN ISO 11731-1: 2008. Checks have been performed on equipment for the comparison of cold water, hot water and air conditioning in nursing homes, retirement homes and hospitals.The results obtained show that the method CSR April 4, 2000 restricts the search to L. pneumophila permitting, than the method EN ISO 11731-1: 2008, to carry out a risk assessment well targeted to the actual pathogen.The culture method for the detection of L. pneumophila allows you to not only prevention, but also to implement a series of targeted interventions following the directions of the legislation.

  15. Environmental guidance regulatory bulletin

    International Nuclear Information System (INIS)

    1997-01-01

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

  16. American Society of Clinical Oncology Policy Statement: The Role of the Oncologist in Cancer Prevention and Risk Assessment

    Science.gov (United States)

    Zon, Robin T.; Goss, Elizabeth; Vogel, Victor G.; Chlebowski, Rowan T.; Jatoi, Ismail; Robson, Mark E.; Wollins, Dana S.; Garber, Judy E.; Brown, Powel; Kramer, Barnett S.

    2009-01-01

    Oncologists have a critical opportunity to utilize risk assessment and cancer prevention strategies to interrupt the initiation or progression of cancer in cancer survivors and individuals at high risk of developing cancer. Expanding knowledge about the natural history and prognosis of cancers positions oncologists to advise patients regarding the risk of second malignancies and treatment-related cancers. In addition, as recognized experts in the full spectrum of cancer care, oncologists are afforded opportunities for involvement in community-based cancer prevention activities. Although oncologists are currently providing many cancer prevention and risk assessment services to their patients, economic barriers exist, including inadequate or lack of insurance, that may compromise uniform patient access to these services. Additionally, insufficient reimbursement for existing and developing interventions may discourage patient access to these services. The American Society of Clinical Oncology (ASCO), the medical society representing cancer specialists involved in patient care and clinical research, is committed to supporting oncologists in their wide-ranging involvement in cancer prevention. This statement on risk assessment and prevention counseling, although not intended to be a comprehensive overview of cancer prevention describes the current role of oncologists in risk assessment and prevention; provides examples of risk assessment and prevention activities that should be offered by oncologists; identifies potential opportunities for coordination between oncologists and primary care physicians in prevention education and coordination of care for cancer survivors; describes ASCO's involvement in education and training of oncologists regarding prevention; and proposes improvement in the payment environment to encourage patient access to these services. PMID:19075281

  17. The Guidance Counselor and the Reading Curriculum.

    Science.gov (United States)

    Ediger, Marlow

    There are many ways guidance counselors can help teachers achieve more optimal reading instruction. Counselors first may have to ascertain the kinds of problems faced by a student in learning to read. Assessing a student's ability to use picture clues to decipher words may be necessary with primary grade students. Knowledge about phonics, using…

  18. Assessing Cardiovascular Health Using Life′s Simple 7 in a Chinese Population Undergoing Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Qiong Yang

    2015-01-01

    Conclusions: Few Chinese patients undergoing stroke prevention had optimal CVH (determined using LS7. Additionally, fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention. In particular, physical activity and diet status in this population require improvement.

  19. Assessing implementation of evidence-based childhood obesity prevention strategies in schools

    Directory of Open Access Journals (Sweden)

    Christine M.W. Totura

    2015-01-01

    Conclusion: Obesity prevention strategy implementation relies on the supportiveness and structure of school climates. Barriers to prevention can impede efforts despite school commitment toward prevention, while stakeholder collaboration can enhance the likelihood that practices are in place.

  20. Ecological Restoration: Guidance from Theory

    Directory of Open Access Journals (Sweden)

    Joy Zedler

    2005-09-01

    Full Text Available A review of the science and practice of ecosystem restoration led me to identify key ecological theories and concepts that are relevant to planning, implementing, and sustaining restoration efforts. From experience with actual restoration projects, I provide guidance for improving the restoration process. Despite an abundance of theory and guidance, restoration goals are not always achieved, and pathways toward targets are not highly predictable. This is understandable, since each restoration project has many constraints and unique challenges. To improve restoration progress, I advise that sites be designed as experiments to allow learning while doing. At least the larger projects can be restored in phases, each designed as experimental treatments to test alternative restoration approaches. Subsequent phases can then adopt one or more of the treatments that best achieved goals in earlier phases while applying new tests of other restoration measures. Both science and restoration can progress simultaneously. This phased, experimental approach (called “adaptive restoration” is an effective tool for improving restoration when monitoring, assessment, interpretation and research are integrated into the process.

  1. Risk assessment and prevention of malaria among Italian troops in Afghanistan, 2002 to 2011.

    Science.gov (United States)

    Peragallo, Mario S; Sarnicola, Giuseppe; Boccolini, Daniela; Romi, Roberto; Mammana, Giacomo

    2014-01-01

    Malaria prevention policy is different among coalition troops in Afghanistan, ranging from the combined use of suppressive and terminal chemoprophylaxis to the absence of any prophylactic regimen. The objective of this study was to assess the compliance with malaria prevention measures and the risk of malaria among Italian troops in Afghanistan. Target population was the cohort of 32,500 army soldiers deployed in Afghanistan, 2002 to 2011; eligible subjects were the 21,900 soldiers stationed in endemic areas, who were prescribed mefloquine chemoprophylaxis. Adherence to chemoprophylaxis was assessed by a cross-sectional study in a volunteer sample of 5,773 (26.4%) of eligible subjects. The risk of malaria was assessed by detecting malaria cases in the target population. Mefloquine chemoprophylaxis was administered to 4,123 (71.4%) of the 5,773 enrolled soldiers and 3,575 (86.7%) of these took it regularly; however, compliance dropped from 80.9% (2,592/3,202) in 2002 to 2006 to 59.5% (1,531/2,571) in 2007 to 2011 (p Afghanistan, and one Plasmodium vivax case was reported in Italy, yielding an incidence rate of 3.24 cases per 10,000 person-months of exposure (1/3,091) during the transmission season of 2003. In spite of the decreasing compliance with chemoprophylaxis, suggesting a low perception of the risk of malaria, this study confirmed the good tolerability of mefloquine in the military. The risk of malaria for Italian troops in Afghanistan was very low, and chemoprophylaxis was suspended in 2012. A similar policy may be adopted by the generality of International Security Assistance Force troops, and any chemoprophylaxis may be restricted to soldiers stationing in areas where the risk of malaria is substantial. © 2013 International Society of Travel Medicine.

  2. Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

    Science.gov (United States)

    Rizzo, Albert ‘Skip’; Shilling, Russell

    2017-01-01

    ABSTRACT Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. The current article presents the use of Virtual Reality (VR) as a clinical tool to address the assessment, prevention, and treatment of PTSD, based on the VR projects that were evolved at the University of Southern California Institute for Creative Technologies since 2004. A brief discussion of the definition and rationale for the clinical use of VR is followed by a description of a VR application designed for the delivery of prolonged exposure (PE) for treating Service Members (SMs) and Veterans with combat- and sexual assault-related PTSD. The expansion of the virtual treatment simulations of Iraq and Afghanistan for PTSD assessment and prevention is then presented. This is followed by a forward-looking discussion that details early efforts to develop virtual human agent systems that serve the role of virtual patients for training the next generation of clinical providers, as healthcare guides that can be used to support anonymous access to trauma-relevant behavioural healthcare information, and as clinical interviewers capable of automated behaviour analysis of users to infer psychological state. The paper will conclude with a discussion of VR as a tool for breaking down barriers to care in addition to its direct application in assessment and intervention. PMID:29372007

  3. Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD.

    Science.gov (United States)

    Rizzo, Albert 'Skip'; Shilling, Russell

    2017-01-01

    Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. The current article presents the use of Virtual Reality (VR) as a clinical tool to address the assessment, prevention, and treatment of PTSD, based on the VR projects that were evolved at the University of Southern California Institute for Creative Technologies since 2004. A brief discussion of the definition and rationale for the clinical use of VR is followed by a description of a VR application designed for the delivery of prolonged exposure (PE) for treating Service Members (SMs) and Veterans with combat- and sexual assault-related PTSD. The expansion of the virtual treatment simulations of Iraq and Afghanistan for PTSD assessment and prevention is then presented. This is followed by a forward-looking discussion that details early efforts to develop virtual human agent systems that serve the role of virtual patients for training the next generation of clinical providers, as healthcare guides that can be used to support anonymous access to trauma-relevant behavioural healthcare information, and as clinical interviewers capable of automated behaviour analysis of users to infer psychological state. The paper will conclude with a discussion of VR as a tool for breaking down barriers to care in addition to its direct application in assessment and intervention.

  4. Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

    Science.gov (United States)

    Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

    2018-01-01

    Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

  5. Pollution prevention at the Kansas City Division through process waste assessments

    International Nuclear Information System (INIS)

    Pemberton, S.E.; Gentile, C.C.

    1992-01-01

    Allied-Signal Inc., Kansas City Division (KCD) is committed to the hazardous waste minimization requirements set forth under RCRA as amended by the Pollution Prevention Act and DOE Order 5400.1. To assure compliance with these regulations, the KCD has developed a comprehensive Pollution Prevention Program which focuses on the elimination or minimization of all material releases to all environmental media. The ownership of waste minimization is given to all of the waste generators through Departmental Pollution Prevention Plans. These plans include tools to achieve the waste minimization goals. One of these tools is the process waste assessment (PWA). A PWA is a planned procedure with the objective of identifying opportunities and methods to reduce or eliminate waste. A material balance is performed around a specific process which qualifies and quantifies the materials entering and exiting the process. These materials are further defined to the hazardous component level. The exiting materials are separated into what goes into the product, sent to waste management, and what is released to the air (fugitive or point source). Next, opportunities are identified and evaluated for the ability to eliminate or minimize the waste streams exiting the process. Therefore, the PWA provides the basic tool for the creation of a comprehensive process baseline and identification of opportunities to eliminate/minimize the release of hazardous and non-hazardous wastes. This presentation will describe the status and activities of the program conceived to initiate PWAs at the Kansas City Division (KCD) of Allied-Signal Inc.. This program is organized through business units Which consist of manufacturing, quality, and engineering personnel from a specific product line. The departments that these business units represent are the generators of the major process waste at the KCD. Included in the update will be a brief overview of the lessons learned from the methodology development and

  6. HOLISTIC VISION: INTEGRATIVE APPROACH IN GUIDANCE AND COUNSELING SERVICES

    Directory of Open Access Journals (Sweden)

    Ade Hidayat

    2016-06-01

    Full Text Available Abstract: The philosophical issues in Guidance and Counseling especially in epistemological discourse have made paradigmatic friction that pointed by some issues from therapeutic-clinical to comprehensive way with preventive development prespective approach. It was also caused by the wider friction where quantum physic has remove classic Newtonian one, then the influence has generally removed another disciplines, where Guidance and Counseling in one of them. Through the comprehensive paradigm, Guidance dan Counseling need to take prepare the expert in order to capable to develop integrated and comprehensive thinking awareness. It means the Guidance and Counseling holistic vision is urged. Through the holistic vision, all of the competency of student is noticed integrally, such as intellectual, emotional, social, physical, artistic, creativity, ecological awareness, and spiritual competencies.Keywords: Ecoliteracy, Holictic Vision, Guidance and Counseling of Comprehensive.

  7. The effectiveness of baby books for providing pediatric anticipatory guidance to new mothers.

    Science.gov (United States)

    Reich, Stephanie M; Bickman, Leonard; Saville, Benjamin R; Alvarez, Joann

    2010-05-01

    To assess whether embedding pediatric anticipatory guidance into books read to infants is an effective way to educate low-income, first-time mothers about injury-prevention and health-promotion practices. Primiparous women (N = 168) were randomly assigned to 1 of 3 groups: an educational-book group; a noneducational-book group; or a no-book group. Knowledge of anticipatory-guidance topics regarding children from birth to 12 months of age (eg, injury prevention, parenting, nutrition) was assessed during the third trimester of pregnancy and again when infants were approximately 2, 4, 6, 9, 12, and 18 months of age. Women in the educational-book group scored consistently higher on knowledge than did those in the other 2 groups. Those in the educational-book group were found to have significantly higher knowledge scores than those in both the noneducational-book group (effect size [ES]: 0.3, P book group (ES: 0.3, P Books read by mothers to infants seem to be an effective way to provide anticipatory guidance to new mothers. However, future work is needed to determine if increased knowledge translates into safer and more developmentally appropriate parenting practices.

  8. Tsunami prevention and mitigation necessities and options derived from tsunami risk assessment in Indonesia

    Science.gov (United States)

    Post, J.; Zosseder, K.; Wegscheider, S.; Steinmetz, T.; Mück, M.; Strunz, G.; Riedlinger, T.; Anwar, H. Z.; Birkmann, J.; Gebert, N.

    2009-04-01

    Risk and vulnerability assessment is an important component of an effective End-to-End Tsunami Early Warning System and therefore contributes significantly to disaster risk reduction. Risk assessment is a key strategy to implement and design adequate disaster prevention and mitigation measures. The knowledge about expected tsunami hazard impacts, exposed elements, their susceptibility, coping and adaptation mechanisms is a precondition for the development of people-centred warning structures, local specific response and recovery policy planning. The developed risk assessment and its components reflect the disaster management cycle (disaster time line) and cover the early warning as well as the emergency response phase. Consequently the components hazard assessment, exposure (e.g. how many people/ critical facilities are affected?), susceptibility (e.g. are the people able to receive a tsunami warning?), coping capacity (are the people able to evacuate in time?) and recovery (are the people able to restore their livelihoods?) are addressed and quantified. Thereby the risk assessment encompasses three steps: (i) identifying the nature, location, intensity and probability of potential tsunami threats (hazard assessment); (ii) determining the existence and degree of exposure and susceptibility to those threats; and (iii) identifying the coping capacities and resources available to address or manage these threats. The paper presents results of the research work, which is conducted in the framework of the GITEWS project and the Joint Indonesian-German Working Group on Risk Modelling and Vulnerability Assessment. The assessment methodology applied follows a people-centred approach to deliver relevant risk and vulnerability information for the purposes of early warning and disaster management. The analyses are considering the entire coastal areas of Sumatra, Java and Bali facing the Sunda trench. Selected results and products like risk maps, guidelines, decision support

  9. Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

    Science.gov (United States)

    Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

    Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

  10. Readability assessment of concussion and traumatic brain injury publications by Centers for Disease Control and Prevention

    Directory of Open Access Journals (Sweden)

    Gill PS

    2012-11-01

    Full Text Available Preetinder S Gill,1 Tejkaran S Gill,2 Ashwini Kamath,3 Billy Whisnant41College of Technology, Eastern Michigan University, Ypsilanti, MI; 2College of Engineering, University of Michigan, Ann Arbor, MI; 3School of Information, University of Texas, Austin, TX; 4College of Technology, Eastern Michigan University, Ypsilanti, MI, USAAbstract: Health literacy is associated with a person’s capacity to find, access, contextualize, and understand information needed for health care-related decisions. The level of health literacy thus has an influence on an individual’s health status. It can be argued that low health literacy is associated with poor health status. Health care literature (eg, pamphlets, brochures, postcards, posters, forms are published by public and private organizations worldwide to provide information to the general public. The ability to read, use, and understand is critical to the successful application of knowledge disseminated by this literature. This study assessed the readability, suitability, and usability of health care literature associated with concussion and traumatic brain injury published by the United States Centers for Disease Control and Prevention. The Flesch–Kincaid Grade Level, Flesch Reading Ease, Gunning Fog, Simple Measure of Gobbledygook, and Suitability Assessment of Materials indices were used to assess 40 documents obtained from the Centers for Disease Control and Prevention website. The documents analyzed were targeted towards the general public. It was found that in order to be read properly, on average, these documents needed more than an eleventh grade/high school level education. This was consistent with the findings of other similar studies. However, the qualitative Suitability Assessment of Materials index showed that, on average, usability and suitability of these documents was superior. Hence, it was concluded that formatting, illustrations, layout, and graphics play a pivotal role in improving

  11. 76 FR 16425 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2011-03-23

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

  12. Security of radioactive sources. Interim guidance for comment

    International Nuclear Information System (INIS)

    2003-06-01

    In previous IAEA publications, there have been only rather general security requirements for non-nuclear radioactive material. These requirements were primarily directed to such issues as unintentional exposure to radiation, negligence and inadvertent loss. However, it is clear that more guidance is needed to not only try and prevent further events involving orphan sources, but also to prevent the deliberate attempt to acquire radioactive sources for malevolent purposes. Member States have requested guidance on the type and nature of security measures that might be put in place and on the methodology to be used in choosing such measures. These requests were also endorsed in the findings of the international conference on 'Security of Radioactive Sources' held in March 2003. Practical advice on assessing and implementing security measures complements the general commitments in the proposed Revised Code of Conduct on Safety and Security of radioactive Sources. A Safety Guide entitled 'Safety and Security of Radiation Sources' that, amongst other things, discusses these issues is being drafted. However, it is recognized that guidance material is required before this document will be finalized in order to allow Member States opportunity to put in place appropriate actions and planning to address current issues. Hence the purpose of the current document is to provide advice on security approaches and to allow comment on detailed recommendations for levels of security on radioactive sources that may be incorporated within the Safety Guide. This report is primarily addressed to Regulatory Authorities but it is also intended to provide guidance to manufacturers, suppliers and users of sources. Its objective is to assist Member States in deciding which security measures are needed to ensure consistency with the International Basic Safety Standards and the Revised Code of Conduct for the Safety and Security of Radioactive Sources. It is recognized that there must be a

  13. Pollution prevention opportunity assessment for the K-25 Site Steam Plant -- Level 3

    International Nuclear Information System (INIS)

    1995-09-01

    A Level 3 pollution prevention opportunity assessment (PPOA) was performed for the K-1501 Steam Plant at the K-25 Site. The primary objective was to identify and evaluate pollution prevention (P2) options to reduce the quantities of each waste stream generated by the Steam Plant. For each of the waste streams, P2 options were evaluated to first reduce the quantity of waste generated and second to recycle the waste. This report provides a process description of the facility; identification, evaluation, and recommendations of P2 options; an implementation schedule with funding sources; and conclusions. Largely for economic reasons, only 3 of the 14 P2 options are being recommended for implementation. All are source reduction options. When implemented, these three options are estimated to reduce the annual generation of waste by 658,412 kg and will result in a cost savings of approximately $29,232/year for the K-25 Site. The recommended options are to: install a flue gas return System in Boiler 7; reduce steam loss from traps; and increase lapse time between rinses. The four boilers currently in operation at the Steam Plant use natural gas or fuel oil as fuel sources

  14. Full report: Assessment and opportunity identification of energy efficient pollution prevention technologies and processes

    Energy Technology Data Exchange (ETDEWEB)

    1994-11-01

    US industry produces about 12 billion tons of waste a year, or two-thirds of the waste generated in the US. The costs of handling and disposing of these wastes are significant, estimated to be between $25 and $43 billion in 1991, and represent an increase of 66% since 1986. US industry also uses about one-third of all energy consumed in the nation, which adds to the environmental burden. Industrial wastes affect the environmental well-being of the nation and, because of their growing costs, the competitive abilities of US industry. As part of a national effort to reduce industrial wastes, the US Congress passed the Energy Policy Act (EPAct, P.L. 102-486). Section 2108, subsections (b) and (c), of EPAct requires the Department of Energy (DOE) to identify opportunities to demonstrate energy efficient pollution prevention technologies and processes; to assess their availability and the energy, environmental, and cost effects of such technologies; and to report the results. Work for this report clearly pointed to two things, that there is insufficient data on wastes and that there is great breadth and diversity in the US industrial sector. This report identifies: information currently available on industrial sector waste streams, opportunities for demonstration of energy efficient pollution prevention technologies in two industries that produce significant amounts of waste--chemicals and petroleum, characteristics of waste reducing and energy saving technologies identifiable in the public literature, and potential barriers to adoption of waste reducing technologies by industry.

  15. Assessment and prevention of the professional risks in the operations of industrial radiography

    International Nuclear Information System (INIS)

    Pizzorno, M.; Paul, D.; Coletti, F.; Sari Minodier, I.; Azzopardi, G.; Klemenic, O.; Botta, A.

    2006-01-01

    Industrial radiography is a nocturnal activity, hazardous and little known; it is among the professions the most exposed to ionizing radiation. This study analyse the doses, received the industrial radiographers, their workplace conditions and organization of their tasks. Dosimetry observations on site, together with calculations using the Mercurad code, allowed mean values for reference doses for all the work (including transport, gammatron manipulation, collimator manipulation, shooting) to be established. These value were integrated into a table entitled 'reference doses' in order to provisionally evaluate the doses received by the operators. Distances for security zone demarcation, so as to forbid access to non exposed personnel during shooting, were evaluated. Assessment of the professional risks for industrial radiography, taking into account all the risks (radiological and others), has been made and is under evaluation. This led to measures for prevention based on the material used (collimator, tripod, gamma-stops), on the organization and the conditions of work (for example, time limits permitting a prior visit to the site and preparation for radiography, suitable scaffolding, sufficient lighting, siting of shootings). These prevention measure will be integrated into the new charter of good practice in industrial radiography in the Provence Alpes Cote d'Azur region (south of France). (authors)

  16. A systematic review of financial and economic assessments of bovine viral diarrhea virus (BVDV) prevention and mitigation activities worldwide.

    Science.gov (United States)

    Pinior, Beate; Firth, Clair L; Richter, Veronika; Lebl, Karin; Trauffler, Martine; Dzieciol, Monika; Hutter, Sabine E; Burgstaller, Johann; Obritzhauser, Walter; Winter, Petra; Käsbohrer, Annemarie

    2017-02-01

    Infection with bovine viral diarrhea virus (BVDV) results in major economic losses either directly through decreased productive performance in cattle herds or indirectly, such as through expenses for control programs. The aim of this systematic review was to review financial and/or economic assessment studies of prevention and/or mitigation activities of BVDV at national, regional and farm level worldwide. Once all predefined criteria had been met, 35 articles were included for this systematic review. Studies were analyzed with particular focus on the type of financially and/or economically-assessed prevention and/or mitigation activities. Due to the wide range of possible prevention and/or mitigation activities, these activities were grouped into five categories: i) control and/or eradication programs, ii) monitoring or surveillance, iii) prevention, iv) vaccination and v) individual culling, control and testing strategies. Additionally, the studies were analyzed according to economically-related variables such as efficiency, costs or benefits of prevention and/or mitigation activities, the applied financial and/or economic and statistical methods, the payers of prevention and/or mitigation activities, the assessed production systems, and the countries for which such evaluations are available. Financial and/or economic assessments performed in Europe were dominated by those from the United Kingdom, which assessed mostly vaccination strategies, and Norway which primarily carried out assessments in the area of control and eradication programs; whereas among non-European countries the United States carried out the majority of financial and/or economic assessments in the area of individual culling, control and testing. More than half of all studies provided an efficiency calculation of prevention and/or mitigation activities and demonstrated whether the inherent costs of implemented activities were or were not justified. The dairy sector was three times more likely to

  17. Integrated environmental assessment and pollution prevention in Vietnam: the case of anthracite production

    Energy Technology Data Exchange (ETDEWEB)

    Chinh, L.D.; Gheewala, S.H.; Bonnet, S. [King Mongkuts University of Technology at Thonburi, Bangkok (Thailand)

    2007-07-01

    Abstract: Using the concept of life cycle analysis, the whole life cycle of anthracite production in Vietnam was assessed and the environmental 'hot-spots' were identified. These include (I) dust pollution at coal transfer points or piles in storage; (ii) noise pollution resulting from the usage of heavy equipment, and (iii) high volume of acid and turbid mine water discharged into the environment. Pollution prevention and treatment options were identified and discussed in this study which consists of wet treatment of dust, planning, collection and treatment of mine water, planting of trees for dust and noise reduction as well as minimization of erosion. Some recommendations are made for pollution abatement from coal production and improvement of anthracite production in the region.

  18. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies.

    Science.gov (United States)

    Borg, M A; Waisfisz, B; Frank, U

    2015-05-01

    It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  19. Gas migration from closed coal mines to the surface. Risk assessment methodology and prevention means

    International Nuclear Information System (INIS)

    Pokryszka, Z.; Tauziede, Ch.; Lagny, C.; Guise, Y.; Gobillot, R.; Planchenault, J.M.; Lagarde, R.

    2005-01-01

    French law as regards renunciation to mining concessions calls for the mining operator to first undertake analyses of the risks represented by their underground mining works. The problem of gas migration to the surface is especially significant in the context of coal mines. This is because mine gas can migrate to the earth's surface, then present significant risks: explosion, suffocation or gas poisoning risks. As part of the scheduled closure of all coal mining operations in France, INERIS has drawn up, at the request of national mining operator Charbonnages de France, a general methodology for assessing the risk linked to gas in the context of closed coal mines. This article presents the principles of this methodology. An application example based on a true case study is then described. This is completed by a presentation of the preventive and monitoring resources recommended and usually applied in order to manage the risk linked to gaseous emissions. (authors)

  20. Waste prevention in liquid detergent distribution: a comparison based on life cycle assessment.

    Science.gov (United States)

    Nessi, Simone; Rigamonti, Lucia; Grosso, Mario

    2014-11-15

    The distribution of liquid detergents through self-dispensing systems has been adopted in some Italian retail stores over the last few years. By enabling the consumer to refill several times the same container, it is proposed as a less waste-generating and more environmentally friendly alternative to the traditional distribution with single-use plastic containers. For this reason, its implementation is encouraged by the national waste prevention programme recently adopted in Italy. In order to assess such claims, a life cycle assessment was carried out to evaluate whether detergent distribution through self-dispensing systems actually allows to achieve the expected reduction in waste generation and environmental impacts. The focus was on the distribution within the large-scale retail trade and on the categories of laundry detergents, fabric softeners and hand dishwashing detergents. For each of them, a set of baseline single-use scenarios were compared with two alternative waste prevention scenarios, where the detergent is distributed through self-dispensing systems. Beyond waste generation, also the Cumulative Energy Demand and thirteen midpoint-level potential impact indicators were calculated for the comparison. Results showed that a reduction in waste generation up to 98% can be achieved, depending on the category of detergent, on the baseline scenario of comparison and on the number of times the refillable container is used. A progressive reduction in the energy demand and in most of the potential impacts was also observed, starting from a minimum number of uses of the refillable container. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Medical homes for at-risk children: parental reports of clinician-parent relationships, anticipatory guidance, and behavior changes.

    Science.gov (United States)

    Nelson, Catherine S; Higman, Susan M; Sia, Calvin; McFarlane, Elizabeth; Fuddy, Loretta; Duggan, Anne K

    2005-01-01

    Family-centeredness, compassion, and trust are 3 attributes of the clinician-parent relationship in the medical home. Among adults, these attributes are associated with patients' adherence to clinicians' advice. The objectives were (1) to measure medical home attributes related to the clinician-parent relationship, (2) to measure provision of anticipatory guidance regarding injury and illness prevention, (3) to relate anticipatory guidance to parental behavior changes, and (4) to relate medical home attributes to anticipatory guidance and parental behavior changes. A cross-sectional study of data collected among at-risk families when children were 1 year of age, in a randomized, controlled trial of a home-visiting program to prevent child abuse and neglect, was performed. Modified subscales of the Primary Care Assessment Survey were used to measure parental ratings of clinicians' family-centeredness, compassion, and trust. Parental reports of provision of anticipatory guidance regarding injury and illness prevention topics (smoke alarms, infant walkers, car seats, hot water temperature, stair guards, sunscreen, firearm safety, and bottle propping) and behavior changes were recorded. Of the 564 mothers interviewed when their children were 1 year of age, 402 (71%) had a primary care provider and had complete data for anticipatory guidance items. By definition, poverty, partner violence, poor maternal mental health, and maternal substance abuse were common in the study sample. Maternal ratings of clinicians' family-centeredness, compassion, and trust were fairly high but ranged widely and varied among population subgroups. Families reported anticipatory guidance for a mean of 4.6 +/- 2.2 topics relevant for discussion. Each medical home attribute was positively associated with parental reports of completeness of anticipatory guidance, ie, family-centeredness (beta = .026, SE = .004), compassion (beta = .019, SE = .005), and trust (beta = .016, SE = .005). Parents

  2. Integrating Hazardous Materials Characterization and Assessment Tools to Guide Pollution Prevention in Electronic Products and Manufacturing

    Science.gov (United States)

    Lam, Carl

    Due to technology proliferation, the environmental burden attributed to the production, use, and disposal of hazardous materials in electronics have become a worldwide concern. The major theme of this dissertation is to develop and apply hazardous materials assessment tools to systematically guide pollution prevention opportunities in the context of electronic product design, manufacturing and end-of-life waste management. To this extent, a comprehensive review is first provided on describing hazard traits and current assessment methods to evaluate hazardous materials. As a case study at the manufacturing level, life cycle impact assessment (LCIA)-based and risk-based screening methods are used to quantify chemical and geographic environmental impacts in the U.S. printed wiring board (PWB) industry. Results from this industrial assessment clarify priority waste streams and States to most effectively mitigate impact. With further knowledge of PWB manufacturing processes, select alternative chemical processes (e.g., spent copper etchant recovery) and material options (e.g., lead-free etch resist) are discussed. In addition, an investigation on technology transition effects for computers and televisions in the U.S. market is performed by linking dynamic materials flow and environmental assessment models. The analysis forecasts quantities of waste units generated and maps shifts in environmental impact potentials associated with metal composition changes due to product substitutions. This insight is important to understand the timing and waste quantities expected and the emerging toxic elements needed to be addressed as a consequence of technology transition. At the product level, electronic utility meter devices are evaluated to eliminate hazardous materials within product components. Development and application of a component Toxic Potential Indicator (TPI) assessment methodology highlights priority components requiring material alternatives. Alternative

  3. Assessment of Geohazards and Preventative Countermeasures Using AHP Incorporated with GIS in Lanzhou, China

    Directory of Open Access Journals (Sweden)

    Hai-Min Lyu

    2018-01-01

    Full Text Available This research investigates geohazards and preventative countermeasures for Lanzhou City, China. To investigate the factors related to the development of geohazards in Lanzhou, the regional geological conditions around Lanzhou were investigated. The geomorphology of the region is comprised of a loess landform underlying quaternary loess deposits. A large number of faults induced by strong neotectonic movements are present in the area. Therefore, earthquakes frequently occur around Lanzhou. Earthquakes cause numerous rock falls and landslides, with landslide masses found scattered on the upper middle level of the area’s mountains. When intense rainfall occurs, a lot of loose deposits are brought together along steep gullies, forming debris flows; hence, a disaster chain of earthquake–landslide–debris flow is formed. To evaluate the georisks around Lanzhou, the Analytic Hierarchy Process (AHP was employed to assess geohazards. The spatial distribution of the evaluated georisk levels was mapped using a Geographic Information System (GIS. Based on the assessed results, about 55% of the urban area and 44% of Gaolan County have high or very high-risk levels. The ratio of relatively high disaster risk levels is up to 31% of the total area. To mitigate these geohazards, both strategic decision making and technical countermeasures should be implemented.

  4. Dietary assessment in children adhering to a food allergen avoidance diet for allergy prevention.

    Science.gov (United States)

    Vlieg-Boerstra, B J; van der Heide, S; Bijleveld, C M A; Kukler, J; Duiverman, E J; Wolt-Plompen, S A A; Dubois, A E J

    2006-12-01

    The purpose of this investigation was to verify if avoidance of allergenic foods in children adhering to a food allergen avoidance diet from birth was complete and feasible, and whether dietary assessment can be used as a tool in predicting the outcome of double-blind, placebo-controlled food challenges (DBPCFCs). Children adhering to an allergen avoidance diet from birth underwent DBPCFCs. The investigator-dietician verified whether the elimination was complete, using food frequency questionnaires for common allergenic foods. University Medical Centre Groningen, the Netherlands. Thiry-eight children aged 1-13 years, who were consecutively referred to the University Medical Centre Groningen for DBPCFC between January 2002 and February 2004. Among the 38 children undergoing DBPCFCs, there were 15 challenges with egg, 15 with peanut, five with hazelnut and three with soy. Fifteen food challenges (39%) were positive. Small quantities of allergenic foods were inadvertently present in the diets of 13 patients (34%), were possibly present in the diets of 14 patients (37%) and could not be identified in the diets of 11 patients (29%). Seven patients (54%) who had inadvertently ingested small quantities of allergenic foods without sequelae had a positive DBPCFC. Dietary avoidance was incomplete and not feasible in most cases. Tolerance of small amounts of allergenic foods does not preclude positive challenge reactions. Dietary assessment does not seem a useful tool in predicting the outcome of DBPCFC in children adhering to an elimination diet. The Stichting Astma Bestrijding (Foundation for the Prevention of Asthma), The Netherlands.

  5. Assessment of Knowledge and Perception towards Breast Cancer Prevention and Early Detection

    Directory of Open Access Journals (Sweden)

    Saleh Hadi Alharbi

    2018-01-01

    Full Text Available Background: Breast cancer was the ninth leading cause of mortality for women in Saudi Arabia, and to reduce the burden of this disease appropriate information about breast cancer and its’ early detection measures are highly needed. Therefore, the aim of this study was to assess the knowledge and perception of Northern Saudi Arabia people towards breast cancer prevention and early detection. Methodology: In this cross sectional descriptive study, data about breast cancer were obtained from 566 Saudi volunteers living in the city of Hail, Saudi Arabia. Results: When the level of individual’s knowledge about breast cancer was assessed, the majority of the study subjects were found with good knowledge followed by moderate and poor representing 187 (34.3%, 170 (31.2% and 86 (15.8%, respectively. For females, most of them were found with good knowledge followed by moderate and poor constituting 142 (36.1%, 111 (28.2% and 62 (15.8%, respectively. Conclusion: The findings of the present study have delivered evidence that women in Northern Saudi Arabia lack appropriate information about breast cancer and its’ early detection measures.

  6. Managing industrial risk--having a tested and proven system to prevent and assess risk.

    Science.gov (United States)

    Heller, Stephen

    2006-03-17

    Some relatively easy techniques exist to improve the risk picture/profile to aid in preventing losses. Today with the advent of computer system resources, focusing on specific aspects of risk through systematic scoring and comparison, the risk analysis can be relatively easy to achieve. Techniques like these demonstrate how working experience and common sense can be combined mathematically into a flexible risk management tool or risk model for analyzing risk. The risk assessment methodology provided by companies today is no longer the ideas and practices of one group or even one company. It is reflective of the practice of many companies, as well as the ideas and expertise of academia and government regulators. The use of multi-criteria decision making (MCDM) techniques for making critical decisions has been recognized for many years for a variety of purposes. In today's computer age, the easy accessing and user-friendly nature for using these techniques, makes them a favorable choice for use in the risk assessment environment. The new user of these methodologies should find many ideas directly applicable to his or her needs when approaching risk decision making. The user should find their ideas readily adapted, with slight modification, to accurately reflect a specific situation using MCDM techniques. This makes them an attractive feature for use in assessment and risk modeling. The main advantage of decision making techniques, such as MCDM, is that in the early stages of a risk assessment, accurate data on industrial risk, and failures are lacking. In most cases, it is still insufficient to perform a thorough risk assessment using purely statistical concepts. The practical advantages towards deviating from strict data-driven protocol seem to outweigh the drawbacks. Industry failure data often comes at a high cost when a loss occurs. We can benefit from this unfortunate acquisition of data through the continuous refining of our decisions by incorporating this new

  7. Guidance for the application of an assessment methodology for innovative nuclear energy systems. INPRO manual - Environment. Vol. 7 of the final report of phase 1 of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO)

    International Nuclear Information System (INIS)

    2008-11-01

    The International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) was initiated in the year 2000, based on a resolution of the IAEA General Conference (GC(44)/RES/21). The main objectives of INPRO are (1) to help to ensure that nuclear energy is available to contribute in fulfilling energy needs in the 21st century in a sustainable manner, (2) to bring together both technology holders and technology users to consider jointly the international and national actions required to achieve desired innovations in nuclear reactors and fuel cycles; and (3) to create a forum to involve all relevant stakeholders that will have an impact on, draw from, and complement the activities of existing institutions, as well as ongoing initiatives at the national and international level. The INPRO manual is comprised of an overview volume (No. 1), and eight additional volumes covering the areas of economics (Volume 2), infrastructure (Volume 3), waste management (Volume 4), proliferation resistance (Volume 5), physical protection (Volume 6), environment (laid out in this volume) (Volume 7), safety of nuclear reactors (Volume 8), and safety of nuclear fuel cycle facilities (Volume 9). This volume should provide guidance to the assessor of an INS that is planned (or maintained or enlarged), describing how to apply the INPRO methodology in the area of environment. It follows the guidelines of the INPRO report 'Methodology for the assessment of innovative nuclear reactors and fuel cycles', together with its previous report 'Guidance for the evaluation for innovative nuclear reactors and fuel cycles'. The INPRO Manual starts with an introduction in Chapter 1. In Chapter 2 an overview is presented what kind of information must be available to an INPRO assessor to perform his environmental assessment. In Chapter 3 the background of the INPRO environmental basic principle BP1, the corresponding user requirements (UR) and criteria (CR) consisting of indicators (IN) and acceptance

  8. Taxonometric Guidance for Developing Quality Assurance

    International Nuclear Information System (INIS)

    Thomadsen, Bruce; Lin, She-Woei

    2008-01-01

    A taxonomy is an ordered classification system. In error reduction analysis, an examination of the human failures that lead to an event often uses a taxonomy to classify the failures according to some aspect of their characteristics. These classifications provide insights into the forces that kept the persons involved from achieving their intended actions. They also can provide guidance for changing the situation to prevent failure in the future. For example, the corrective action would be different if a therapist pressed the wrong button because several buttons looked alike or they forgot which button to press. Different types of failures lead to particular types of remediation. Taxonomies can provide guidance in selecting between possible corrective actions

  9. A pilot assessment of relapse prevention for heroin addicts in a Chinese rehabilitation center.

    Science.gov (United States)

    Min, Zhao; Xu, Li; Chen, Hanhui; Ding, Xu; Yi, Zhang; Mingyuang, Zhang

    2011-05-01

    To conduct a pilot assessment of relapse prevention (RP) group therapy for heroin-dependent patients in a drug rehabilitation center in China. A randomized case-control study was conducted to assess the efficacy of RP delivered over a 2-month period to male heroin addicts (n = 50, RP group) in the Shanghai Labor Drug Rehabilitation Center (LDRC) compared with an equal number of participants (n = 50, labor rehabilitation (LR) group) in the LDRC program receiving standard-of-care treatment. Outcomes were assessed by the Beck Depression Inventory (BDI), the Self-Rating Anxiety Scale (SAS), the Self-Efficacy Scale (SE), and the Self-Esteem Scale (SES) after completion of RP, and by the Addiction Severity Index (ASI) and abstinence rates of heroin use at 3-month follow-up post release from the LDRC for both groups. Significant improvements in scores on SAS, SE, and SES were found in the RP group after completion of the 2-month RP group therapy compared with the LR group (SAS 7.85 ± 6.20 vs 1.07 ± 5.42, SE 3.88 ± 3.60 vs .08 ± 2.89, and SES 3.83 ± 3.31 vs .78 ± 2.55). At 3-month follow-up, the RP group participants had more improvements on ASI scores in most domains and had higher abstinence rates than that in the LR group (37.2% vs 16.7%). An RP component can be effective in increasing abstinence rates among post-program heroin-dependent individuals and may help reduce anxiety and improve self-esteem and self-efficacy during and following treatment. This study suggests RP as a potentially effective component of treatment for heroin addicts.

  10. Addressing the Needs of Preschool Children in the Context of Disasters and Terrorism: Assessment, Prevention, and Intervention.

    Science.gov (United States)

    Wolmer, Leo; Hamiel, Daniel; Pardo-Aviv, Lee; Laor, Nathaniel

    2017-07-01

    The goal of this paper is to review the research literature regarding the needs of preschoolers in the context of disasters and terrorism with the aim of understanding the existing methods for assessment, prevention, and intervention to provide recommendations and point out required research and development. We differentiate between screening tools that provide initial evaluation and assessment tools for diagnosing preschooler children's pathology and review possible interventions that address the preschool child's needs before, during, and after the incident itself. We also emphasize the lack of dissemination and research of prevention programs and mass interventions for preschoolers. Programs for community mass prevention and intervention for preschoolers should be developed and evaluated and interventions should be adapted for individual and group delivery. Moreover, the increase in the number of children refugees requires cultural adaptations of assessment measures and interventions.

  11. Guidance for the application of an assessment methodology for innovative nuclear energy systems. INPRO manual - Physical protection. Vol. 6 of the final report of phase 1 of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO)

    International Nuclear Information System (INIS)

    2008-11-01

    The International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) was initiated in the year 2000, based on a resolution of the IAEA General Conference (GC(44)/RES/21). The main objectives of INPRO are (1) to help to ensure that nuclear energy is available to contribute in fulfilling energy needs in the 21st century in a sustainable manner, (2) to bring together both technology holders and technology users to consider jointly the international and national actions required to achieve desired innovations in nuclear reactors and fuel cycles; and (3) to create a forum to involve all relevant stakeholders that will have an impact on, draw from, and complement the activities of existing institutions, as well as ongoing initiatives at the national and international level. This document follows the guidelines of the INPRO report M ethodology for the assessment of innovative nuclear reactors and fuel cycles, Report of Phase 1B (first part) of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) , IAEA-TECDOC-1434 (2004), together with its previous report G uidance for the evaluation for innovative nuclear reactors and fuel cycles, Report of Phase 1A of the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO), IAEATECDOC-1362 (2003). This INPRO manual is comprised of an overview volume and eight additional volumes covering the areas of economics (Volume 2), infrastructure (Volume 3), waste management (Volume 4), proliferation resistance (Volume 5), physical protection (Volume 6), environment (Volume 7), safety of reactors (Volume 8), and safety of nuclear fuel cycle facilities (Volume 9). The INPRO Manual for the area of physical protection (Volume 6) provides guidance to the assessor of an INS (innovative nuclear energy system) under a physical protection regime in a country that is planning to install a nuclear power program (or maintaining or enlarging an existing one), and describes the application of the

  12. Guidance for Identifying, Selecting and Evaluating Open Literature Studies

    Science.gov (United States)

    This guidance for Office of Pesticide Program staff will assist in their evaluation of open literature studies of pesticides. It also describes how we identify, select, and ensure that data we use in risk assessments is of sufficient scientific quality.

  13. Assessing Domestic Violence Shelter Workers Views and Practices Pertaining to HIV Prevention Services for Women Residing in Domestic Violence Shelters.

    Science.gov (United States)

    Cavanaugh, Courtenay E; Harvey, Jenna; Alexander, Kamila A; Saraczewski, Samantha; Campbell, Jacquelyn C

    2018-06-01

    There is a need for studies to assess domestic violence (DV) shelter workers views about brief HIV prevention interventions for shelter residents to improve these workers' provision of HIV prevention interventions to shelter residents. This mixed methods study assessed DV shelter workers' views about the following: (a) the need for and appropriateness of HIV prevention services within DV shelters, (b) the utility (i.e., acceptability, systems support, understanding, and feasibility) of an HIV Risk Assessment and Safety Plan (HIV RASP) for women in DV shelters, and (c) suggested changes to or concerns about using the HIV RASP. Workers from DV shelters located in the 10 states in the United States with the highest rates of HIV reviewed the HIV RASP and answered survey questions about it including the Usage Rating Profile-Intervention (URP-I) Questionnaire and two open-ended questions. Although workers felt it was appropriate to provide HIV prevention interventions within DV shelters, only 23% reported that HIV prevention interventions had ever been implemented at their shelter and only 42% had provided residents with educational brochures about HIV prevention. Workers generally agreed that the HIV RASP was acceptable, understandable, and feasible. They somewhat disagreed about their ability to implement the tool independently. Findings suggest that little progress has been made in engaging DV shelter workers in HIV prevention efforts for residents during the past decade and reveal ways to improve the HIV RASP and overcome barriers to implementing it. The study findings may be used to help reduce gaps between the science and practice of HIV prevention for abused women.

  14. Unified State Plan for Guidance, Counseling and Placement in Colorado. Grades 7-12.

    Science.gov (United States)

    Terrill, Jerry; And Others

    This guide, one of three units in the Colorado state plan for guidance program development, is written for educators as both a guideline and a needs assessment instrument to assist in the identification of deficit areas in school guidance programs. In a beginning section, this unit for grades 7-12 provides a brief philosophy of guidance and…

  15. 77 FR 24722 - Draft Guidance for Industry: Safety of Nanomaterials in Cosmetic Products; Availability

    Science.gov (United States)

    2012-04-25

    ...] Draft Guidance for Industry: Safety of Nanomaterials in Cosmetic Products; Availability AGENCY: Food and... safety assessment of nanomaterials in cosmetic products. This guidance is intended to assist industry in... Cosmetic Products.'' The draft guidance is intended to assist industry in identifying the potential safety...

  16. Obesity Prevention and Weight Maintenance After Loss.

    Science.gov (United States)

    German, Alexander James

    2016-09-01

    Obesity is one of the most prevalent medical diseases in pets. Outcomes are often disappointing; many animals either fail to reach target weight or regain weight. This article discusses managing obesity, focusing on prevention. It gives guidance on establishing monitoring programs that use regular body weight and condition assessments to identify animals at risk of inappropriate weight gain, enabling early intervention. Weight management in obese animals is a lifelong process. Regular weight and body condition monitoring are key to identifying animals that rebound early, while continuing to feed a therapeutic weight loss diet can help prevent it from happening. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Assessing the role of pavement macrotexture in preventing crashes on highways.

    Science.gov (United States)

    Pulugurtha, Srinivas S; Kusam, Prasanna R; Patel, Kuvleshay J

    2010-02-01

    The objective of this article is to assess the role of pavement macrotexture in preventing crashes on highways in the State of North Carolina. Laser profilometer data obtained from the North Carolina Department of Transportation (NCDOT) for highways comprising four corridors are processed to calculate pavement macrotexture at 100-m (approximately 330-ft) sections according to the American Society for Testing and Materials (ASTM) standards. Crash data collected over the same lengths of the corridors were integrated with the calculated pavement macrotexture for each section. Scatterplots were generated to assess the role of pavement macrotexture on crashes and logarithm of crashes. Regression analyses were conducted by considering predictor variables such as million vehicle miles of travel (as a function of traffic volume and length), the number of interchanges, the number of at-grade intersections, the number of grade-separated interchanges, and the number of bridges, culverts, and overhead signs along with pavement macrotexture to study the statistical significance of relationship between pavement macrotexture and crashes (both linear and log-linear) when compared to other predictor variables. Scatterplots and regression analysis conducted indicate a more statistically significant relationship between pavement macrotexture and logarithm of crashes than between pavement macrotexture and crashes. The coefficient for pavement macrotexture, in general, is negative, indicating that the number of crashes or logarithm of crashes decreases as it increases. The relation between pavement macrotexture and logarithm of crashes is generally stronger than between most other predictor variables and crashes or logarithm of crashes. Based on results obtained, it can be concluded that maintaining pavement macrotexture greater than or equal to 1.524 mm (0.06 in.) as a threshold limit would possibly reduce crashes and provide safe transportation to road users on highways.

  18. Assessing Injury and Violence Prevention in North Carolina’s Local Health Departments

    Science.gov (United States)

    Mouw, Mary S.; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E.; Maman, Suzanne; Proescholdbell, Scott K.

    2016-01-01

    Context Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) is not well described. Objectives 1) Provide a baseline assessment of IVP in the state’s LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. 2) Describe a replicable, cost-effective method for systematic assessment of regional IVP. Design An observational, cross-sectional study, through a survey of NC’s 85 LHDs. Results Representatives from 77 LHDs (91%) responded. Nearly a third (n=23, 30%) reported no staff were familiar with evidence-based interventions in IVP; over a third (n=29, 38%) reported their LHD did not train staff in IVP. Almost half (n=37, 46%) had no dedicated funding. On average, respondents said about half of their programs were evidence-based; however, there was marked variation (mean 52%, SD = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs’ programs. Conclusions Despite funding constraints, NC’s LHDs are engaged in a broad range of IVP activities. Programming did not uniformly address state injury and violence priorities, however, nor local injury and violence burden. Staff need training in evidence-based strategies targeting priority areas. Multi-sector partnerships were common and increased LHDs’ capacity. These findings are actionable at the state and local-level. PMID:27621337

  19. Assessing Injury and Violence Prevention in North Carolina's Local Health Departments.

    Science.gov (United States)

    Mouw, Mary S; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E; Maman, Suzanne; Proescholdbell, Scott K

    2016-01-01

    Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) has not been well described. One objective of the current study is to provide a baseline assessment of IVP in the state's LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. The study will also describe a replicable, cost-effective method for systematic assessment of regional IVP. This is an observational, cross-sectional study that was conducted through a survey of North Carolina's 85 LHDs. Representatives from 77 LHDs (91%) responded. Nearly one-third (n = 23; 30%) reported that no staff members were familiar with evidence-based interventions in IVP, and over one-third (n = 29; 38%) reported that their LHD did not train staff in IVP. Almost one-half (n = 37; 48%) had no dedicated funding for IVP. On average, respondents said that about half of their programs were evidence-based; however, there was marked variation (mean, 52%; standard deviation = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs' programs. Despite funding constraints, North Carolina's LHDs engaged in a broad range of IVP activities. However, programming did not uniformly address state injury and violence priorities, nor local injury and violence burden. Staff members need training in evidence-based strategies that target priority areas. Multisector partnerships were common and increased LHDs' capacity. These findings are actionable at the state and local level. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  20. A State-by-State Assessment of Food Service Regulations for Prevention of Norovirus Outbreaks.

    Science.gov (United States)

    Kambhampati, Anita; Shioda, Kayoko; Gould, L Hannah; Sharp, Donald; Brown, Laura G; Parashar, Umesh D; Hall, Aron J

    2016-09-01

    Noroviruses are the leading cause of foodborne disease in the United States. Foodborne transmission of norovirus is often associated with contamination of food during preparation by an infected food worker. The U.S. Food and Drug Administration's Food Code provides model food safety regulations for preventing transmission of foodborne disease in restaurants; however, adoption of specific provisions is at the discretion of state and local governments. We analyzed the food service regulations of all 50 states and the District of Columbia (i.e., 51 states) to describe differences in adoption of norovirus-related Food Code provisions into state food service regulations. We then assessed potential correlations between adoption of these regulations and characteristics of foodborne norovirus outbreaks reported to the National Outbreak Reporting System from 2009 through 2014. Of the 51 states assessed, all (100%) required food workers to wash their hands, and 39 (76%) prohibited bare-hand contact with ready-to-eat food. Thirty states (59%) required exclusion of staff with vomiting and diarrhea until 24 h after cessation of symptoms. Provisions requiring a certified food protection manager (CFPM) and a response plan for contamination events (i.e., vomiting) were least commonly adopted; 26 states (51%) required a CFPM, and 8 (16%) required a response plan. Although not statistically significant, states that adopted the provisions prohibiting bare-hand contact (0.45 versus 0.74, P =0.07), requiring a CFPM (0.38 versus 0.75, P =0.09), and excluding ill staff for ≥24 h after symptom resolution (0.44 versus 0.73, P =0.24) each reported fewer foodborne norovirus outbreaks per million person-years than did those states without these provisions. Adoption and compliance with federal recommended food service regulations may decrease the incidence of foodborne norovirus outbreaks.

  1. Assessment of the Sustainability Capacity of a Coordinated Approach to Chronic Disease Prevention.

    Science.gov (United States)

    Moreland-Russell, Sarah; Combs, Todd; Polk, LaShaun; Dexter, Sarah

    2017-12-07

    This article outlines some factors that influenced the sustainability capacity of a coordinated approach to chronic disease prevention in state and territory health departments. This study involved a cross-sectional design and mixed-methods approach. Quantitative data were collected using the Program Sustainability Assessment Tool (PSAT), a 40-item multiple-choice instrument that assesses 8 domains of sustainability capacity (environmental support, funding stability, partnerships, organizational capacity, program evaluation, program adaptation, communications, and strategic planning). Qualitative data were collected via phone interviews. The PSAT was administered to staff and stakeholders from public health departments in 50 US states, District of Columbia, and Puerto Rico, who were involved in the implementation of coordinated chronic disease programs. Phone interviews were conducted with program coordinators in each state. Sustainability score patterns and state-level categorical results, as well as strengths and opportunities for improvement across the 8 program sustainability domains, were explored. On average, programs reported the strongest sustainability capacity in the domains of program adaptation, environmental support, and organizational capacity, while funding stability, strategic planning, and communications yielded lowest scores, indicating weakest capacity. Scores varied the most by state in environmental support and strategic planning. The PSAT results highlight the process through which states approached the sustainability of coordinated chronic disease initiatives. This process included an initial focus on program evaluation and partnerships with transfer of priority to long-term strategic planning, communications, and funding stability to further establish coordinated chronic disease efforts. Qualitative interviews provided further context to PSAT results, indicating that leadership, communications, partnerships, funding stability, and policy

  2. Suicide Risk Assessment and Prevention: A Systematic Review Focusing on Veterans.

    Science.gov (United States)

    Nelson, Heidi D; Denneson, Lauren M; Low, Allison R; Bauer, Brian W; O'Neil, Maya; Kansagara, Devan; Teo, Alan R

    2017-10-01

    Suicide rates in veteran and military populations in the United States are high. This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. Trials, observational studies, and systematic reviews relevant to U.S. veterans and military personnel were identified in searches of MEDLINE, PsycINFO, SocINDEX, and Cochrane databases (January 1, 2008, to September 11, 2015), on Web sites, and in reference lists. Investigators extracted and confirmed data and dual-rated risk of bias for included studies. Nineteen studies evaluated accuracy of risk assessment methods, including models using retrospective electronic records data and clinician- or patient-rated instruments. Most methods demonstrated sensitivity ≥80% or area-under-the-curve values ≥.70 in single studies, including two studies based on electronic records of veterans and military personnel, but specificity varied. Suicide rates were reduced in six of eight observational studies of population-level interventions. Only two of ten trials of individual-level psychotherapy reported statistically significant differences between treatment and usual care. Risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility. Research to refine these methods and examine clinical applications is needed. Studies of suicide prevention interventions are inconclusive; trials of population-level interventions and promising therapies are required to support their clinical use.

  3. Best clinical practice guidance for management of early caries lesions in children and young adults

    DEFF Research Database (Denmark)

    Kühnisch, J; Ekstrand, K R; Pretty, I

    2016-01-01

    BACKGROUND: The European Academy of Paediatric Dentistry (EAPD) encourages prevention and arrest of active dental caries. Therefore, the present guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment......-invasively in the majority of cases. The spectrum of measures includes a low cariogenicity tooth-friendly diet, daily and appropriate management of the biofilm, home and within the dental office/surgery usage of fluorides as well as sealing techniques. CONCLUSION: The detection and management of non-cavitated caries...... is an essential aspect of preventive dentistry. Therefore, the EAPD encourages oral health care providers and caregivers to implement preventive practices that can arrest early caries and improve individual and public dental health....

  4. Health literacy demands of written health information materials: an assessment of cervical cancer prevention materials.

    Science.gov (United States)

    Helitzer, Deborah; Hollis, Christine; Cotner, Jane; Oestreicher, Nancy

    2009-01-01

    Health literacy requires reading and writing skills as well as knowledge of health topics and health systems. Materials written at high reading levels with ambiguous, technical, or dense text, often place great comprehension demands on consumers with lower literacy skills. This study developed and used an instrument to analyze cervical cancer prevention materials for readability, comprehensibility, suitability, and message design. The Suitability Assessment of Materials (SAM) was amended for ease of use, inclusivity, and objectivity with the encouragement of the original developers. Other novel contributions were specifically related to "comprehensibility" (CAM). The resulting SAM + CAM was used to score 69 materials for content, literacy demand, numeric literacy, graphics, layout/typography, and learning stimulation variables. Expert reviewers provided content validation. Inter-rater reliability was "substantial" (kappa = .77). The mean reading level of materials was 11th grade. Most materials (68%) scored as "adequate" for comprehensibility, suitability, and message design; health education brochures scored better than other materials. Only one-fifth were ranked "superior" for ease of use and comprehensibility. Most written materials have a readability level that is too high and require improvement in ease of use and comprehensibility for the majority of readers.

  5. Genomic-based tools for the risk assessment, management, and prevention of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Johansen Taber KA

    2015-01-01

    Full Text Available Katherine A Johansen Taber, Barry D DickinsonDepartment of Science and Biotechnology, American Medical Association, Chicago, IL, USAAbstract: Type 2 diabetes (T2D is a common and serious disorder and is a significant risk factor for the development of cardiovascular disease, neuropathy, nephropathy, retinopathy, periodontal disease, and foot ulcers and amputations. The burden of disease associated with T2D has led to an emphasis on early identification of the millions of individuals at high risk so that management and intervention strategies can be effectively implemented before disease progression begins. With increasing knowledge about the genetic basis of T2D, several genomic-based strategies have been tested for their ability to improve risk assessment, management and prevention. Genetic risk scores have been developed with the intent to more accurately identify those at risk for T2D and to potentially improve motivation and adherence to lifestyle modification programs. In addition, evidence is building that oral antihyperglycemic medications are subject to pharmacogenomic variation in a substantial number of patients, suggesting genomics may soon play a role in determining the most effective therapies. T2D is a complex disease that affects individuals differently, and risk prediction and treatment may be challenging for health care providers. Genomic approaches hold promise for their potential to improve risk prediction and tailor management for individual patients and to contribute to better health outcomes for those with T2D.Keywords: diabetes, genomic, risk prediction, management

  6. Assessment of the Isoniazid Preventive Therapy Uptake and Associated Characteristics: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Francine Mwayuma Birungi

    2018-01-01

    Full Text Available Objective. To assess the uptake of isoniazid preventive therapy (IPT by eligible children in Kigali, Rwanda, and associated individual, households, and healthcare systems characteristics. Methods. A cross-sectional study was conducted among child contacts of index cases having sputum smear-positive pulmonary tuberculosis. Data were collected from 13 selected primary health centres. Descriptive statistics were used to generate frequency tables and figures. Logistic regression models were performed to determine characteristics associated with IPT uptake. Results. Of 270 children (under 15 years, who were household contacts of 136 index cases, 94 (35% children were less than 5 years old and eligible for IPT; and 84 (89%, 95% CI 81–94 were initiated on IPT. The reasons for not initiating IPT in the remaining 10 children were parents/caregivers’ lack of information on the need for IPT, refusal to give IPT to their children, and poor quality services offered at health centres. Factors associated with no uptake of IPT included children older than 3 years, unfriendly healthcare providers, HIV infected index cases, and the index case not being the child’s parent. Conclusion. The National Tuberculosis Program’s policy on IPT delivery was effectively implemented. Future interventions should find strategies to manage factors associated with IPT uptake.

  7. Pollution prevention opportunity assessment for the SNL/California waste management facilities

    International Nuclear Information System (INIS)

    Braye, S.; Phillips, N.M.

    1995-01-01

    SNL/California's waste management facilities, Bldgs. 961 and 962-2, generate a secondary stream of hazardous and radioactive waste. This waste stream is generated mainly during the processing and handling of hazardous, radioactive, and mixed wastes (primary waste stream), which are generated by the laboratories, and when cleaning up spills. The secondary waste stream begins with the removal of a generator's hazardous, radioactive, and mixed waste from specified collection areas. The waste stream ends when the containers of processed waste are loaded for shipment off-site. The total amount of secondary hazardous waste generated in the waste management facilities from January 1993 to July 1994 was 1,160.6 kg. The total amount of secondary radioactive waste generated during the same period was 1,528.8 kg (with an activity of 0.070 mCi). Mixed waste usually is not generated in the secondary waste stream. This pollution prevention opportunity assessment (PPOA) was conducted using the graded approach methodology developed by the Department of Energy (DOE) PPOA task group. The original method was modified to accommodate the needs of Sandia's site-specific processes. The options generated for potential hazardous waste minimization, cost savings, and environmental health and safety were the result of a waste minimization team effort. The results of the team efforts are summarized

  8. Assessment of a head support system to prevent pediatric out-of-position: an observational study.

    Science.gov (United States)

    Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria

    Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.

  9. Preventing diarrhoea with household ceramic water filters: assessment of a pilot project in Bolivia.

    Science.gov (United States)

    Clasen, Thomas F; Brown, Joseph; Collin, Simon M

    2006-06-01

    In an attempt to prevent diarrhoea in a rural community in central Bolivia, an international non-governmental organization implemented a pilot project to improve drinking water quality using gravity-fed, household-based, ceramic water filters. We assessed the performance of the filters by conducting a five-month randomized controlled trial among all 60 households in the pilot community. Water filters eliminated thermotolerant (faecal) coliforms from almost all intervention households and significantly reduced turbidity, thereby improving water aesthetics. Most importantly, the filters were associated with a 45.3% reduction in prevalence of diarrhoea among the study population (p = 0.02). After adjustment for household clustering and repeated episodes in individuals and controlling for age and baseline diarrhoea, prevalence of diarrhoea among the intervention group was 51% lower than controls, though the protective effect was only borderline significant (OR 0.49, 95% CI: 0.24, 1.01; p = 0.05). A follow-up survey conducted approximately 9 months after deployment of the filters found 67% being used regularly, 13% being used intermittently, and 21% not in use. Water samples from all regularly used filters were free of thermotolerant coliforms.

  10. Nationwide Operational Assessment of Hazards and success stories in disaster prevention and mitigation in the Philippines

    Science.gov (United States)

    Mahar Francisco Lagmay, Alfredo

    2016-04-01

    The Philippines, being a locus of typhoons, tsunamis, earthquakes, and volcanic eruptions, is a hotbed of disasters. Natural hazards inflict loss of lives and costly damage to property in the country. In 2011, after tropical storm Washi devastated cities in southern Philippines, the Department of Science and Technology put in place a responsive program to warn and give communities hours-in-advance lead-time to prepare for imminent hazards and use advanced science and technology to enhance geohazard maps for more effective disaster prevention and mitigation. Since its launch, there have been many success stories on the use of Project NOAH, which after Typhoon Haiyan was integrated into the Pre-Disaster Risk Assessment (PDRA) system of the National Disaster Risk Reduction and Management Council (NDRRMC), the government agency tasked to prepare for, and respond to, natural calamities. Learning from past disasters, NDRRMC now issues warnings, through scientific advise from DOST-Project NOAH and PAGASA (Philippine Weather Bureau) that are hazards-specific, area-focused and time-bound. Severe weather events in 2015 generated dangerous hazard phenomena such as widespread floods and massive debris flows, which if not for timely, accessible and understandable warnings, could have turned into disasters. We call these events as "disasters that did not happen". The innovative warning system of the Philippine government has so far proven effective in addressing the impacts of hydrometeorological hazards and can be employed elsewhere in the world.

  11. Guidance of reactor operators and TSC personnel with the severe accident management guidance under shutdown and low power conditions

    International Nuclear Information System (INIS)

    Van Haesendonck, M.F.; Prior, R.P.

    2000-01-01

    The Westinghouse Owners Group Severe Accident Management Guidance (WOG SAMG) was developed between 1991 and 1994. The primary goals for severe accident management that form the basis of the WOG SAMG are to terminate any radioactive releases to the environment; to prevent failure of any containment fission product boundary and to return the plant to a controlled stable condition. The WOG SAMG is primarily a TSC tool for mitigation of low probability core damage events. The philosophy is that control room operators should remain focused on the prevention of core damage, whereas the TSC personnel should concentrate on the mitigation of the severe accident. The symptom based package is built up as a structured process for choosing appropriate actions based on actual plant conditions. No detailed knowledge of severe accident phenomena is required. The scope of the WOG SAMG is limited to severe accidents resulting from initiating events occurring during full power operation. However, a number of studies such as the EdF EPS 1300 Probabilistic Safety Assessment (PSA), the shutdown Probabilistic Risk Assessment (PRA) for Surry, the BERA shutdown PRA for Beznau, the EPRI/ Westinghouse ORAM methodology etc. have shown that the frequency of core damage (a severe accident) during shutdown and low power operation can be of the same order of magnitude as for full power operation. The at-power SAMG is viewed as the resolution of the severe accident issue. Similarly, it is expected that as shutdown PRAs mature, the final resolution of the severe accident issue will lie in SAMG for low power and shutdown operation. Therefore in resolution of this issue, Westinghouse has developed the Shutdown Severe Accident Management Guidance (SSAMG) which gives guidance for both control room and TSC personnel to mitigate a severe accident under shutdown or low power conditions. In the last few years, many LWR plants have been implementing SAMG. In the US, all plants have developed SAMG, and many

  12. ASSESSMENT OF EFFICACY IN APPLICATION OF TOPICAL IMMUNOLOGIC RESPONSE MODIFIER FOR PREVENTION OF INFLUENZA AND ACUTE RESPIRATORY INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    I.N. Lytkina

    2009-01-01

    Full Text Available The purpose of this work was to assess the efficacy of bacterial lysate for prevention of acute respiratory infections. The article provides results of monitoring children in the orphanage who were administered the medication of this group as a prophylactic drug against acute respiratory infections. Children also from orphanages who were not administered the medication were selected as a control group. It was found that out of 80 children who underwent preventive treatment, only 26 children fell ill, while out of 80 children in the control group so did 78 orphans. The results achieved allowed the topical immunologic response modifier to be recommended as a general preventive medication for wide use in children in the period of seasonal respiratory infection incidence rate pickup.Key words: influenza, acute respiratory infections, preventive treatment, children.

  13. Assessing Knowledge and Perceptions Related to Preventive Methods and Treatment of Malaria in the Local Endemic Area of Trujillo, Honduras.

    Science.gov (United States)

    Campodonico, Joanna; Sevilla-Martir, Javier; Arrizabalaga, Gustavo; Kochhar, Komal

    2015-01-01

    Malaria in Honduras is endemic and accounts for 40% of the total cases in Central America. Our goal was to assess knowledge of preventive methods and current treatment of malaria among the affected community of Trujillo, Honduras. A cross-sectional survey was administered to 71 individuals. Most respondents had a good understanding about common malaria symptoms but not about the complications associated with severe cases. More important, we found that less than 20% of the respondents recognized indoor residual sprays and insecticide-treated nets as effective preventive measures, which are the most efficient preventive methods. Our study highlights the perceptions the people of Trujillo have about malaria. From our observations, we put forward recommendations to implement a comprehensive campaign to educate the Trujillo population about malaria preventive methods and to recruit local and international efforts to distribute insecticide-treated nets.

  14. WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME?

    Science.gov (United States)

    Afuakwah, Charles; Welbury, Richard

    2015-11-01

    Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.

  15. International guidance activities

    International Nuclear Information System (INIS)

    Richardson, Allan C.B.

    1989-01-01

    International principles for setting Protective Action Guides (PAGs) are contained in two key documents that contain identical statements. One is Publication Number 40 of the ICRP, which was issued in 1985. The title is 'Protection of the Public in the Event of Major Radiation Accidents, Principles for Planning'. The other is the IAEA's Safety Series Publication Number 72, also issued in 1985, written by many of the same authors and titled, 'Principles for Establishing Intervention Levels'. The principles that were set forth in these documents were identical, were incomplete, and they are, unfortunately, the only principles that are now in effect, while proposed revisions go through one draft after another. There are several such draft revisions that are of significance. The most important is that of the ICRP. The basic guidance that applies to most planned exposure to radiation is ICRP Publication 26. That document has been under revision by the Commission for a number of years, and the new version will, for the first time, include recommendations for emergency response. They are now getting close to closure, and I think it should be a very much improved and useful document. But it isn't finished yet. Such guidance doesn't get developed in a vacuum, and there have been a couple of parallel efforts which have provided significant input to the ICRP, which is essentially a behind-closed-doors effort. These other efforts are more open. One of these is being carried out within the IAEA, which has convened annual meetings of national experts for a number of years in Vienna, to generate a replacement for Safety Series No. 72, mentioned earlier. There is a meeting scheduled this December to complete this effort; and, hopefully, we will reach closure at that meeting on at least the basic principles. The Nuclear Energy Agency (NEA) has also been at work. It has convened a group of experts from member nations that have been developing recommendations. There is an overlap

  16. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    2006-01-01

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: 'each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application.' It further states: 'each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application.' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with 10 Code of Federal Regulations (CFR) 1.8, 'Deliberate Misconduct.' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. In accordance with 10 CFR Part 71, 'Packaging and Transportation of Radioactive Material,' certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, 'Reporting of Defects and Noncompliance,' regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous location where the activities subject to these

  17. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    2008-01-01

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package (also known as the 'RH-TRU 72-B cask') and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: 'each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application.' It further states: 'each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application.' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with Title 10 Code of Federal Regulations (CFR) 71.8, 'Deliberate Misconduct.' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. The CBFO will evaluate the issue and notify the NRC if required.In accordance with 10 CFR Part 71, 'Packaging and Transportation of Radioactive Material,' certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, 'Reporting of Defects and Noncompliance,' regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous

  18. Preventive care delivered within Public Dental Service after caries risk assessment of young adults

    DEFF Research Database (Denmark)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-01-01

    OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

  19. Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers

    Directory of Open Access Journals (Sweden)

    Murtomaa Heikki

    2011-05-01

    Full Text Available Abstract Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73 and dental hygienists (n = 22 in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%. We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion' to 0.71 ('environmental context and resources'. The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4 and was identified as a potential implementation difficulty. The domain emotion

  20. Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers.

    Science.gov (United States)

    Amemori, Masamitsu; Michie, Susan; Korhonen, Tellervo; Murtomaa, Heikki; Kinnunen, Taru H

    2011-05-26

    Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55

  1. User Guidance for Application of TREECS (trademark) and CTS for Environmental Risk Assessment of Contaminants on Department of Defense (DoD) Ranges

    Science.gov (United States)

    2017-06-01

    of Agriculture USLE Universal Soil Loss Equation used for annual soil erosion estimates in HGCT USMA U.S. Military Academy, West Point, NY UXO...model. Erosion rate is computed by the Universal Soil Loss Equation ( USLE ) (USDA SCS 1983) for average annual hydrology and by the Modified...Marine Corps Base MEPAS Multimedia Environmental Pollutant Assessment System MMR Massachusetts Military Reservation MUSLE Modified Universal Soil Loss

  2. Assessment of topical microbicides to prevent HIV-1 transmission: concepts, testing, lessons learned.

    Science.gov (United States)

    Friend, David R; Kiser, Patrick F

    2013-09-01

    The development of topically applied products capable of preventing vaginal and rectal transmission of HIV-1 has been on-going for nearly 20 years. Despite this, only one clinical trial has demonstrated protection against sexual transmission of HIV-1 in women. This review covers the development of microbicides, also referred to as topical pre-exposure prophylaxis (PrEP), through three stages. The first stage focused on nonspecific agents, including surfactants such as nonoxynol-9 (N-9), to prevent HIV-1 transmission. Unfortunately, N-9 enhanced susceptibility to sexual transmission of HIV-1 when evaluated for efficacy. Soon thereafter, other nonspecific agents (polyanions) were quickly moved into large efficacy trials. Due to a lack of coordination among investigators and funders, a large investment was made in a class of compounds shown ultimately to be ineffective, although poor adherence may have contributed to these findings. The second stage involved the assessment of the antiretroviral drug tenofovir, formulated as a vaginal gel, which was found to be modestly effective in a Phase IIb trial (CAPRISA-004) when dosed in a coitally-dependent manner. In another Phase IIb trial, VOICE (MTN-003), tenofovir gel was found to be ineffective when dosed once-daily in a coitally-independent manner. Based on pharmacokinetic data, it was concluded the participants were poorly adherent to this dosing regimen, leading to a lack of efficacy. Tenofovir gel is currently in a Phase III safety and efficacy trial in South Africa (FACTS-001), using the coitally-dependent dosing regimen employed in CAPRISA-004. We are now in the third stage of microbicide research. The antiretroviral drug dapivirine is currently in two Phase III safety and efficacy studies formulated as a vaginal ring. It is hoped that the once-monthly dosing regimen will lead to higher adherence than found in the VOICE study. It is now clear that product adherence could be the greatest challenge to demonstrating

  3. Early school leaving and lifelong guidance

    DEFF Research Database (Denmark)

    Plant, Peter; Oomen, Annemarie

    Early school leaving (ESL) is costly for the individual, for society and for the economy. Not just in economic terms, but also in terms of low self esteem, and the risk of social exclusion. More, and, in particular, better education can lead to positive outcomes, in relation to employment, level...... of salaries, better health, less crime, higher social cohesion, lower public and social costs and higher productivity. This is why ESL is a policy focal point. In these terms, lifelong guidance has a key role to play in terms of both prevention, intervention, and of compensation strategies....

  4. Social Media-Based Civic Engagement Solutions for Dengue Prevention in Sri Lanka: Results of Receptivity Assessment

    Science.gov (United States)

    Lwin, May O.; Vijaykumar, Santosh; Foo, Schubert; Fernando, Owen Noel Newton; Lim, Gentatsu; Panchapakesan, Chitra; Wimalaratne, Prasad

    2016-01-01

    This article focuses on a novel social media-based system that addresses dengue prevention through an integration of three components: predictive surveillance, civic engagement and health education. The aim was to conduct a potential receptivity assessment of this system among smartphone users in the city of Colombo, the epicenter of the dengue…

  5. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT OF THE UNITED STATES ARMY CORPS OF ENGINEERS GARRISON DAM HYDRO- ELECTRIC POWERPLANT - RIVERDALE, NORTH DAKOTA

    Science.gov (United States)

    The report describes the results of pollution prevention opportunity assessments conducted at a representative U.S. Army Corps of Engineers civil works dam and hydroelectric power plant. ecommended methods for reducing pollution resulting primarily from the operation of these fac...

  6. Risk assessment of parents' concerns at 18 months in preventive child health care predicted child abuse and neglect

    NARCIS (Netherlands)

    Staal, I.I.E.; Hermanns, J.M.A.; Schrijvers, A.J.P.; van Stel, H.F.

    2013-01-01

    Objective: As child maltreatment has a major impact, prevention and early detection of parenting problems are of great importance. We have developed a structured interview which uses parents’ concerns for a joint needs assessment by parents and a child health care nurse, followed by a professional

  7. Metrics to assess injury prevention programs for young workers in high-risk occupations: a scoping review of the literature

    Directory of Open Access Journals (Sweden)

    Jennifer Smith

    2018-05-01

    Full Text Available Introduction: Despite legal protections for young workers in Canada, youth aged 15–24 are at high risk of traumatic occupational injury. While many injury prevention initiatives targeting young workers exist, the challenge faced by youth advocates and employers is deciding what aspect(s of prevention will be the most effective focus for their efforts. A review of the academic and grey literatures was undertaken to compile the metrics—both the indicators being evaluated and the methods of measurement—commonly used to assess injury prevention programs for young workers. Metrics are standards of measurement through which efficiency, performance, progress, or quality of a plan, process, or product can be assessed. Methods: A PICO framework was used to develop search terms. Medline, PubMed, OVID, EMBASE, CCOHS, PsychINFO, CINAHL, NIOSHTIC, Google Scholar and the grey literature were searched for articles in English, published between 1975-2015. Two independent reviewers screened the resulting list and categorized the metrics in three domains of injury prevention: Education, Environment and Enforcement. Results: Of 174 acquired articles meeting the inclusion criteria, 21 both described and assessed an intervention. Half were educational in nature (N=11. Commonly assessed metrics included: knowledge, perceptions, self-reported behaviours or intentions, hazardous exposures, injury claims, and injury counts. One study outlined a method for developing metrics to predict injury rates. Conclusion: Metrics specific to the evaluation of young worker injury prevention programs are needed, as current metrics are insufficient to predict reduced injuries following program implementation. One study, which the review brought to light, could be an appropriate model for future research to develop valid leading metrics specific to young workers, and then apply these metrics to injury prevention programs for youth.

  8. The assessment of the readiness of five countries to implement child maltreatment prevention programs on a large scale.

    Science.gov (United States)

    Mikton, Christopher; Power, Mick; Raleva, Marija; Makoae, Mokhantso; Al Eissa, Majid; Cheah, Irene; Cardia, Nancy; Choo, Claire; Almuneef, Maha

    2013-12-01

    This study aimed to systematically assess the readiness of five countries - Brazil, the Former Yugoslav Republic of Macedonia, Malaysia, Saudi Arabia, and South Africa - to implement evidence-based child maltreatment prevention programs on a large scale. To this end, it applied a recently developed method called Readiness Assessment for the Prevention of Child Maltreatment based on two parallel 100-item instruments. The first measures the knowledge, attitudes, and beliefs concerning child maltreatment prevention of key informants; the second, completed by child maltreatment prevention experts using all available data in the country, produces a more objective assessment readiness. The instruments cover all of the main aspects of readiness including, for instance, availability of scientific data on the problem, legislation and policies, will to address the problem, and material resources. Key informant scores ranged from 31.2 (Brazil) to 45.8/100 (the Former Yugoslav Republic of Macedonia) and expert scores, from 35.2 (Brazil) to 56/100 (Malaysia). Major gaps identified in almost all countries included a lack of professionals with the skills, knowledge, and expertise to implement evidence-based child maltreatment programs and of institutions to train them; inadequate funding, infrastructure, and equipment; extreme rarity of outcome evaluations of prevention programs; and lack of national prevalence surveys of child maltreatment. In sum, the five countries are in a low to moderate state of readiness to implement evidence-based child maltreatment prevention programs on a large scale. Such an assessment of readiness - the first of its kind - allows gaps to be identified and then addressed to increase the likelihood of program success. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Plowshare radiation protection guidance

    International Nuclear Information System (INIS)

    Parker, H.M.

    1969-01-01

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

  10. Plowshare radiation protection guidance

    Energy Technology Data Exchange (ETDEWEB)

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

    1969-07-01

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

  11. NGST fine guidance sensor

    Science.gov (United States)

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

    2003-03-01

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

  12. Hanford Site Guide for Preparing and Maintaining Generator Group Pollution Prevention Documentation

    International Nuclear Information System (INIS)

    PLACE, B.G.

    2000-01-01

    This document provides guidance to generator groups for preparing and maintaining documentation of Pollution Prevention/Waste Minimization (P2/WMin) Program activities. The guidance is one of a hierarchical series that includes the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan (DOE-RL, 2000) and Prime Contractor implementation plans describing programs required by Resource Conservation and Recovery Act of 1976 (RCRA) 3002(b) and 3005(h) (RCRA and EPA, 1994) and Department of Energy Acquisition Regulations (DEAR) (48 CFR 970.5204-2 and 48 CFR 970.5204-78). Documentation guidance for the following five P2/WMin elements is discussed: Fiscal Year (FY) Goals; Budget and Staffing; Pollution Prevention (P2) Reporting; WMin Certification; and Waste Minimization (WMin) Assessments (WMAs)

  13. Assessing the quality of mental health promotion and prevention in Croatia: The case of Istria

    NARCIS (Netherlands)

    Mihic, J.; Novak, M.; Hosman, C.M.H.; Domitrovich, C.

    2017-01-01

    While the availability of mental health promotion and prevention programs worldwide is growing, there is divergence in their level of effectiveness that has led to increasing interest in the development of 'effect management' strategies. Mental health promotion and prevention science and practice

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

    Science.gov (United States)

    Dieter, Hermann H

    2014-03-01

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

  15. An Assessment of the Cocooning Strategy for Preventing Infant Pertussis—United States, 2011

    Science.gov (United States)

    Blain, Amy E.; Lewis, Melissa; Banerjee, Emily; Kudish, Kathy; Liko, Juventila; McGuire, Suzanne; Selvage, David; Watt, James; Martin, Stacey W.; Skoff, Tami H.

    2017-01-01

    Background Infants are at greatest risk for severe pertussis. In 2006, the Advisory Committee on Immunization Practices recommended that adolescents and adults, especially those with infant contact, receive a single dose of Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine). To assess the effectiveness of cocooning, we conducted a case-control evaluation of infant close contacts. Methods Pertussis cases aged <2 months with onset between 1 January 2011 and 31 December 2011 were identified in Emerging Infections Program Network sites. For each case, we recruited 3 controls from birth certificates and interviewed identified adult close contacts (CCs) or parents of CCs aged <18 years. Pertussis vaccination was verified through medical providers and/or immunization registries. Results Forty-two cases were enrolled, with 154 matched controls. Around enrolled infants, 859 CCs were identified (600 adult and 259 nonadult). An average of 5.4 CCs was identified per case and 4.1 CCs per control. Five hundred fifty-four (64.5%) CCs were enrolled (371 adult and 183 non-adult CCs); 119 (32.1% of enrolled) adult CCs had received Tdap. The proportion of Tdap-vaccinated adult CCs was similar between cases and controls (P = .89). The 600 identified adult CCs comprised 172 potential cocoons; 71 (41.3%) potential cocoons had all identified adult CCs enrolled. Of these, 9 were fully vaccinated and 43.7% contained no Tdap-vaccinated adults. The proportion of fully vaccinated case (4.8%) and control (10.0%) cocoons was similar (P = .43). Conclusions Low Tdap coverage among adult CCs reinforces the difficulty of implementing the cocooning strategy and the importance of vaccination during pregnancy to prevent infant pertussis. PMID:27838676

  16. Assessment of common interventions and perceived barriers to pressure ulcer prevention in southwest Nigeria.

    Science.gov (United States)

    Ilesanmi, Rose Ekama; Olabisi, Prisca

    2014-01-01

    We examined the interventions used by nurses to prevent pressure ulcers in 3 hospitals in south west Nigeria and perceived barriers to effective nursing pressure ulcer prevention interventions. One hundred ninety-three nurses were purposively selected from neurological, orthopedic, intensive care, and accident and emergency units of participating hospitals. Study sites were 3 teaching hospitals in south west Nigeria (Lagos State University Teaching Hospital, Lagos; University College Hospital, Ibadan; and Obafemi Awolowo Teaching Hospital Ile-Ife). Data were collected via a structured questionnaire designed for this study. It included 3 sections: demographic information, practices used for pressure ulcer prevention, and perceived barriers to prevention. Sections of the questionnaire that queried interventions and perceived barriers to pressure ulcer prevention were evaluated for face and content validity. Reliability was evaluated via internal consistency; the split half reliability was 0.82. Similar practices regarding pressure ulcer prevention were found across the 3 hospitals. The most commonly used intervention was patient repositioning every 2 hours; the least used intervention was completion of a validated pressure ulcer risk scale. Nurses described using interventions that have not proved effective for pressure ulcer prevention such as massaging bony prominences and application of talcum powder. Nurses identified 2 principal factors that act as barriers to successful prevention of pressure ulcers: inadequate manpower and inadequate supply of linens on the wards. Nurses use a combination of evidence-based interventions, along with interventions that have not proved effective for pressure ulcer prevention. We recommend development of national standards for pressure ulcer prevention in Nigeria that are based on current best evidence and consistent with current international guidelines.

  17. The application of the rapid assessment and response methodology for cannabis prevention research among youth in the Netherlands.

    Science.gov (United States)

    Dupont, Hans B; Kaplan, Charles D; Braam, Richard V; Verbraeck, Hans T; de Vries, Nanne K

    2015-08-01

    Drug prevention methods tailored to specific target groups have become increasingly important. There is a growing need to find ways to rapidly assess and situate target groups in their particular contexts. This need is associated with the implementation of evidence-based interventions (EBIs) for these specific target groups. This article describes the application of Rapid Assessment and Response (RAR) as a necessary first step in designing and implementing a prevention intervention plan for problematic cannabis use among "loitering" youth in the South of the Netherlands. Seven RAR studies were conducted using an innovative stepwise model in which the prevention field worker is central. The normative structure for the use of cannabis was found to vary across the neighborhoods of the RAR studies and emerged as the focal point in designing a suitable response. The RAR studies also identified the need in the prevention toolbox for a tailored, low-threshold, effective, individual brief intervention for youth problematic cannabis use. The RAR was found to provide a powerful methodology for detecting target groups and generating contextual and normative data that enable the prevention field worker to select and adapt from the spectrum of existing Evidence based Interventions (EBIs) or develop the most promising model for implementation with the specific target group. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  18. Model review and evaluation for application in DOE safety basis documentation of chemical accidents - modeling guidance for atmospheric dispersion and consequence assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lazaro, M. A. [Argonne National Lab. (ANL), Argonne, IL (United States); Woodarad, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Hanna, S. R. [Argonne National Lab. (ANL), Argonne, IL (United States); Hesse, D. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Huang, J. -C. [Argonne National Lab. (ANL), Argonne, IL (United States); Lewis, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Mazzola, C. A. [Argonne National Lab. (ANL), Argonne, IL (United States)

    1997-09-01

    The U.S. Department of Energy (DOE), through its Defense Programs (DP), Office of Engineering and Operations Suppon, established the Accident Phenomenology and Consequence (AP AC) Methodology Evaluation Program to identify and evaluate methodologies and computer codes to support accident phenomenological and consequence calculations for both radiological and nonradiological materials at DOE facilities and to identify development needs. The program is also intended to define and recommend "best or good engineering/safety analysis practices" to be followed in preparing ''design or beyond design basis" assessments to be included in DOE nuclear and nonnuclear facility safety documents. The AP AC effort is intended to provide scientifically sound and more consistent analytical approaches, by identifying model selection procedures and application methodologies, in order to enhance safety analysis activities throughout the DOE complex.

  19. Evidence of Limited Motion of the Prostate by Carefully Emptying the Rectum as Assessed by Daily MVCT Image Guidance with Helical Tomotherapy

    International Nuclear Information System (INIS)

    Fiorino, Claudio Ph.D.; Di Muzio, Nadia; Broggi, Sara; Cozzarini, Cesare; Maggiulli, Eleonora M.Sc.; Alongi, Filippo; Valdagni, Riccardo; Fazio, Ferruccio; Calandrino, Riccardo

    2008-01-01

    Purpose: To assess setup and organ motion error by means of analysis of daily megavoltage computed tomography (MVCT) of patients treated with hypofractionated helical tomotherapy (71.4-74.2 Gy in 28 fractions). Methods and Materials: Data from 21 patients were analyzed. Patients were instructed to empty the rectum carefully before planning CT and every morning before therapy by means of a self-applied rectal enema. The position of the prostate was assessed by means of automatic bone matching (BM) with the planning kilovoltage CT (BM, setup error) followed by a direct visualization (DV) match on the prostate. Deviations between planning and therapy positions referred to BM and BM + DV were registered for the three main axes. In case of a full rectum at MVCT with evident shift of the prostate, treatment was postponed until after additional rectal emptying procedures; in this case, additional MVCT was performed before delivering the treatment. Data for 522 fractions were available; the impact of post-MVCT procedure was investigated for 17 of 21 patients (410 fractions). Results: Prostate motion relative to bony anatomy was limited. Concerning posterior-anterior shifts, only 4.9% and 2.7% of fractions showed deviation of 3 mm or greater of the prostate relative to BM without and with consideration of post-MVCT procedures, respectively. Interobserver variability for BM + DV match was within 0.8 mm (1 SD). Conclusions: Daily MVCT-based correction is feasible. The BM + DV matching was found to be consistent between operators. Rectal emptying using a daily enema is an efficient tool to minimize prostate motion, even for centers that have not yet implemented image-guided radiotherapy

  20. General RMP Guidance - Appendix D: OSHA Guidance on PSM

    Science.gov (United States)

    OSHA's Process Safety Management (PSM) Guidance on providing complete and accurate written information concerning process chemicals, process technology, and process equipment; including process hazard analysis and material safety data sheets.

  1. CAREER GUIDANCE EXPERIENCE ABROAD

    Directory of Open Access Journals (Sweden)

    Sergey N. Tolstoguzov

    2015-01-01

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

  2. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    Washington TRU Solutions, LLC

    2003-01-01

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

  3. The continuum of behavior guidance.

    Science.gov (United States)

    Nelson, Travis

    2013-01-01

    Behavior guidance is a continuum of techniques, basic and advanced, fundamental to the provision of quality dental care for pediatric patients. This practice must be individualized, pairing the correct method of behavior guidance with each child. To select the appropriate technique, the clinician must have a thorough understanding of each aspect of the continuum and anticipate parental expectations, child temperament, and the technical procedures necessary to complete care. By effectively using techniques within the continuum of behavior guidance, a healing relationship with the family is maintained while addressing dental disease and empowering the child to receive dental treatment throughout their lifetime. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Regulatory guidance for license renewal

    International Nuclear Information System (INIS)

    Thoma, John A.

    1991-01-01

    The proposed 10 CFR Part 54 rule proceduralizes the process for license renewal by identifying both the administrative and technical requirements for a renewal application. To amplify and support this regulation, written guidance has been provided in the form of a draft Regulatory Guide (DG 1009) and a draft Standard Review Plan for License Renewal (NUREG 1299). This guidance is scheduled to be finalized in 1992. Similar guidance will be provided for the proposed revisions to 10 CFR Part 51 concerning the environmental aspects of license renewal. (author)

  5. Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric.

    Science.gov (United States)

    Soe, Minn M; Gould, Carolyn V; Pollock, Daniel; Edwards, Jonathan

    2015-12-01

    To develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved. Acute care hospitals that report HAI data to the Centers for Disease Control and Prevention's National Healthcare Safety Network. METHODS :The cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order. Of 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal. The CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal.

  6. Importance Sampling Based Decision Trees for Security Assessment and the Corresponding Preventive Control Schemes: the Danish Case Study

    DEFF Research Database (Denmark)

    Liu, Leo; Rather, Zakir Hussain; Chen, Zhe

    2013-01-01

    Decision Trees (DT) based security assessment helps Power System Operators (PSO) by providing them with the most significant system attributes and guiding them in implementing the corresponding emergency control actions to prevent system insecurity and blackouts. DT is obtained offline from time...... and adopts a methodology of importance sampling to maximize the information contained in the database so as to increase the accuracy of DT. Further, this paper also studies the effectiveness of DT by implementing its corresponding preventive control schemes. These approaches are tested on the detailed model...

  7. Pollution prevention opportunity assessment for MicroFab and SiFab facilities at Sandia National Laboratories.

    Energy Technology Data Exchange (ETDEWEB)

    Gerard, Morgan Evan

    2011-12-01

    This Pollution Prevention Opportunity Assessment (PPOA) was conducted for the MicroFab and SiFab facilities at Sandia National Laboratories/New Mexico in Fiscal Year 2011. The primary purpose of this PPOA is to provide recommendations to assist organizations in reducing the generation of waste and improving the efficiency of their processes and procedures. This report contains a summary of the information collected, the analyses performed, and recommended options for implementation. The Sandia National Laboratories Environmental Management System (EMS) and Pollution Prevention (P2) staff will continue to work with the organizations to implement the recommendations.

  8. Assessing Folic Acid Awareness and its Usage for the Prevention of ...

    African Journals Online (AJOL)

    Antenatal and Population health educational strategies and fortification of ... However, these serious birth defects are to a large extent preventable .... This relatively high-rate of awareness among the study population ..... developing economy.

  9. SPLC Sustainable Purchasing Guidance Profile

    Science.gov (United States)

    To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

  10. CDM Convective Forecast Planning guidance

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The CDM Convective Forecast Planning (CCFP) guidance product provides a foreast of en-route aviation convective hazards. The forecasts are updated every 2 hours and...

  11. Guidance at the educational marketplace

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    in educational policies and institutions. As educational systems have expanded and, further, have been restructured with the expansion of choice opportunities since the 1980s, guidance has become prioritized as a form of counseling or coaching, which can support students. Thus, guidance has become an important...... `agent´ on the educational "market´, assisting (potential) students into and around the `marketplace´. Consequently, guidance is also an important `agent´ for educational institutions that increasingly use marketing strategies to promote themselves on the market to attract and hold on to their “customers......” in order for the institutions to increase their ´market value´, `sales” and “turnover”. Thus, the expansion of guidance is nurtured by the expansion of the logic of marketization and consumerism. Drawing on Foucauldian perspectives in educational research, which highlight the expansion of powerful...

  12. Assessment of Food Waste Prevention and Recycling Strategies Using a Multilayer Systems Approach.

    Science.gov (United States)

    Hamilton, Helen A; Peverill, M Samantha; Müller, Daniel B; Brattebø, Helge

    2015-12-15

    Food waste (FW) generates large upstream and downstream emissions to the environment and unnecessarily consumes natural resources, potentially affecting future food security. The ecological impacts of FW can be addressed by the upstream strategies of FW prevention or by downstream strategies of FW recycling, including energy and nutrient recovery. While FW recycling is often prioritized in practice, the ecological implications of the two strategies remain poorly understood from a quantitative systems perspective. Here, we develop a multilayer systems framework and scenarios to quantify the implications of food waste strategies on national biomass, energy, and phosphorus (P) cycles, using Norway as a case study. We found that (i) avoidable food waste in Norway accounts for 17% of sold food; (ii) 10% of the avoidable food waste occurs at the consumption stage, while industry and retailers account for only 7%; (iii) the theoretical potential for systems-wide net process energy savings is 16% for FW prevention and 8% for FW recycling; (iv) the theoretical potential for systems-wide P savings is 21% for FW prevention and 9% for FW recycling; (v) while FW recycling results in exclusively domestic nutrient and energy savings, FW prevention leads to domestic and international savings due to large food imports; (vi) most effective is a combination of prevention and recycling, however, FW prevention reduces the potential for FW recycling and therefore needs to be prioritized to avoid potential overcapacities for FW recycling.

  13. [Anterior guidance in complete dentures].

    Science.gov (United States)

    Dubreuil, J; Trevelo, A

    1990-01-01

    Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

  14. A Systematic Approach for Dynamic Security Assessment and the Corresponding Preventive Control Scheme Based on Decision Trees

    DEFF Research Database (Denmark)

    Liu, Leo; Sun, Kai; Rather, Zakir Hussain

    2014-01-01

    This paper proposes a decision tree (DT)-based systematic approach for cooperative online power system dynamic security assessment (DSA) and preventive control. This approach adopts a new methodology that trains two contingency-oriented DTs on a daily basis by the databases generated from power...... system simulations. Fed with real-time wide-area measurements, one DT of measurable variables is employed for online DSA to identify potential security issues, and the other DT of controllable variables provides online decision support on preventive control strategies against those issues. A cost......-effective algorithm is adopted in this proposed approach to optimize the trajectory of preventive control. The paper also proposes an importance sampling algorithm on database preparation for efficient DT training for power systems with high penetration of wind power and distributed generation. The performance...

  15. A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    Dzuba Ilana

    2005-12-01

    Full Text Available Abstract Background Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur. Methods Using an adaptation of stage one of the World Health Organization's Strategic Approach to Improving Reproductive Health Policies and Programmes, an assessment of the quality of cervical cancer services was carried out by a multidisciplinary team of stakeholders. The assessment included a review of the available literature, observations of services, collection of hospital statistics and the conduct of qualitative research (in-depth interviews and focus group discussions to assess the perspectives of women, providers, policy makers and community members. Results There were gaps in provider knowledge and practices, potentially attributable to limited provider training and professional development opportunities. In the absence of a state policy on cervical cancer, screening of asymptomatic women was practically absent, except in the military sector. Cytology-based cancer screening tests (i.e. pap smears were often used to help diagnose women with symptoms of reproductive tract infections but not routinely screen asymptomatic women. Access to appropriate treatment of precancerous lesions was limited and often inappropriately managed by hysterectomy in many urban centers. Cancer treatment facilities were well equipped but mostly inaccessible for women in need. Finally, policy makers, community members and clients were mostly unaware about cervical cancer and its preventable nature, although with information, expressed a strong interest in having services

  16. Holistic risk assessment and risk prevention approach to the mechanized NDT and the inspection procedure

    International Nuclear Information System (INIS)

    Bertovic, Marija; Mueller, Christina; Fahlbruch, Babette; Ronneteg, Ulf; Pitkaenen, Jorma

    2013-01-01

    The difficulty to deal with human factors in non-destructive testing (NDT) stems from their diversity and complexity - no single human or organizational factor is responsible for the entire fluctuations in the NDT performance. The typical approach to decrease the variability in the inspection results had been found in replacing manual NDT with mechanized methods. However, even though some human errors can be avoided by automating the process, there are new risks that can arise from its application and need to be further investigated. To address this problem, a combination of theoretical and practical approaches should be applied, where the source of error is not seen only in the inspector, but also in his interaction with social and technical systems, as well as the organization. An analysis of potential risks in the use of mechanized inspections methods for spent fuel canisters has shown potential for human error in acquisition, as well as in the evaluation of the gathered results. Assessed causes of those errors lay in the inspector, but also in the organization and in shortcomings of the inspection procedure. The aim of the analysis was to provide with preventive measures and optimization recommendations. Those include further automation of the process, application of human redundancy, improvements of the inspection procedure, hardware and software improvements etc. Before improvements can be made, there is a need to understand the resulting processes and the influence of their interaction on the inspection results. The results have shown that when working with an automated system, one must avoid over relying on its proper functioning and form appropriate trust towards automation. Furthermore, human redundancy should be applied only in cases where the redundant inspectors are completely unaware of each other, in order to avoid the effects of social loafing and shirking. The inspection procedure is one of the most important tools in the application of NDT. On an

  17. Holistic risk assessment and risk prevention approach to the mechanized NDT and the inspection procedure

    Energy Technology Data Exchange (ETDEWEB)

    Bertovic, Marija; Mueller, Christina [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany); Fahlbruch, Babette [TUEV NORD Systems GmbH und Co. KG, Berlin (Germany); Ronneteg, Ulf [SKB Swedish Nuclear Fuel and Waste Management Co., Oskarshamn (Sweden); Pitkaenen, Jorma [Posiva Oy, Eurajoki (Finland)

    2013-07-01

    The difficulty to deal with human factors in non-destructive testing (NDT) stems from their diversity and complexity - no single human or organizational factor is responsible for the entire fluctuations in the NDT performance. The typical approach to decrease the variability in the inspection results had been found in replacing manual NDT with mechanized methods. However, even though some human errors can be avoided by automating the process, there are new risks that can arise from its application and need to be further investigated. To address this problem, a combination of theoretical and practical approaches should be applied, where the source of error is not seen only in the inspector, but also in his interaction with social and technical systems, as well as the organization. An analysis of potential risks in the use of mechanized inspections methods for spent fuel canisters has shown potential for human error in acquisition, as well as in the evaluation of the gathered results. Assessed causes of those errors lay in the inspector, but also in the organization and in shortcomings of the inspection procedure. The aim of the analysis was to provide with preventive measures and optimization recommendations. Those include further automation of the process, application of human redundancy, improvements of the inspection procedure, hardware and software improvements etc. Before improvements can be made, there is a need to understand the resulting processes and the influence of their interaction on the inspection results. The results have shown that when working with an automated system, one must avoid over relying on its proper functioning and form appropriate trust towards automation. Furthermore, human redundancy should be applied only in cases where the redundant inspectors are completely unaware of each other, in order to avoid the effects of social loafing and shirking. The inspection procedure is one of the most important tools in the application of NDT. On an

  18. Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems.

    Science.gov (United States)

    Pottie, Kevin; Mayhew, Alain D; Morton, Rachael L; Greenaway, Christina; Akl, Elie A; Rahman, Prinon; Zenner, Dominik; Pareek, Manish; Tugwell, Peter; Welch, Vivian; Meerpohl, Joerg; Alonso-Coello, Pablo; Hui, Charles; Biggs, Beverley-Ann; Requena-Méndez, Ana; Agbata, Eric; Noori, Teymur; Schünemann, Holger J

    2017-09-11

    The European Centre for Disease Prevention and Control is developing evidence-based guidance for voluntary screening, treatment and vaccine prevention of infectious diseases for newly arriving migrants to the European Union/European Economic Area. The objective of this systematic review protocol is to guide the identification, appraisal and synthesis of the best available evidence on prevention and assessment of the following priority infectious diseases: tuberculosis, HIV, hepatitis B, hepatitis C, measles, mumps, rubella, diphtheria, tetanus, pertussis, poliomyelitis (polio), Haemophilus influenza disease, strongyloidiasis and schistosomiasis. The search strategy will identify evidence from existing systematic reviews and then update the effectiveness and cost-effectiveness evidence using prospective trials, economic evaluations and/or recently published systematic reviews. Interdisciplinary teams have designed logic models to help define study inclusion and exclusion criteria, guiding the search strategy and identifying relevant outcomes. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. There are no ethical or safety issues. We anticipate disseminating the findings through open-access publications, conference abstracts and presentations. We plan to publish technical syntheses as GRADEpro evidence summaries and the systematic reviews as part of a special edition open-access publication on refugee health. We are following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols reporting guideline. This protocol is registered in PROSPERO: CRD42016045798. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Development of Science-Based Permitting Guidance for Geological Sequestration of CO2 in Deep Saline Aquifers Based on Modeling and Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jean-Philippe Nicot; Renaud Bouroullec; Hugo Castellanos; Susan Hovorka; Srivatsan Lakshminarasimhan; Jeffrey Paine

    2006-06-30

    Underground carbon storage may become one of the solutions to address global warming. However, to have an impact, carbon storage must be done at a much larger scale than current CO{sub 2} injection operations for enhanced oil recovery. It must also include injection into saline aquifers. An important characteristic of CO{sub 2} is its strong buoyancy--storage must be guaranteed to be sufficiently permanent to satisfy the very reason that CO{sub 2} is injected. This long-term aspect (hundreds to thousands of years) is not currently captured in legislation, even if the U.S. has a relatively well-developed regulatory framework to handle carbon storage, especially in the operational short term. This report proposes a hierarchical approach to permitting in which the State/Federal Government is responsible for developing regional assessments, ranking potential sites (''General Permit'') and lessening the applicant's burden if the general area of the chosen site has been ranked more favorably. The general permit would involve determining in the regional sense structural (closed structures), stratigraphic (heterogeneity), and petrophysical (flow parameters such as residual saturation) controls on the long-term fate of geologically sequestered CO{sub 2}. The state-sponsored regional studies and the subsequent local study performed by the applicant will address the long-term risk of the particular site. It is felt that a performance-based approach rather than a prescriptive approach is the most appropriate framework in which to address public concerns. However, operational issues for each well (equivalent to the current underground injection control-UIC-program) could follow regulations currently in place. Area ranking will include an understanding of trapping modes. Capillary (due to residual saturation) and structural (due to local geological configuration) trappings are two of the four mechanisms (the other two are solubility and mineral trappings

  20. Solid transport in mountain rivers: monitoring techniques and long term assessment as flood prevention tools

    Science.gov (United States)

    Longoni, Laura; Brambilla, Davide; Ivanov, Vladislav; Messa, Giacomo; Veronelli, Andrea; Radice, Alessio; Papini, Monica

    2017-04-01

    Floods are calamitous phenomena with an ever-increasing frequency around the globe, that often result in socio-economic damage and casualties. The role of the solid fraction in the river dynamic has been widely debated in the last decade and its importance is recognized as critical and not negligible in flood simulations as it has been evidenced that the severity of an event is often the result of the coupling of a flood wave with elevated solid transport rates. Nevertheless, assessing the quantity of sediment mobilized in a particular event is not feasible without a long term analysis of the river's dynamics and its morphological evolution since it is defined by past events. This work is focused on the techniques to improve knowledge about sediment production and transport through hydrological networks as a necessary component of a wise flood prevention planning. In particular, a multidisciplinary approach that combines hydraulic and geological knowledge is required in order to understand the evolution of the river sediment and how it will influence the following critical event. The methods are presented through a case study in Italy where a series of different approaches have been integrated to gain a comprehensive understanding of the problem: the sediment movement has been studied by a Eulerian as well as a Lagrangian approaches while hydraulic properties of the stream have been measured. The research started with an attempt to monitor sediment movements: in June 2016 300 sample pebbles, equipped with RFID (Radio Frequency IDentification) transponders, have been deployed in the river and tracked after every major rainfall event. The obtained data-set has been combined with a morphological analysis and a river flow discharge computed through PIV (Particle Image Velocimetry) method in order to identify the relation between a given rainfall event and sediment transport. Moreover, critical sediment size has been estimated from field data using three approaches: two

  1. Do dual tasks have an added value over single tasks for balance assessment in fall prevention programs? A mini-review

    NARCIS (Netherlands)

    Ufkes, T.; Skelton, D. A.; Lundin-Olsson, L.; Zijlstra, Wiebren; Zijlstra, Agnes

    2008-01-01

    Background: The Prevention of Falls Network Europe (ProFaNE) aims to bring together European researchers and clinicians to focus on the development of effective falls prevention programs for older people. One of the objectives is to identify suitable balance assessment tools. Assessment procedures

  2. The European ASAMPSA_E project : towards guidance to model the impact of high amplitude natural hazards in the probabilistic safety assessment of nuclear power plants. Information on the project progress and needs from the geosciences.

    Science.gov (United States)

    Raimond, Emmanuel; Decker, Kurt; Guigueno, Yves; Klug, Joakim; Loeffler, Horst

    2015-04-01

    The Fukushima nuclear accident in Japan resulted from the combination of two correlated extreme external events (earthquake and tsunami). The consequences, in particular flooding, went beyond what was considered in the initial engineering design design of nuclear power plants (NPPs). Such situations can in theory be identified using probabilistic safety assessment (PSA) methodology. PSA results may then lead industry (system suppliers and utilities) or Safety Authorities to take appropriate decisions to reinforce the defence-in-depth of the NPP for low probability event but high amplitude consequences. In reality, the development of such PSA remains a challenging task. Definitions of the design basis of NPPs, for example, require data on events with occurrence probabilities not higher than 10-4 per year. Today, even lower probabilities, down to 10-8, are expected and typically used for probabilistic safety analyses (PSA) of NPPs and the examination of so-called design extension conditions. Modelling the combinations of natural or man-made hazards that can affect a NPP and affecting some meaningful probability of occurrence seems to be difficult. The European project ASAMPSAE (www.asampsa.eu) gathers more than 30 organizations (industry, research, safety control) from Europe, US and Japan and aims at identifying some meaningful practices to extend the scope and the quality of the existing probabilistic safety analysis developed for nuclear power plants. It offers a framework to discuss, at a technical level, how "extended PSA" can be developed efficiently and be used to verify if the robustness of Nuclear Power Plants (NPPs) in their environment is sufficient. The paper will present the objectives of this project, some first lessons and introduce which type of guidance is being developed. It will explain the need of expertise from geosciences to support the nuclear safety assessment in the different area (seismotectonic, hydrological, meteorological and biological

  3. The Lichtenberg Financial Decision Screening Scale (LFDSS): A new tool for assessing financial decision making and preventing financial exploitation.

    Science.gov (United States)

    Lichtenberg, Peter A; Ficker, Lisa; Rahman-Filipiak, Analise; Tatro, Ron; Farrell, Cynthia; Speir, James J; Mall, Sanford J; Simasko, Patrick; Collens, Howard H; Jackman, John Daniel

    2016-01-01

    One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale's implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.

  4. Preventive child health care at elementary school age: The costs of routine assessments with a triage approach.

    Directory of Open Access Journals (Sweden)

    Janine Bezem

    Full Text Available Triage in Preventive Child Health Care (PCH assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6 years and 10/11 years. In a triage approach, PCH assistants conduct pre-assessments to identify children requiring follow-up assessments by a physician or nurse. In the usual approach, all children are assessed by a physician and an assistant (children aged 5/6 years or a nurse (children aged 10/11 years.All the direct costs of conducting routine PCH assessments with the triage and usual approach were assessed using a bottom-up micro-costing approach. In four PCH services in the Netherlands, two using triage and two the usual approach, professionals completed questionnaires about time spent on assessments, including time related to non-attendance at assessments, the referral of children and administration.The projected costs for PCH professionals working on PCH assessments amounted to €5.2 million per cohort of 100,000 children aged 5/6 years in the triage approach, and €7.6 million in the usual approach. The projected costs in both approaches for children aged 10/11 years were about €4 million per 100,000 children.The triage approach to PCH resulted in a projected cost reduction of about one-third, compared with usual practice, for routine assessments by physicians of children aged 5/6 years. There are minimal cost savings in the group of children aged 10/11 years when nurses are involved and so other considerations such as workforce shortages would be required to justify a change to a triage approach. Further research is needed to investigate the differences in costs of care after the completion of the routine assessments.

  5. Recruitment, Methods, and Descriptive Results of a Physiologic Assessment of Latino Farmworkers: The California Heat Illness Prevention Study.

    Science.gov (United States)

    Mitchell, Diane C; Castro, Javier; Armitage, Tracey L; Vega-Arroyo, Alondra J; Moyce, Sally C; Tancredi, Daniel J; Bennett, Deborah H; Jones, James H; Kjellstrom, Tord; Schenker, Marc B

    2017-07-01

    The California heat illness prevention study (CHIPS) devised methodology and collected physiological data to assess heat related illness (HRI) risk in Latino farmworkers. Bilingual researchers monitored HRI across a workshift, recording core temperature, work rate (metabolic equivalents [METs]), and heart rate at minute intervals. Hydration status was assessed by changes in weight and blood osmolality. Personal data loggers and a weather station measured exposure to heat. Interviewer administered questionnaires were used to collect demographic and occupational information. California farmworkers (n = 588) were assessed. Acceptable quality data was obtained from 80% of participants (core temperature) to 100% of participants (weight change). Workers (8.3%) experienced a core body temperature more than or equal to 38.5 °C and 11.8% experienced dehydration (lost more than 1.5% of body weight). Methodology is presented for the first comprehensive physiological assessment of HRI risk in California farmworkers.

  6. 76 FR 12361 - Request for Information: Update of NIOSH Nanotechnology Strategic Plan for Research and Guidance

    Science.gov (United States)

    2011-03-07

    ... Control and Prevention (CDC) has pioneered research on the toxicological properties and characteristics of nanoparticles. This research has involved characterizing occupationally relevant nanoparticles for predicting... explosion safety, (8) recommendations and guidance, (9) communication and information, and (10) applications...

  7. Quality in career guidance: The Danish case

    DEFF Research Database (Denmark)

    Plant, Peter

    2011-01-01

    Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach......Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach...

  8. Assessing the effectiveness of problem-based learning of preventive medicine education in China.

    Science.gov (United States)

    Ding, Xiaojie; Zhao, Liping; Chu, Haiyan; Tong, Na; Ni, Chunhui; Hu, Zhibin; Zhang, Zhengdong; Wang, Meilin

    2014-05-30

    Problem-based learning (PBL) is defined as a student-centered pedagogy which can provide learners more opportunities for application of knowledge acquired from basic science to the working situations than traditional lecture-based learning (LBL) method. In China, PBL is increasingly popular among preventive medicine educators, and multiple studies have investigated the effectiveness of PBL pedagogy in preventive medicine education. A pooled analysis based on 15 studies was performed to obtain an overall estimate of the effectiveness of PBL on learning outcomes of preventive medicine. Overall, PBL was associated with a significant increase in students' theoretical examination scores (SMD = 0.62, 95% CI = 0.41-0.83) than LBL. For the attitude- and skill-based outcomes, the pooled PBL effects were also significant among learning attitude (OR = 3.62, 95% CI = 2.40-5.16), problem solved skill (OR = 4.80, 95% CI = 2.01-11.46), self-directed learning skill (OR = 5.81, 95% CI = 3.11-10.85), and collaborative skill (OR = 4.21, 95% CI = 0.96-18.45). Sensitivity analysis showed that the exclusion of a single study did not influence the estimation. Our results suggest that PBL of preventive medicine education in China appears to be more effective than LBL in improving knowledge, attitude and skills.

  9. Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

    Science.gov (United States)

    Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

    2015-12-01

    Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. © 2013 John Wiley & Sons Ltd.

  10. REPORT TO CONGRESS: ASSESSMENT OF INTERNATIONAL AIR POLLUTION PREVENTION AND CONTROL TECHNOLOGY VOLUME 1. EXECUTIVE SUMMARY

    Science.gov (United States)

    The report gives results of a study that identifies new and innovative air pollution prevention and/or control technologies, of selected industrialized countries, that are not currently used extensively in the U.S. The technologies may be entirely new to the U.S., or they may be ...

  11. Parking guidance - modelling, simulation and impact assessment

    NARCIS (Netherlands)

    Jonkers, E.; Noort, M. van; Veen, J.L. van der

    2011-01-01

    Intelligent parking services that help drivers with reservation of a parking spot, navigation and automated payment have reached the deployment phase. These services may provide significant benefits to drivers and municipalities. Drivers may experience an increase in comfort and lower and more

  12. Groundwater Circulating Well Assessment and Guidance

    Science.gov (United States)

    1998-04-03

    storage tank. 1 .3 .3.2.3 Biofiltration . Vapor-phase bioreactors are an effective method for treat ing a variety of gas-phase organic contam inants and...operation. Another advantage of the dipole test is that water is not withdrawn from the ground, eliminating d isposal requirements. It is strongly...example, if a bioprocess is being considered, respiration gases m ust be mon itored to provide evidence for treatment process effectiveness. Conversely

  13. Determinants of participation in a fall assessment and prevention programme among elderly fallers in Hong Kong: prospective cohort study.

    Science.gov (United States)

    Wong, Eliza L Y; Woo, Jean; Cheung, Annie W L; Yeung, Pui-Yi

    2011-04-01

    The study was undertaken to estimate the uptake rate of a fall prevention programme among older fallers and explore related factors. Fall injuries are a major cause nationally of the loss of independence in old age, but they are preventable. Acceptance of fall prevention programmes is therefore important to reduce the risk of falling. Patients aged ≥60 attending the Department of Accident & Emergency of a regional hospital in Hong Kong between 2006 and 2007 were recruited. The study included a baseline interview, focus group interview and a cross-sectional 1-year follow-up telephone survey to assess uptake and its related factors. A total 68% of 1194 older people attended the fall programme. Factors associated with programme participation included the perception of fall as being preventable [OR=3.47, 95% CI (1.59-7.56)] or recoverable [OR=1.73, 95% CI (1.06-2.82)], a safe outside environment; absence of chronic illness, and ability to walk without aids. Old-age people, those living in old-age homes and of lower education level were less likely to join the programme. Older people with the selected characteristics were less likely to attend the fall prevention programme, thus were less likely to benefit from them. Support from family/carers may be an important element in participation. In a nursing context, in primary care practice, all of these factors should be taken into account in any future development of a fall prevention programme in Hong Kong of this nature. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  14. GUIDANCE ON SELECTING AGE GROUPS FOR ...

    Science.gov (United States)

    This guidance document provides a set of early-lifestage age groups for Environmental Protection Agency scientists to consider when assessing children’s exposure to environmental contaminants and the resultant potential dose. These recommended age groups are based on current understanding of differences in behavior and physiology which may impact exposures in children. A consistent set of early-life age groups, supported by an underlying scientific rationale, is expected to improve Agency exposure and risk assessments for children by increasing the consistency and comparability of risk assessments across the Agency; by improving accuracy and transparency in assessments for those cases where current practice might too broadly combine behaviorally and physiologically disparate age groups; and by fostering a consistent approach to future exposure surveys and monitoring efforts to generate improved exposure factors for children. see description

  15. Assessing the efficiency of Mediterranean ditch networks in preventing vineyards soil erosion within landscape

    Science.gov (United States)

    Levavasseur, Florent; Bailly, Jean-Stéphane; Lagacherie, Philippe

    2013-04-01

    Water erosion of cultivated soils is a threat to the sustainability of agriculture, especially in Mediterranean areas. For a long time, Mediterranean farmers have thus adopted some soil conservation practices. Actual ditch networks, which are generally associated with terraces, result from historical successive farmer settlements and are one of these soil conservation practices. By intercepting surface run-off, ditches decrease slope length and prevent soil erosion on downstream plots. However, since water erosion hazard and ditch network geometries are highly variable in vineyards landscape and since ditch building and maintaining are costly, the objective of this study was to identify and map the resulting efficiency of ditch networks in preventing soil erosion. For a given area, a ditch network efficiency is defined here as the balance between the network density, i.e. network cumulated length for a given area unit, and the erosion sensitivity over an area which measures the performance of the ditch network in limiting soil erosion. The erosion efficiency of ditch networks was thus identified using both i) computer generated ditch networks with various spatial configurations and ii) the stream power index as an erosion sensitivity indicator, computed from a DTM in which each ditch network was burned. The stream power index of the actual networks were compared with a set of generated networks whose density and topology were selected to maximize the performance in preventing soil erosion thanks to the use of a self-developed optimized stochastic network generator. For four 1 km² hillslopes, we showed that the performances of actual networks to prevent soil erosion was among the best that were obtained by simulated networks with even greater densities. Furthermore, we showed that the stream power index values that accounted for the actual ditch networks to prevent soil erosion hazard was both minimal and weakly variable in the whole study area (30 km²) at

  16. Information architecture. Volume 3: Guidance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

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

  17. Assessing HIV Stigma on Prevention Strategies for Black Men Who Have Sex with Men in the United States.

    Science.gov (United States)

    Sang, Jordan M; Matthews, Derrick D; Meanley, Steven P; Eaton, Lisa A; Stall, Ron D

    2018-06-02

    The deleterious effects of HIV stigma on HIV+ Black MSM care continuum outcomes have been well-documented. How HIV stigma shapes HIV prevention for HIV- persons in this community is poorly understood. We sought to test the relationship of HIV stigma with HIV- Black MSM on HIV testing, pre-exposure prophylaxis (PrEP) awareness, and PrEP use. We recruited 772 participants at Black Pride events across five US cities in 2016. Multivariable logistic regression models assessed the association of external HIV stigma on prevention outcomes adjusting for sociodemographic variables. Stigma was positively associated with PrEP awareness (AOR = 1.34; 95% CI = 1.09, 1.66; p value = 0.005), and not associated with PrEP use or HIV testing in our sample. These findings highlight the complex nature of HIV stigma among BMSM and include results for PrEP, which can affect uptake other prevention methods. We support anti-HIV stigma efforts and advise further exploration on HIV stigma among BMSM and prevention outcomes.

  18. Assessment of Critical Care Provider's Application of Preventive Measures for Ventilator-Associated Pneumonia in Intensive Care Units.

    Science.gov (United States)

    Bagheri-Nesami, Masoumeh; Amiri-Abchuyeh, Maryam; Gholipour-Baradari, Afshin; Yazdani-Cherati, Jamshid; Nikkhah, Attieh

    2015-08-01

    The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP. The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran. This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability. The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all. The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.

  19. A Framework for Assessing the Value of Investments in Nonclinical Prevention.

    Science.gov (United States)

    Miller, George; Roehrig, Charles; Russo, Pamela

    2015-12-10

    We present a high-level framework to show the process by which an investment in primary prevention produces value. We define primary prevention broadly to include investments in any of the determinants of health. Although it builds on previously developed frameworks, ours incorporates several additional features. It distinguishes direct and upstream determinants of health, a distinction that can help identify, describe, and track the impact of a policy or program on health and health care costs. It recognizes multiple dimensions of value, including the need to establish the nonhealth value of investments whose objectives are not limited to improvements in health (and whose costs should not be attributed solely to the health benefits). Finally, it emphasizes the need to describe value from the perspectives of the multiple stakeholders that can influence such investments.

  20. Forging Consensus for Atrocity Prevention: Assessing the Record of the OSCE

    Directory of Open Access Journals (Sweden)

    Matthew Levinger

    2018-03-01

    Full Text Available This essay examines the record of the Organization for Security and Cooperation in Europe (OSCE in fostering norms and collaborative practices for preventing mass atrocities in Eurasia. Comprising fifty-seven participating states “from Vancouver to Vladivostok,” the OSCE is the sole regional security organization spanning all of the members of NATO and the former Warsaw Pact. Its consensus-based approach to advancing “common and comprehensive security” has proved successful in preventing escalation or containing levels of violence in various conflicts in the Baltic states, Ukraine, Southeastern Europe, and the Caucasus. Since the late 1990s, however, rising geopolitical tensions between NATO and the Russian Federation have undermined the effectiveness of the OSCE’s conflict prevention initiatives. In order for the OSCE to play a more robust role in enhancing human security in Eurasia, it will need to find a path toward rebuilding the normative consensus between Russia and its Western participating states.

  1. A quantitative risk assessment model to evaluate effective border control measures for rabies prevention

    Science.gov (United States)

    Weng, Hsin-Yi; Wu, Pei-I; Yang, Ping-Cheng; Tsai, Yi-Lun; Chang, Chao-Chin

    2009-01-01

    Border control is the primary method to prevent rabies emergence. This study developed a quantitative risk model incorporating stochastic processes to evaluate whether border control measures could efficiently prevent rabies introduction through importation of cats and dogs using Taiwan as an example. Both legal importation and illegal smuggling were investigated. The impacts of reduced quarantine and/or waiting period on the risk of rabies introduction were also evaluated. The results showed that Taiwan’s current animal importation policy could effectively prevent rabies introduction through legal importation of cats and dogs. The median risk of a rabid animal to penetrate current border control measures and enter Taiwan was 5.33 × 10−8 (95th percentile: 3.20 × 10−7). However, illegal smuggling may pose Taiwan to the great risk of rabies emergence. Reduction of quarantine and/or waiting period would affect the risk differently, depending on the applied assumptions, such as increased vaccination coverage, enforced custom checking, and/or change in number of legal importations. Although the changes in the estimated risk under the assumed alternatives were not substantial except for completely abolishing quarantine, the consequences of rabies introduction may yet be considered to be significant in a rabies-free area. Therefore, a comprehensive benefit-cost analysis needs to be conducted before recommending these alternative measures. PMID:19822125

  2. Optimizing prevention of hospital-acquired venous thromboembolism (VTE): prospective validation of a VTE risk assessment model.

    Science.gov (United States)

    Maynard, Gregory A; Morris, Timothy A; Jenkins, Ian H; Stone, Sarah; Lee, Joshua; Renvall, Marian; Fink, Ed; Schoenhaus, Robert

    2010-01-01

    Hospital-acquired (HA) venous thromboembolism (VTE) is a common source of morbidity/mortality. Prophylactic measures are underutilized. Available risk assessment models/protocols are not prospectively validated. Improve VTE prophylaxis, reduce HA VTE, and prospectively validate a VTE risk-assessment model. Observational design. Academic medical center. Adult inpatients on medical/surgical services. A simple VTE risk assessment linked to a menu of preferred VTE prophylaxis methods, embedded in order sets. Education, audit/feedback, and concurrent identification of nonadherence. Randomly sampled inpatient audits determined the percent of patients with "adequate" VTE prevention. HA VTE cases were identified concurrently via digital imaging system. Interobserver agreement for VTE risk level and judgment of adequate prophylaxis were calculated from 150 random audits. Interobserver agreement with 5 observers was high (kappa score for VTE risk level = 0.81, and for judgment of "adequate" prophylaxis = 0.90). The percent of patients on adequate prophylaxis improved each of the 3 years (58%, 78%, and 93%; P risk of HA VTE (risk ratio [RR] = 0.69; 95% confidence interval [CI] = 0.47-0.79) and preventable HA VTE (RR = 0.14; 95% CI = 0.06-0.31) occurred. We detected no increase in heparin-induced thrombocytopenia (HIT) or prophylaxis-related bleeding using administrative data/chart review. We prospectively validated a VTE risk-assessment/prevention protocol by demonstrating ease of use, good interobserver agreement, and effectiveness. Improved VTE prophylaxis resulted in a substantial reduction in HA VTE. (c) 2010 Society of Hospital Medicine.

  3. Screening of Toxoplasma gondii infection among childbearing age females and assessment of nurses' role in prevention and control of toxoplasmosis.

    Science.gov (United States)

    Saleh, Ahmed Megahed Ahmed; Ali, Hisham abd El-Raouf; Ahmed, Salwa Abdalla Mohamed; Hosny, Samah Mostafa; Morsy, Tosson A

    2014-08-01

    Toxoplasmosis, caused by Toxoplasma gondii is an obligate intracellular zoonotic protozoan parasite, with a worldwide distribution particularly in Arab countries including Egypt. The study evaluated toxoplasmosis infection among childbearing age Egyptian females and assessed the military nursing staff knowledge, attitude and compliance to toxoplasmosis prevention and control measures. The study was conductedin a general military hospital. CROSS-section descriptive research design was used to conduct this study. The subjects consisted of 14 young females (11 were in-patients undergoing gynecological treatment in a military hospital and 3 were staff nurses. On the other hand, 44 staff nurses were available for assessment who met the inclusion criteria. 4 tools were used for data collection: first consisted of self-administered questionnaires to assess nurses' socio-demographic data and knowledge, second rating scale to assess nurses' attitude towards toxoplasmosis infection and its prevention, third performance check list to measure nurses' compliance to infection control measures, and fourth measured the anti-Toxoplasma antibodies by commercial indirect hemagglutination test (IHAT). The results showed that almost half of the nurses had satisfactory levels of knowledge, attitude, and compliance to toxoplasmosis infection control measures. 22.2% of the pregnant women and 20% of non-pregnant ones showed antibodies against T. gondii. Thus health education about toxoplasmosis should be tailored to women whether married or single to help in avoiding the risk of infection. Frequent periodic IHAT should be done for people who continuously contact with cats. Adherence to strict infection prevention measures is a must to eliminate exposure to toxoplasmosis infection. Training intervention should be implemented to achieve successful improvement in knowledge, attitude, and compliance of toxoplasmosis control measures.

  4. [An assessment scale for the prevention of pressure sores in children].

    Science.gov (United States)

    Chauvet, Corinne; Poirier, Marie-Renée; Sourisseau, Petronela Rachieru; Béduneau, Denis; Soulard, Anthony; Delacroix, Delphine

    2015-04-01

    Pressure sores in children are rare. However, when they do occur they can have significant consequences. Professionals in paediatric units realised the importance of assessing the risk of pressure sores and developed a pressure sore assessment scale specific to children. This project, carried out through a hospital-training school partnership, emphasises the importance of clinical reasoning in nursing practices.

  5. Bias assessment and prevention in non-cognitive outcome measures in PISA questionnaires

    NARCIS (Netherlands)

    van de Vijver, Fons; He, Jia; Kuger, S.; Klieme, E.; Jude, N.; Kaplan, D.

    2016-01-01

    Assessing students’ personal characteristics, as well as the structures and processes of teaching and learning, is an integral part of the Programme for International Student Assessment (PISA). Providing input for solid evidence-based educational policies, one of the main aims of PISA, creates huge

  6. Pollution prevention opportunity assessment for the K-25 Site Toxic Substances Control Act Incinerator Operations, Level III

    International Nuclear Information System (INIS)

    1995-09-01

    A Level III pollution prevention opportunity assessment (PPOA) was performed for the Oak Ridge K-25 Site Toxic Substances Control Act (TSCA) Incinerator to evaluate pollution prevention (P2) options for various waste streams: The main objective of this study was to identify and evaluate options to reduce the quantities of each waste stream generated by the TSCA Incinerator operations to realize significant environmental and/or economic benefits from P2. For each of the waste streams, P2 options were evaluated following the US Environmental Protection Agency (EPA) hierarchy to (1) reduce the quantity of waste generated, (2) recycle the waste, and/or (3) use alternate waste treatment or segregation methods. This report provides process descriptions, identification and evaluation of P2 options, and final recommendations

  7. Tools to prevent process safety events at university research facility - chemical risk assessment and experimental set-up risk assessment

    DEFF Research Database (Denmark)

    Jensen, Niels; Jørgensen, Sten Bay

    2014-01-01

    The article discusses the two forms developed to examine the hazards of the chemicals to be used in the experiments in the experimental setup in the Department of Chemical and Biochemical Engineering of the Technical University of Denmark. A system for the safety assessment of new experimental se...... setups in university research and teaching laboratories is presented. The significance of the forms for the effort of researchers in improving work with significant hazards is described....

  8. Fall risk and prevention needs assessment in an older adult Latino population: a model community global health partnership.

    Science.gov (United States)

    Hanlin, Erin R; Delgado-Rendón, Angélica; Lerner, E Brooke; Hargarten, Stephen; Farías, René

    2013-01-01

    The impact of falls in older adults presents a significant public health burden. Fall risk is not well-described in Latino populations nor have fall prevention programs considered the needs of this population. The objectives of this study were to develop a needs assessment of falls in older adult Latinos at a community center (CC), determine fall prevention barriers and strengths in this population, determine the level of interest in various fall prevention methods, and provide medical students an opportunity for participation in a culturally diverse community project. A cross-sectional survey was conducted with a convenience sample of older adult program participants. The survey was developed in collaboration with both partners. CC participants were approached by the interviewer and asked to participate. They were read the survey in their preferred language and their answers were recorded. Data were analyzed using descriptive statistics. We conducted 103 interviews. We found that 54% of participants had fallen in the last year, and of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. Of all respondents, 52% had 5 or more of the 10 surveyed risk factors for falling; 4% had no risk factors. Of all respondents, 75% were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (78% and 65%, respectively). Older adult Latinos in this selected population frequently fall and are worried about falling. Risk factors are prevalent. A fall prevention program is warranted and should include exercise classes and a connection with local primary care providers. A partnership between an academic organization and a CC is an ideal collaboration for the future development of prevention program.

  9. The Underlying Mechanism of Preventing Facial Nerve Stimulation by Triphasic Pulse Stimulation in Cochlear Implant Users Assessed With Objective Measure.

    Science.gov (United States)

    Bahmer, Andreas; Baumann, Uwe

    2016-10-01

    Triphasic pulse stimulation prevents from facial nerve stimulation (FNS) because of a different electromyographic input-output function compared with biphasic pulse stimulation. FNS is sometimes observed in cochlear implant users as an unwanted side effect of electrical stimulation of the auditory nerve. The common stimulation applied in current cochlear implant consists of biphasic pulse patterns. Two common clinical remedies to prevent unpleasant FNS caused by activation of certain electrodes are to expand their pulse phase duration or simply deactivate them. Unfortunately, in some patients these methods do not provide sufficient FNS prevention. In these patients triphasic pulse can prevent from FNS. The underlying mechanism is yet unclear. Electromyographic (EMG) recordings of muscles innervated by the facial nerve (musculi orbicularis ori and oculi) were applied to quantitatively assess the effects on FNS. Triphasic and biphasic fitting maps were compared in four subjects with severe FNS. Based on the recordings, a model is presented which intends to explain the beneficial effects of triphasic pulse application. Triphasic stimulation provided by fitting of an OPUS 2 speech processor device. For three patients, EMG was successfully recorded depending on stimulation level up to uncomfortable and intolerable FNS stimulation as upper boarder. The obtained EMG recordings demonstrated high individual variability. However, a difference between the input-output function for biphasic and triphasic pulse stimulation was visually observable. Compared with standard biphasic stimulation, triphasic pulses require higher stimulation levels to elicit an equal amount of FNS, as reflected by EMG amplitudes. In addition, we assume a steeper slope of the input-output function for biphasic pulse stimulation compared with triphasic pulse stimulation. Triphasic pulse stimulation prevents from FNS because of a smaller gradient of EMG input-output function compared with biphasic pulse

  10. Assessment of the age for a preventive ultrasonographic examination of the prostate in the dog.

    Science.gov (United States)

    Mantziaras, G; Alonge, S; Faustini, M; Luvoni, G C

    2017-09-15

    The prostate commonly develops benign prostatic hyperplasia (BPH) in dogs over 5 years, while in aged dogs other pathological findings might be revealed by ultrasonographic exam. The aim of the present study was to estimate the most suitable age for a preventive ultrasonographic examination of the prostate in the dog. The prostate of 1003 intact male dogs of 64 different breeds, of different ages (1-18 years) and bodyweights (2-55 kg) was evaluated with ultrasound, irrespective of the reason for clinical examination. The age of each dog was expressed as the ratio between the actual age and the maximum longevity expected for the breed. Dogs were divided in two groups based on breeds' life expectancy as short life (SL) and long life (LL). The size of the prostate (normal, enlarged or small) and the presence of abnormal sonographic findings were recorded for each dog. The results of the present study indicate that the most suitable age for a preventive ultrasonographic exam of the prostate in the dog is approximately at 40% of its expected longevity, both in short and long life breeds, because at this age there is a strong possibility to be able to detect abnormal prostatic findings. In 47.5% of the dogs at least one abnormal finding of the prostate was revealed by ultrasonographic exam, while dogs with long life expectancy showed a significantly higher prevalence of abnormalities, than dogs with short life expectancy. The most frequent findings were the increase of prostatic size (33.5%) and the presence of at least one cyst (33.6%), with no difference between SL and LL dogs. In conclusion, a preventive examination of the prostate starting at 40% of expected longevity in dogs of short and long life breeds is strongly recommended for early detection of abnormalities, for scheduling specific follow up and for suggesting effective therapeutic protocols. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Preventive distribution of steady iodine in France: assessment of the 2009 campaign around nuclear power stations

    International Nuclear Information System (INIS)

    Godino, O.

    2010-01-01

    This report describes the strategy adopted for the preventive distribution in 2009 and 2010 of steady iodine tablets to people living or working within 10 kilometres around the French nuclear power plants. It first recalls the results obtained by the previous campaign in 2005-2006. It describes how the campaign has been prepared (address files, tablet purchase and delivery), which distribution method has been adopted (mailing, retrieval in chemist's shops, direct distribution during a second phase, tablets at permanent disposal during a third phase). It indicates the missions of chemists and of the power plan operator (EDF). It briefly comments the main figures associated with and obtained by this campaign

  12. Assessing the effectiveness of Malaysia's drug prevention education and rehabilitation programs.

    Science.gov (United States)

    Scorzelli, J F

    1988-01-01

    The multifaceted drug prevention education and rehabilitation system of Malaysia appears to have contributed to the steady decrease of the number of identified drug abusers in the country. In this article, those components of the Malaysian system that would be most applicable to the American effort were examined. In the same manner, because the fastest growing minority group in the United States are Asian Americans, in which a significant proportion involve persons from Southeast Asia, those components in the Malaysian system that are applicable to Southeast Asian Americans were examined.

  13. DOE Waste Treatability Group Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, T.D.

    1995-01-01

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

  14. Agent Based Individual Traffic Guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen

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

  15. Consensus standard requirements and guidance

    International Nuclear Information System (INIS)

    Putman, V.L.

    1995-01-01

    This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning

  16. DOE Waste Treatability Group Guidance

    International Nuclear Information System (INIS)

    Kirkpatrick, T.D.

    1995-01-01

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

  17. Assessment of family history of substance abuse for preventive interventions with patients experiencing chronic pain: A quality improvement project.

    Science.gov (United States)

    Pestka, Elizabeth; Nash, Virginia; Evans, Michele; Cronin, Joan; Bee, Susan; King, Susan; Osborn, Kristine; Gehin, Jessica; Weis, Karen; Loukianova, Larissa

    2016-04-01

    This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings. © 2015 John Wiley & Sons Australia, Ltd.

  18. System 80+ design features for severe accident prevention and mitigation

    International Nuclear Information System (INIS)

    Jacob, M.C.; Schneider, R.E.; Finnicum, D.J.

    1993-01-01

    ABB-CE, in cooperation with the US Department of Energy, is working to develop and certify the System 80+ design, which is ABB-CE's standardized evolutionary Advanced Light Water Reactor (ALWR) design. It incorporates design enhancements based on Probabilistic Risk Assessment (PRA) insights, guidance from the EPRI's Utility Requirements Document, and US NRC's Severe Accident Policy. Major severe accident prevention and mitigation design features of the system is discussed along with its conformance to EPRI URD guidance, as applicable. Computer simulation of a best estimate severe accident scenario is presented to illustrate the acceptable containment performance of the design. It is concluded that by considering severe accident prevention and mitigation early in the design process, the System 80+ design represents a robust plant design that has low core damage frequencies, low containment conditional failure probabilities, and acceptable deterministic containment performance under severe accident conditions

  19. Assessment of Nurses’ Knowledge, Attitude, and Perceived Barriers to Expressed Pressure Ulcer Prevention Practice in Addis Ababa Government Hospitals, Addis Ababa, Ethiopia, 2015

    OpenAIRE

    Abebe Dilie; Daniel Mengistu

    2015-01-01

    Background. Although pressure ulcer development is now generally considered as an indicator for quality of nursing care, questions and concerns about situations in which they are unavoidable remain. Awareness about the significance of the problem, positive attitude towards prevention, and an adequate level of knowledge are cornerstones to effectively prevent pressure ulcers. Objective. To assess nurses’ knowledge, attitudes, and perceived barriers to expressed pressure ulcer prevention practi...

  20. Wind turbine blade life-time assessment model for preventive planning of operation and maintenance

    DEFF Research Database (Denmark)

    Florian, Mihai; Sørensen, John Dalsgaard

    2014-01-01

    Out of the total wind turbine failure events, blade damage accounts for a substantial part, with some studies estimating it at around 23%. Current operation and maintenance (O&M) practices typically make use of corrective type maintenance as the basic approach, implying high costs for repair...... of information on the blades structural health to the decision maker. Further, inspections of the blades are often performed in connection with service. In light of the obtained information, a preventive type of maintenance becomes feasible, with the potential of predicting the blades remaining life to support O......&M decisions for avoiding major failure events. The present paper presents a fracture mechanics based model for estimating the remaining life of a wind turbine blade, focusing on the crack propagation in the blades adhesive joints. A generic crack propagation model is built in Matlab based on a Paris law...

  1. Wind Turbine Blade Life-Time Assessment Model for Preventive Planning of Operation and Maintenance

    DEFF Research Database (Denmark)

    Florian, Mihai; Sørensen, John Dalsgaard

    2015-01-01

    Out of the total wind turbine failure events, blade damage accounts for a substantial part, with some studies estimating it at around 23%. Current operation and maintenance (O&M) practices typically make use of corrective type maintenance as the basic approach, implying high costs for repair...... of information on the blades structural health to the decision maker. Further, inspections of the blades are often performed in connection with service. In light of the obtained information, a preventive type of maintenance becomes feasible, with the potential of predicting the blades remaining life to support O......&M decisions for avoiding major failure events. The present paper presents a fracture mechanics based model for estimating the remaining life of a wind turbine blade, focusing on the crack propagation in the blades adhesive joints. A generic crack propagation model is built in Matlab based on a Paris law...

  2. National Environmental Policy Act guidance: A model process

    International Nuclear Information System (INIS)

    Angle, B.M.; Lockhart, V.A.T.; Sema, B.; Tuott, L.C.; Irving, J.S.

    1995-04-01

    The ''Model National Environmental Policy Act (NEPA) Process'' includes: References to regulations, guidance documents, and plans; training programs; procedures; and computer databases. Legislative Acts and reference documents from Congress, US Department of Energy, and Lockheed Idaho Technologies Company provide the bases for conducting NEPA at the Idaho National Engineering Laboratory (INEL). Lockheed Idaho Technologies Company (LITCO) NEPA / Permitting Department, the Contractor Environmental Organization (CEO) is responsible for developing and maintaining LITCO NEPA and permitting policies, guidance, and procedures. The CEO develops procedures to conduct environmental evaluations based on NEPA, Council on Environmental Quality (CEQ) regulations, and DOE guidance. This procedure includes preparation or support of environmental checklists, categorical exclusion determinations, environmental assessment determinations, environmental assessments, and environmental impact statements. In addition, the CEO uses this information to train personnel conducting environmental evaluations at the INEL. Streamlining these procedures fosters efficient use of resources, quality documents, and better decisions on proposed actions

  3. Method for screening prevention and control measures and technologies based on groundwater pollution intensity assessment.

    Science.gov (United States)

    Li, Juan; Yang, Yang; Huan, Huan; Li, Mingxiao; Xi, Beidou; Lv, Ningqing; Wu, Yi; Xie, Yiwen; Li, Xiang; Yang, Jinjin

    2016-05-01

    This paper presents a system for determining the evaluation and gradation indices of groundwater pollution intensity (GPI). Considering the characteristics of the vadose zone and pollution sources, the system decides which anti-seepage measures should be implemented at the contaminated site. The pollution sources hazards (PSH) and groundwater intrinsic vulnerability (GIV) are graded by the revised Nemerow Pollution Index and an improved DRTAS model, respectively. GPI is evaluated and graded by a double-sided multi-factor coupling model, which is constructed by the matrix method. The contaminated sites are categorized as prior, ordinary, or common sites. From the GPI results, we develop guiding principles for preventing and removing pollution sources, procedural interruption and remediation, and end treatment and monitoring. Thus, we can select appropriate prevention and control technologies (PCT). To screen the technological schemes and optimize the traditional analytical hierarchy process (AHP), we adopt the technique for order preference by the similarity to ideal solution (TOPSIS) method. Our GPI approach and PCT screening are applied to three types of pollution sites: the refuse dump of a rare earth mine development project (a potential pollution source), a chromium slag dump, and a landfill (existing pollution sources). These three sites are identified as ordinary, prior, and ordinary sites, respectively. The anti-seepage materials at the refuse dump should perform as effectively as a 1.5-m-thick clay bed. The chromium slag dump should be preferentially treated by soil flushing and in situ chemical remediation. The landfill should be treated by natural attenuation technology. The proposed PCT screening approach was compared with conventional screening methods results at the three sites and proved feasible and effective. The proposed method can provide technical support for the monitoring and management of groundwater pollution in China. Copyright © 2015

  4. Preventing chronic lung disease in an aging society by improved building ventilation : An economic assessment

    NARCIS (Netherlands)

    Franchimon, F.; Ament, A.H.J.A.; Pernot, C.E.E.; Knies, J.; Bronswijk, van J.E.M.H.

    2008-01-01

    Leading edge ventilation systems in buildings might slow down the degradation of quality of life in a population. We therefore performed an economic assessment to determine the Incremental Cost-Effectiveness Ratio (the amount of money needed to produce one healthy life year) for a full-scale

  5. The assessment of ongoing community-based interventions to prevent obesity: lessons learned

    NARCIS (Netherlands)

    Gubbels, J.S.; Mathisen, F.K.S.; Samdal, O.; Lobstein, T.; Kohl, L.F.M.; Leversen, I.; Lakerveld, J.; Kremers, S.P.J.; Assema, P.

    2015-01-01

    Background: The assessment of real-life, community-based interventions to tackle obesity is an important step in the development of effective policies. Especially multi-level interventions have a high likely effectiveness and potential reach in counteracting the obesity epidemic. Although much can

  6. Fast assessment of the effect of preventive wide area emergency control

    DEFF Research Database (Denmark)

    Dmitrova, Evgenia; Jóhannsson, Hjörtur; Nielsen, Arne Hejde

    2013-01-01

    This paper describes an approach to quick assessment of the effect that a suggested countermeasure would have on the system generators stability margins in respect to aperiodic rotor angle small signal stability. The approach ensures that computational demanding simulations can be avoided...

  7. POLLUTION PREVENTION ASSESSMENT FOR A MANUFACTURER OF FOOD SERVICE EQUIPMENT (EPA/600/S-95/026)

    Science.gov (United States)

    The U.S. Environmental Protection Agency (EPA) has funded a pilot project to assist small and medium-size manufacturers who want to minimize their generation of waste but who lack the expertise to do so. Waste Minimization Assessment Centers (WMACs) were established at selected u...

  8. A modeling approach to assess the effectiveness of BLEVE prevention measures

    NARCIS (Netherlands)

    Landucci, G.; Molag, M.; Reinders, J.; Tugnoli, A.; Cozzani, V.

    2014-01-01

    Distribution and storage of liquefied pressurised gases is a critical safety issue, often resulting in a very high individual and societal risk, at least in densely populated zones. Several risk assessments pointed out that this is mostly due to the possible occurrence of a Boiling Liquid Expanding

  9. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT HISTOLOGY LABORATORY XYLENE USE - FORT CARSON, COLORADO

    Science.gov (United States)

    Under the WREAFS program, RREL has performed a waste minimization opportunity assessment (WMOA) at the Evans Community Hospital Histopathology Laboratory on the Ft. Carson Army Base, Colorado, in the area of waste xylene and ethyl alcohol contaminated with human tissue. The waste...

  10. Assessing the Effects of Information About Global Population Growth on Risk Perceptions and Support for Mitigation and Prevention Strategies.

    Science.gov (United States)

    Dawson, Ian G J

    2018-05-16

    The human population is forecast to increase by 3-4 billion people during this century and many scientists have expressed concerns that this could increase the likelihood of certain adverse events (e.g., climate change and resource shortages). Recent research shows that these concerns are mirrored in public risk perceptions and that these perceptions correlate with a willingness to adopt mitigation behaviors (e.g., reduce resource consumption) and preventative actions (e.g., support actions to limit growth). However, little research has assessed the factors that influence risk perceptions of global population growth (GPG). To contribute to this important goal, this article presents three studies that examined how risk perceptions of GPG might be influenced by textual-visual representations (like those in media and Internet articles) of the potential effects of GPG. Study 1 found that a textual narrative that highlighted the potential negative (cf. positive) consequences of GPG led to higher perceived risk and greater willingness to adopt mitigation behaviors, but not to support preventative actions. Notably, the influence of the narratives on perceived risk was largely moderated by the participant's prior knowledge and perceptions of GPG. Contrary to expectations, studies 2 and 3 revealed, respectively, that photographs depicting GPG-related imagery and graphs depicting GPG rates had no significant effect on the perceived risk of GPG or the willingness to embrace mitigation or preventative actions. However, study 3 found that individuals with higher "graph literacy" perceived GPG as a higher risk and were more willing to adopt mitigation behaviors and support preventative actions. © 2018 Society for Risk Analysis.

  11. Knowledge, Attitude and Practice Assessment in Health Workers regarding Rabies Disease and its Prevention in district Dehradun of Uttarakhand

    Directory of Open Access Journals (Sweden)

    Surekha Kishore

    2015-09-01

    Full Text Available Introduction: Rabies is a deadly disease in which first aid and immuno-prophylaxis after animal bite play a vital role in prevention. Animal bites are usually more prevalent in rural areas and the first aid is sought most commonly from health workers in rural areas. The same is the case in Uttarakhand due to vast expanse of forests and rural area. In the present study, the knowledge, attitude and practices regarding prevention of this disease among a special group of people, i.e. health workers were assessed. Material and Methods: District Dehradun was selected as study area and all the health workers in the district (162 health workers, males and females both were enumerated and interviewed. The data were collected by administering semi structured questionnaire to them. The knowledge was assessed by evolving a scoring system. Practices and attitudes were assessed based on their past experiences and their present willingness for proper management of a case of animal bite.  Results & Conclusion: Most of the study participants (59.9% obtained a medium score (10-17 in knowledge regarding disease and its prevention. All of the participants had heard of the disease and knew about mode of spread. Most of the participants (83.3% lack knowledge about anti-rabies immunoglobulin and pre-exposure prophylaxis (80.2%. Most of the participants (81.4% had attitude scores in satisfactory range (2-3. Sixty percent had practice scores in low range (0-2.Though the knowledge regarding pet vaccination and full course of human vaccination was lacking in some, but the willingness to encourage pet owners to vaccinate their pets and encourage bite victims to get full course of vaccine was 100%. There is a need for sensitization of health workers so that their knowledge can be enhanced and their positive attitude (100% willingness can be translated into proper practices for prevention and control of Rabies.  

  12. Social media-based civic engagement solutions for dengue prevention in Sri Lanka: results of receptivity assessment.

    Science.gov (United States)

    Lwin, May O; Vijaykumar, Santosh; Foo, Schubert; Fernando, Owen Noel Newton; Lim, Gentatsu; Panchapakesan, Chitra; Wimalaratne, Prasad

    2016-02-01

    This article focuses on a novel social media-based system that addresses dengue prevention through an integration of three components: predictive surveillance, civic engagement and health education. The aim was to conduct a potential receptivity assessment of this system among smartphone users in the city of Colombo, the epicenter of the dengue epidemic in the island country of Sri Lanka. Grounded in Protection Motivation Theory (PMT) and using a convenience sampling approach, the cross-sectional survey assessed perceived severity (PSe), perceived susceptibility (PSu), perceived response efficacy (PRE), perceived self-efficacy (PSE) and intention-to-use (IU) among 513 individuals. The overall receptivity to the system was high with a score of >4.00 on a five-point scale. Participants belonging to younger, better educated and higher income groups reported significantly better perceptions of the efficaciousness of the system, were confident in their ability to use the system, and planned to use it in the future. PMT variables contributed significantly to regression models predicting IU. We concluded that a social media-based system for dengue prevention will be positively received among Colombo residents and a targeted, strategic health communication effort to raise dengue-related threat perceptions will be needed to encourage greater adoption and use of the system. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  13. Assessing missed opportunities for the prevention of mother-to-child HIV transmission in an Eastern Cape local service area.

    Science.gov (United States)

    Rispel, L C; Peltzer, K; Phaswana-Mafuya, N; Metcalf, C A; Treger, L

    2009-03-01

    Prevention of new HIV infections is a critical imperative for South Africa; the prevention of mother-to-child transmission (PMTCT) is one of the most efficacious HIV prevention interventions. Assessment of a PMTCT programme to determine missed opportunities. The Kouga local service area (LSA), bordering Nelson Mandela Bay Municipality (Port Elizabeth) in the Eastern Cape. An assessment was conducted in 2007 before implementing technical support for strengthening the PMTCT programme, including: interviews with 20 PMTCT managers, 4 maternity staff and 27 other health workers on service provision, management, infrastructure, human resources and the health information system; 296 antenatal clinic users on their service perceptions; 70 HIV-positive women on HIV knowledge, infant feeding, coping, support and service perceptions; 8 representatives from community organisations and 101 traditional health practitioners (THPs). Observations were conducted during site visits to health facilities, and the District Health Information System (DHIS) data were reviewed. Staff had high levels of awareness of HIV policies and most had received some relevant training. Nevirapine uptake varied by clinic, with an average of 56%. There were many missed opportunities for PMTCT, with 67% of pregnant women tested for HIV and only 43% of antenatal care attendees tested during a previous pregnancy. Only 6% of HIV-positive women reported support group participation. Reducing missed opportunities for PMTCT requires strengthening of the formal health sector, intersectoral liaison, and greater community support. Priority areas that require strengthening in the formal health sector include HIV counselling and testing; family planning and nutrition counselling; infant follow-up; human resources; and monitoring and evaluation.

  14. attitude of secondary school students towards guidance

    African Journals Online (AJOL)

    Elizabeth Egbochuku

    gender and school location significantly influenced students' attitude towards guidance ... students respond and perceive guidance and counselling services will, to ... counsellors will be appointed in post-primary institutions and tertiary levels.

  15. [The NETWASS prevention model for early identification and assessment of adolescents in psychosocial crisis].

    Science.gov (United States)

    Sommer, Friederike; Fiedler, Nora; Leuschner, Vincenz; Scheithauer, Herbert

    2016-01-01

    The research-based NETWASS prevention model aims to enable school staff to identify students experiencing a psychosocial crisis that could lead to severe targeted school violence and to initiate appropriate support measures. A detailed analysis of the adolescent psychosocial crisis is conducted at an early stage by evaluating possible warning behaviors, crisis symptoms, a student’s individual and social background, and resources. The model was implemented in 98 schools. During the project duration of seven months staff from 59 schools reported 99 cases of a student’s psychosocial crisis. Three experts conducted a content analysis of the reported qualitative data focusing on crisis symptoms of the students as well as the initiated measures. Results show a broad spectrum of risk factors, whereas aggressive behavior of students was reported most frequently. On the basis of theoretical assumptions, the reported cases were divided into three distinct risk groups. A total of eight high-risk cases were observed and reported by the school staff. The school staff mostly reacted to the student crisis by initiating resource-orientated measures, the expertise of child and youth therapists was mostly requested for the high risk cases. By describing the impact of cases and choice of measures undertaken, the study aims to give an overview of incidents schools as well as clinical psychologists and therapists are confronted with.

  16. Preliminary Assessment of Noise Pollution Prevention in Wind Turbines Based on an Exergy Approach

    Directory of Open Access Journals (Sweden)

    Ofelia A. Jianu

    2017-06-01

    Full Text Available Most existing methods for energy transformation and use are inadvertently contaminating our watersupplies, releasing greenhouse gasses into the atmosphere, emitting compounds that diminish the earth'sprotective blanket of ozone, and depleting the earth's crust of natural resources. As a result, scientists andengineers are increasingly pursuing sustainable technologies so that costs associated with global warmingcan be minimized and adverse impact on living organisms can be prevented. A promising sustainablemethod is to harness energy from the wind via wind turbines. However, the noise generated by wind turbinesproves to be one of the most significant hindrances to the extensive use of wind turbines. In this study,noise generation produced by flow over objects is investigated to characterize the noise generated due toflow-structure interaction and aeroacoustics. As a benchmark, flow over a cylinder has been chosen for thisstudy, with the aim of correlating three main characteristics in noise generation. Hence, the generated soundpressure level, exergy destroyed and the normal flow velocity (∪ ∞ are employed to characterize the systemin order to relate the exergy destruction to the noise generated in the flow. The correlation has the potentialto be used in wind turbine designs to minimize noise pollution due to aerodynamic noise.

  17. Wind Turbine Blade Life-Time Assessment Model for Preventive Planning of Operation and Maintenance

    Directory of Open Access Journals (Sweden)

    Mihai Florian

    2015-09-01

    Full Text Available Out of the total wind turbine failure events, blade damage accounts for a substantial part, with some studies estimating it at around 23%. Current operation and maintenance (O&M practices typically make use of corrective type maintenance as the basic approach, implying high costs for repair and replacement activities as well as large revenue losses, mainly in the case of offshore wind farms. The recent development and evolution of condition monitoring techniques, as well as the fact that an increasing number of installed turbines are equipped with online monitoring systems, offers a large amount of information on the blades structural health to the decision maker. Further, inspections of the blades are often performed in connection with service. In light of the obtained information, a preventive type of maintenance becomes feasible, with the potential of predicting the blades remaining life to support O&M decisions for avoiding major failure events. The present paper presents a fracture mechanics based model for estimating the remaining life of a wind turbine blade, focusing on the crack propagation in the blades adhesive joints. A generic crack propagation model is built in Matlab based on a Paris law approach. The model is used within a risk-based maintenance decision framework to optimize maintenance planning for the blades lifetime.

  18. Review of soil contamination guidance

    International Nuclear Information System (INIS)

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

    1981-08-01

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

  19. [Informatics support for risk assessment and identification of preventive measures in small and micro-enterprises: occupational hazard datasheets].

    Science.gov (United States)

    de Merich, D; Forte, Giulia

    2011-01-01

    Risk assessment is the fundamental process of an enterprise's prevention system and is the principal mandatory provision contained in the Health and Safety Law (Legislative Decree 81/2008) amended by Legislative Decree 106/2009. In order to properly comply with this obligation also in small-sized enterprises, the appropriate regulatory bodies should provide the enterprises with standardized tools and methods for identifying, assessing and managing risks. To assist in particular small and micro-enterprises (SMEs) with risk assessment, by providing a flexible tool that can also be standardized in the form of a datasheet, that can be updated with more detailed information on the various work contexts in Italy. Official efforts to provide Italian SMEs with information may initially make use of the findings of research conducted by ISPESL over the past 20 years, thanks in part to cooperation with other institutions (Regions, INAIL-National Insurance Institute for Occupational Accidents and Diseases), which have led to the creation of an information system on prevention consisting of numerous databases, both statistical and documental ("National System of Surveillance on fatal and serious accidents", "National System of Surveillance on work-related diseases", "Sector hazard profiles" database, "Solutions and Best Practices" database, "Technical Guidelines" database, "Training packages for prevention professionals in enterprises" database). With regard to evaluation criteria applicable within the enterprise, the possibility of combining traditional and uniform areas of assessment (by sector or by risk factor) with assessments by job/occupation has become possible thanks to the cooperation agreement made in 2009 by ISPESL, the ILO (International Labour Organisation) of Geneva and IIOSH (Israel Institute for Occupational Health and Hygiene) regarding the creation of an international Database (HDODB) based on risk datasheets per occupation. The project sets out to assist in

  20. Gatekeepers of health: A qualitative assessment of child care centre staff's perspectives, practices and challenges to enteric illness prevention and management in child care centres

    Directory of Open Access Journals (Sweden)

    Adams Cindy L

    2008-06-01

    Full Text Available Abstract Background Enteric outbreaks associated with child care centres (CCC have been well documented internationally and in Canada. The current literature focuses on identifying potential risk factors for introduction and transmission of enteric disease, but does not examine why these risk factors happen, how the risk is understood and managed by the staff of CCCs, or what challenges they experience responding to enteric illness. The purpose of this study was to explore the understanding, knowledge and actions of CCC staff regarding enteric illness and outbreaks, and to identify challenges that staff encounter while managing them. Methods Focus groups were conducted with staff of regulated CCCs in Southern Ontario. Five focus groups were held with 40 participants. An open ended style of interviewing was used. Data were analyzed using content analysis. Results CCC staff play an important role in preventing and managing enteric illness. Staff used in-depth knowledge of the children, the centre and their personal experiences to assist in making decisions related to enteric illness. The decisions and actions may differ from guidance provided by public health officials, particularly when faced with challenges related to time, money, staffing and parents. Conclusion CCC staff relied on experience and judgment in coordination with public health information to assist decision-making in the management of enteric illness and outbreaks. Advice and guidance from public health officials to CCC staff needs to be consistent yet flexible so that it may be adapted in a variety of situations and meet regulatory and public health requirements.

  1. Guidance on future art commissioning.

    Science.gov (United States)

    2009-05-01

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

  2. Current materiality guidance for auditors

    OpenAIRE

    McKee, Thomas E.; Eilifsen, Aasmund

    2000-01-01

    Auditors have to make materiality judgments on every audit. This is a difficult process, as both quantitative and qualitative factors have to be evaluated. Additionally, there is no formal guidance for how to implement the materiality concepts discussed in the auditing standards. Although they are sometimes difficult to make, good materiality judgments are crucial for the conduct of a successful audit as poor judgments can result in an audit that is ineffective and/or inefficient. This report...

  3. 2011 Army Strategic Planning Guidance

    Science.gov (United States)

    2011-03-25

    TESI ) of 22,000 Soldiers, the Army’s total force by the end of the mid-term period is programmed to be 520K (AC). We will achieve a more...dwell ratios, extending TESI authority to adequately man deploying units and sustain the All-Volunteer Force, right-sizing the generating force, and... TESI Temporary End-Strength Increase WMD Weapons of Mass Destruction 2011 ARMY STRATEGIC PLANNING GUIDANCE Page 19 2011

  4. Vocational guidance in social volunteering

    Directory of Open Access Journals (Sweden)

    Nikolay S. Pryazhnikov

    2017-03-01

    Full Text Available The paper discusses the possibilities and limitations of vocational guidance in the social volunteering system. The essence of volunteer work is closely related with assistance to desperate people in searching for the meaning of living, often coinciding with labour activity that are deemed in terms of “the main matter of life” and “the leading activity”. For adolescents, it is the choice of career, and for adults, it is the work proper (i.e. an essential condition for personal self-realization. The problem of “forced volunteering” for experts in vocational guidance also means that they often have to work voluntarily and unselfishly outside the official guidelines. To clarify the terms «volunteer» and «a person in desperate need of help» the study used the method of analyzing the documents, e.g. the Regulations on Social Volunteering, the generalization of psychological sources, the initial survey of university students as active supporters of the volunteer movement, On the essence of volunteering and the place of career guidance in selfless social work. Vocational guidance is not excluded from the general system of volunteerism, but has an insufficiently defined status and low popularity among participants in social volunteering. Also, the problem of «forced volunteering» of experts in career counseling, which often requires voluntary and unselfish performance of quality work outside the framework of official instructions, is also indicated. Simultaneously, positive aspects of such disinterested career initiatives are noted, in particular, less control by the official inspectors (or customers and, accordingly, greater freedom of creativity than when someone else does the work.

  5. Visual guidance of mobile platforms

    Science.gov (United States)

    Blissett, Rodney J.

    1993-12-01

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

  6. Individual plant examination: Submittal guidance

    International Nuclear Information System (INIS)

    1989-08-01

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

  7. Quality Assurance in University Guidance Services

    Science.gov (United States)

    Simon, Alexandra

    2014-01-01

    In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

  8. Providing Career Guidance for Young Women.

    Science.gov (United States)

    Colby, Pamela G.

    This module is directed at personnel working or planning to work in the areas of guidance, counseling, placement and follow-through in junior and senior high school settings, grades 7-12. The module topic is career guidance for young women of junior and senior high school age, aand the focus will be on providing nonbiased career guidance which…

  9. Radionuclide Data Quality Evaluation Guidance

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  10. A proposed framework for conducting pollution prevention design assessments (P2DAs) on U.S. Department of Energy design projects

    International Nuclear Information System (INIS)

    Dorsey, J.A.

    1995-03-01

    The purpose of this manual is to provide a framework for project managers, engineers, and designers to integrate pollution prevention principles and features into DOE design projects. The framework suggested is referred to as the pollution prevention design assessment (P2DA). The P2DA is based on DOE's method for conducting pollution prevention opportunity assessments (PPOAs) on existing waste-generating operations, but the P2DA is modified because the facility or process it assesses does not physically exist during design. Before the P2DA framework is introduced in the manual, recommendations for establishing the P2DA team and budget are provided. Specific pollution prevention requirements and opportunities for each design stage as delineated in DOE Order 4700.1 Project Management System are also discussed and a sample format for drafting a P2DA report is provided in the appendix. The scope of this manual includes not only the P2DA framework, but also a background discussion of pollution prevention and related topics; the regulatory requirements mandating design for pollution prevention; the benefits and barriers of designing for pollution prevention; and the impact that pollution prevention and related environmental avoidance concepts have had on the engineering profession

  11. Assessing and managing body condition score for the prevention of metabolic disease in dairy cows.

    Science.gov (United States)

    Roche, John R; Kay, Jane K; Friggens, Nic C; Loor, Juan J; Berry, Donagh P

    2013-07-01

    Body condition score (BCS) is an assessment of a cow's body fat (and muscle) reserves, with low values reflecting emaciation and high values equating to obesity. The intercalving profile of BCS is a mirror image of the milk lactation profile. The BCS at which a cow calves, her nadir BCS, and the amount of BCS lost after calving are associated with milk production, reproduction, and health. Genetics, peripartum nutrition, and management are factors that likely interact with BCS to determine the risk of health disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Expert assessment of preventive measures in the zone of guaranteed voluntary resettlement.

    Science.gov (United States)

    Ozerova, I I; Prilipko, V A; Myshkovska, A A

    2013-01-01

    An expert evaluation of preventive measures focused on population health maintenance in the zone of guaranteed voluntary resettlement taking into account the limitations of the provisions of certain articles of the Law of Ukraine on the clean-up of the Chornobyl disaster aftermath. The research survey was applied using a peer review method. The three-level (national, regional, district) expert workgroup was involved been employed within recovery of the Chornobyl disaster aftermath. Professional experience of minimum 10 years, corresponding profile and current position were the requirements for selection. A simple streamlining the values of paired or consistent comparison was applied on the primary empirical data. The arrangements made in recent years by the Cabinet of Ministers of Ukraine and ministries engaged in clean-up and recovery from the Chornobyl nuclear power plant accident are ineffective. Costs from the Fund for the implementation of measures to clean-up the consequences of the Chornobyl disaster and social protection are reduced. There is no consensus among experts regarding some constraint of an action of certain articles of the Law of Ukraine "On the status and social protection of citizens affected by the Chornobyl disaster" on the principles of social protection and healthcare of the population living in contaminated areas. In addressing the social and health consequences of the Chornobyl disaster the Verkhovna Rada of Ukraine just for a long time has passes no amendment to the legislation on the subject. At that there are several restrictions in force for a large number of articles of the existing laws that were adopted in 1991. The mentioned above exacerbates social strain and destroys the "citizen-state relationship". The extreme need has emerged in a comprehensive public review of existing laws with involvement of multidisciplinary group of experts to a "round table" to justify the draft laws. Ozerova Ju. Ju., Prylypko V. A., Myshkovska A. A

  13. Disk battery ingestion: case series with assessment of clinical and financial impact of a preventable disease.

    Science.gov (United States)

    Panella, Nicholas J; Kirse, Daniel J; Pranikoff, Thomas; Evans, Adele K

    2013-02-01

    Commonly, foreign objects are incidentally ingested and pass harmlessly through the gastrointestinal tract; however, disk batteries present exceptional risk. In 2009, the American Association of Poison Control Centers listed disk batteries as the number 1 cause of fatal ingestions in children younger than 5 years. Lithium batteries are the most dangerous, and they are rapidly rising in use by manufacturers. Paralleling that rise, there has been a 6.7-fold increase in major or fatal outcomes between 1985 and 2009. This study describes the variability in patient presentations, the courses of patients' evaluations, and the clinical and financial consequences of disk battery ingestion. In this retrospective study, cases from 2001 to 2011 were reviewed for details of care for disk battery ingestions including presentation and management details. Cost of care information from our patients' records was compared with that of national averages on esophageal foreign bodies using the Healthcare Cost and Utilization Project's Kids' Inpatient Database. Six cases are presented. The patients' age averaged 1.85 years. Presentations varied with respect to symptoms, time course, and steps in treatment. Mean length of stay was 9.0 days, and mean cost was $14,994. Emergency medicine physicians, otolaryngologists, radiologists, gastroenterologists, and pediatric surgeons may be able to mitigate, albeit not entirely prevent, potential serious complications in patients with disk battery ingestions by proper diagnosis and timely treatment. Recommendations for management are presented, which highlight the need for emergent removal of any battery that is lodged and close follow-up of these patients once they are out of the hospital.

  14. Indicators to assess the quality of programs to prevent occupational risk for tuberculosis: are they feasible?

    Science.gov (United States)

    Santos, Talita Raquel Dos; Padoveze, Maria Clara; Nichiata, Lúcia Yasuko Izumi; Takahashi, Renata Ferreira; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins

    2016-06-07

    to analyze the feasibility of quality indicators for evaluation of hospital programs for preventing occupational tuberculosis. a descriptive cross-sectional study. We tested indicators for evaluating occupational tuberculosis prevention programs in six hospitals. The criterion to define feasibility was the time spent to calculate the indicators. time spent to evaluate the indicators ranged from 2h 52min to 15h11min 24sec. The indicator for structure evaluation required less time; the longest time was spent on process indicators, including the observation of healthcare workers' practices in relation to the use of N95 masks. There was an hindrance to test one of the indicators for tuberculosis outcomes in five situations, due to the lack of use of tuberculin skin test in these facilities. The time requires to calculate indicators in regarding to the outcomes for occupational tuberculosis largely depends upon the level of organizational administrative structure for gathering data. indicators to evaluate the structure for occupational tuberculosis prevention are highly feasible. Nevertheless, the feasibility of indicators for process and outcome is limited due to relevant variations in administrative issues at healthcare facilities. analisar a viabilidade de indicadores de qualidade para avaliação de programas hospitalares de prevenção de tuberculose ocupacional. estudo descritivo transversal. Testaram-se indicadores de avaliação de programas de prevenção de tuberculose ocupacional em seis hospitais. O critério para definir a viabilidade foi o tempo necessário para aplicar os indicadores. o tempo necessário para avaliar os indicadores variou de 02'52'' até 15h11'24''. O indicador para a avaliação da estrutura demandou menor tempo; o maior tempo foi utilizado com os indicadores de processo, incluindo a observação das práticas dos trabalhadores de saúde em relação ao uso de máscaras N95. Um dos indicadores de resultados de tuberculose deixou de ser

  15. Assessment and prevention of acute health effects of weather conditions in Europe, the PHEWE project: background, objectives, design

    Directory of Open Access Journals (Sweden)

    Anderson Hugh

    2007-04-01

    Full Text Available Abstract Background The project "Assessment and prevention of acute health effects of weather conditions in Europe" (PHEWE had the aim of assessing the association between weather conditions and acute health effects, during both warm and cold seasons in 16 European cities with widely differing climatic conditions and to provide information for public health policies. Methods The PHEWE project was a three-year pan-European collaboration between epidemiologists, meteorologists and experts in public health. Meteorological, air pollution and mortality data from 16 cities and hospital admission data from 12 cities were available from 1990 to 2000. The short-term effect on mortality/morbidity was evaluated through city-specific and pooled time series analysis. The interaction between weather and air pollutants was evaluated and health impact assessments were performed to quantify the effect on the different populations. A heat/health watch warning system to predict oppressive weather conditions and alert the population was developed in a subgroup of cities and information on existing prevention policies and of adaptive strategies was gathered. Results Main results were presented in a symposium at the conference of the International Society of Environmental Epidemiology in Paris on September 6th 2006 and will be published as scientific articles. The present article introduces the project and includes a description of the database and the framework of the applied methodology. Conclusion The PHEWE project offers the opportunity to investigate the relationship between temperature and mortality in 16 European cities, representing a wide range of climatic, socio-demographic and cultural characteristics; the use of a standardized methodology allows for direct comparison between cities.

  16. Benefit–risk assessment of rivaroxaban versus enoxaparin for the prevention of venous thromboembolism after total hip or knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Levitan B

    2014-03-01

    Full Text Available Bennett Levitan,1 Zhong Yuan,1 Alexander GG Turpie,2 Richard J Friedman,3 Martin Homering,4 Jesse A Berlin,1 Scott D Berkowitz,5 Rachel B Weinstein,1 Peter M DiBattiste61Janssen Research & Development, LLC, Titusville, NJ, USA; 2Hamilton Health Sciences McMaster Clinic, McMaster University, Hamilton, ON, Canada; 3Charleston Orthopaedic Associates, Charleston, SC, USA; 4Bayer HealthCare, Berlin, Germany; 5Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA; 6Janssen Research & Development, Raritan, NJ, USAPurpose: Venous thromboembolism is a common complication after major orthopedic surgery. When prescribing anticoagulant prophylaxis, clinicians weigh the benefits of thromboprophylaxis against bleeding risk and other adverse events. Previous benefit–risk analyses of the REgulation of Coagulation in ORthopaedic surgery to prevent Deep vein thrombosis and pulmonary embolism (RECORD randomized clinical studies of rivaroxaban versus enoxaparin after total hip (THA or knee (TKA arthroplasty generally used pooled THA and TKA results, counted fatal bleeding as both an efficacy and a safety event, and included the active and placebo-controlled portions of RECORD2, which might confound benefit–risk assessments. We conducted a post hoc analysis without these constraints to assess benefit–risk for rivaroxaban versus enoxaparin in the RECORD studies.Patients and methods: Data from the safety population of the two THA and two TKA studies were pooled separately. The primary analysis compared the temporal course of event rates and rate differences between rivaroxaban and enoxaparin prophylaxis for symptomatic venous thromboembolism plus all-cause mortality (efficacy events versus nonfatal major bleeding (safety events. Additionally, these rates were used to derive measures of net clinical benefit, number needed to treat (NNT, and number needed to harm (NNH for these two end points.Results: After THA or TKA, and compared with enoxaparin, rivaroxaban

  17. A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes.

    Science.gov (United States)

    Trogrlić, Zoran; van der Jagt, Mathieu; Bakker, Jan; Balas, Michele C; Ely, E Wesley; van der Voort, Peter H J; Ista, Erwin

    2015-04-09

    Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize what types of implementation strategies have been tested to improve ICU clinicians' ability to effectively assess, prevent and treat delirium and to evaluate the effect of these strategies on clinical outcomes. We searched PubMed, Embase, PsychINFO, Cochrane and CINAHL (January 2000 and April 2014) for studies on implementation strategies that included delirium-oriented interventions in adult ICU patients. Studies were suitable for inclusion if implementation strategies' efficacy, in terms of a clinical outcome, or process outcome was described. We included 21 studies, all including process measures, while 9 reported both process measures and clinical outcomes. Some individual strategies such as "audit and feedback" and "tailored interventions" may be important to establish clinical outcome improvements, but otherwise robust data on effectiveness of specific implementation strategies were scarce. Successful implementation interventions were frequently reported to change process measures, such as improvements in adherence to delirium screening with up to 92%, but relating process measures to outcome changes was generally not possible. In meta-analyses, reduced mortality and ICU length of stay reduction were statistically more likely with implementation programs that employed more (six or more) rather than less implementation strategies and when a framework was used that either integrated current evidence on pain, agitation and delirium management (PAD) or when a strategy of early awakening, breathing, delirium screening and early exercise (ABCDE bundle) was employed. Using implementation strategies aimed at organizational change, next to behavioral change, was also associated with reduced mortality

  18. New IAEA guidance on safety culture

    International Nuclear Information System (INIS)

    Haage, Monica; )

    2012-01-01

    Monica Haage described a project for Kozloduy Nuclear Power Plant in Bulgaria which was also funded by the Norwegian government. This project included the development of guidance documents and training on self-assessment and continuous improvement of safety culture. A draft IAEA safety culture survey was also developed as part of this project in collaboration with St Mary's University, Canada. This project was conducted in parallel with an IAEA project to develop new safety reports on safety culture self-assessment and continuous improvement. A safety report on safety culture during the pre-operational phases of NPPs has also been drafted. The IAEA approach to safety culture assessment was outlined and core principles of the approach were discussed. These include the use of several assessment methods (survey, interview, observation, focus groups, document review), and two distinct levels of analysis. The first is a descriptive analysis of the observed cultural characteristics from each assessment method and overarching themes. This is followed by a 'normative' analysis comparing what has been observed with the desirable characteristics of a strong, positive, safety culture, as defined by the IAEA safety culture framework. The application of this approach during recent Operational Safety Assessment Review Team (OSART) missions was described along with key learning points

  19. Guidance documents relating to landfills and contaminants

    Energy Technology Data Exchange (ETDEWEB)

    Schomaker, N.B.; Zunt, D.A.

    1990-01-01

    The Environmental Protection Agency is developing and updating a series of Technical Guidance Documents to provide best engineering control technology to meet the needs of the Resource Conservation and Recovery Act (RCRA) and the Comprehensive Environmental Response Compensation and Liability Act (CERCLA), respectively. These documents are the compilation of the research efforts to date relating to containment of pollutants from waste disposal to the land as relates to residuals management. The specific areas of research being conducted under the RCRA land disposal program relates to laboratory, pilot and field validation studies in cover systems, waste leaching and solidification, liner systems and disposal facility evaluation. The specific areas of research being conducted under the CERCLA uncontrolled waste sites (Superfund) program relate to in situ treatment, solidification/stabilization for treating hazardous waste, combustion technologies, best demonstrated available technology (BDAT), on-site treatment technologies, emerging biosystems, expert systems, personnel health protection equipment, and site and situation assessment. The Guidance Documents are intended to assist both the regulated community and the permitting authorities, as well as the Program Offices, and Regions, as well as the states and other interested parties, with the latest information relevant to waste management.

  20. A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Daniele Franchi

    2011-02-01

    Full Text Available Daniele Franchi1,2, Davide Cini1, Giorgio Iervasi11Istituto di Fisiologia Clinica, CNR, Pisa, Italy; 2Dipartimento di Oncologia, dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, ItalyBackground: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient's data collection represents a critical issue.Design: A new multipurpose computer-based program has been developed in order to:1 easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2 to design a web-based computerized tool for prospective collection of structured data; 3 to support the doctor in the decision-making process for patients at risk according to recent international guidelines.Methods: During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient's data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient's goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report.Results: In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [± SD] the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values.Conclusion: The web-based system proposed here may represent a feasible and

  1. Strengthening the perception-assessment tools for dengue prevention: a cross-sectional survey in a temperate region (Madeira, Portugal).

    Science.gov (United States)

    Nazareth, Teresa; Teodósio, Rosa; Porto, Graça; Gonçalves, Luzia; Seixas, Gonçalo; Silva, Ana Clara; Sousa, Carla Alexandra

    2014-01-15

    Community participation is mandatory in the prevention of Dengue outbreaks. Taking public views into account is crucial to guide more effective planning and quicker community participation in preventing campaigns. This study aims to assess community perceptions of Madeira population in order to explore their involvement in the A. aegypti's control and reinforce health-educational planning. Due to the lack of accurate methodologies for measuring perception, a new tool to assess the community's perceptions was built. A cross-sectional survey was performed in the Island's aegypti-infested area, exploring residents' perceptions regarding most critical community behaviour: aegypti-source reduction and their domestic aegypti-breeding sites. A novel tool defining five essential topics which underlie the source reduction's awareness and accession was built, herein called Essential-Perception (EP) analysis. Of 1276 individuals, 1182 completed the questionnaire (92 · 6%). EP-Score analysis revealed that community's perceptions were scarce, inconsistent and possibly incorrect. Most of the population (99 · 6%) did not completely understood the five essential topics explored. An average of 54 · 2% of residents only partially understood each essential topic, revealing inconsistencies in their understanding. Each resident apparently believed in an average of four false assumptions/myths. Significant association (p<0.001) was found between both the EP-Score level and the domestic presence of breeding sites, supporting the validity of this EP-analysis. Aedes aegypti's breeding sites, consisting of décor/leisure containers, presented an atypical pattern of infestation comparing with dengue prone regions. The studied population was not prepared for being fully engaged in dengue prevention. Evidences suggest that EP-methodology was efficient and accurate in assessing the community perception and its compliance to practices. Moreover, it suggested a list of myths that

  2. Comparison of ISO 9000 and recent software life cycle standards to nuclear regulatory review guidance

    International Nuclear Information System (INIS)

    Preckshot, G.G.; Scott, J.A.

    1998-01-01

    Lawrence Livermore National Laboratory is assisting the Nuclear Regulatory Commission with the assessment of certain quality and software life cycle standards to determine whether additional guidance for the U.S. nuclear regulatory context should be derived from the standards. This report describes the nature of the standards and compares the guidance of the standards to that of the recently updated Standard Review Plan

  3. 77 FR 39498 - Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection...

    Science.gov (United States)

    2012-07-03

    ...] Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection Devices Applied... Clinical Performance Assessment: Considerations for Computer-Assisted Detection Devices Applied to... guidance, entitled ``Computer-Assisted Detection Devices Applied to Radiology Images and Radiology Device...

  4. Unified State Plan for Guidance, Counseling and Placement in Colorado. Grades K-6.

    Science.gov (United States)

    Terrill, Jerry; And Others

    This guide, one of three units in the Colorado state plan for guidance program development, is written for educators as both a guideline and a needs assessment instrument to assist in the identification of deficit areas in school guidance programs. In a beginning section, this unit for the elementary years provides a brief philosophy of elementary…

  5. 76 FR 59142 - Guidance for Industry on Reproductive and Developmental Toxicities-Integrating Study Results To...

    Science.gov (United States)

    2011-09-23

    ... of study results to assess concerns about human reproductive and developmental toxicities. It does... assist that office in processing your requests. See the SUPPLEMENTARY INFORMATION section for electronic access to the guidance document. Submit electronic comments on the guidance to http://www.regulations.gov...

  6. Cancer prevention awareness among young adult Polish females on the basis of the assessment of knowledge and health behaviours

    Directory of Open Access Journals (Sweden)

    Grażyna R. Wiraszka

    2016-07-01

    Full Text Available Introduction: The accelerating rate of incidence of malignant cancers in Polish women as compared to men and the higher mortality due to these diseases as compared to other regions in Europe is an important medical and social problem. Aim of the research : To attempt an assessment of cancer prevention awareness among young adult Polish females on the basis of the analysis of their knowledge as well as of the prevalence of negative health behaviours. Material and methods : The study was conducted in 270 young Polish females: students of nursing and pedagogy. The study was conducted using a proprietary questionnaire, the Inventory of Health Behaviour, the Fagerström Test for Nicotine Dependence, and Nina Schenider’s Motivation for Quitting Smoking Test. Results : The highest percentages of negative behaviours included low intake of fruit and vegetables (76.3%, whole-grain products (78.9%, and fish (93.3%, as well as tanning (56.7% and smoking (37% and health check behaviours (breast self-exams 60.7%, cervical cytological screening 36%. Conclusions: Despite the relatively high level of knowledge, cancer risk-related lifestyles and behaviours unfavourable for the possibility of early diagnosis were observed among the subjects. The less favourable model of cognitive and behavioural competence in health and cancer prevention was observed at bachelor-level students of pedagogy at the ages below 24 years. Development of skills and motivation for pro-health behaviours and the awareness of behaviour models presented by educators are, along with appropriate knowledge, the most desirable strategies for the success of health education in the area of cancer prevention.

  7. [Assessment of disinfection and sterilization processes in dental practice as an important factors in prevention of infections].

    Science.gov (United States)

    Podgórska, Marta; Jakimiak, Bozenna; Röhm-Rodowald, Ewa; Chojecka, Agnieszka

    2009-01-01

    The dental health-care settings is an environment where disease transmission occurs easily. Prevention of cross infection is therefore a crucial aspect of dental practice and dental clinic stuffmust adopt certain basic routines while practicing. Infections may be transmitted in the dental operatory through direct contact with blood, oral fluids or other secretions; via indirect contact with contaminated instruments, equipment or environmental surfaces; or by contact with airborne contaminants present in either droplet splatter or aerosols of oral and respiratory fluids. Strategies to prevent dental patient infections have focused on disinfection and sterilization. This study evaluates basic routines in prevention of cross-infection in the dentistry. The sample comprised 100 dentists, who completed questionnaires. Based on inquires the conditions for disinfection and sterilization of medical devices were assessed. The following issues were taken into consideration: the way of disinfection and preparation of the disinfectants, the localization of disinfection, preparing to disinfection, washing and packing of dental devices, the frequency of disinfection, methods of sterilization and the monitoring system, type of sterilizers and the available cycles. The dental practices are well equiped to proceed the steam sterilization, but 33% of dentists don't know the available cycles in their autoclaves. Only 35% of them made sterilization process protocols. Very common are three failures of instruments disinfections: multiple use of disinfectant, adding of disinfectant, adding new instruments. There is still need for improvement in disinfection and sterilization in dental practice, especially including: monitoring and documentation of sterilization process, proper use of disinfectants according to manufactures instructions, frequent disinfection of surfaces which contact with patients. Dental stuff should take part in advanced training courses about disinfection and

  8. Assessment of Web-based education resources informing patients about stroke prevention in atrial fibrillation.

    Science.gov (United States)

    Pandya, E; Bajorek, B V

    2016-12-01

    risk and/or bleeding risk within the decision-making. At the 'latent-level' analysis, three overarching themes emerged: (i) The practical ease of managing NOACs over warfarin; (ii) Unbalanced explanation about stroke risk versus bleeding risk; and (iii) Individualized antithrombotic therapy selection. In general, the benefit of stroke prevention with anticoagulant use was emphasized less compared to the risk of bleeding. Overall, one in four resources had an implied preference for either warfarin or the NOACs. The implied inclination of some resources towards particular anticoagulant therapies and imbalanced information about the importance of anticoagulation in AF might misinform and confuse patients. Patients' engagement in shared decision-making and adherence to medicines may be undermined by the suboptimal quality of information provided in the resources. Health professionals have an important role to play in referring patients to appropriate resources to enable patient engagement in shared decision-making when selecting treatment. © 2016 John Wiley & Sons Ltd.

  9. "The Dangerous Age of Childhood": Child Guidance and the "Normal" Child in Great Britain, 1920-1950

    Science.gov (United States)

    Stewart, John

    2011-01-01

    British child guidance was a form of psychiatric, preventive medicine for children and young people and centred, at least in principle, on specialist clinics led by psychiatrists. From small beginnings in the aftermath of the First World War, child guidance expanded steadily, in terms of both numbers of patients and numbers of clinics, and came to…

  10. Psychometrics of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults.

    Science.gov (United States)

    Tomita, Machiko R; Saharan, Sumandeep; Rajendran, Sheela; Nochajski, Susan M; Schweitzer, Jo A

    2014-01-01

    OBJECTIVE. To identify psychometric properties of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults. METHOD. We tested content validity, test-retest reliability, interrater reliability, construct validity, convergent and discriminant validity, and responsiveness to change. RESULTS. The content validity index was .98, the intraclass correlation coefficient for test-retest reliability was .97, and the interrater reliability was .89. The difference on identified risk factors between the use and nonuse of the HSSAT was significant (p = .005). Convergent validity with the Centers for Disease Control and Prevention Home Safety Checklist was high (r = .65), and discriminant validity with fear of falling was very low (r = .10). The responsiveness to change was moderate (standardized response mean = 0.57). CONCLUSION. The HSSAT is a reliable and valid instrument to identify fall risks in a home environment, and the HSSAT booklet is effective as educational material leading to improvement in home safety. Copyright © 2014 by the American Occupational Therapy Association, Inc.

  11. Packaging waste prevention in the distribution of fruit and vegetables: An assessment based on the life cycle perspective.

    Science.gov (United States)

    Tua, Camilla; Nessi, Simone; Rigamonti, Lucia; Dolci, Giovanni; Grosso, Mario

    2017-04-01

    In recent years, alternative food supply chains based on short distance production and delivery have been promoted as being more environmentally friendly than those applied by the traditional retailing system. An example is the supply of seasonal and possibly locally grown fruit and vegetables directly to customers inside a returnable crate (the so-called 'box scheme'). In addition to other claimed environmental and economic advantages, the box scheme is often listed among the packaging waste prevention measures. To check whether such a claim is soundly based, a life cycle assessment was carried out to verify the real environmental effectiveness of the box scheme in comparison to the Italian traditional distribution. The study focused on two reference products, carrots and apples, which are available in the crate all year round. An experience of a box scheme carried out in Italy was compared with some traditional scenarios where the product is distributed loose or packaged at the large-scale retail trade. The packaging waste generation, 13 impact indicators on environment and human health and energy consumptions were calculated. Results show that the analysed experience of the box scheme, as currently managed, cannot be considered a packaging waste prevention measure when compared with the traditional distribution of fruit and vegetables. The weaknesses of the alternative system were identified and some recommendations were given to improve its environmental performance.

  12. [Assessment and training of strength and balance for fall prevention in the elderly: recommendations of an interdisciplinary expert panel].

    Science.gov (United States)

    Granacher, U; Muehlbauer, T; Gschwind, Y J; Pfenninger, B; Kressig, R W

    2014-08-01

    The proportion of elderly people in societies of western industrialized countries is continuously rising. Biologic aging induces deficits in balance and muscle strength/power in old age, which is responsible for an increased prevalence of falls. Therefore, nationwide and easy-to-administer fall prevention programs have to be developed in order to contribute to the autonomy and quality of life in old age and to help reduce the financial burden on the public health care system due to the treatment of fall-related injuries. This narrative (qualitative) literature review deals with a) the reasons for an increased prevalence of falls in old age, b) important clinical tests for fall-risk assessment, and c) evidence-based intervention/training programs for fall prevention in old age. The findings of this literature review are based on a cost-free practice guide that is available to the public (via the internet) and that was created by an expert panel (i.e., geriatricians, exercise scientists, physiotherapists, geriatric therapists). The present review provides the scientific foundation of the practice guide.

  13. [Empowerment in prevention and health promotion--a critical conceptual evaluation of basic understanding, dimensions and assessment problems].

    Science.gov (United States)

    Kliche, T; Kröger, G

    2008-12-01

    Empowerment is an important concept in health care, but despite its prevalence it seems to be more of a buzz word. Thus, a conceptual review on empowerment in prevention and health promotion was carried out. 62 German and international theoretical contributions, reviews and studies were incorporated, covering the fields of prevention, care and therapy, rehabilitation, health-care research, nursing and work-related stress. The analysis revealed eight main dimensions of empowerment: (1) shared decision-making, (2) self-efficacy, (3) social support and social capital, (4) skills and competences, (5) health care utilisation, (6) goal setting and attainment, (7) reflexive thought and (8) innovation. Their empirical assessment can be carried out on a micro-, meso-, or macro-level. Three distinct basic conceptual notions emerged from the analysis, each applying its own specific research questions and measurement instruments: clinical, organizational-professional and political understanding of "empowerment". Therefore, these three specific conceptual notions should each be developed and tested separately, in particular in reviews, and empirical studies should embrace all eight subdimensions.

  14. Assessment of the presence and quality of osteoporosis prevention education among at-risk internal medicine patients.

    Science.gov (United States)

    Shulha, Jennifer A; Sviggum, Cortney B; O'Meara, John G; Berg, Melody L

    2014-01-01

    Appropriate calcium and vitamin D intake for the prevention of osteoporosis represents an important component of osteoporosis prevention education (OPE). We sought to assess the presence and quality of OPE among osteoporotic and at-risk inpatients. Prospective chart review plus cross-sectional interview. One academic tertiary referral medical center in Rochester, Minnesota. Adults admitted to an inpatient medicine service who were determined to be at risk for osteoporosis based on an investigator-developed screening tool or previously diagnosed with osteoporosis. Four hundred sixtyfour patients were screened, 192 patients were approached for participation, and 150 patients consented to be interviewed for the study. Source of OPE, rates of appropriate calcium intake and supplementation. OPE from a health care provider was reported by 31.3% of patients, with only one patient reporting education from a pharmacist. Self OPE and no OPE were received by 29.3% and 39.3% of patients, respectively. Appropriate overall calcium intake was found in 30.7% of patients, and only 21.3% of patients were taking an appropriate calcium salt. Patients with osteoporosis and risk factors for osteoporosis lack adequate education from health care providers regarding appropriate intake of dietary and supplemental calcium and vitamin D. A particular deficit was noted in pharmacist-provided education. Specific education targeting elemental calcium amounts, salt selection, and vitamin D intake should be provided to increase the presence of appropriate overall calcium consumption.

  15. The use of administrative sanctions to prevent environmental damage in impact assessment follow-ups.

    Science.gov (United States)

    Garcia, Luiz Carlos; Fonseca, Alberto

    2018-08-01

    Scholars have long been highlighting the value of administrative sanctions in improving environmental policy enforcement. However, few studies have evaluated how such sanctions are implemented, particularly in the context of environmental impact assessments (EIA) and their respective follow-up programs. The main objective of this article was to evaluate how administrative sanctions have been used in EIA follow-ups, using the Brazilian state of Minas Gerais as the empirical context. More specifically it tried to understand what have been the main triggers, frequency, nature and financial values of the sanctions issued to noncompliant mining projects operating under the conditions of environmental licenses. First, through literature reviews, the study characterized the institutional and regulatory framework in which administrative sanctions are applied. Content analyzes of 29 infraction processes further revealed that lump sum fines are the preferred option of administrative sanction in EIA follow-ups. The analysis also revealed that the fines could be perceived as disproportionally small if one considers the size and financial power of non-compliant companies. The great majority of the fines were paid by developers: a fact that contradicts previous empirical findings and anecdotal evidence in Brazil. Overall, the study suggests that the impact of administrative sanctions in corporate behavior, while unclear, is likely small. The study concludes by discussing practical and academic implications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Complication assessment and prevention strategies using midfoot fusion bolt for medial column stabilization in Charcot's osteoarthropathy

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander T; Walther, Markus; Iblher, Niklas

    2016-01-01

    and stabilization using midfoot fusion bolt and lateral lag screws. Age, gender, presence of preoperative osteomyelitis or ulcer, number of complications and operative revisions, Hba1c value, consolidation of arthrodesis, presence of a load-bearing foot and period to bolt dislocation was assessed. The mean follow......-up was 21.4±14.6 (mean±SDM) months, 64% of patients suffered from diabetes with a preoperative Hba1c of 8.5±2.4. The mean number of revisions per foot was 3.6±4.1. Bolt dislocation was seen in 57% of the patients following 11.3±8.5 months; in 75% of these patients bony healing occurred before dislocation....... There was a significant association between preoperative increased Hba1c value, presence of preoperative ulcer and wound infection. Healing of arthrodesis was demonstrated in 57% and a permanent weight-bearing foot without recurrent ulcer was achieved in 79%. The early and late postoperative complications could...

  17. [Assessment of nutritional education and iron supplement impact on prevention of pregnancy anemia].

    Science.gov (United States)

    Parra, Beatriz Elena; Manjarrés, Luz Mariela; Gómez, Alba Lucía; Alzate, Dora María; Jaramillo, María Clemencia

    2005-06-01

    Iron and folic acid deficiencies are the major causes of health problems among pregnant women and children, with a significant negative impact on economic and social development. From April 2002 to April 2003 at the Gilberto Mejía Mejía Hospital (Rionegro, Antioquia), the prenatal program was assessed for its impact on a cohort of pregnant women concerning knowledge of the following nutritional parameters: iron and folic acid functions, their source foods and bioavailability, supplement intake and tolerance, and globular indexes. A sample of 42 pregnant women was subjected to a nutritional education program along with the administration of a supplement consisting of 60 mg elemental iron, 400 microg folic acid, and 70 mg vitamin C. This formulation was prepared specifically for the study by Laboratorio Profesional Farmacéutico, LAPROFF. The effect of the educational program was measured by knowledge changes about how patient behaviours affect nutrient bioavailability via source foods intake, as well as recognition of the tolerance limits of supplements and potential effect of non-adherance. The physiological status of each patient was measured by three hematologic variables--hemoglobin, hematocrit, and ferritin. A positive understanding of how to improve nutritional practices was observed. With the supplements, 94.4% of women did not show anaemia at the end of pregnancy. These results agree with those in other, similar populations and indicate that implementation of prenatal control programs by educational and supplement administration is worthwhile.

  18. Discussing Firearm Ownership and Access as Part of Suicide Risk Assessment and Prevention: "Means Safety" versus "Means Restriction".

    Science.gov (United States)

    Stanley, Ian H; Hom, Melanie A; Rogers, Megan L; Anestis, Michael D; Joiner, Thomas E

    2017-01-01

    The goal of this study was to describe the relative utility of the terms "means safety" versus "means restriction" in counseling individuals to limit their access to firearms in the context of a mock suicide risk assessment. Overall, 370 participants were randomized to read a vignette depicting a clinical scenario in which managing firearm ownership and access was discussed either using the term "means safety" or "means restriction." Participants rated the term "means safety" as significantly more acceptable and preferable than "means restriction." Participants randomized to the "means safety" condition reported greater intentions to adhere to clinicians' recommendations to limit access to a firearm for safety purposes (F[1,367] = 7.393, p = .007, [Formula: see text]). The term "means safety" may be more advantageous than "means restriction" when discussing firearm ownership and access in clinical settings and public health-oriented suicide prevention efforts.

  19. 78 FR 4848 - Social Media: Consumer Compliance Risk Management Guidance

    Science.gov (United States)

    2013-01-23

    ...: Consumer Compliance Risk Management Guidance AGENCY: Federal Financial Institutions Examination Council... Media: Consumer Compliance Risk Management Guidance'' (guidance). Upon completion of the guidance, and... management practices adequately address the consumer compliance and legal risks, as well as related risks...

  20. Pulsed magnetic fields and their assessment according to the accident prevention regulation BGV B11; Gepulste magnetische Felder und Ihre Bewertung nach der Unfallverhuetungsvorschrift BGV B11

    Energy Technology Data Exchange (ETDEWEB)

    Heinrich, H. [2h-engineering, Hausen (Germany)

    2004-07-01

    The accident prevention regulation BGV B11 - Electromagnetic Fields - contains a method for the assessment of pulsed fields. This paper gives valuable hints and background information and presents a new tool for the computer-based assessment of these fields. (orig.)

  1. Assessing effects of a media campaign on HIV/AIDS awareness and prevention in Nigeria: results from the VISION Project.

    Science.gov (United States)

    Keating, Joseph; Meekers, Dominique; Adewuyi, Alfred

    2006-05-03

    In response to the growing HIV epidemic in Nigeria, the U.S. Agency for International Development (USAID) initiated the VISION Project, which aimed to increase use of family planning, child survival, and HIV/AIDS services. The VISION Project used a mass-media campaign that focused on reproductive health and HIV/AIDS prevention. This paper assesses to what extent program exposure translates into increased awareness and prevention of HIV/AIDS. This analysis is based on data from the 2002 and 2004 Nigeria (Bauchi, Enugu, and Oyo) Family Planning and Reproductive Health Surveys, which were conducted among adults living in the VISION Project areas. To correct for endogeneity, two-stage logistic regression is used to investigate the effect of program exposure on 1) discussion of HIV/AIDS with a partner, 2) awareness that consistent condom use reduces HIV risk, and 3) condom use at last intercourse. Exposure to the VISION mass media campaign was high: 59%, 47%, and 24% were exposed to at least 1 VISION radio, printed advertisement, or TV program about reproductive health, respectively. The differences in outcome variables between 2002 baseline data and the 2004 follow-up data were small. However, those with high program exposure were almost one and a half (Odds Ratio [O.R.] = 1.47, 95% Confidence Interval [C.I.] 1.01-2.16) times more likely than those with no exposure to have discussed HIV/AIDS with a partner. Those with high program exposure were over twice (O.R. = 2.20, C.I. 1.49-3.25) as likely as those with low exposure to know that condom use can reduce risk of HIV infection. Program exposure had no effect on condom use at last sex. The VISION Project reached a large portion of the population and exposure to mass media programs about reproductive health and HIV prevention topics can help increase HIV/AIDS awareness. Programs that target rural populations, females, and unmarried individuals, and disseminate information on where to obtain condoms, are needed to reduce

  2. Assessing effects of a media campaign on HIV/AIDS awareness and prevention in Nigeria: results from the VISION Project

    Directory of Open Access Journals (Sweden)

    Adewuyi Alfred

    2006-05-01

    Full Text Available Abstract Background In response to the growing HIV epidemic in Nigeria, the U.S. Agency for International Development (USAID initiated the VISION Project, which aimed to increase use of family planning, child survival, and HIV/AIDS services. The VISION Project used a mass-media campaign that focused on reproductive health and HIV/AIDS prevention. This paper assesses to what extent program exposure translates into increased awareness and prevention of HIV/AIDS. Methods This analysis is based on data from the 2002 and 2004 Nigeria (Bauchi, Enugu, and Oyo Family Planning and Reproductive Health Surveys, which were conducted among adults living in the VISION Project areas. To correct for endogeneity, two-stage logistic regression is used to investigate the effect of program exposure on 1 discussion of HIV/AIDS with a partner, 2 awareness that consistent condom use reduces HIV risk, and 3 condom use at last intercourse. Results Exposure to the VISION mass media campaign was high: 59%, 47%, and 24% were exposed to at least 1 VISION radio, printed advertisement, or TV program about reproductive health, respectively. The differences in outcome variables between 2002 baseline data and the 2004 follow-up data were small. However, those with high program exposure were almost one and a half (Odds Ratio [O.R.] = 1.47, 95% Confidence Interval [C.I.] 1.01–2.16 times more likely than those with no exposure to have discussed HIV/AIDS with a partner. Those with high program exposure were over twice (O.R. = 2.20, C.I. 1.49–3.25 as likely as those with low exposure to know that condom use can reduce risk of HIV infection. Program exposure had no effect on condom use at last sex. Conclusion The VISION Project reached a large portion of the population and exposure to mass media programs about reproductive health and HIV prevention topics can help increase HIV/AIDS awareness. Programs that target rural populations, females, and unmarried individuals, and

  3. A Quasi-experimental Study to Assess an Interactive Educational Intervention on Nurses' Knowledge of Pressure Ulcer Prevention in Nigeria.

    Science.gov (United States)

    Ekama Ilesanmi, Rose; Morohunfoluwa Oluwatosin, Odunayo

    2016-04-01

    Educational intervention programs are an important element to improve nurses' knowledge of pressure ulcer (PU) prevention. Various teaching methods have been used with diverse results but none have been analyzed in Nigeria. A quasi- experimental study using a pretest/post test design was conducted among 193 registered nurses with >6 months experience who worked in purposefully selected wards (neuroscience, orthopedics, renal, and cardiac) in 3 teaching hospitals to examine the level of knowledge retention after interactive instruction. Participants were randomized to intervention (IG, n = 127 from 2 hospitals) and control (CG, n = 66 from 1 hospital) groups; the IG was provided a 5-day, face-to-face interactive lecture, and the CG engaged in a 1-day, 4-hour discussion of PU prevention practices. The Pressure Ulcer Knowledge Tool, a 47-item questionnaire in which a correct answer = 1 point and an incorrect/"I don't know" answer = 0 (maximum score 47), was used to assess and compare knowledge retention at 3 time points: baseline (T1), immediately after instruction (T2), and after 3 months (T3). Three trained research assistants assisted with registration of participants and distribution and collection of the questionnaires. All questionnaires were retrieved at T1 before the intervention be- gan. Respondents were encouraged to respond to all questions. Data were analyzed using t-test and ANOVA (P = 0.05). At T1, knowledge scores were comparable between the IG and CG (32.5 ± 4.2 and 30.8 ± 5.0 for IG and CG, respectively). At T2, knowledge scores increased significantly only in the IG to 40.7 ± 3.4 (d = 1.94, P less than 0.05). The mean difference between T1 and T2 was -8.2 ± 5.4, t = -17.0, P = 0.000. Similarly, mean scores increased significantly from T2 to T3 in the IG (mean= -2.0 ± 5.5, t = -4.1, P = 0.000); scores in the CG were -6.2 ± 7.2, t = -6.3 (P = 0.000). A face-to-face interactive lecture was shown to be an effective method of program delivery for

  4. Assessment of global guidelines for preventive chemotherapy against schistosomiasis and soil-transmitted helminthiasis: a cost-effectiveness modelling study.

    Science.gov (United States)

    Lo, Nathan C; Lai, Ying-Si; Karagiannis-Voules, Dimitrios-Alexios; Bogoch, Isaac I; Coulibaly, Jean T; Bendavid, Eran; Utzinger, Jürg; Vounatsou, Penelope; Andrews, Jason R

    2016-09-01

    WHO guidelines recommend annual treatment for schistosomiasis or soil-transmitted helminthiasis when prevalence in school-aged children is at or above a threshold of 50% and 20%, respectively. Separate treatment guidelines are used for these two helminthiases, and integrated community-wide treatment is not recommended. We assessed the cost-effectiveness of changing prevalence thresholds and treatment guidelines under an integrated delivery framework. We developed a dynamic, age-structured transmission and cost-effectiveness model that simulates integrated preventive chemotherapy programmes against schistosomiasis and soil-transmitted helminthiasis. We assessed a 5-year treatment programme with praziquantel (40 mg/kg per treatment) against schistosomiasis and albendazole (400 mg per treatment) against soil-transmitted helminthiasis at 75% coverage. We defined strategies as highly cost-effective if the incremental cost-effectiveness ratio was less than the World Bank classification for a low-income country (gross domestic product of US$1045 per capita). We calculated the prevalence thresholds for cost-effective preventive chemotherapy of various strategies, and estimated treatment needs for sub-Saharan Africa. Annual preventive chemotherapy against schistosomiasis was highly cost-effective in treatment of school-aged children at a prevalence threshold of 5% (95% uncertainty interval [UI] 1·7-5·2; current guidelines recommend treatment at 50% prevalence) and for community-wide treatment at a prevalence of 15% (7·3-18·5; current recommendation is unclear, some community treatment recommended at 50% prevalence). Annual preventive chemotherapy against soil-transmitted helminthiasis was highly cost-effective in treatment of school-aged children at a prevalence of 20% (95% UI 5·4-30·5; current guidelines recommend treatment at 20% prevalence) and the entire community at 60% (35·3-85·1; no guidelines available). When both helminthiases were co-endemic, prevalence

  5. Guidance on accidents involving radioactivity

    International Nuclear Information System (INIS)

    1989-01-01

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

  6. Advantages of computed tomographic guidance

    International Nuclear Information System (INIS)

    Casola, G.; Vansonnenberg, E.

    1987-01-01

    Both ultrasound and CT are successfully used to guide interventional procedures throughout the body. There are advantages and disadvantages to each modality and choosing one over the other will vary from case to case. Major factors influencing choice are discussed in this paper. As a general rule CT guidance is usually required for lesions in the thorax, the adrenals, the pancreas, lymph nodes, and for percutaneous abscess drainage. The authors feel that a complimentary use of ultrasound and CT is essential to optimize success and cost-effectiveness; therefore, the interventional radiologist should be familiar with both imaging modalities

  7. Agent Based Individual Traffic guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen Bundgaard

    2004-01-01

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

  8. Psychometric properties of a questionnaire assessing nursing professionals′ knowledge regarding etiology and prevention of viral hepatitis B and C

    Directory of Open Access Journals (Sweden)

    Anita Thakur

    2014-01-01

    Full Text Available Background: Viral hepatitis B and C are a global public health problem. For better targeting their detection and prevention, nursing professionals′ should have adequate knowledge and skills. Aims and Objectives: This study aimed at developing a "viral hepatitis questionnaire" and then validating it among nursing professionals′ working in a Medical College of North India. Materials and Methods: A fifteen-item questionnaire was developed by the principal investigator. This was based on a systematic search in database namely "PubMed" "IndMed" "Directory of Open Access journals" and "Google scholar". It was then administered to 318 nursing professionals′. The psychometric properties of the questionnaire were assessed in terms of construct validity and reliability. Results: The average age of the study subjects was 23.4 years (SD = 17.2, range = 18 years-54 years. Sampling adequacy as measured by Kaiser-Meyer-Olkin (KMO test was 0.82. This indicated relevance of the factorial model. Varimax rotation revealed that all items had achieved the required loading of 0.3. The internal consistency ranged from 0.81 to 0.87. The intra class correlation coefficient ranged from 0.67 to 0.71. Conclusion: " Viral hepatitis questionnaire" (VHQ appears to be a reliable and valid measure of assessing nursing professionals′ knowledge about viral hepatitis B and C. Its periodic use can serve the purpose of assessing nursing professionals′ training needs. It is further recommended that it should be tested among nursing staff in different healthcare facilities of India, in order to assess its wider performance.

  9. Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials.

    Science.gov (United States)

    Shields, Lynn; Henderson, Victoria; Caslake, Robert

    2017-07-01

    To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. Systematic review and metaanalysis. Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions. MEDLINE, EMBASE, CINAHL and PsycINFO databases; Clinicaltrials.gov; and the Central Register of Controlled Trials were searched. Reference lists from full-text articles were reviewed. Incidence of delirium was the primary outcome. Length of stay, delirium severity, institutionalization, long-term cognition and mortality were predefined secondary outcomes. Duration of delirium was included as a post hoc outcome. There was a significant reduction in delirium overall (relative risk (RR) = 0.81, 95% confidence interval (CI) = 0.69-0.94) in the intervention group. Post hoc subgroup analysis found this effect to be preserved in the team-based intervention group (RR = 0.77, 95% CI = 0.61-0.98) but not the ward-based group. No significant effect was observed on any secondary outcome. There was a reduction in the incidence of delirium after hip fracture with CGA. This is in keeping with results of non-randomized controlled trials and trials in other populations. Team-based interventions appeared superior in contrast to the Ellis CGA paper, but it is likely that heterogeneity in interventions and population studied affected this. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. Guidance document on practices to model and implement Earthquake hazards in extended PSA (final version). Volume 1

    International Nuclear Information System (INIS)

    Decker, K.; Hirata, K.; Groudev, P.

    2016-01-01

    The current report provides guidance for the assessment of seismo-tectonic hazards in level 1 and 2 PSA. The objective is to review existing guidance, identify methodological challenges, and to propose novel guidance on key issues. Guidance for the assessment of vibratory ground motion and fault capability comprises the following: - listings of data required for the hazard assessment and methods to estimate data quality and completeness; - in-depth discussion of key input parameters required for hazard models; - discussions on commonly applied hazard assessment methodologies; - references to recent advances of science and technology. Guidance on the assessment of correlated or coincident hazards comprises of chapters on: - screening of correlated hazards; - assessment of correlated hazards (natural and man-made); - assessment of coincident hazards. (authors)

  11. Design of the Prevention of Adult Caries Study (PACS: A randomized clinical trial assessing the effect of a chlorhexidine dental coating for the prevention of adult caries

    Directory of Open Access Journals (Sweden)

    Snyder John J

    2010-10-01

    Full Text Available Abstract Background Dental caries is one of the primary causes of tooth loss among adults. It is estimated to affect a majority of Americans aged 55 and older, with a disproportionately higher burden in disadvantaged populations. Although a number of treatments are currently in use for caries prevention in adults, evidence for their efficacy and effectiveness is limited. Methods/Design The Prevention of Adult Caries Study (PACS is a multicenter, placebo-controlled, double-blind, randomized clinical trial of the efficacy of a chlorhexidine (10% w/v dental coating in preventing adult caries. Participants (n = 983 were recruited from four different dental delivery systems serving four diverse communities, including one American Indian population, and were randomized to receive either chlorhexidine or a placebo treatment. The primary outcome is the net caries increment (including non-cavitated lesions from baseline to 13 months of follow-up. A cost-effectiveness analysis also will be considered. Discussion This new dental treatment, if efficacious and approved for use by the Food and Drug Administration (FDA, would become a new in-office, anti-microbial agent for the prevention of adult caries in the United States. Trial Registration Number NCT00357877

  12. Risk assessment of parents' concerns at 18 months in preventive child health care predicted child abuse and neglect.

    Science.gov (United States)

    Staal, Ingrid I E; Hermanns, Jo M A; Schrijvers, Augustinus J P; van Stel, Henk F

    2013-07-01

    As child maltreatment has a major impact, prevention and early detection of parenting problems are of great importance. We have developed a structured interview which uses parents' concerns for a joint needs assessment by parents and a child health care nurse, followed by a professional judgment on the risk level of future parenting and developmental problems: the Structured Problem Analysis of Raising Kids (SPARK). Previous results have shown that the risk assessment of the SPARK is associated with risk factors for child maltreatment. This study reports the predictive value of the SPARK for reports on high impact parenting problems and child abuse and neglect. Cross-sectional study with a 1.5-year follow-up based on 1,850 18-month old children, living in Zeeland, a province of the Netherlands. Data on the SPARK were obtained in the period of June 2007 to March 2008. Outcomes of the SPARK were in October 2009 compared to reports of the Advice and Reporting Centers for Child Abuse and Neglect (ARCAN) and Youth Care Agency (YCA). Univariate and multivariate logistic regression analysis was done using the risk assessment, parents' concerns, the perceived need for support and known risk factors as predictors. The overall risk assessment of the SPARK is the strongest predictor for reports to ARCAN and YCA in the 1.5 years after completing the SPARK (odds ratio of high versus low risk: 16.3 [95% confidence interval: 5.2-50.8]. Controlling for the risk assessment, only the sum of known risk factors and an unemployed father remained as significant predictors. The reported groups differ significantly from the children without a report with regard to family characteristics, but not with regard to child characteristics. A structured assessment of the concerns and care needs of toddlers' parents by a child health care nurse is a valuable predictor of reports on child abuse and neglect and serious parenting problems in toddlers. Systematically exploring and evaluating parental

  13. Laser guidance of mesoscale particles

    Science.gov (United States)

    Underdown, Frank Hartman, Jr.

    Mesoscale particles are guided and trapped in hollow optical fibers using radiation pressure forces. Laser light from a 0.4W, 780nm diode laser is guided in a low- loss fiber mode and used to generate the guidance forces. Laser scattering and absorption forces propels particles along the fiber and polarization gradient forces attract them to the fiber's axial center. Using two counter propagating laser beams, inside the fiber, particles can be trapped in three dimensions. Measuring the spring constant of the trap gives the gradient force. This dissertation describes Rayleigh and Mie scattering models for calculating guidance forces. Calculated forces as a function of particle size and composition (i.e. dielectric, semiconductor, and metals) will be presented. For example, under typical experimental conditions 100nm Au particles are guided by a 2 × 10-14 N propulsive force in a water filled fiber. In comparison, the measured force, obtained from the particle's velocity and Stokes' law, is 7.98 × 10-14 N.

  14. In vitro assessment of the ability of probiotics, blueberry and food carbohydrates to prevent S. pyogenes adhesion on pharyngeal epithelium and modulate immune responses

    DEFF Research Database (Denmark)

    Taverniti, Valentina; Dalla Via, Alessandro; Minuzzo, Mario

    2017-01-01

    Group A streptococci (GAS) cause 20-30% of pediatric pharyngitis episodes, which are a major cause of ambulatory care visits. Therefore, a strategy to prevent GAS dissemination in children could significantly benefit public healthcare. Contextually, we assessed the possibility of employing...... alternative food-grade strategies to be used with the oral probiotic L. helveticus MIMLh5 for the prevention of pharyngeal infections. First, we demonstrated through an antagonism-by-exclusion assay that guaran may potentially prevent S. pyogenes adhesion on pharyngeal cells. Subsequently, we showed...

  15. Observational study to assess pregnant women’s knowledge and behaviour to prevent toxoplasmosis, listeriosis and cytomegalovirus.

    NARCIS (Netherlands)

    Pereboom, M.T.R.; Manniën, J.; Spelten, E.R.; Schellevis, F.G.; Hutton, E.K.

    2013-01-01

    Background: Toxoplasmosis, listeriosis and cytomegalovirus (CMV) can negatively affect pregnancy outcomes, but can be prevented by simple precautions of pregnant women. Literature suggests that pregnant women are not always adequately informed by their care provider about preventable infectious

  16. Benzodiazepine Use During Hospitalization: Automated Identification of Potential Medication Errors and Systematic Assessment of Preventable Adverse Events.

    Directory of Open Access Journals (Sweden)

    David Franklin Niedrig

    Full Text Available Benzodiazepines and "Z-drug" GABA-receptor modulators (BDZ are among the most frequently used drugs in hospitals. Adverse drug events (ADE associated with BDZ can be the result of preventable medication errors (ME related to dosing, drug interactions and comorbidities. The present study evaluated inpatient use of BDZ and related ME and ADE.We conducted an observational study within a pharmacoepidemiological database derived from the clinical information system of a tertiary care hospital. We developed algorithms that identified dosing errors and interacting comedication for all administered BDZ. Associated ADE and risk factors were validated in medical records.Among 53,081 patients contributing 495,813 patient-days BDZ were administered to 25,626 patients (48.3% on 115,150 patient-days (23.2%. We identified 3,372 patient-days (2.9% with comedication that inhibits BDZ metabolism, and 1,197 (1.0% with lorazepam administration in severe renal impairment. After validation we classified 134, 56, 12, and 3 cases involving lorazepam, zolpidem, midazolam and triazolam, respectively, as clinically relevant ME. Among those there were 23 cases with associated adverse drug events, including severe CNS-depression, falls with subsequent injuries and severe dyspnea. Causality for BDZ was formally assessed as 'possible' or 'probable' in 20 of those cases. Four cases with ME and associated severe ADE required administration of the BDZ antagonist flumazenil.BDZ use was remarkably high in the studied setting, frequently involved potential ME related to dosing, co-medication and comorbidities, and rarely cases with associated ADE. We propose the implementation of automated ME screening and validation for the prevention of BDZ-related ADE.

  17. Assessment of preventive measures for accidental blood exposure in operating theaters: a survey of 20 hospitals in Northern France.

    Science.gov (United States)

    Tarantola, Arnaud; Golliot, Franck; L'Heriteau, François; Lebascle, Karin; Ha, Catherine; Farret, Danièle; Bignon, Sylvie; Smaïl, Amar; Doutrellot-Philippon, Catherine; Astagneau, Pascal; Bouvet, Elisabeth

    2006-08-01

    Accidental exposures to blood of body fluids (ABE) expose health care workers (HCW) to the risk of occupational infection. Our aim was to assess the prevention equipment available in the operating theater (OT) with reference to guidelines or recommendations and its use by the staff in that OT on that day and past history of ABE. Correspondents of the Centre de Coordination de la Lutte contre les Infections Nosocomiales (CCLIN) Paris-Nord ABE Surveillance Taskforce carried out an observational multicenter survey in 20 volunteer French hospitals. In total, 260 operating staff (including 151 surgeons) were investigated. Forty-nine of the 260 (18.8%) staff said they double-gloved for all patients and procedures, changing gloves hourly. Blunt-tipped suture needles were available in 49.1% of OT; 42 of 76 (55.3%) of the surgeons in these OT said they never used them. Overall, 60% and 64% of surgeons had never self-tested for HIV and hepatitis C virus (HCV), respectively. Fifty-five surgeons said they had sustained a total of 96 needlestick injuries during the month preceding the survey. Ten of these surgeons had notified of 1 needlestick injury each to the occupational health department of their hospital (notification rate, 10.4%). The occurrence of needlestick injury remained high in operating personnel in France in 2000. Although hospitals may improve access to protective devices, operating staff mindful of safety in the OT should increase their use of available devices, their knowledge of their own serostatus, and their ABE notification rate to guide well-targeted prevention efforts.

  18. The Assessment of Social Support and Self-Care Requisites for Preventing Diabetic Foot Ulcer in Diabetic Foot Patients

    Directory of Open Access Journals (Sweden)

    Mohammad Taher

    2016-03-01

    Full Text Available Background and Objectives: Diabetic foot as one of the most common complications of diabetes is involved in more than %25 of diabetic patients’ lives, and if not treated properly can lead to amputation up to %20. The lack of self-care is the underlying cause of mortality, morbidity and chronic complications of diabetes. Identification and rectifying of diabetic foot care needs of patients can additionally reduce readmission; also, %85 of diabetic foot problems can be prevented. Materials and Methods: In this descriptive study, 130patients with diabetic foot from Shahid Modarres hospital were selected using census method. Data in forms of demographic questionnaire, self-care requisites assessment tool for preventing diabetic foot ulcer, and Social Support Behavior Scale were completed by patients and then were collected. Data were analyzed by SPSS version 16. Results: In this study, a significant relationship was found between self-care and social support (P<0.05. This means that people with better social support reported better self-care than those with weaker social support. A significant relationship in level of education and monthly income with self-care was seen, as well as in level of education, monthly income and marital status with social support (P<0.001. Conclusions: The results showed that social support can be considered as an effective factor in individual self-care behaviors, and with regard to this factor in educational, treatment and care programs of patients, can improve their self-care, in addition to decreasing economic costs, and improve their qualities of lives as well.

  19. Cost assessment of a new oral care program in the intensive care unit to prevent ventilator-associated pneumonia.

    Science.gov (United States)

    Ory, Jérôme; Mourgues, Charline; Raybaud, Evelyne; Chabanne, Russell; Jourdy, Jean Christophe; Belard, Fabien; Guérin, Renaud; Cosserant, Bernard; Faure, Jean Sébastien; Calvet, Laure; Pereira, Bruno; Guelon, Dominique; Traore, Ousmane; Gerbaud, Laurent

    2018-06-01

    Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infections in intensive care units (ICU). In the bundle of care to prevent the VAP, the oral care is very important strategies, to decrease the oropharyngeal bacterial colonization and presence of causative bacteria of VAP. In view of the paucity of medical economics studies, our objective was to determine the cost of implementing this oral care program for preventing VAP. In five ICUs, during period 1, caregivers used a foam stick for oral care and, during period 2, a stick and tooth brushing with aspiration. Budgetary effect of the new program from the hospital's point of view was analyzed for both periods. The costs avoided were calculated from the incidence density of VAP (cases per 1000 days of intubation). The cost study included device cost, benefit lost, and ICU cost (medication, employer and employee contributions, blood sample analysis…). A total of 2030 intubated patients admitted to the ICUs benefited from oral care. The cost of implementing the study protocol was estimated to be €11,500 per year. VAP rates decreased significantly between the two periods (p1 = 12.8% and p2 = 8.5%, p = 0.002). The VAP revenue was ranged from €28,000 to €45,000 and the average cost from €39,906 to €42,332. The total cost assessment calculated was thus around €1.9 million in favor of the new oral care program. Our study showed that the implementation of a simple strategy improved the quality of patient care is economically viable. NCT02400294.

  20. Assessing Community Coalition Capacity and its Association with Underage Drinking Prevention Effectiveness in the Context of the SPF SIG.

    Science.gov (United States)

    Flewelling, Robert L; Hanley, Sean M

    2016-10-01

    Community coalitions are a prominent organizational structure through which community-based substance abuse prevention efforts are implemented. There is little empirical evidence, however, regarding the association between coalition attributes and success in achieving community-level reductions in substance abuse behaviors. In this study, we assessed the relationship between coalition capacity, based on coalition coordinator responses to 16 survey items, and reductions in underage drinking prevalence rates. The coalitions were funded through the federally sponsored Strategic Prevention Framework State Incentive Grant (SPF SIG). We first examined whether coalition capacity increased over the life of the projects. Mean capacity scores increased for all 16 capacity items examined (N = 318 coalitions), the majority of which were statistically significant. Analysis of the associations between capacity and reductions in underage drinking was limited to coalitions that targeted underage drinking and provided usable outcome measures based on student survey data for either past 30-day alcohol use (N = 129) or binge drinking (N = 100). Bivariate associations between the capacity items and prevalence reductions for each outcome were consistently positive, although many were not statistically significant. Composite measures of correlated items were then created to represent six different capacity constructs, and included in multivariate models to predict reductions in the targeted outcomes. Constructs that significantly predicted reductions in one or both outcome measures included internal organization and structure, community connections and outreach, and funding from multiple sources. The findings provide support for the expectation that high functioning community coalitions can be effective agents for producing desirable community-level changes in targeted substance abuse behaviors.