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Sample records for prevention planning guide

  1. Manufacturing Planning Guide

    Science.gov (United States)

    Waid, Michael

    2011-01-01

    Manufacturing process, milestones and inputs are unknowns to first-time users of the manufacturing facilities. The Manufacturing Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their project engineering personnel in manufacturing planning and execution. Material covered includes a roadmap of the manufacturing process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, products, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  2. Pollution prevention program implementation plan

    International Nuclear Information System (INIS)

    Engel, J.A.

    1996-09-01

    The Pollution Prevention Program Implementation Plan (the Plan) describes the Pacific Northwest National Laboratory's (PNNL) Pollution Prevention (P2) Program. The Plan also shows how the P2 Program at PNNL will be in support of and in compliance with the Hanford Site Waste Minimization and Pollution Prevention (WMin/P2) Awareness Program Plan and the Hanford Site Guide for Preparing and Maintaining Generator Group Pollution Prevention Program Documentation. In addition, this plan describes how PNNL will demonstrate compliance with various legal and policy requirements for P2. This plan documents the strategy for implementing the PNNL P2 Program. The scope of the P2 Program includes implementing and helping to implement P2 activities at PNNL. These activities will be implemented according to the Environmental Protection Agency's (EPA) hierarchy of source reduction, recycling, treatment, and disposal. The PNNL P2 Program covers all wastes generated at the Laboratory. These include hazardous waste, low-level radioactive waste, radioactive mixed waste, radioactive liquid waste system waste, polychlorinated biphenyl waste, transuranic waste, and sanitary waste generated by activities at PNNL. Materials, resource, and energy conservation are also within the scope of the PNNL P2 Program

  3. Special Observance Planning Guide

    Science.gov (United States)

    2015-11-01

    Guide DEFENSE EQUAL OPPORTUNITY MANAGEMENT INSTITUTE DIRECTORATE OF RESEARCH DEVELOPMENT AND STRATEGIC INITIATIVES Dr. Richard...ii Observance Overview…..…………………………………………..…….…………….. 1 Budgetary Requirements...………………………………………………………….…... 4 Event ...the Air Force. (2012, August 16). Financial Management : Budget Guidance and Procedures (AF Instruction 65-601). Washington, DC: Department of the

  4. Telecommunications Planning Guide for Educators.

    Science.gov (United States)

    Wigley, Griff

    1988-01-01

    Presents guide developed by the McGraw-Hill Information Exchange (MIX) to help educators plan effectively for the use of computer telecommunications. Highlights include telephone lines; modems; software; commercial information services that offer such services as electronic mail and computer conferencing; basic costs and billing formats; and a…

  5. Electric motor predictive and preventive maintenance guide

    International Nuclear Information System (INIS)

    Oliver, J.A.

    1992-07-01

    Electric motor performance is vital to the reliable and efficient operation of power plants. The failure of one or more critical motors could cause lost capacity and excessive repair and maintenance cost. However, existing maintenance recommendations proposed by vendors for electric motors have sometimes encouraged many overly conservative maintenance practices. These practices have lead to excessive maintenance activities and costs which have provided no extra margin of operability. EPRI has sponsored RP2814-35 to develop a guide which provides power plants with information and guidance for establishing an effective maintenance program which will aid in preventing unexpected motor failures and assist in planning motor maintenance efforts. The guide includes a technical description which summarizes technical data relative to the four basic types of motors and their components in general use in power plants. The significant causes of motor failures are investigated and described in detail and methods to optimize service life and minimize maintenance cost through appropriate preventive maintenance and conditioning program are presented. This guide provides a foundation for an effective electric motor maintenance program and simplifies the selection of predictive and preventive maintenance tasks. Its use will enable maintenance personnel in nuclear and fossil plants to plan motor repairs during scheduled outages and avoid costly unexpected failures

  6. PFP requirements development planning guide

    International Nuclear Information System (INIS)

    SINCLAIR, J.C.

    1999-01-01

    The PFP Requirements Development Planning Guide presents the strategy and process used for the identification, allocation, and maintenance of requirements within the Plutonium Finishing Plant (PFP) integrated project baseline. Future revisions to this document will be included as attachments (e.g., results of the PFP Requirements Analysis attributable to this approach). This document is intended be a Project-owned management tool. As such, this document will periodically require revisions resulting from improvements of the information, processes, and techniques as now described. Future updates may be made to this document by PFP management and final approval of the content will be accomplished in a Baseline Change Request as it impacts the Multi-Year Work Plan, or baseline information managed in the Hanford Site Systems Engineering Baseline

  7. Wilmar Planning Tool, user guide

    International Nuclear Information System (INIS)

    Larsen, Helge V.

    2006-01-01

    This is a short user guide to the Wilmar Planning Tool developed in the project Wind Power Integration in Liberalised Electricity Markets (WILMAR) supported by EU (Contract No. ENK5-CT-2002-00663). A User Shell implemented in an Excel workbook controls the Wilmar Planning Tool. All data are contained in Access databases that communicate with various sub-models through text files that are exported from or imported to the databases. In the User Shell various scenario variables and control parameters are set, and export of model data from the input database, activation of the models, as well as import of model results to the output database are triggered from the shell. (au)

  8. Work hazard prevention plans

    International Nuclear Information System (INIS)

    Albertos Campos, F.

    2009-01-01

    The prevention of industrial risks is a constantly evolving discipline that has changed considerable in the last 25 years. The Cofrentes Nuclear Power Plants has always been operated with a clear policy favoring prevention by supporting the principle of its integration, i. e., that the hierarchical functional organization of the company make sure that industrial risk prevention is effective and that health and safety standards are met. The historical evolution of occupational safety in the Cofrentes Nuclear Power Plant shows a a clear trend towards improvement and is the results of many years of hard work and effort by the plants own and contractor personnel in the field of industrial risk prevention. (Author)

  9. Model Commissioning Plan and Guide Specifications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    The objectives of Model Commissioning Plan and Guide Specifications are to ensure that the design team applies commissioning concepts to the design and prepares commissioning specifications and a commission plan for inclusion in the bid construction documents.

  10. Wilderness fire management planning guide

    Science.gov (United States)

    William C. Fischer

    1984-01-01

    Outlines a procedure for fire management planning for parks; wilderness areas; and other wild, natural, or essentially undeveloped areas. Discusses background and philosophy of wilderness fire management, planning concepts, planning elements, and planning methods.

  11. Marketing Internships: A Planning and Implementation Guide.

    Science.gov (United States)

    Faught, Suzanne G.

    This planning and implementation guide is designed to assist marketing educators and others supportive of marketing education. It begins with definitions of vocabulary of related terminology and descriptions of the four models of internships presented in the guide: full-year, rotation-type format; 1-semester, rotation-type format; full-year format…

  12. EPRI's pumped storage planning and evaluation guide

    International Nuclear Information System (INIS)

    Chen, H.H.

    1991-01-01

    EPRI's Hydropower Pumped Storage Planning and Evaluation Guide was published in 1990. The Guide provides step-by-step procedures to: evaluate pumped-storage operation in a utility system, establish site development concept, estimate capital cost, and conduct economic analysis. The Guide provides a floppy diskette containing a production costing model simulating the chronologic operation of pumped storage in a generating system. It provides a series of estimating curves for the preparation of capital cost estimates. The paper presents how the Guide was organized and prepared, and highlights its contents

  13. The PLAN Classroom. A Guide for Consultants.

    Science.gov (United States)

    1969

    This document is a guide for consultants observing teacher behavior, its effects on students, and learning environment conditions in a PLAN (Program for Learning in Accordance with Needs) classroom. (Appended are a series of 27 questions and answers which describe PLAN, an individualized, computer-assisted instructional system initially operating…

  14. Family-Directed Transition Planning Guide.

    Science.gov (United States)

    Colorado State Dept. of Education, Denver. Div. of Special Education Services.

    This guide to family-directed transition planning is intended to help parents and students with disabilities take leading roles in the process of transition from school to post-school activities. First, a letter to families examines the challenge of change and the transition process. Section 2 examines regulations that affect transition planning,…

  15. Hanford Site waste minimization and pollution prevention awareness program plan

    International Nuclear Information System (INIS)

    Place, B.G.

    1998-01-01

    This plan, which is required by US Department of Energy (DOE) Order 5400. 1, provides waste minimization and pollution prevention guidance for all Hanford Site contractors. The plan is primary in a hierarchical series that includes the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan, Prime contractor implementation plans, and the Hanford Site Guide for Preparing and Maintaining Generator Group Pollution Prevention Program Documentation (DOE-RL, 1997a) describing programs required by Resource Conservation and Recovery Act of 1976 (RCRA) 3002(b) and 3005(h) (RCRA and EPA, 1994). Items discussed include the pollution prevention policy and regulatory background, organizational structure, the major objectives and goals of Hanford Site's pollution prevention program, and an itemized description of the Hanford Site pollution prevention program. The document also includes US Department of Energy, Richland Operations Office's (RL's) statement of policy on pollution prevention as well as a listing of regulatory drivers that require a pollution prevention program

  16. Good Practice Guide Waste Minimization/Pollution Prevention

    Energy Technology Data Exchange (ETDEWEB)

    J Dorsey

    1999-10-14

    This Good Practice Guide provides tools, information, and examples for promoting the implementation of pollution prevention during the design phases of U.S. Department of Energy (DOE) projects. It is one of several Guides for implementing DOE Order 430.1, Life-cycle Asset Management. DOE Order 430.1 provides requirements for DOE, in partnership with its contractors, to plan, acquire, operate, maintain, and dispose of physical assets. The goals of designing for pollution prevention are to minimize raw material consumption, energy consumption, waste generation, health and safety impacts, and ecological degradation over the entire life of the facility (EPA 1993a). Users of this Guide will learn to translate national policy and regulatory requirements for pollution prevention into action at the project level. The Guide was written to be applicable to all DOE projects, regardless of project size or design phase. Users are expected to interpret the Guide for their individual project's circumstances, applying a graded approach so that the effort is consistent with the anticipated waste generation and resource consumption of the physical asset. This Guide employs a combination of pollution prevention opportunity assessment (PPOA) methods and design for environment (DfE) philosophies. The PPOA process was primarily developed for existing products, processes, and facilities. The PPOA process has been modified in this Guide to address the circumstances of the DOE design process as delineated in DOE Order 430.1 and its associated Good Practice Guides. This modified form of the PPOA is termed the Pollution Prevention Design Assessment (P2DA). Information on current nationwide methods and successes in designing for the environment also have been reviewed and are integrated into this guidance.

  17. Good Practice Guide Waste Minimization/Pollution Prevention; TOPICAL

    International Nuclear Information System (INIS)

    J Dorsey

    1999-01-01

    This Good Practice Guide provides tools, information, and examples for promoting the implementation of pollution prevention during the design phases of U.S. Department of Energy (DOE) projects. It is one of several Guides for implementing DOE Order 430.1, Life-cycle Asset Management. DOE Order 430.1 provides requirements for DOE, in partnership with its contractors, to plan, acquire, operate, maintain, and dispose of physical assets. The goals of designing for pollution prevention are to minimize raw material consumption, energy consumption, waste generation, health and safety impacts, and ecological degradation over the entire life of the facility (EPA 1993a). Users of this Guide will learn to translate national policy and regulatory requirements for pollution prevention into action at the project level. The Guide was written to be applicable to all DOE projects, regardless of project size or design phase. Users are expected to interpret the Guide for their individual project's circumstances, applying a graded approach so that the effort is consistent with the anticipated waste generation and resource consumption of the physical asset. This Guide employs a combination of pollution prevention opportunity assessment (PPOA) methods and design for environment (DfE) philosophies. The PPOA process was primarily developed for existing products, processes, and facilities. The PPOA process has been modified in this Guide to address the circumstances of the DOE design process as delineated in DOE Order 430.1 and its associated Good Practice Guides. This modified form of the PPOA is termed the Pollution Prevention Design Assessment (P2DA). Information on current nationwide methods and successes in designing for the environment also have been reviewed and are integrated into this guidance

  18. Pollution prevention program plan 1996

    International Nuclear Information System (INIS)

    1996-01-01

    This plan serves as the principal crosscutting guidance to Department of Energy (DOE) Headquarters, Operations Office, laboratory, and contractor management to fully implement pollution prevention programs within the DOE complex between now and 2000. To firmly demonstrate DOE's commitment to pollution prevention, the Secretary of Energy has established goals, to be achieved by December 31, 1999, that will aggressively reduce DOE's routine generation of radioactive, mixed, and hazardous wastes, and total releases and offsite transfers of toxic chemicals. The Secretary also has established sanitary waste reduction, recycling, and affirmative procurement goals. Site progress in meeting these goals will be reported annually to the Secretary in the Annual Report on Waste Generation and Waste Minimization Progress, using 1993 as the baseline year. Implementation of this plan will represent a major step toward reducing the environmental risks and costs associated with DOE operations

  19. Temperature Control. Honeywell Planning Guide.

    Science.gov (United States)

    Honeywell, Inc., Minneapolis, Minn.

    Presents planning considerations in selecting proper temperature control systems. Various aspects are discussed including--(1) adequate environmental control, (2) adequate control area, (3) control system design, (4) operators rate their systems, (5) type of control components, (6) basic control system, (7) automatic control systems, and (8)…

  20. Teen Drinking Prevention Program. Event Action Guide.

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Prevention.

    Underage drinking presents a serious health risk not only to young people themselves but to entire communities. This program guide is designed to help communities establish their own underage drinking prevention programs. Community norms, actions, and attitudes toward alcohol affect young people, as do the ways in which alcohol is promoted.…

  1. Emerging technologies planning guide, 1993 edition

    Energy Technology Data Exchange (ETDEWEB)

    1992-11-01

    Information system technology enhancements during the next five years are expected to provide some of the most significant individual and organization work improvements ever made in the office environment. This guide is an aid to planning these technologies and assessing their roles in improving the effectiveness of Headquarters programs. Their implementation will cost-effectively support Departmental operations and the National Energy Strategy. At the hear of this process is an understanding of the relationship which exists between technology introduction and the planning, budgeting and acquisition process. The 1993 edition of this guide covers the 1993--1997 time frame.

  2. Fuzzy logic guided inverse treatment planning

    International Nuclear Information System (INIS)

    Yan Hui; Yin Fangfang; Guan Huaiqun; Kim, Jae Ho

    2003-01-01

    A fuzzy logic technique was applied to optimize the weighting factors in the objective function of an inverse treatment planning system for intensity-modulated radiation therapy (IMRT). Based on this technique, the optimization of weighting factors is guided by the fuzzy rules while the intensity spectrum is optimized by a fast-monotonic-descent method. The resultant fuzzy logic guided inverse planning system is capable of finding the optimal combination of weighting factors for different anatomical structures involved in treatment planning. This system was tested using one simulated (but clinically relevant) case and one clinical case. The results indicate that the optimal balance between the target dose and the critical organ dose is achieved by a refined combination of weighting factors. With the help of fuzzy inference, the efficiency and effectiveness of inverse planning for IMRT are substantially improved

  3. The Ernst & Young Business Plan Guide

    CERN Document Server

    Ford, Brian R; Pruitt, Patrick T; Young, Ernst

    2010-01-01

    In today's competitive business environment, a well thought out business plan is more important than ever before. Not only can it assist you in raising the money needed to start or expand a business-by attracting the interest of potential investors-but it can also help you keep tabs on your progress once the business is up and running.Completely revised and updated to reflect today's dynamic business environment, The Ernst & Young Business Plan Guide, Third Edition leads you carefully through every aspect involved in researching, writing, and presenting a winning business plan. Illustrating ea

  4. City planning as preventive medicine.

    Science.gov (United States)

    Corburn, Jason

    2015-08-01

    The health and well-being of rapidly growing urban populations is a global health issue. Cities in the global north and south are faced with rising health inequities - or avoidable differences in health determinants and outcomes based on place, social status and ethnicity. This commentary suggests that focusing only on treatment interventions in cities is likely to fail because populations will be forced to go back into the urban living and working conditions that likely made them sick in the first place. City planning as preventive medicine includes taking a relational and systems approach to urban health, requiring health assessments for all urban policy making, promoting neighborhood health centers as engines of community economic development and gathering place-based health indicator data to track progress and adapt interventions over time as conditions change. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Preventive distribution and plans of iodine tablets stocks management

    International Nuclear Information System (INIS)

    2002-01-01

    This official note includes two parts: one concerns the new preventive distribution of iodine tablets on the areas defined by the Particular Intervention Plans (P.P.I.) around nuclear facilities and the other one the setting up of iodine tablets stocks beyond the P.P.I. areas. In annexe is a guide for the elaboration of stocks management plans for steady iodine tablets. (N.C.)

  6. Guide to oil spill exercise planning

    International Nuclear Information System (INIS)

    1996-01-01

    The International Convention on Oil Pollution Preparedness, Response and Cooperation (OPRC Convention) foresees a future in which all at risk states have national oil spill preparedness and response plans. The Convention also encourages the idea that national plans be developed in cooperation with oil and shipping industries. The ultimate test of any contingency plan is measured by performance in a real emergency. It is vital, therefore, that any programme for developing a national contingency plan must include an ongoing programme to test the plan through realistic exercises. An exercise programme must progressively prepare the Oil Spill Energy Response Team to perform effectively in realistic representations of the risks that the contingency plan has been designed to meet. This report has been designed to guide all those in government or industry who are faced with the responsibility of developing and managing oil spill response exercises at all levels. It carries with it the authority that derives from peer review by many centres of oil spill response excellence around the world. It is well-illustrated with brief case histories of exercises that have been carried out by many IPIECA member companies. Each of those companies has indicated its preparedness to share more information by providing contact name and address details within this report. (author)

  7. The Local Agenda 21 Planning Guide: An Introduction to ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1996-01-01

    The Local Agenda 21 Planning Guide: An Introduction to Sustainable Development Planning. Book cover The Local Agenda 21 Planning Guide: An Introduction to Sustainable Development Planning. Author(s):. International Council for Local Environmental Initiatives. Publisher(s):. IDRC. January 1, 1996. ISBN: Out of print.

  8. PFP Interface identification and management planning guide

    International Nuclear Information System (INIS)

    SINCLAIR, J.C.

    1999-01-01

    The purpose of-this planning guide is to present the process used to identify, document, and control PFP Stabilization and Deactivation Project interfaces. Revisions to this document will include, as attachments, the most recent version of the Project Interface Management List. A preliminary Interface Management List is included in Appendix A. This document is intended be a Project owned management tool. As such, this document will periodically require revisions resulting from improvements of the information, processes, and techniques as now described. For most revisions that suggest improved processes, PFP management approval is all that will be required

  9. Westinghouse Hanford Company Pollution Prevention Program Implementation Plan

    International Nuclear Information System (INIS)

    Floyd, B.C.

    1994-10-01

    This plan documents Westinghouse Hanford Company's (WHC) Pollution Prevention (P2) (formerly Waste Minimization) program. The program includes WHC; BCS Richland, Inc. (BCSR); and ICF Kaiser Hanford Company (ICF KH). The plan specifies P2 program activities and schedules for implementing the Hanford Site Waste Minimization and Pollution Prevention Awareness (WMin/P2) Program Plan requirements (DOE 1994a). It is intended to satisfy the U.S. Department of Energy (DOE) and other legal requirements that are discussed in both the Hanford Site WMin/P2 plan and paragraph C of this plan. As such, the Pollution Prevention Awareness Program required by DOE Order 5400.1 (DOE 1988) is included in the WHC P2 program. WHC, BCSR, and ICF KH are committed to implementing an effective P2 program as identified in the Hanford Site WMin/P2 Plan. This plan provides specific information on how the WHC P2 program will develop and implement the goals, activities, and budget needed to accomplish this. The emphasis has been to provide detailed planning of the WHC P2 program activities over the next 3 years. The plan will guide the development and implementation of the program. The plan also provides background information on past program activities. Because the plan contains greater detail than in the past, activity scope and implementation schedules may change as new priorities are identified and new approaches are developed and realized. Some activities will be accelerated, others may be delayed; however, all of the general program elements identified in this plan and contractor requirements identified in the Site WMin/P2 plan will be developed and implemented during the next 3 years. This plan applies to all WHC, BCSR, and ICF KH organizations and subcontractors. It will be distributed to those with defined responsibilities in this plan; and the policy, goals, objectives, and strategy of the program will be communicated to all WHC, BCSR, and ICF KH employees

  10. Waste Minimization and Pollution Prevention Awareness Plan

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    The purpose of this plan is to document Lawrence Livermore National Laboratory (LLNL) projections for present and future waste minimization and pollution prevention. The plan specifies those activities and methods that are or will be used to reduce the quantity and toxicity of wastes generated at the site. It is intended to satisfy Department of Energy (DOE) requirements. This Plan provides an overview of projected activities from FY 1994 through FY 1999. The plans are broken into site-wide and problem-specific activities. All directorates at LLNL have had an opportunity to contribute input, to estimate budget, and to review the plan. In addition to the above, this plan records LLNL`s goals for pollution prevention, regulatory drivers for those activities, assumptions on which the cost estimates are based, analyses of the strengths of the projects, and the barriers to increasing pollution prevention activities.

  11. Waste Minimization and Pollution Prevention Awareness Plan

    International Nuclear Information System (INIS)

    1994-04-01

    The purpose of this plan is to document Lawrence Livermore National Laboratory (LLNL) projections for present and future waste minimization and pollution prevention. The plan specifies those activities and methods that are or will be used to reduce the quantity and toxicity of wastes generated at the site. It is intended to satisfy Department of Energy (DOE) requirements. This Plan provides an overview of projected activities from FY 1994 through FY 1999. The plans are broken into site-wide and problem-specific activities. All directorates at LLNL have had an opportunity to contribute input, to estimate budget, and to review the plan. In addition to the above, this plan records LLNL's goals for pollution prevention, regulatory drivers for those activities, assumptions on which the cost estimates are based, analyses of the strengths of the projects, and the barriers to increasing pollution prevention activities

  12. Waste minimization and pollution prevention awareness plan

    International Nuclear Information System (INIS)

    1991-01-01

    The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. The intent of this plan is to respond to and comply with (DOE's) policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Programs and Departments. 14 refs

  13. Waste minimization and pollution prevention awareness plan

    Energy Technology Data Exchange (ETDEWEB)

    1991-05-31

    The purpose of this plan is to document the Lawrence Livermore National Laboratory (LLNL) Waste Minimization and Pollution Prevention Awareness Program. The plan specifies those activities and methods that are or will be employed to reduce the quantity and toxicity of wastes generated at the site. The intent of this plan is to respond to and comply with (DOE's) policy and guidelines concerning the need for pollution prevention. The Plan is composed of a LLNL Waste Minimization and Pollution Prevention Awareness Program Plan and, as attachments, Program- and Department-specific waste minimization plans. This format reflects the fact that waste minimization is considered a line management responsibility and is to be addressed by each of the Programs and Departments. 14 refs.

  14. Bullying 101: The Club Crew's Guide to Bullying Prevention

    Science.gov (United States)

    PACER Center, 2013

    2013-01-01

    "Bullying 101" is the Club Crew's Guide to Bullying Prevention. A visually-friendly, age-appropriate, 16-page colorful guide for students to read or for parents to use when talking with children, this guide describes and explains what bullying is and is not, the roles of other students, and tips on what each student can do to prevent…

  15. Guide to Developing an Environmental Management System - Plan

    Science.gov (United States)

    This page takes you though the basic steps (Plan, Do, Check, Act) of building an Environmental Management System (EMS) as they are outlined in the 2001 Second Edition of Environmental Management Systems: An Implementation Guide. Plan section.

  16. Planning for Emergencies: A Guide for People with Chronic Kidney Disease

    Science.gov (United States)

    Planning for Emergencies A Guide for People with Chronic Kidney Disease Contents Planning for Emergencies .................................................................. 3 How can I ... Planning for Emergencies: A Guide for People With Chronic Kidney Disease ■ Planning for Emergencies: A Guide for Dialysis Facilities ■ ...

  17. Changing Minds : A Guide to Facilitated Participatory Planning ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Changing Minds : A Guide to Facilitated Participatory Planning. Couverture du livre Changing Minds : A Guide to Facilitated Participatory Planning. Auteur(s) : Cole P. Dodge et Gavin Bennett. Maison(s) d'édition : Academic Foundation, Fountain Publishers, CRDI. 1 octobre 2011. ISBN : 9788171888603. 192 pages. e-ISBN ...

  18. Menu Planning Guide for School Food Service. Revised.

    Science.gov (United States)

    VanEgmont-Pannell, Dorothy; And Others

    This menu planning guide for school lunches and breakfasts contains: (1) lunch requirements, recommendations, and policies; (2) the basics of menu planning; (3) how to vary portions for various age/grade groups; (4) planning breakfasts; (5) merchandising school lunches and breakfasts; and (6) nutrition education and menu planning; Appendixes…

  19. Whole Life Planning: A Guide for Organizers and Facilitators.

    Science.gov (United States)

    Butterworth, John; Hagner, David; Heikkinen, Bonnie; Faris, Sherill; DeMello, Shirley; McDonough, Kirsten

    This guide to whole life planning for people with disabilities describes whole life planning as a person-centered way of assisting people with disabilities to plan for their future. Whole life planning relies on the involvement of a small group of committed people who are willing to act as advocates and resources to the focal person. The manual…

  20. 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.

  1. A Planning Guide for Instructional Networks, Part I.

    Science.gov (United States)

    Daly, Kevin F.

    1994-01-01

    Discusses three phases in implementing a master plan for a school-based local area network (LAN): (1) network software selection; (2) hardware selection, network topology, and site preparation; and (3) implementation time table. Sample planning and specification worksheets and a list of planning guides are included. (Contains six references.) (KRN)

  2. Alcohol Abuse Prevention: A Comprehensive Guide for Youth Organizations.

    Science.gov (United States)

    Boys' Clubs of America, New York, NY.

    This guide, the culmination of a three year Project TEAM effort by the Boys' Clubs of America, describes numerous strategies for developing an alcohol abuse prevention program. The core of this guide consists of program models developed by the Boys' Club project at seven pilot sites. The models presented cover the following areas: peer leadership,…

  3. The public transportation system security and emergency preparedness planning guide

    Science.gov (United States)

    2003-01-01

    Recent events have focused renewed attention on the vulnerability of the nation's critical infrastructure to major events, including terrorism. The Public Transportation System Security and Emergency Preparedness Planning Guide has been prepared to s...

  4. U.S. Arctic Voyage Planning Guide (AVPG)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Arctic Voyage Planning Guide is a compilation of official U.S. Government information and references to sources of information that may be consulted by mariners...

  5. Changing Minds : A Guide to Facilitated Participatory Planning ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1 oct. 2011 ... Couverture du livre Changing Minds : A Guide to Facilitated Participatory Planning. Author(s):. Cole P. Dodge ... IDRC's support of BetterEvaluation, an international collaboration to improve evaluation practice and theory, has resulted in an online guide for an often overlooked group of people who greatly.

  6. Guide of Ideas for Planning and Implementing Intergenerational Projects

    Science.gov (United States)

    Pinto, Teresa Almeida; Marreel, Iris; Hatton-Yeo, Alan

    2009-01-01

    "Guide of Ideas for Planning and Implementing Intergenerational Projects," is for all professionals that are or wish to be enrolled in the development of intergenerational activities. This "Guide" is the main product of the Project MATES--Mainstreaming Intergenerational Solidarity, co-financed by the Lifelong Learning…

  7. VET Providers Planning to Deliver Degrees: Good Practice Guide

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…

  8. Drunk Driving Public Information Program Strategies and Planning Guide.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This guide, designed to accompany a videocassette of selected television spots is a compendium of specific drunk driving topics and issues for each of the major planning steps of a public information program. The guide is organized around these steps, which are (1) select program strategies, (2) select target audiences, (3) select media channels,…

  9. Teen Pregnancy Prevention. A Legislator's Guide.

    Science.gov (United States)

    Guiden, Mary

    This publication presents an overview of adolescent pregnancy, including national and state statistical information; funding sources for teen pregnancy prevention programs; examples of the effects of teen pregnancy prevention on society; illustrations of teenagers' perspectives on the issue; recent developments and initiatives in the arena of teen…

  10. Communication Systems Simulation Laboratory (CSSL): Simulation Planning Guide

    Science.gov (United States)

    Schlesinger, Adam

    2012-01-01

    The simulation process, milestones and inputs are unknowns to first-time users of the CSSL. The Simulation Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their engineering personnel in simulation planning and execution. Material covered includes a roadmap of the simulation process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, facility interfaces, and inputs necessary to define scope, cost, and schedule are included as an appendix to the guide.

  11. Audio Development Laboratory (ADL) User Test Planning Guide

    Science.gov (United States)

    Romero, Andy

    2012-01-01

    Test process, milestones and inputs are unknowns to first-time users of the ADL. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  12. The Local Agenda 21 Planning Guide: An Introduction to ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Couverture du livre The Local Agenda 21 Planning Guide: An Introduction to Sustainable Development Planning. Auteur(s) : International Council for Local ... La recherche sur les incidences et les impacts des technologies de l'information et de la communication (TIC) sur le développement social et humain est ...

  13. The BWR owners' group planning guide for life extension

    International Nuclear Information System (INIS)

    Smith, S.K.; Lehnert, D.F.; Locke, R.K.

    1991-01-01

    Extending the operating life of a commercial nuclear power plant has been shown to be economically beneficial to both the utility and the electric customer. As such, many utilities are planning and implementing plant life extension (PLEX) programs. A document has been developed which provides guidance to utilities in formulating a PLEX program plant for one or more boiling water reactor (BWR) plants. The guide has been developed by the BWR Owners' Group Plant Life Extension Committee. The principal bases for this guide were the BWR Pilot and Lead Plant Programs. These programs were used as models to develop the 'base plan' described in this guide. By formulating their program plant utilizing the base plan, utilities will be able to maximize the use of existing evaluations and results. The utility planner will build upon the base plan by adding any tasks or features that are unique to their programs. (author)

  14. Preventive distribution and plans of iodine tablets stocks management; Distribution preventive et plans de gestion des stocks de comprimes d'iode

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This official note includes two parts: one concerns the new preventive distribution of iodine tablets on the areas defined by the Particular Intervention Plans (P.P.I.) around nuclear facilities and the other one the setting up of iodine tablets stocks beyond the P.P.I. areas. In annexe is a guide for the elaboration of stocks management plans for steady iodine tablets. (N.C.)

  15. Idaho National Laboratory Site Pollution Prevention Plan

    Energy Technology Data Exchange (ETDEWEB)

    E. D. Sellers

    2007-03-01

    It is the policy of the Department of Energy (DOE) that pollution prevention and sustainable environmental stewardship will be integrated into DOE operations as a good business practice to reduce environmental hazards, protect environmental resources, avoid pollution control costs, and improve operational efficiency and mission sustainability. In furtherance of this policy, DOE established five strategic, performance-based Pollution Prevention (P2) and Sustainable Environmental Stewardship goals and included them as an attachment to DOE O 450.1, Environmental Protection Program. These goals and accompanying strategies are to be implemented by DOE sites through the integration of Pollution Prevention into each site's Environmental Management System (EMS). This document presents a P2 and Sustainability Program and corresponding plan pursuant to DOE Order 450.1 and DOE O 435.1, Radioactive Waste Management. This plan is also required by the state of Idaho, pursuant to the Resource Conservation and Recovery Act (RCRA) partial permit. The objective of this document is to describe the Idaho National Laboratory (INL) Site P2 and Sustainability Program. The purpose of the program is to decrease the environmental footprint of the INL Site while providing enhanced support of its mission. The success of the program is dependent on financial and management support. The signatures on the previous page indicate INL, ICP, and AMWTP Contractor management support and dedication to the program. P2 requirements have been integrated into working procedures to ensure an effective EMS as part of an Integrated Safety Management System (ISMS). This plan focuses on programmatic functions which include environmentally preferable procurement, sustainable design, P2 and Sustainability awareness, waste generation and reduction, source reduction and recycling, energy management, and pollution prevention opportunity assessments. The INL Site P2 and Sustainability Program is administratively

  16. Idaho National Laboratory Site Pollution Prevention Plan

    International Nuclear Information System (INIS)

    E. D. Sellers

    2007-01-01

    It is the policy of the Department of Energy (DOE) that pollution prevention and sustainable environmental stewardship will be integrated into DOE operations as a good business practice to reduce environmental hazards, protect environmental resources, avoid pollution control costs, and improve operational efficiency and mission sustainability. In furtherance of this policy, DOE established five strategic, performance-based Pollution Prevention (P2) and Sustainable Environmental Stewardship goals and included them as an attachment to DOE O 450.1, Environmental Protection Program. These goals and accompanying strategies are to be implemented by DOE sites through the integration of Pollution Prevention into each site's Environmental Management System (EMS). This document presents a P2 and Sustainability Program and corresponding plan pursuant to DOE Order 450.1 and DOE O 435.1, Radioactive Waste Management. This plan is also required by the state of Idaho, pursuant to the Resource Conservation and Recovery Act (RCRA) partial permit. The objective of this document is to describe the Idaho National Laboratory (INL) Site P2 and Sustainability Program. The purpose of the program is to decrease the environmental footprint of the INL Site while providing enhanced support of its mission. The success of the program is dependent on financial and management support. The signatures on the previous page indicate INL, ICP, and AMWTP Contractor management support and dedication to the program. P2 requirements have been integrated into working procedures to ensure an effective EMS as part of an Integrated Safety Management System (ISMS). This plan focuses on programmatic functions which include environmentally preferable procurement, sustainable design, P2 and Sustainability awareness, waste generation and reduction, source reduction and recycling, energy management, and pollution prevention opportunity assessments. The INL Site P2 and Sustainability Program is administratively

  17. Computer guided pre-operative planning and dental implant placement

    Directory of Open Access Journals (Sweden)

    Dušan Grošelj

    2007-05-01

    Full Text Available Background: Implants in dentistry are, besides fixed, removable and maxillofacial prosthodontics, one of the reliable possibility to make functional and aesthetic rehabilitation of the edentulism. Surgical and prosthodontic implant complications are often an inattentive consequence of wrong diagnosis, planning, and placement. In this article we present a technique using a highly advanced software program along with a rapid prototyping technology named stereolithography. A planning software for implant placement needs basically the high quality computed tomographic scan of one or both jaws for making accurate preoperative diagnostics and 3D preoperative plan. Later individual drill guide is designed and generated based on both the CT images and the preoperative planning. The patient specific drill guide transfers the virtual planning to the patient’s mouth at time of surgery.Conclusions: The advantages of computer guided implantology are the better prepared surgery with visualisation of critical anatomic structures, assessment of available bone and data about bone quality, increased confidence for the surgeon, deceased operative time, less frequent use of bone grafts, higher quality of collaboration between specialists and prosthetic lab and better communication with patients. Radiographic examination of the operation field for computer guided planning for implant placement is due to high costs justified as the most important information source on the areas to be implanted.

  18. An overview and guide: planning instructional radio.

    Science.gov (United States)

    Imhoof, M

    1984-03-01

    Successful instructional radio projects require both comprehensive and complex planning. The instructional radio planning team needs to have knowledge and capabilities in several technical, social, and educational areas. Among other skills, the team must understand radio, curriculum design, the subject matter being taught, research and evaluation, and the environment in which the project operates. Once a basic approach to educational planning has been selected and broad educational goals set, radio may be selected as a cost effective means of achieving some of the goals. Assuming radio is a wise choice, there are still several factors which must be analyzed by a team member who is a radio specialist. The most obvious consideration is the inventory and evaluation of the facilities: studios; broadcast, recording, and transmission equipment; classroom radios; and so on. Capabilities of broadcast personnel are another consideration. Initial radio lessons need to teach the learners how to listen to the radio if they have no previous experience with institutional radio broadcasts. A captive, inschool audience ready to listen to radio instructions requires a different use of the medium than a noncaptive audience. With the noncaptive audience, the educational broadcaster must compete with entertaining choices from other media and popular activities and pastimes of the community. The most complex knowledge and analysis required in planning instructional radio concerns the relationship of the content to the medium. Environmental factors are important in planning educational programs. The physical environment may present several constraints on the learning experience and the use of radio. The most obvious is the effect of climate and terrain on the quality of radio reception. The physical environment is easily studied through experience in the target area, but this knowledge plays a significant role in designing effective learning materials for specific learners. Social

  19. Complete guide to preventive and predictive maintenance

    CERN Document Server

    Levitt, Joel

    2011-01-01

    This book shares the best practices, mistakes, victories, and essential steps for success which the author has gleaned from working with countless organizations. Unlike other books that only focus on the engineering issues (task lists) or management issues (CMMS), this in-depth resource is the first to give true emphasize to the four aspects of success in preventive maintenance systems - engineering, management, economic, and psychological - thereby enabling readers to have a balanced view and understanding of what is happening in their organizations. Additionally, it blends concrete actionable steps and structures with the theory behind the steps. It includes check sheets, history of PM, stories, photographs, and case histories. It contains a glossary of terms. It provides sample task lists for a variety of equipment with some of the logic behind each task. It offers templates for developing your own tasking. It includes protocols for detailed economic analysis with examples.

  20. Preventing readmissions through comprehensive discharge planning.

    Science.gov (United States)

    Hunter, Tabitha; Nelson, James Rex; Birmingham, Jackie

    2013-01-01

    Case managers, including nurses and social workers, provide essential services to hospitalized patients, including mandated discharge planning that has been shown to impact patient safety and patient outcomes. The heightened attention to readmission is evident in both reimbursement and accreditation initiatives. The Centers for Medicare & Medicaid Services, Office of Clinical Standards & Quality/Survey & Certification Group, is revising worksheets to be used by surveyors to review how hospitals are complying with the Medicare Conditions of Participation with a focus on discharge planning as it relates to patient safety. This is an opportunity for case managers to apply the principles of case management to the targeted problem of readmissions. Now case managers must identify the reasons for readmission on a patient-by-patient basis, collect data, analyze processes, and then change practice in the hospital and work more closely with community-based providers. The purpose of this article is to recommend improvement in a consistent case management practice that will positively influence patient readmissions. Hospital-based case managers who are responsible for discharge planning functions. Hospital administrators will also find this information valuable as a tool to assess strategies to control preventable readmissions and to comply with the Medicare Conditions of Participation for discharge planning. Hospital-based case managers, responsible for discharge planning, have a unique opportunity to interact face-to-face with patients who are readmitted to determine factors that lead to the readmission. Case managers need to change their practice to include assessing patients on the basis of their prior level of care. Pharmacists need to play a bigger role in discharge planning, especially for patients who have experienced a potentially avoidable readmission. Working closely with community-based providers is essential to target reasons for readmission. The Medicare

  1. Drupal The Guide to Planning and Building Websites

    CERN Document Server

    McCourt, Cynthia

    2011-01-01

    A complete lifecycle guide to planning and building a site with Drupal Drupal allows you to quickly and easily build a wide variety of web sites, from very simple blog sites to extremely complex sites that integrate with other systems. In order to maximize what Drupal can do for you, you need to plan. Whether you are building with Drupal 6 or 7, this book details the steps necessary to plan your site so you can make informed decisions before you start to build.Explains how to define the scope of your projectShows you how to create a design plan taking into consideration how Drupal worksHelps y

  2. Specialized Environmental Chamber Test Complex: User Test Planning Guide

    Science.gov (United States)

    Montz, Michael E.

    2011-01-01

    Test process, milestones and inputs are unknowns to first-time users of the Specialized Environmental Test Complex. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  3. A Guide for Planning, Organizing, and Utilizing Advisory Councils.

    Science.gov (United States)

    Illinois State Office of Education, Springfield. Div. of Vocational and Technical Education.

    Designed for administrators and teachers at the community college/secondary/elementary levels, the guide is a reference source for establishing and developing citizen advisory councils. A section on Advisory Councils--Planning discusses the need for citizen advisory councils, definition and purpose, advisory council types, and operational…

  4. Integrating Resources into Curriculum with the Systems Connect Planning Guide

    Science.gov (United States)

    Oshry, A.; Bean, J. R.

    2017-12-01

    A broadly applicable and guided approach for planning curriculum and instruction around new academic standards or initiatives is critical for implementation success. Curriculum and assessment differs across schools and districts, so built-in adaptability is important for maximal adoption and ease of use by educators. The Systems Connect Planning Guide directs the flow of instruction for building conceptual links between topics in a unit/curriculum through critical vetting and integration of relevant resources. This curricular template is flexible for use in any setting or subject area, and ensures applicability, high impact and responsiveness to academic standards while providing inquiry-based, real-world investigations and action that incorporate authentic research and data. These needs are what informed the creation of the three components of the planning guide:• Curriculum Anchor: alignment with academic standards & learning outcomes and setting the context of the topic• Issues Investigations: informing how students explore topics, and incorporate authentic research and data into learning progressions• Civic Action: development of how students could apply their knowledgeThe Planning Guide also incorporates criteria from transdisciplinary practices, cross-cutting concepts, and organizational charts for outlining guiding questions and conceptual links embedded in the guide. Integration of experiential learning and real-world connections into curricula is important for proficiency and deeper understanding of content, replacing discrete, stand-alone experiences which are not explicitly connected. Rather than information being dispelled through individual activities, relying on students to make the connections, intentionally documenting explicit connections provides opportunities to foster deeper understanding by building conceptual links between topics, which is how fundamental knowledge about earth and living systems is gained. Through the critical vetting

  5. Pollution Prevention Successes Database (P2SDb) user guide

    International Nuclear Information System (INIS)

    1995-07-01

    When Pollution Prevention Opportunity Assessments (P2OAs) were launched at the Hanford Site during the summer of 1994, the first comment received from those using them expressed the desire for a method to report assessments electronically. As a temporary measure, macros were developed for use on word processing systems, but a more formal database was obviously needed. Additionally, increased DOE and Washington state reporting requirements for pollution prevention suggested that a database system would streamline the reporting process. The Pollution Prevention Group of Westinghouse Hanford Company (WHC) contracted with the Data Automation Engineering Department from ICF Kaiser Hanford Company (ICFKH) to develop the system. The scope was to develop a database that will track P2OAs conducted by the facilities and contractors at the Hanford Site. It will also track pollution prevention accomplishments that are not the result of P2OAs and document a portion of the Process Waste Assessments conducted in the past. To accommodate the above criteria, yet complete the system in a timely manner, the Pollution Prevention Successes Database (P2SDb) is being implemented in three phases. The first phase will automate the worksheets to provide both input and output of the data associated with the worksheets. The second phase will automate standard summary reports and ad hoc reports. The third phase will provide automated searching of the database to facilitate the sharing of pollution prevention experiences among various users. This User's Guide addresses only the Phase 1 system

  6. Pollution Prevention Successes Database (P2SDb) user guide

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    When Pollution Prevention Opportunity Assessments (P2OAs) were launched at the Hanford Site during the summer of 1994, the first comment received from those using them expressed the desire for a method to report assessments electronically. As a temporary measure, macros were developed for use on word processing systems, but a more formal database was obviously needed. Additionally, increased DOE and Washington state reporting requirements for pollution prevention suggested that a database system would streamline the reporting process. The Pollution Prevention Group of Westinghouse Hanford Company (WHC) contracted with the Data Automation Engineering Department from ICF Kaiser Hanford Company (ICFKH) to develop the system. The scope was to develop a database that will track P2OAs conducted by the facilities and contractors at the Hanford Site. It will also track pollution prevention accomplishments that are not the result of P2OAs and document a portion of the Process Waste Assessments conducted in the past. To accommodate the above criteria, yet complete the system in a timely manner, the Pollution Prevention Successes Database (P2SDb) is being implemented in three phases. The first phase will automate the worksheets to provide both input and output of the data associated with the worksheets. The second phase will automate standard summary reports and ad hoc reports. The third phase will provide automated searching of the database to facilitate the sharing of pollution prevention experiences among various users. This User`s Guide addresses only the Phase 1 system.

  7. A guide for preparing Hanford Site facility effluent monitoring plans

    International Nuclear Information System (INIS)

    Nickels, J.M.

    1992-06-01

    This document provides guidance on the format and content of effluent monitoring plans for facilities at the Hanford Site. The guidance provided in this document is designed to ensure compliance with US Department of Energy (DOE) Orders 5400.1 (DOE 1988a), 5400.3 (DOE 1989a), 5400.4 (DOE 1989b), 5400.5 (DOE 1990a), 5480.1 (DOE 1982), 5480.11 (DOE 1988b), and 5484.1 (DOE 1981). These require environmental monitoring plans for each site, facility, or process that uses, generates, releases, or manages significant pollutants of radioactive or hazardous materials. In support of DOE Orders 5400.5 (Radiation Protection of the Public and the Environment) and 5400.1 (General Environmental Protection Program), the DOE Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance (DOE 1991) should be used to establish elements of a radiological effluent monitoring program in the Facility Effluent Monitoring Plan. Evaluation of facilities for compliance with the US Environmental Protection Agency Clean Air Act of 1977 requirements also is included in the airborne emissions section of the Facility Effluent Monitoring Plans. Sampling Analysis Plans for Liquid Effluents, as required by the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement), also are included in the Facility Effluent Monitoring Plans. The Facility Effluent Monitoring Plans shall include complete documentation of gaseous and liquid effluent sampling and monitoring systems

  8. Impact of the Prevention Plan on Employee Health Risk Reduction

    OpenAIRE

    Loeppke, Ronald; Edington, Dee W.; Bég, Sami

    2010-01-01

    This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...

  9. Waste minimization and pollution prevention awareness plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-01

    The purpose of this plan is to document Lawrence Livermore National Laboratory (LLNL) projections for present and future waste minimization and pollution prevention. The plan specifies those activities and methods that are or will be used to reduce the quantity and toxicity of wastes generated at the site. It is intended to satisfy Department of Energy (DOE) requirements. This Waste Minimization and Pollution Prevention Awareness Plan provides an overview of projected activities from FY 1994 through FY 1999. The plans are broken into site-wide and problem-specific activities. All directorates at LLNL have had an opportunity to contribute input, estimate budgets, and review the plan. In addition to the above, this plan records LLNL`s goals for pollution prevention, regulatory drivers for those activities, assumptions on which the cost estimates are based, analyses of the strengths of the projects, and the barriers to increasing pollution prevention activities.

  10. Waste minimization and pollution prevention awareness plan. Revision 1

    International Nuclear Information System (INIS)

    1994-07-01

    The purpose of this plan is to document Lawrence Livermore National Laboratory (LLNL) projections for present and future waste minimization and pollution prevention. The plan specifies those activities and methods that are or will be used to reduce the quantity and toxicity of wastes generated at the site. It is intended to satisfy Department of Energy (DOE) requirements. This Waste Minimization and Pollution Prevention Awareness Plan provides an overview of projected activities from FY 1994 through FY 1999. The plans are broken into site-wide and problem-specific activities. All directorates at LLNL have had an opportunity to contribute input, estimate budgets, and review the plan. In addition to the above, this plan records LLNL's goals for pollution prevention, regulatory drivers for those activities, assumptions on which the cost estimates are based, analyses of the strengths of the projects, and the barriers to increasing pollution prevention activities

  11. Adverse Drug Event Prevention: 2014 Action Plan Conference.

    Science.gov (United States)

    Ducoffe, Aaron R; Baehr, Avi; Peña, Juliet C; Rider, Briana B; Yang, Sandra; Hu, Dale J

    2016-09-01

    Adverse drug events (ADEs) have been highlighted as a national patient safety and public health challenge by the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan), which was released by the Office of Disease Prevention and Health Promotion in August 2014. The following October, the ADE Prevention: 2014 Action Plan Conference provided an opportunity for federal agencies, national experts, and stakeholders to coordinate and collaborate in the initiative to reduce preventable ADEs. The single-day conference included morning plenary sessions focused on the surveillance, evidence-based prevention, incentives and oversights, and additional research needs of the drug classes highlighted in the ADE Action Plan: anticoagulants, diabetes agents, and opioids. Afternoon breakout sessions allowed for facilitated discussions on measures for tracking national progress in ADE prevention and the identification of opportunities to ensure safe and high-quality health care and medication use. © The Author(s) 2015.

  12. Energy emergency planning guide: Winter 1977-78

    Energy Technology Data Exchange (ETDEWEB)

    1977-11-01

    This Energy Emergency Planning Guide for Winter, 1977-78 has been prepared in order to: identify and evaluate actions available to deal with energy emergencies this winter; provide an advance indication to the public of those actions considered most likely to be taken by the government, and provide industry, state, and local governments with suggestions about actions which they can take to deal with energy emergencies. The Guide contains specifications for over 50 standby programs and procedures, recommended implementation guidelines for using these programs keyed to a pre-emergency phase and three phases of shortfalls, and a design for an Energy Emergency Center. Flexible implementation guidelines are proposed for natural gas, petroleum, electricity/coal, and propane shortages. (MCW)

  13. The MSFC Systems Engineering Guide: An Overview and Plan

    Science.gov (United States)

    Shelby, Jerry; Thomas, L. Dale

    2007-01-01

    This paper describes the guiding vision, progress to date and the plan forward for development of the Marshall Space Flight Center (MSFC) Systems Engineering Guide (SEG), a virtual systems engineering handbook and archive that describes the system engineering processes used by MSFC in the development of ongoing complex space systems such as the Ares launch vehicle and forthcoming ones as well. It is the intent of this website to be a "One Stop Shop' for MSFC systems engineers that will provide tutorial information, an overview of processes and procedures and links to assist system engineering with guidance and references, and provide an archive of relevant systems engineering artifacts produced by the many NASA projects developed and managed by MSFC over the years.

  14. Work hazard prevention plans; Plan de prevencion de riesgos laborales

    Energy Technology Data Exchange (ETDEWEB)

    Albertos Campos, F.

    2009-07-01

    The prevention of industrial risks is a constantly evolving discipline that has changed considerable in the last 25 years. The Cofrentes Nuclear Power Plants has always been operated with a clear policy favoring prevention by supporting the principle of its integration, i. e., that the hierarchical functional organization of the company make sure that industrial risk prevention is effective and that health and safety standards are met. The historical evolution of occupational safety in the Cofrentes Nuclear Power Plant shows a a clear trend towards improvement and is the results of many years of hard work and effort by the plants own and contractor personnel in the field of industrial risk prevention. (Author)

  15. PFP Interface identification and management planning guide; TOPICAL

    International Nuclear Information System (INIS)

    SINCLAIR, J.C.

    1999-01-01

    The purpose of-this planning guide is to present the process used to identify, document, and control PFP Stabilization and Deactivation Project interfaces. Revisions to this document will include, as attachments, the most recent version of the Project Interface Management List. A preliminary Interface Management List is included in Appendix A. This document is intended be a Project owned management tool. As such, this document will periodically require revisions resulting from improvements of the information, processes, and techniques as now described. For most revisions that suggest improved processes, PFP management approval is all that will be required

  16. 3-Dimensional implant planning in prosthetic dentistry and surgical guides

    Directory of Open Access Journals (Sweden)

    Abdullah Oğuz Hamiş

    2016-01-01

    Full Text Available In implant dentistry, technological inventions are now being utilized in order to achieve better treatment results; thus failures associated with conventional surgical techniques are reduced. With the use of 3-dimensional computer-assisted planning, the density and the width of bone, and anatomic landmarks can be observed in detail and also a 3-dimensional model of the bone tissue can be constructed. By using contemporary radiological and surgical guides, fabrication of superior quality implant-supported restorations is possible. In this review, information regarding planning methods to get better prosthetic results in dental implant treatments has been given. Also, the accuracy of these methods has been evaluated in the light of the current dental literature.

  17. Planning for transit-supportive development : a practitioner's guide. Section 5 : local planning and transit-supportive development.

    Science.gov (United States)

    2014-06-01

    Planning for Transit-Supportive Development: A Practitioners Guide is a toolkit of practical and innovative measures to help : Metropolitan Planning Organizations (MPOs), regional planners, transit agencies, and local government elected o...

  18. Planning for transit-supportive development : a practitioner's guide. Section 2 : general transit-supportive development planning topics.

    Science.gov (United States)

    2014-06-01

    Planning for Transit-Supportive Development: A Practitioners Guide is a toolkit of practical and innovative measures to help : Metropolitan Planning Organizations (MPOs), regional planners, transit agencies, and local government elected o...

  19. Planning for transit-supportive development : a practitioner's guide. Section 4 : corridor planning and transit-supportive development.

    Science.gov (United States)

    2014-06-01

    Planning for Transit-Supportive Development: A Practitioners Guide is a toolkit of practical and innovative measures to help : Metropolitan Planning Organizations (MPOs), regional planners, transit agencies, and local government elected o...

  20. Guided Autotransplantation of Teeth: A Novel Method Using Virtually Planned 3-dimensional Templates.

    Science.gov (United States)

    Strbac, Georg D; Schnappauf, Albrecht; Giannis, Katharina; Bertl, Michael H; Moritz, Andreas; Ulm, Christian

    2016-12-01

    The aim of this study was to introduce an innovative method for autotransplantation of teeth using 3-dimensional (3D) surgical templates for guided osteotomy preparation and donor tooth placement. This report describes autotransplantation of immature premolars as treatment of an 11-year-old boy having suffered severe trauma with avulsion of permanent maxillary incisors. This approach uses modified methods from guided implant surgery by superimposition of Digital Imaging and Communications in Medicine files and 3D data sets of the jaws in order to predesign 3D printed templates with the aid of a fully digital workflow. The intervention in this complex case could successfully be accomplished by performing preplanned virtual transplantations with guided osteotomies to prevent bone loss and ensure accurate donor teeth placement in new recipient sites. Functional and esthetic restoration could be achieved by modifying methods used in guided implant surgery and prosthodontic rehabilitation. The 1-year follow-up showed vital natural teeth with physiological clinical and radiologic parameters. This innovative approach uses the latest diagnostic methods and techniques of guided implant surgery, enabling the planning and production of 3D printed surgical templates. These accurate virtually predesigned surgical templates could facilitate autotransplantation in the future by full implementation of recommended guidelines, ensuring an atraumatic surgical protocol. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Environmental Restoration Program pollution prevention checklist guide for the feasibility study project phase

    International Nuclear Information System (INIS)

    1993-09-01

    Feasibility studies (FS) determine what remedial alternatives are presented to regulators for site cleanup. A key consideration in this process is the waste to be generated. Minimizing the volume and toxicity of this waste will ultimately contribute to the selection of the best remedial option. The purpose of this checklist guide is to assist the user in incorporating pollution prevention/waste minimization (PP/WM) in all FS phase projects of the Environmental Restoration (ER) Program. This guide will help users document PP/WM activities for technology transfer and reporting requirements. Automated computer screens will be created from the checklist data to assist users with implementing and evaluating waste reduction. Users can then establish numerical performance measures to measure progress in planning, training, self-assessments, field implementation, documentation, and technology transfer. Cost savings result as users train and assess themselves and perform preliminary waste assessments

  2. Developing the strategic plan for pollution prevention in defense programs

    International Nuclear Information System (INIS)

    Marchetti, John A.; Betschart, James F.; Suffern, J. Samuel

    1992-01-01

    In order to provide effective leadership and to ensure a consistent pollution prevention effort in all of its production facilities and laboratories, Defense Programs (DP) Headquarters, in close cooperation with the Field, has developed a strategic plan for its Pollution Prevention Program. The strategic plan is built upon the history of waste minimization, waste reduction, and pollution prevention activity to date, and articulates both long- and short-term strategies to ensure program initiation, growth, and stability. The organization of the program, including Headquarters staffing and linkages to the Geld, is described. Life-cycle analysis of program barriers and bottlenecks, along with associated initiatives and action plans are discussed. (author)

  3. Stormwater Pollution Prevention Plan - TA-60 Asphalt Batch Plant

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-01-31

    This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector P-Land Transportation and Warehousing as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA-60-01 Asphalt Batch Plant at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-60 Asphalt Batch Plant and associated areas. The current permit expires at midnight on June 4, 2020.

  4. Stormwater Pollution Prevention Plan - TA-60 Material Recycling Facility

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-01-31

    This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector P-Land Transportation and Warehousing as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA- 60 Material Recycling Facility at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-60 Material Recycling Facility. The current permit expires at midnight on June 4, 2020.

  5. Training Cambodian Village Health Support Guides in Diabetes Prevention: Effects on Guides' Knowledge and Teaching Activities Over 6 Months.

    Science.gov (United States)

    Wagner, Julie; Keuky, Lim; Fraser-King, Lorraine; Kuoch, Theanvy; Scully, Mary

    2016-04-01

    Type 2 diabetes is a pressing public health concern in Cambodia, a country with limited human resource capacity due to genocide. Cambodian village health support guides (Guides) promote health at the local level. This paper reports preliminary results of training Guides in diabetes prevention. The curriculum, called Eat, Walk, Sleep was delivered to Guides in Siem Reap province once over 3 h. Participants completed a pretest and posttest on diabetes knowledge. Guides were offered continuing education through Eat, Walk, Sleep resources and were encouraged to teach Eat, Walk, Sleep in their villages. For each of 6 months following their training, Guides completed a checklist regarding their activities. One hundred eighty-five Guides attended one of ten trainings. Knowledge scores increased significantly from pretest to posttest. During 6 months of follow-up, n = 159 Guides (85 %) completed at least one monthly checklist. Guides reported high rates of uptake and delivery of the Eat, Walk, Sleep curriculum and moderate rates of continuing education about diabetes. Diabetes prevention in Cambodia is nascent. Guides show excellent uptake and dissemination of the curriculum. Future research should examine effect of support for Guide activities and the effect of the curriculum on villager health behaviors, and ultimately, on rates of type 2 diabetes.

  6. Weather integration in TMC operations : a self-evaluation and planning guide.

    Science.gov (United States)

    2009-04-01

    This flyer describes how Traffic Management Centers (TMC) can integrate weather information into their daily operations, and is based on the Road Weather Management Program publication, Self-Evaluation and Planning Guide (FHWA-JPO-08-057). The Guide ...

  7. Lake Superior Aquatic Invasive Species Complete Prevention Plan

    Science.gov (United States)

    The Lake Superior Aquatic Invasive Species Complete Prevention Plan is an expression of the best professional judgment of the members of the Lake Superior Task Force as to what is necessary to protect Lake Superior from new aquatic invasive species.

  8. B Plant Complex pollution prevention plan. Revision 1

    International Nuclear Information System (INIS)

    Beam, T.G.

    1994-01-01

    The US Department of Energy (DOE) has directed Westinghouse Hanford Company (WHC) to develop an effective strategy to minimize the generation of hazardous, radioactive, and mixed wastes at Hanford in compliance with state and federal regulations. WHC has formalized a pollution prevention program composed of management policies, management requirements and procedures. This plan addresses pollution prevention for B Plant Complex. A pollution prevention team is in place and has been assigned responsibility for implementing the plan. This plan includes actions and goals for reducing volume and toxicity of waste generated, as well as a basis for evaluation of progress. Descriptions of waste streams, current specific goals, general pollution prevention methods, and specific accomplishments are in the appendices of this plan

  9. National Action Plan for Adverse Drug Event Prevention: Recommendations for Safer Outpatient Opioid Use.

    Science.gov (United States)

    Ducoffe, Aaron R; York, Andrew; Hu, Dale J; Perfetto, Deborah; Kerns, Robert D

    2016-12-01

    Adverse drug events (ADEs) have been highlighted as a major patient safety and public health challenge by the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan), which was released by the Office of Disease Prevention and Health Promotion (ODPHP) in August 2014. The ADE Action Plan focuses on surveillance, evidence-based prevention, incentives, and oversights, additional research needs as well as possible measures and metrics to track progress of ADE prevention within three drug classes: anticoagulants, diabetes agents, and opioids.Objectives and Recommendations. With outpatient opioid prescriptions being a great concern among many healthcare providers, this article focuses on recommendations from the ADE Action Plan to help guide safer opioid use in healthcare delivery settings. Its aim is to discuss current federal methods in place to prevent opioid ADEs while also providing evidence to encourage providers and hospitals to innovate new systems and practices to increase prevention. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

  10. Preventative maintenance plan for emergency pumping trailers

    International Nuclear Information System (INIS)

    Wiggins, D.D.

    1994-09-01

    The purpose/goal of this document is to identify the maintenance requirements and resources available to properly maintain the readiness and condition of the Emergency Pumping Equipment controlled by the Tank Waste Remediation System Tank Farms Plant Engineering and Tank Stabilization Operations. This equipment is intended to pump a single-shell tank (SST) that has been identified as an assumed leaking tank. The goal is to commence pumping (submersible or jet) as soon as safely possible after identifying a SST as an assumed leaking tank. Important information pertaining to the Emergency Pumping Equipment, Over-Ground Piping installation, and procedures is found in WHC-SD-WM-AP-005, ''Single Shell Tank Leak Emergency Pumping Guide.''

  11. Livermore Site Spill Prevention, Control, and Countermeasures Plan, May 2017

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mertesdorf, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-05-01

    This Spill Prevention, Control, and Countermeasure (SPCC) Plan describes the measures that are taken at Lawrence Livermore National Laboratory’s (LLNL) Livermore Site in Livermore, California, to prevent, control, and handle potential spills from aboveground containers that can contain 55 gallons or more of oil.

  12. Autonomous guided vehicles methods and models for optimal path planning

    CERN Document Server

    Fazlollahtabar, Hamed

    2015-01-01

      This book provides readers with extensive information on path planning optimization for both single and multiple Autonomous Guided Vehicles (AGVs), and discusses practical issues involved in advanced industrial applications of AGVs. After discussing previously published research in the field and highlighting the current gaps, it introduces new models developed by the authors with the goal of reducing costs and increasing productivity and effectiveness in the manufacturing industry. The new models address the increasing complexity of manufacturing networks, due for example to the adoption of flexible manufacturing systems that involve automated material handling systems, robots, numerically controlled machine tools, and automated inspection stations, while also considering the uncertainty and stochastic nature of automated equipment such as AGVs. The book discusses and provides solutions to important issues concerning the use of AGVs in the manufacturing industry, including material flow optimization with A...

  13. PFP issues/assumptions development and management planning guide

    International Nuclear Information System (INIS)

    SINCLAIR, J.C.

    1999-01-01

    The PFP Issues/Assumptions Development and Management Planning Guide presents the strategy and process used for the identification, allocation, and maintenance of an Issues/Assumptions Management List for the Plutonium Finishing Plant (PFP) integrated project baseline. Revisions to this document will include, as attachments, the most recent version of the Issues/Assumptions Management List, both open and current issues/assumptions (Appendix A), and closed or historical issues/assumptions (Appendix B). This document is intended be a Project-owned management tool. As such, this document will periodically require revisions resulting from improvements of the information, processes, and techniques as now described. Revisions that suggest improved processes will only require PFP management approval

  14. Emergency planning at Class I nuclear facilities and uranium mines and mills. Regulatory guide G-225

    International Nuclear Information System (INIS)

    2001-08-01

    This regulatory guide is intended to help (1) applicants for operating licences for Class I nuclear facilities and (2) applicants for licences in respect of uranium mines and mills to develop emergency measures that satisfy the following: paragraph 6(k) of the Class I Nuclear Facilities Regulations and subparagraph 3(c)(x) of the Uranium Mines and Mills Regulations; and, the requirements of subsection 24(4) of the Nuclear Safety and Control Act, by demonstrating that the applicant will, in carrying on the proposed activity, make adequate provision for the protection of the environment, the health and safety of persons, and the maintenance of national security and measures required to implement international obligations to which Canada has agreed. The guide is also intended to aid the Canadian Nuclear Safety Commission (CNSC) in its evaluations of the adequacy of the emergency measures proposed by the above-mentioned applicants.This guide applies to applicants for a CNSC licence to operate a Class I nuclear facility, and to applicants for uranium mine and mill licences. The guide describes and discusses the elements of emergency preparedness and response that licence applicants should typically consider when they are developing plans to prevent or mitigate the effects of accidental releases from a Class I nuclear facility or a uranium mine or mill. (author)

  15. Site 300 Spill Prevention, Control, and Countermeasures (SPCC) Plan

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mertesdorf, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-12-01

    This Spill Prevention, Control, and Countermeasure (SPCC) Plan describes the measures that are taken at Lawrence Livermore National Laboratory’s (LLNL) Experimental Test Site (Site 300) near Tracy, California, to prevent, control, and handle potential spills from aboveground containers that can contain 55 gallons or more of oil. This SPCC Plan complies with the Oil Pollution Prevention regulation in Title 40 of the Code of Federal Regulations, Part 112 (40 CFR 112) and with 40 CFR 761.65(b) and (c), which regulates the temporary storage of polychlorinated biphenyls (PCBs). This Plan has also been prepared in accordance with Division 20, Chapter 6.67 of the California Health and Safety Code (HSC 6.67) requirements for oil pollution prevention (referred to as the Aboveground Petroleum Storage Act [APSA]), and the United States Department of Energy (DOE) Order No. 436.1. This SPCC Plan establishes procedures, methods, equipment, and other requirements to prevent the discharge of oil into or upon the navigable waters of the United States or adjoining shorelines for aboveground oil storage and use at Site 300. This SPCC Plan has been prepared for the entire Site 300 facility and replaces the three previous plans prepared for Site 300: LLNL SPCC for Electrical Substations Near Buildings 846 and 865 (LLNL 2015), LLNL SPCC for Building 883 (LLNL 2015), and LLNL SPCC for Building 801 (LLNL 2014).

  16. Waste minimization and pollution prevention awareness plan

    International Nuclear Information System (INIS)

    1994-08-01

    The primary mission of DOE/NV is to manage and operate the Nevada Test Site (NTS) and other designated test locations, within and outside the United States; provide facilities and services to DOE and non-DOE NTS users; and plan. coordinate, and execute nuclear weapons tests and related test activities. DOE/NV also: (a) Supports operations under interagency agreements pertaining to tests, emergencies, and related functions/activities, (b) Plans, coordinates, and executes environmental restoration, (c) Provides support to the Yucca Mountain Site Characterization Project Office in conjunction with DOE/HQ oversight, (d) Manages the Radioactive Waste Management Sites (RWMS) for disposal of low-level and mixed wastes received from the NTS and off-site generators, and (e) Implements waste minimization programs to reduce the amount of hazardous, mixed, radioactive, and nonhazardous solid waste that is generated and disposed The NTS, which is the primary facility controlled by DOE/NV, occupies 1,350 square miles of restricted-access, federally-owned land located in Nye County in Southern Nevada. The NTS is located in a sparsely populated area, approximately 65 miles northwest of Las Vegas, Nevada

  17. New plan to prevent female infanticide mooted.

    Science.gov (United States)

    1999-06-05

    The Campaign Against Female Infanticide in Tamil Nadu (CAFIT), sponsored by the Union Ministry of Human Resource Development, has brought to light a quadrangular model for the prevention of the social evil of female infanticide. The existence of female infanticide, according to the CAFIT, exposed the deplorable condition of women in society and reflected the perpetuation of customary and traditional practices in the sociocultural life of the people. The practice was associated with militant communities and other weaker segments living in less developed regions and with backward pockets marked by illiteracy, superstition, poverty, indebtedness, fear of liability, and emotional attachments to the soil and to cults. This paper also indicates the following preventive measures against female infanticide that are aimed at empowering women: establishing self-help groups and the sanction of micro credit for women in order to facilitate economic development, establishing rural and agriculture-based small-scale industries in order to generate local self-employment, and synchronization of crop insurance and marketing facilities in order to facilitate the provision of appropriate compensation in the event of crop failure caused by natural disasters.

  18. Environmental Release Prevention and Control Plan

    International Nuclear Information System (INIS)

    Mamatey, A.; Arnett, M.

    1997-01-01

    During the history of SRS, continual improvements in facilities, process, and operations, and changes in the site''s mission have reduced the amount of radioactive liquid releases. In the early years of SRS (1958 to 1965), the amount of tritium discharged to the Savannah River averaged approximately 61,000 curies a year. During the mid-1980''s (1983 to 1988), liquid releases of tritium averaged 27,000 curies a year. By 1996, liquid releases of tritium are projected to be just 3000 curies for the year. This large projected decrease is the result of the planned shut-down of all reactors and the anticipated significant decline in the amount of tritium migrating from the site seepage basins and the Solid Waste Disposal Facility

  19. Hanford site pollution prevention plan progress report, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Kirkendall, J.R.

    1996-08-26

    This report tracks progress made during 1995 against the goals stated in DOE/RL-92-62, Executive Summary, Hanford Site Pollution Prevention Plan. The Executive Summary of the plan was submitted to the Washington State Department of Ecology (Ecology) in September 1992. The plan, Executive Summary, and the progress reports are elements of a pollution prevention planning program that is required by WAC 173-307,`Plans,` for all hazardous substance users and/or all hazardous waste generators regulated by Ecology. These regulations implement RCW 70.95C, `Waste Reduction,` an act relating to hazardous waste reduction. The act encourages voluntary efforts to redesign industrial processes to help reduce or eliminate hazardous substances and hazardous waste byproducts, and to maximize the in- process reuse or reclamation of valuable spent material.

  20. 78 FR 32235 - Availability of Compliance Guide for Residue Prevention and Response to Comments

    Science.gov (United States)

    2013-05-29

    ... discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion...] Availability of Compliance Guide for Residue Prevention and Response to Comments AGENCY: Food Safety and... (FSIS) is announcing the availability of the final revision of the compliance guide for the prevention...

  1. 77 FR 24671 - Compliance Guide for Residue Prevention and Agency Testing Policy for Residues

    Science.gov (United States)

    2012-04-25

    ... Food Safety and Inspection Service Compliance Guide for Residue Prevention and Agency Testing Policy for Residues AGENCY: Food Safety and Inspection Service, USDA. ACTION: Notice of availability and... availability of a compliance guide for the prevention of violative residues in livestock slaughter...

  2. Environmental Restoration Contractor Waste Minimization and Pollution Prevention Plan

    International Nuclear Information System (INIS)

    Lewis, R.A.

    1994-11-01

    The purpose of this plan is to establish the Environmental Restoration Contractor (ERC) Waste Minimization and Pollution Prevention (WMin/P2) Program and outline the activities and schedules that will be employed to reduce the quantity and toxicity of wastes generated as a result of restoration and remediation activities. It is intended to satisfy the US Department of Energy (DOE) and other legal requirements. As such, the Pollution Prevention Awareness program required by DOE Order 5400.1 is included with the Pollution Prevention Program. This plan is also intended to aid projects in meeting and documenting compliance with the various requirements for WMin/P2, and contains the policy, objectives, strategy, and support activities of the WMin/P2 program. The basic elements of the plan are pollution prevention goals, waste assessments of major waste streams, implementation of feasible waste minimization opportunities, and a process for reporting achievements. Various pollution prevention techniques will be implemented with the support of employee training and awareness programs to reduce waste and still meet applicable requirements. Information about the Hanford Site is in the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan

  3. Implementing post-trial access plans for HIV prevention research.

    Science.gov (United States)

    Paul, Amy; Merritt, Maria W; Sugarman, Jeremy

    2018-02-27

    Ethics guidance increasingly recognises that researchers and sponsors have obligations to consider provisions for post-trial access (PTA) to interventions that are found to be beneficial in research. Yet, there is little information regarding whether and how such plans can actually be implemented. Understanding practical experiences of developing and implementing these plans is critical to both optimising their implementation and informing conceptual work related to PTA. This viewpoint is informed by experiences with developing and implementing PTA plans for six large-scale multicentre HIV prevention trials supported by the HIV Prevention Trials Network. These experiences suggest that planning and implementing PTA often involve challenges of planning under uncertainty and confronting practical barriers to accessing healthcare systems. Even in relatively favourable circumstances where a tested intervention medication is approved and available in the local healthcare system, system-level barriers can threaten the viability of PTA plans. The aggregate experience across these HIV prevention trials suggests that simply referring participants to local healthcare systems for PTA will not necessarily result in continued access to beneficial interventions for trial participants. Serious commitments to PTA will require additional efforts to learn from future approaches, measuring the success of PTA plans with dedicated follow-up and further developing normative guidance to help research stakeholders navigate the complex practical challenges of realising PTA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. The MSFC Systems Engineering Guide: An Overview and Plan

    Science.gov (United States)

    Shelby, Jerry A.; Thomas, L. Dale

    2007-01-01

    As systems and subsystems requirements become more complex in the pursuit of the exploration of space, advanced technology will demand and require an integrated approach to the design and development of safe and successful space vehicles and there products. System engineers play a vital and key role in transforming mission needs into vehicle requirements that can be verified and validated. This will result in a safe and cost effective design that will satisfy the mission schedule. A key to successful vehicle design within systems engineering is communication. Communication, through a systems engineering infrastructure, will not only ensure that customers and stakeholders are satisfied but will also assist in identifying vehicle requirements; i.e. identification, integration and management. This vehicle design will produce a system that is verifiable, traceable, and effectively satisfies cost, schedule, performance, and risk throughout the life-cycle of the product. A communication infrastructure will bring about the integration of different engineering disciplines within vehicle design. A system utilizing these aspects will enhance system engineering performance and improve upon required activities such as Development of Requirements, Requirements Management, Functional Analysis, Test, Synthesis, Trade Studies, Documentation, and Lessons Learned to produce a successful final product. This paper will describe the guiding vision, progress to date and the plan forward for development of the Marshall Space Flight Center (MSFC) Systems Engineering Guide (SEG), a virtual systems engineering handbook and archive that will describe the system engineering processes that are used by MSFC in the development of complex systems such as the Ares launch vehicle. It is the intent of this website to be a "One Stop Shop" for our systems engineers that will provide tutorial information, an overview of processes and procedures and links to assist system engineering with guidance and

  5. Self-Study Guide for Florida VPK Provider Improvement Plan Development

    Science.gov (United States)

    Phillips, Beth M.; Mazzeo, Debbie; Smith, Kevin

    2016-01-01

    This Self-Study Guide has been developed to support Florida Voluntary Prekindergarten Providers (VPK) who are required to complete an improvement plan process (i.e., low-performing providers). The guide has sections that can be used during both the process of selecting target areas for an improvement plan and the process of implementing new or…

  6. General Mechanical Repair. Minor Automotive Maintenance, Small Engine [Repair, and] Welding: Curriculum Guide and Lesson Plans.

    Science.gov (United States)

    Hamlin, Larry

    This document contains a curriculum guide and lesson plans for a general mechanical repair course with three sections: minor automotive maintenance, small engine repair, and welding. The curriculum guide begins with a matrix that relates the lesson plans to essential elements of math, science, language arts, and social studies and to Texas…

  7. Back-to-School Countdown: A Planning Guide for Time-Conscious Teachers.

    Science.gov (United States)

    Spann, Mary Beth

    1991-01-01

    This planning guide for efficient use of the last weeks before school opens offers ideas for interactive hall and wall displays, a guide to self-made math manipulatives, a materials checklist, a four-week task planning countdown, and a listing of teacher resource books and other classroom materials. (SM)

  8. Cervical cancer in Iquitos, Peru: local realities to guide prevention planning Câncer cérvico-uterino em Iquitos, Peru: realidade local como guia para planejamento da prevenção

    Directory of Open Access Journals (Sweden)

    Jennifer L. Hunter

    2004-02-01

    Full Text Available Cervical cancer is a major public health problem in Latin America, and in much of the underdeveloped world. This issue has not historically been addressed as a health priority, but in recent years is receiving increased attention and funding. This ethnographic study on the experience of cervical cancer was conducted in Iquitos, Peru, between August 1998 and May 1999. Research methodologies included: (1 observation and household interviews to obtain background knowledge about the region, medical systems, and local cultural understanding of illness; (2 cancer experience interviews; and (3 case studies of women in various stages of cervical cancer or diagnosis. Findings are presented related to local knowledge and experience of Pap smears and cervical cancer and the ineffectiveness of a recently initiated cervical cancer screening program. The findings guide recommendations for interventions in the region in relation to: (1 needed changes in health education, (2 screening frequency and age, (3 sites for screening and treatment, (4 type and availability of treatment, (5 payment issues, (6 documentation of care, and (7 the potential of herbal remedies.O câncer cérvico-uterino representa um desafio para a saúde pública na América Latina e em grande parte do mundo subdesenvolvido como um todo. Historicamente, a questão não tem sido tratada como prioridade de saúde; entretanto, nos últimos anos houve um aumento de interesse e de financiamento para enfrentar o problema. Este estudo etnográfico sobre a experiência com o câncer cérvico-uterino foi realizado em Iquitos, Peru, entre agosto de 1998 e maio de 1999. As metodologias de pesquisa incluíram: (1 observação e entrevistas domiciliares para levantar dados sobre a ocorrência na região, sobre os sistemas de saúde e a cultura local em relação ao processo da doença; (2 entrevistas sobre experiências pessoais e familiares com o câncer; e (3 estudos de caso de mulheres em diversas

  9. Livermore Site Spill Prevention, Control, and Countermeasures (SPCC) Plan

    Energy Technology Data Exchange (ETDEWEB)

    Bellah, W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Griffin, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mertesdorf, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-09-21

    This Spill Prevention, Control, and Countermeasure (SPCC) Plan describes the measures that are taken at Lawrence Livermore National Laboratory’s (LLNL) Livermore Site in Livermore, California, to prevent, control, and handle potential spills from aboveground containers that can contain 55 gallons or more of oil. This SPCC Plan complies with the Oil Pollution Prevention regulation in Title 40 of the Code of Federal Regulations (40 CFR), Part 112 (40 CFR 112) and with 40 CFR 761.65(b) and (c), which regulates the temporary storage of polychlorinated biphenyls (PCBs). This Plan has also been prepared in accordance with Division 20, Chapter 6.67 of the California Health and Safety Code (HSC 6.67) requirements for oil pollution prevention (referred to as the Aboveground Petroleum Storage Act [APSA]), and the United States Department of Energy (DOE) Order No. 436.1. This SPCC Plan establishes procedures, methods, equipment, and other requirements to prevent the discharge of oil into or upon the navigable waters of the United States or adjoining shorelines for aboveground oil storage and use at the Livermore Site.

  10. Planning and environment linkages program : a guide to measuring progress in linking transportation planning and environmental analysis

    Science.gov (United States)

    2009-12-01

    Transportation agencies use a variety of metrics to document progress toward achieving specific goals and objectives. This guide, developed by Federal Highway Administration (FHWA) Planning and Environmental Linkages (PEL) program, is intended to hel...

  11. 2010-2014 Pollution Prevention Program Strategic Plan

    Science.gov (United States)

    This Strategic Plan identifies a number of opportunities for EPA's Pollution Prevention (P2) Program to help reduce: the emission of greenhouse gasses; the use of hazardous materials; and the use of natural resources, while contributing to a greener and more sustainable economy.

  12. Braden Scale risk assessments and pressure ulcer prevention planning: what's the connection?

    Science.gov (United States)

    Magnan, Morris A; Maklebust, Joann

    2009-01-01

    To investigate the relationship between risk assessment scores on Braden subscales and nurses' selection of 10 commonly used best-practice pressure ulcer (PU) preventive interventions. Exploratory secondary data analysis, using a descriptive correlational design. A total of 377 Braden Scale PU risk assessments were made on 102 patients at different levels of risk. Assessments were made by RNs working at 3 different acute care hospitals. RNs making risk assessments also used an intervention checklist to select from 10 commonly used preventive interventions that should be implemented based on patient level of risk on each Braden subscale. The Braden Scale for Predicting Pressure Sore Risk was used to guide risk assessments. The Registered Nurses Intervention Checklist was used to identify PU preventive interventions that should be implemented. Braden subscale ratings influenced nurses' endorsement of preventive interventions in 2 distinct ways. First, endorsement of most (9 out of 10) preventive interventions was influenced by risk information embedded in unique combinations of Braden subscale assessments. Second, there appears to be a predictable pattern of increase in the likelihood of endorsing an intervention as Braden subscale scores decreased and the level of risk increased. Variability in Braden subscale ratings differentially predicts nurses' endorsements of selected PU-prevention interventions. Also, there is a predictable pattern of increase in the likelihood of endorsing a preventive intervention as PU risk levels increase, a pattern that may be related to the timing of risk assessment and PU-prevention planning activities.

  13. Waste Minimization/Pollution Prevention Crosscut Plan, 1994

    International Nuclear Information System (INIS)

    1994-01-01

    This plan establishes a Department-wide goal to reduce total releases of toxic chemicals to the environment and off-site transfers of such toxic chemicals by 50 percent by December 31, 1999, in compliance with Executive Order 12856. Each site that meets the threshold quantities of toxic chemicals established in the Emergency Planning and Community Right-to-Know Act (EPCRA) will participate in this goal. In addition, each DOE site will establish site-specific goals to reduce generation of hazardous, radioactive, radioactive mixed, and sanitary wastes and pollutants, as applicable. Implementation of this plan will represent a major step toward the environmental risks and costs associated with DOE operations and increasing the Department's use of preventive environmental management practices. Investing in Waste Minimization Pollution Prevention (WMin/PP) steadily reduce hazardous and radioactive waste generation and will reduce the need for waste management and unnecessary expenditures for waste treatment, storage, and disposal. A preventive approach to waste management will help solve current environmental and regulatory issues and reduce the need for costly future corrective actions. The purpose of this plan is to establish the strategic framework for integrating WMin/PP into all DOE internal activities. This program includes setting DOE policy and goals for reducing the generation of wastes and pollutants, increasing recycling activities, and establishing an infrastructure to achieve and measure the goals throughout the DOE complex. Waste Minimization and Pollution Prevention Awareness Plans, submitted to Headquarters by DOE field sites, will incorporate the WMin/PP activities and goals outlined in this plan. Success of the DOE WMin/PP program is dependent upon each field operation becoming accountable for resources used, wastes and pollutants generated, and wastes recycled

  14. Hanford Site Pollution Prevention Plan Progress report, 1993

    International Nuclear Information System (INIS)

    1994-08-01

    This report tracks progress against the goals stated in the Hanford Site 5-year Pollution Prevention Plan. The executive summary of the plan was submitted to the Washington State Department of Ecology (Ecology) in September 1992. The plan, executive summary, and the progress reports are elements of a pollution prevention planning program that is required by Washington Administrative Code (WAC) 173-307 for all hazardous substance users and/or all hazardous waste generators regulated by Ecology. These regulations implement Chapter 70.95C, Revised Code of Washington, an act relating to hazardous waste reduction. The act encourages voluntary efforts to redesign industrial processes to help reduce or eliminate hazardous substances and hazardous waste byproducts, and to maximize the inprocess reuse or reclamation of valuable spent material. Although the Hanford Site is exempt, it is voluntarily complying with this state regulatory-mandated program. This is the first year the Hanford Site is submitting a progress report. It covers calendar year 1993 plus the last quarter of 1992. What is reported, in accordance with WAC 173-307, are reductions in hazardous substance use and hazardous waste generated. A system of Process Waste Assessments (PWA) was chosen to meet the requirements of the program. The PWAs were organized by a physical facility or company organization. Each waste-generating facility/organization performed PWAs to identify, screen, and analyze their own reduction options. Each completed PWA identified any number of reduction opportunities, that are listed individually in the plan and summarized by category in the executive summary. These opportunities were to be implemented or evaluated further over the duration of the 5-year plan. The basis of this progress report is to track action taken on these PWA reduction opportunities in relationship to achieving the goals stated in the Pollution Prevention Plan

  15. Hanford Site Pollution Prevention Plan Progress report, 1993

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-01

    This report tracks progress against the goals stated in the Hanford Site 5-year Pollution Prevention Plan. The executive summary of the plan was submitted to the Washington State Department of Ecology (Ecology) in September 1992. The plan, executive summary, and the progress reports are elements of a pollution prevention planning program that is required by Washington Administrative Code (WAC) 173-307 for all hazardous substance users and/or all hazardous waste generators regulated by Ecology. These regulations implement Chapter 70.95C, Revised Code of Washington, an act relating to hazardous waste reduction. The act encourages voluntary efforts to redesign industrial processes to help reduce or eliminate hazardous substances and hazardous waste byproducts, and to maximize the inprocess reuse or reclamation of valuable spent material. Although the Hanford Site is exempt, it is voluntarily complying with this state regulatory-mandated program. This is the first year the Hanford Site is submitting a progress report. It covers calendar year 1993 plus the last quarter of 1992. What is reported, in accordance with WAC 173-307, are reductions in hazardous substance use and hazardous waste generated. A system of Process Waste Assessments (PWA) was chosen to meet the requirements of the program. The PWAs were organized by a physical facility or company organization. Each waste-generating facility/organization performed PWAs to identify, screen, and analyze their own reduction options. Each completed PWA identified any number of reduction opportunities, that are listed individually in the plan and summarized by category in the executive summary. These opportunities were to be implemented or evaluated further over the duration of the 5-year plan. The basis of this progress report is to track action taken on these PWA reduction opportunities in relationship to achieving the goals stated in the Pollution Prevention Plan.

  16. Strategic Planning in Higher Education: A Guide for Leaders. Second Edition [with CD-ROM

    Science.gov (United States)

    Tromp, Sherrie A.; Ruben, Brent D.

    2010-01-01

    "Strategic Planning in Higher Education" unveils a comprehensive approach to planning that has proved successful at Rutgers University. The SPHE framework, developed by authors Tromp and Ruben, provides a blueprint for planning--a step-by-step approach that guides leaders on strategic thinking; helps them align organizational goals with…

  17. Scheduling language and algorithm development study. Volume 2, phase 2: Introduction to plans programming. [user guide

    Science.gov (United States)

    Cochran, D. R.; Ishikawa, M. K.; Paulson, R. E.; Ramsey, H. R.

    1975-01-01

    A user guide for the Programming Language for Allocation and Network Scheduling (PLANS) is presented. Information is included for the construction of PLANS programs. The basic philosophy of PLANS is discussed, and access and update reference techniques are described along with the use of tree structures.

  18. Hanford Site waste minimization and pollution prevention awareness program plan

    International Nuclear Information System (INIS)

    1994-05-01

    The Hanford Site WMin/P2 program is an organized, comprehensive, and continual effort to systematically reduce the quantity and toxicity of hazardous, radioactive, mixed, and sanitary wastes; conserve resources; and prevent or minimize pollutant releases to all environmental media from all Site activities. The Hanford Site WMin/P2 program plan reflects national and DOE waste minimization and pollution prevention goals and policies, and represents an ongoing effort to make WMin/P2 part of the Site operating philosophy. In accordance with these policies, a hierarchical approach to environmental management has been adopted and is applied to all types of polluting and waste generating activities. Pollution prevention and waste minimization through source reduction are first priority in the Hanford WMin/P2 program, followed by environmentally safe recycling. Treatment to reduce the quantity, toxicity, and/or mobility will be considered only when prevention or recycling are not possible or practical. Environmentally safe disposal is the last option

  19. A resource-efficient planning for pressure ulcer prevention.

    Science.gov (United States)

    Ostadabbas, Sarah; Yousefi, Rasoul; Nourani, Mehrdad; Faezipour, Miad; Tamil, Lakshman; Pompeo, Matthew Q

    2012-11-01

    Pressure ulcer is a critical problem for bed-ridden and wheelchair-bound patients, diabetics, and the elderly. Patients need to be regularly repositioned to prevent excessive pressure on a single area of body, which can lead to ulcers. Pressure ulcers are extremely costly to treat and may lead to several other health problems, including death. The current standard for prevention is to reposition at-risk patients every two hours. Even if it is done properly, a fixed schedule is not sufficient to prevent all ulcers. Moreover, it may result in nurses being overworked by turning some patients too frequently. In this paper, we present an algorithm for finding a nurse-effort optimal repositioning schedule that prevents pressure ulcer formation for a finite planning horizon. Our proposed algorithm uses data from a commercial pressure mat assembled on the beds surface and provides a sequence of next positions and the time of repositioning for each patient.

  20. 2013 Vehicle Theft Prevention Quick Reference Guide for the Law Enforcement Community

    Science.gov (United States)

    2013-08-01

    "This and future versions of the Vehicle TheftPrevention Quick Reference Guide for the Law Enforcement Community will provide comprehensive information for vehicle lines. The parts-marking requirements have been : extended to include: : all passe...

  1. Environmental restoration program pollution prevention checklist guide for the evaluation of alternatives project phase

    International Nuclear Information System (INIS)

    1993-09-01

    Evaluation of alternative studies determine what decontamination and decommissioning (D ampersand D) alternatives are presented to regulators for facility and site cleanup. A key consideration in this process is the waste to be generated. Minimizing the volume and toxicity of this waste will ultimately contribute to the selection of the best clean-up option. The purpose of this checklist guide is to assist the user with incorporating pollution prevention/waste minimization (PP/WM) in all Evaluation of Alternatives (EV) phase projects of the Environmental Restoration (ER) Program. This guide will assist users with documenting PP/WM activities for technology transfer and reporting requirements. Automated computer screens will be created from the checklist data to help users implement and evaluate waste reduction. Users can then establish numerical performance measures to measure progress in planning, training, self-assessments, field implementation, documentation, and technology transfer. Cost savings result as users train and assess themselves, eliminating expensive process waste assessments and audit teams

  2. Hanford Site Pollution Prevention Plan progress report, 1994. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    This report tracks progress made during 1994 against the goals stated in DOE/RL-92-62, Executive Summary, Hanford Site Pollution Prevention Plan. The Executive Summary of the plan was submitted to the Washington State Department of Ecology (Ecology) in September 1992. The plan, Executive Summary, and the progress reports are elements of a pollution prevention planning program that is required by WAC 173-307, ``Plans,`` for all hazardous substance users and/or all hazardous waste generators regulated by Ecology. These regulations implement RCW 70.95C, ``Waste Reduction,`` an act relating to hazardous waste reduction. The act encourages voluntary efforts to redesign industrial processes to help reduce or eliminate hazardous substances and hazardous waste byproducts, and to maximize the in-process reuse or reclamation of valuable spent material. The Hanford Site is voluntarily complying with this state regulatory-mandated program. All treatment, storage, or disposal (TSD) facilities are exempt from participating; the Hanford Site is classified as a TSD.

  3. Hanford Site Pollution Prevention Plan progress report, 1994. Revision 1

    International Nuclear Information System (INIS)

    1995-09-01

    This report tracks progress made during 1994 against the goals stated in DOE/RL-92-62, Executive Summary, Hanford Site Pollution Prevention Plan. The Executive Summary of the plan was submitted to the Washington State Department of Ecology (Ecology) in September 1992. The plan, Executive Summary, and the progress reports are elements of a pollution prevention planning program that is required by WAC 173-307, ''Plans,'' for all hazardous substance users and/or all hazardous waste generators regulated by Ecology. These regulations implement RCW 70.95C, ''Waste Reduction,'' an act relating to hazardous waste reduction. The act encourages voluntary efforts to redesign industrial processes to help reduce or eliminate hazardous substances and hazardous waste byproducts, and to maximize the in-process reuse or reclamation of valuable spent material. The Hanford Site is voluntarily complying with this state regulatory-mandated program. All treatment, storage, or disposal (TSD) facilities are exempt from participating; the Hanford Site is classified as a TSD

  4. Chemical Spill Prevention, Control, and Countermeasures Plan: 100 Areas

    International Nuclear Information System (INIS)

    Chien, Y.M.

    1989-06-01

    The purpose of this Chemical Spill Prevention, Control, and Countermeasures (SPCC) Plan is to identify the chemical spill control practices, procedures, and containment devices Westinghouse Hanford Company (Westinghouse Hanford) employs to prevent a reportable quantity (RQ) of a hazardous substance (as defined in 40 CFR Part 302) from being released to the environment. The chemical systems and chemical storage facilities in the 100 Areas are described. This document traces the ultimate fate of accidental chemical spills at the 100 Areas. Also included in the document destinations, spill containment devices, and systems surveillance frequencies. 2 tabs

  5. Standard Guide for Environmental Monitoring Plans for Decommissioning of Nuclear Facilities

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This guide covers the development or assessment of environmental monitoring plans for decommissioning nuclear facilities. This guide addresses: (1) development of an environmental baseline prior to commencement of decommissioning activities; (2) determination of release paths from site activities and their associated exposure pathways in the environment; and (3) selection of appropriate sampling locations and media to ensure that all exposure pathways in the environment are monitored appropriately. This guide also addresses the interfaces between the environmental monitoring plan and other planning documents for site decommissioning, such as radiation protection, site characterization, and waste management plans, and federal, state, and local environmental protection laws and guidance. This guide is applicable up to the point of completing D&D activities and the reuse of the facility or area for other purposes.

  6. Design an effective storm water pollution prevention plan

    International Nuclear Information System (INIS)

    Vivona, M.A.

    1995-01-01

    A case history shows ''how'' to plan and organize a storm water pollution prevention program (SWPPP). Using easy-to-use worksheets and guidelines, hydrocarbon processing industry (HPI) operators can build upon existing best management practices (i.e., housekeeping procedures, visual inspections, spill prevention programs, etc.) to meet tighter restrictions set by National Pollutant Discharge Elimination system (NPDES) permits. Especially in high rainfall areas, storm water poses an intermittent, but large volume problem. The facility's site size is another factor that impacts the scope and cost for SWPPP. The five steps to implementing a SWPPP are: Planning and organization; Assessment; Best management practice (BMP) identification; Implementation; Evaluation and monitoring. Initially, HPI operators must identify all potential contamination sources and past spills and leak areas. Following the SWPP guidelines, operators can map out a cost-effective storm water program that meets all NPDES requirements

  7. Dare To Dream: A Guide to Planning Your Future. Revised.

    Science.gov (United States)

    Webb, Kristine; Repetto, Jeanne; Beutel, Adory; Perkins, Dollean; Bailey, Mary; Schwartz, Stuart

    This workbook is intended to help students with disabilities plan their postschool futures. In addition to the general material, "Dare To Know" boxes highlight important information, while "Dare To Think" and "Dare To Do" boxes provide activities to help with planning. Individual sections focus on topics such as the following: planning my…

  8. Guides to Pollution Prevention: Research and Educational Institutions.

    Science.gov (United States)

    Environmental Protection Agency, Cincinnati, OH. Office of Research and Development.

    This guide provides an overview of waste generating processes and operations that occur in educational or research institutions and presents options for minimizing waste generation through source reduction and recycling. A broad spectrum of waste chemicals in laboratories, art studios, print shops, maintenance, and other operations can be…

  9. Guide to DCP Study Close-Out: Milestones and Tasks | Division of Cancer Prevention

    Science.gov (United States)

    This guide assists Consortium Lead Organization (CLO) planning for DCP study close-out. Study close-out tasks are organized under milestones, which help mark progress toward completion of the close-out process. Once tasks associated with a milestone are underway, planning for the next milestone may begin. Click on a milestone to view the associated close-out tasks. |

  10. Six-Degree-of-Freedom Dynamic Test System (SDTS) User Test Planning Guide

    Science.gov (United States)

    Stokes, LeBarian

    2012-01-01

    Test process, milestones and inputs are unknowns to first-time users of the SDTS. The User Test Planning Guide aids in establishing expectations for both NASA and non- NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  11. Guides to pollution prevention: Selected hospital waste streams

    International Nuclear Information System (INIS)

    1990-06-01

    The hazardous wastes generated by general medical and surgical hospitals are small in volume relative to those of industrial facilities; however, the wastes are of a wide variety. Some of the hazardous materials used by hospitals that become part of their waste streams include chemotherapy and antineoplastic chemicals, solvents, formaldehyde, photographic chemicals, radionuclides, mercury, waste anesthetic gases; and other toxic, corrosive and miscellaneous chemicals. Additional wastes such as infectious waste, incinerator exhaust, laundry-related waste, utility wastes, and trash were not addressed in the guide. Reducing the generation of these materials at the source, or recycling the wastes on- or off-site, will benefit hospitals by reducing disposal costs and lowering the liabilities associated with hazardous waste disposal. The guide provides an overview of hospital waste generating processes and presents options for minimizing waste generation through source reduction and recycling

  12. Assessing Changes in Job Behavior Due to Training: A Guide to the Participant Action Plan Approach.

    Science.gov (United States)

    Office of Personnel Management, Washington, DC.

    This guide provides a brief introduction to the Participant Action Plan Approach (PAPA) and a user's handbook. Part I outlines five steps of PAPA which determine how job behavior is changed by training course or program participation. Part II, the manual, is arranged by the five steps of the PAPA approach. Planning for PAPA discusses making…

  13. Guide for prepare the plan for radiological emergency by the users of ionizing radiation sources

    International Nuclear Information System (INIS)

    1992-01-01

    The Radiological Emergency Plan foresees all the possible radiological accidents with the ionizing sources the entity is using. The measures should be adopted by every factor is supped to take part in the emergencies created. The effectiveness of the guaranteed. THis guide establishes the model for elaborating the radiological Emergency Plans

  14. Automatic image processing solutions for MRI-guided minimally invasive intervention planning

    NARCIS (Netherlands)

    Noorda, YH

    2016-01-01

    In this thesis, automatic image processing methods are discussed for the purpose of improving treatment planning of MRI-guided minimally invasive interventions. Specifically, the following topics are addressed: rib detection in MRI, liver motion modeling in MRI and MR-CT registration of planning

  15. A Minimum Effort Control Approach to Guided Munition Path Planning

    National Research Council Canada - National Science Library

    Borkowski, Jeffrey M

    2006-01-01

    .... The foundation of this path planning method is found in the principles of minimum effort control optimization. Results demonstrate the ability of the path planning algorithm to determine a path for the munition to follow which is both stable and feasible.

  16. Understanding HPV Disease and Prevention: A Guide for School Nurses

    Science.gov (United States)

    Lockwood-Rayermann, Suzy; McIntyre, Susan J.

    2009-01-01

    Oncogenic human papillomavirus (HPV) causes 99.7% of all cervical cancers. HPV Types 16 and 18 are responsible for approximately 77% of cases, and peak prevalence occurs in females younger than 25 years of age. The recent implementation of HPV vaccination provides females with the opportunity to prevent infection. School nurses are advocates of…

  17. Planning against crime: preventing crime with people not barriers

    CSIR Research Space (South Africa)

    Landman, K

    2005-03-01

    Full Text Available committees to work closely with the police, and in some instances involving local employees (such as domestic workers) to act as the ‘eyes on the street’ and report suspicious behaviour.7 The question that arises is, therefore, how to plan against crime... AND LIEBERMANN six policing areas in the Northern Cape and is also being used in KwaZulu-Natal as part of a broader local crime prevention strategy. So far, the evidence suggests that the model has significant potential to enhance local safety. The model...

  18. Technology disaster response and recovery planning a LITA guide

    CERN Document Server

    Mallery, Mary

    2015-01-01

    Featuring contributions from librarians who offer hard-won advice gained from personal experience, this compendium leads readers through a step-by-step process of creating a library technology disaster response and recovery plan.

  19. A practical guide to prevention for forensic nursing.

    Science.gov (United States)

    Trujillo, Angelia C; Delapp, Tina D; Hendrix, Thomas J

    2014-01-01

    Interpersonal violence (IPV) is a pervasive issue across the United States, affecting one in five women and costing the nation up to $750 billion per year in additional healthcare spending. Prevention of IPV by forensic nurses may be an underrecognized and underutilized activity as forensic nursing emphasizes collection of evidence and provision of acute care to victims of violence. The "Upstream Adage" parable has been used to identify activities that can be applied to the care of victims. Forensic nurses can expand their practice activities into an "upstream" focus by targeting communities and individuals at different levels of risk and participating in key interventions before violence occurs. The role for forensic nurses to inform, participate, and implement primary, secondary, and tertiary prevention activities can have positive influences on the problem of IPV that extends well beyond the provision of direct care.

  20. A DVH-guided IMRT optimization algorithm for automatic treatment planning and adaptive radiotherapy replanning

    International Nuclear Information System (INIS)

    Zarepisheh, Masoud; Li, Nan; Long, Troy; Romeijn, H. Edwin; Tian, Zhen; Jia, Xun; Jiang, Steve B.

    2014-01-01

    Purpose: To develop a novel algorithm that incorporates prior treatment knowledge into intensity modulated radiation therapy optimization to facilitate automatic treatment planning and adaptive radiotherapy (ART) replanning. Methods: The algorithm automatically creates a treatment plan guided by the DVH curves of a reference plan that contains information on the clinician-approved dose-volume trade-offs among different targets/organs and among different portions of a DVH curve for an organ. In ART, the reference plan is the initial plan for the same patient, while for automatic treatment planning the reference plan is selected from a library of clinically approved and delivered plans of previously treated patients with similar medical conditions and geometry. The proposed algorithm employs a voxel-based optimization model and navigates the large voxel-based Pareto surface. The voxel weights are iteratively adjusted to approach a plan that is similar to the reference plan in terms of the DVHs. If the reference plan is feasible but not Pareto optimal, the algorithm generates a Pareto optimal plan with the DVHs better than the reference ones. If the reference plan is too restricting for the new geometry, the algorithm generates a Pareto plan with DVHs close to the reference ones. In both cases, the new plans have similar DVH trade-offs as the reference plans. Results: The algorithm was tested using three patient cases and found to be able to automatically adjust the voxel-weighting factors in order to generate a Pareto plan with similar DVH trade-offs as the reference plan. The algorithm has also been implemented on a GPU for high efficiency. Conclusions: A novel prior-knowledge-based optimization algorithm has been developed that automatically adjust the voxel weights and generate a clinical optimal plan at high efficiency. It is found that the new algorithm can significantly improve the plan quality and planning efficiency in ART replanning and automatic treatment

  1. Standard Guide for Preparing Waste Management Plans for Decommissioning Nuclear Facilities

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This guide addresses the development of waste management plans for potential waste streams resulting from decommissioning activities at nuclear facilities, including identifying, categorizing, and handling the waste from generation to final disposal. 1.2 This guide is applicable to potential waste streams anticipated from decommissioning activities of nuclear facilities whose operations were governed by the Nuclear Regulatory Commission (NRC) or Agreement State license, under Department of Energy (DOE) Orders, or Department of Defense (DoD) regulations. 1.3 This guide provides a description of the key elements of waste management plans that if followed will successfully allow for the characterization, packaging, transportation, and off-site treatment or disposal, or both, of conventional, hazardous, and radioactive waste streams. 1.4 This guide does not address the on-site treatment, long term storage, or on-site disposal of these potential waste streams. 1.5 This standard does not purport to address ...

  2. Planning for disasters involving children in Australia: A practical guide.

    Science.gov (United States)

    Grindlay, Joanne; Breeze, Katina Mai

    2016-02-01

    Children comprise 19% of the Australian population. Children are at risk of higher morbidity and mortality in disaster events than adults; however, there is a paucity of paediatric-specific disaster preparedness in Australia. Paediatric disaster plans should be developed, tested and renewed regularly. Plans need to address unaccompanied and unidentified children, medical and psychosocial needs and family reunification. Specific management is required for chemical, biological and radiological events. © 2016 The Authors Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  3. Commentary: evidence to guide gun violence prevention in America.

    Science.gov (United States)

    Webster, Daniel W

    2015-03-18

    Gun violence is a major threat to the public's health and safety in the United States. The articles in this volume's symposium on gun violence reveal the scope of the problem and new trends in mortality rates from gunfire. Leading scholars synthesize research evidence that demonstrates the ability of numerous policies and programs-each consistent with lessons learned from successful efforts to combat public health problems-to prevent gun violence. Each approach presents challenges to successful implementation. Future research should inform efforts to assess which approaches are most effective and how to implement evidence-based interventions most effectively.

  4. A municipal guide to least cost utility planning

    International Nuclear Information System (INIS)

    1992-03-01

    The recent track record of ''traditional'' electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states' least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process

  5. A municipal guide to least cost utility planning

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    The recent track record of traditional'' electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states' least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process.

  6. A municipal guide to least cost utility planning

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    The recent track record of ``traditional`` electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states` least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process.

  7. A Guide for Planning Programs in Agricultural Education.

    Science.gov (United States)

    Eichelberger, A. E.; And Others

    The general information necessary for planning a high school program in agricultural educated is provided, based on the following briefly described occupational areas: agricultural production, agricultural supplied/services, agricultural mechanics, agricultural products (processing, inspection, and marketing), agricultural resources (conversation,…

  8. Planning guide for radiologic installations. fascicle 1 -- radiation therapy installations

    International Nuclear Information System (INIS)

    Tuddenham, W.J.

    1976-01-01

    Five articles dealing with the development and operation of radiation therapy facilities present recommendations for the design of various types of radiation therapy facilities, including the university center, the free-standing private oncology center, and the community hospital radiation therapy department. Different concepts of department design are represented. In one article, the planning room is conceived to be the central feature of a facility; in another article, radiation therapy is designed around examination rooms. Shielding requirements are also discussed, as are the advantages and space and licensing requirements of various types of equipment. There is a need for planning appropriate computer facilities in conjunction with other equipment plans, and a critique of one radiation therapy unit is provided. The concept of a regional network for the delivery of radiation therapy services is then explored. The volume contains extensive illustrations in the form of floor plans, drawings, figures, and tables. Many of the articles include a bibliography. This is the first in a series of publications on radiation department design which will be useful to architects, engineers, and hospital planners

  9. Medication Errors: New EU Good Practice Guide on Risk Minimisation and Error Prevention.

    Science.gov (United States)

    Goedecke, Thomas; Ord, Kathryn; Newbould, Victoria; Brosch, Sabine; Arlett, Peter

    2016-06-01

    A medication error is an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient. Reducing the risk of medication errors is a shared responsibility between patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. In 2015, the EU regulatory network released a two-part good practice guide on medication errors to support both the pharmaceutical industry and regulators in the implementation of the changes introduced with the EU pharmacovigilance legislation. These changes included a modification of the 'adverse reaction' definition to include events associated with medication errors, and the requirement for national competent authorities responsible for pharmacovigilance in EU Member States to collaborate and exchange information on medication errors resulting in harm with national patient safety organisations. To facilitate reporting and learning from medication errors, a clear distinction has been made in the guidance between medication errors resulting in adverse reactions, medication errors without harm, intercepted medication errors and potential errors. This distinction is supported by an enhanced MedDRA(®) terminology that allows for coding all stages of the medication use process where the error occurred in addition to any clinical consequences. To better understand the causes and contributing factors, individual case safety reports involving an error should be followed-up with the primary reporter to gather information relevant for the conduct of root cause analysis where this may be appropriate. Such reports should also be summarised in periodic safety update reports and addressed in risk management plans. Any risk minimisation and prevention strategy for medication errors should consider all stages of a medicinal product's life-cycle, particularly the main sources and types of medication errors during product development. This article

  10. Changing Minds: A Guide to Facilitated Participatory Planning ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-10-01

    Oct 1, 2011 ... Changing Minds is authored by former Regional Director of UNICEF and FPP pioneer Cole P. Dodge, and award-winning Strategic Communication ... IDRC is supporting research that studies the most effective ways to empower women, prevent gender-based violence, and make digital platforms work for ...

  11. Evaluation of an artificial intelligence guided inverse planning system: Clinical case study

    International Nuclear Information System (INIS)

    Yan Hui; Yin Fangfang; Willett, Christopher

    2007-01-01

    Purpose: An artificial intelligence (AI) guided method for parameter adjustment of inverse planning was implemented on a commercial inverse treatment planning system. For evaluation purpose, four typical clinical cases were tested and the results from both plans achieved by automated and manual methods were compared. Methods and materials: The procedure of parameter adjustment mainly consists of three major loops. Each loop is in charge of modifying parameters of one category, which is carried out by a specially customized fuzzy inference system. A physician prescribed multiple constraints for a selected volume were adopted to account for the tradeoff between prescription dose to the PTV and dose-volume constraints for critical organs. The searching process for an optimal parameter combination began with the first constraint, and proceeds to the next until a plan with acceptable dose was achieved. The initial setup of the plan parameters was the same for each case and was adjusted independently by both manual and automated methods. After the parameters of one category were updated, the intensity maps of all fields were re-optimized and the plan dose was subsequently re-calculated. When final plan arrived, the dose statistics were calculated from both plans and compared. Results: For planned target volume (PTV), the dose for 95% volume is up to 10% higher in plans using the automated method than those using the manual method. For critical organs, an average decrease of the plan dose was achieved. However, the automated method cannot improve the plan dose for some critical organs due to limitations of the inference rules currently employed. For normal tissue, there was no significant difference between plan doses achieved by either automated or manual method. Conclusion: With the application of AI-guided method, the basic parameter adjustment task can be accomplished automatically and a comparable plan dose was achieved in comparison with that achieved by the manual

  12. Information Center Planning and Implementation Guide. Part B. Revision

    Science.gov (United States)

    1986-10-20

    Plan (IMP) a. Approval b. Funding .0 w~Ne- V. Hardware Availability a. PRIME MINI ( PRIMOS /UNIX) b. INTEL MICRO (UNLX) c. MICRO (MS-DOS) d. DA MINI e...FroiucLs Ab wii is cxplutt kno%.ILUJ. 01 ;,)I Lij-t",,-&st,. EzoJL zo1 OViijbic on Ux. int-i . levi um.irar.Imc. IKcticcg vr wil ’~V L;AC10-JIL’j t..rc

  13. Lexical Complexity of Decision-Making Writing Tasks: Form-focused Guided Strategic Planning

    Directory of Open Access Journals (Sweden)

    Fatemeh Mahdavirad

    2016-06-01

    Full Text Available The present study is an attempt to investigate the effect of form-focused guided strategic planning on lexical complexity of learners’ performance in writing tasks. The twenty intermediate level participants of the study performed an unplanned and then a planned decision-making task. In the planned task condition, the participants were provided with form-focused guided strategic planning which contained detailed instructions about how to plan, by being instructed to focus on form. The guidance included an explanation of the necessary structural and lexical patterns employed to express the learners’ views while developing a comparison-and-contrast paragraph in each task. The results of the statistical analysis indicated that the participants produced a written product with a greater lexical complexity in their performance of the task in the form-focused strategic planning condition. The findings emphasize the importance of guided strategic planning as a task condition in syllabus design for task-based language teaching and the necessity of incorporating this task feature for accomplishing lexical complexity in decision-making writing tasks.

  14. Are virtual planning and guided surgery for head and neck reconstruction economically viable?

    Science.gov (United States)

    Zweifel, Daniel Fritz; Simon, Christian; Hoarau, Remy; Pasche, Philippe; Broome, Martin

    2015-01-01

    Virtual planning and guided surgery with or without prebent or milled plates are becoming more and more common for mandibular reconstruction with fibular free flaps (FFFs). Although this excellent surgical option is being used more widely, the question of the additional cost of planning and cutting-guide production has to be discussed. In capped payment systems such additional costs have to be offset by other savings if there are no special provisions for extra funding. Our study was designed to determine whether using virtual planning and guided surgery resulted in time saved during surgery and whether this time gain resulted in self-funding of such planning through the time saved. All consecutive cases of FFF surgery were evaluated during a 2-year period. Institutional data were used to determine the price of 1 minute of operative time. The time for fibula molding, plate adaptation, and insetting was recorded. During the defined period, we performed 20 mandibular reconstructions using FFFs, 9 with virtual planning and guided surgery and 11 freehand cases. One minute of operative time was calculated to cost US $47.50. Multiplying this number by the time saved, we found that the additional cost of virtual planning was reduced from US $5,098 to US $1,231.50 with a prebent plate and from US $6,980 to US $3,113.50 for a milled plate. Even in capped health care systems, virtual planning and guided surgery including prebent or milled plates are financially viable. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Guided Learning at Workstations about Drug Prevention with Low Achievers in Science Education

    Science.gov (United States)

    Thomas, Heyne; Bogner, Franz X.

    2012-01-01

    Our study focussed on the cognitive achievement potential of low achieving eighth graders, dealing with drug prevention (cannabis). The learning process was guided by a teacher, leading this target group towards a modified learning at workstations which is seen as an appropriate approach for low achievers. We compared this specific open teaching…

  16. Fire Safety's My Job. Eighth Grade. Fire Safety for Texans: Fire and Burn Prevention Curriculum Guide.

    Science.gov (United States)

    Texas State Commission on Fire Protection, Austin.

    This booklet comprises the eighth grade component of a series of curriculum guides on fire and burn prevention. Designed to meet the age-specific needs of eighth grade students, its objectives include: (1) focusing on technical aspects of fire hazards and detection, and (2) exploring fire hazards outside the home. Texas essential elements of…

  17. Impact of field number and beam angle on functional image-guided lung cancer radiotherapy planning

    Science.gov (United States)

    Tahir, Bilal A.; Bragg, Chris M.; Wild, Jim M.; Swinscoe, James A.; Lawless, Sarah E.; Hart, Kerry A.; Hatton, Matthew Q.; Ireland, Rob H.

    2017-09-01

    To investigate the effect of beam angles and field number on functionally-guided intensity modulated radiotherapy (IMRT) normal lung avoidance treatment plans that incorporate hyperpolarised helium-3 magnetic resonance imaging (3He MRI) ventilation data. Eight non-small cell lung cancer patients had pre-treatment 3He MRI that was registered to inspiration breath-hold radiotherapy planning computed tomography. IMRT plans that minimised the volume of total lung receiving  ⩾20 Gy (V20) were compared with plans that minimised 3He MRI defined functional lung receiving  ⩾20 Gy (fV20). Coplanar IMRT plans using 5-field manually optimised beam angles and 9-field equidistant plans were also evaluated. For each pair of plans, the Wilcoxon signed ranks test was used to compare fV20 and the percentage of planning target volume (PTV) receiving 90% of the prescription dose (PTV90). Incorporation of 3He MRI led to median reductions in fV20 of 1.3% (range: 0.2-9.3% p  =  0.04) and 0.2% (range: 0 to 4.1%; p  =  0.012) for 5- and 9-field arrangements, respectively. There was no clinically significant difference in target coverage. Functionally-guided IMRT plans incorporating hyperpolarised 3He MRI information can reduce the dose received by ventilated lung without comprising PTV coverage. The effect was greater for optimised beam angles rather than uniformly spaced fields.

  18. A Guide for Teaching Regional Environmental Planning. Final Report of Project - Inservice Personnel Development: Regional Environmental Planning Workshops for Tri-County Secondary School Teachers.

    Science.gov (United States)

    Gallagher, James Joseph, Ed.

    This guide is designed for teachers, administrators, inservice leaders, and teacher educators. Its purpose is to provide an organizational framework, material, and resources for the development of instructional plans and strategies for incorporating regional environmental planning in the secondary school curriculum. The guide is divided into three…

  19. Writing Information Literacy Assessment Plans: A Guide to Best Practice

    Directory of Open Access Journals (Sweden)

    Megan Oakleaf

    2010-03-01

    Full Text Available Academic librarians throughout higher education add value to the teaching and learning missions of their institutions though information literacy instruction. To demonstrate the full impact of librarians on students in higher education, librarians need comprehensive information literacy assessment plans, composed of instructional program-level and outcome-level components, that summarize the purpose of information literacy assessment, emphasize the theoretical basis of their assessment efforts, articulate specific information literacy goals and outcomes, describe the major assessment methods and tools used to capture evidence of student learning, report assessment results, and highlight improvements made as a consequence of learning assessment.

  20. Restoration planning to guide Aichi targets in a megadiverse country.

    Science.gov (United States)

    Tobón, Wolke; Urquiza-Haas, Tania; Koleff, Patricia; Schröter, Matthias; Ortega-Álvarez, Rubén; Campo, Julio; Lindig-Cisneros, Roberto; Sarukhán, José; Bonn, Aletta

    2017-10-01

    Ecological restoration has become an important strategy to conserve biodiversity and ecosystems services. To restore 15% of degraded ecosystems as stipulated by the Convention on Biological Diversity Aichi target 15, we developed a prioritization framework to identify potential priority sites for restoration in Mexico, a megadiverse country. We used the most current biological and environmental data on Mexico to assess areas of biological importance and restoration feasibility at national scale and engaged stakeholders and experts throughout the process. We integrated 8 criteria into 2 components (i.e., biological importance and restoration feasibility) in a spatial multicriteria analysis and generated 11 scenarios to test the effect of assigning different component weights. The priority restoration sites were distributed across all terrestrial ecosystems of Mexico; 64.1% were in degraded natural vegetation and 6% were in protected areas. Our results provide a spatial guide to where restoration could enhance the persistence of species of conservation concern and vulnerable ecosystems while maximizing the likelihood of restoration success. Such spatial prioritization is a first step in informing policy makers and restoration planners where to focus local and large-scale restoration efforts, which should additionally incorporate social and monetary cost-benefit considerations. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  1. 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

  2. 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

  3. Guide for Educational Planning of Public School Buildings and Sites in Minnesota. Revised.

    Science.gov (United States)

    Minnesota State Dept. of Administration, St. Paul. Documents Section.

    This guide serves as a manual for Minnesota school boards, administrators, architects, engineers, and others engaged in developing school plant programs. Part I considers State and local responsibilities in school plant planning procedures; Part II deals with site selection and the requirements for elementary, secondary, service, central, and…

  4. Frustration-guided motion planning reveals conformational transitions in proteins.

    Science.gov (United States)

    Budday, Dominik; Fonseca, Rasmus; Leyendecker, Sigrid; van den Bedem, Henry

    2017-10-01

    Proteins exist as conformational ensembles, exchanging between substates to perform their function. Advances in experimental techniques yield unprecedented access to structural snapshots of their conformational landscape. However, computationally modeling how proteins use collective motions to transition between substates is challenging owing to a rugged landscape and large energy barriers. Here, we present a new, robotics-inspired motion planning procedure called dCC-RRT that navigates the rugged landscape between substates by introducing dynamic, interatomic constraints to modulate frustration. The constraints balance non-native contacts and flexibility, and instantaneously redirect the motion towards sterically favorable conformations. On a test set of eight proteins determined in two conformations separated by, on average, 7.5 Å root mean square deviation (RMSD), our pathways reduced the Cα atom RMSD to the goal conformation by 78%, outperforming peer methods. We then applied dCC-RRT to examine how collective, small-scale motions of four side-chains in the active site of cyclophilin A propagate through the protein. dCC-RRT uncovered a spatially contiguous network of residues linked by steric interactions and collective motion connecting the active site to a recently proposed, non-canonical capsid binding site 25 Å away, rationalizing NMR and multi-temperature crystallography experiments. In all, dCC-RRT can reveal detailed, all-atom molecular mechanisms for small and large amplitude motions. Source code and binaries are freely available at https://github.com/ExcitedStates/KGS/. © 2017 Wiley Periodicals, Inc.

  5. Suggested Curriculum and Planning Guide for Developing a Program in Auto Mechanics. Bulletin No. 49-174.

    Science.gov (United States)

    Illinois State Board of Vocational Education and Rehabilitation, Springfield. Div. of Vocational and Technical Education.

    The curriculum and planning guide has two objectives: to give the instructor, planner, and counselor a guide which furnishes current information on the trade, facility planning, equipment, and resource information for all levels of occupational instruction in the field of auto mechanics maintenance and repair; and to enable the student to be…

  6. Functional image guided radiation therapy planning in volumetric modulated arc therapy for patients with malignant pleural mesothelioma

    Directory of Open Access Journals (Sweden)

    Yoshiko Doi, MD

    2017-04-01

    Conclusions: Significant reductions in fV5, fV10, fMLD, V5, and MLD were achieved with the functional image guided VMAT plan without negative effects on other factors. LAA-based functional image guided radiation therapy planning in VMAT is a feasible method to spare the functional lung in patients with MPM.

  7. Beam's-Eye-View Dosimetrics-Guided Inverse Planning for Aperture-Modulated Arc Therapy

    International Nuclear Information System (INIS)

    Ma Yunzhi; Popple, Richard; Suh, Tae-Suk; Xing Lei

    2009-01-01

    Purpose: To use angular beam's-eye-view dosimetrics (BEVD) information to improve the computational efficiency and plan quality of inverse planning of aperture-modulated arc therapy (AMAT). Methods and Materials: In BEVD-guided inverse planning, the angular space spanned by a rotational arc is represented by a large number of fixed-gantry beams with angular spacing of ∼2.5 degrees. Each beam is assigned with an initial aperture shape determined by the beam's-eye-view (BEV) projection of the planning target volume (PTV) and an initial weight. Instead of setting the beam weights arbitrarily, which slows down the subsequent optimization process and may result in a suboptimal solution, a priori knowledge about the quality of the beam directions derived from a BEVD is adopted to initialize the weights. In the BEVD calculation, a higher score is assigned to directions that allow more dose to be delivered to the PTV without exceeding the dose tolerances of the organs at risk (OARs) and vice versa. Simulated annealing is then used to optimize the segment shapes and weights. The BEVD-guided inverse planning is demonstrated by using two clinical cases, and the results are compared with those of a conventional approach without BEVD guidance. Results: An a priori knowledge-guided inverse planning scheme for AMAT is established. The inclusion of BEVD guidance significantly improves the convergence behavior of AMAT inverse planning and results in much better OAR sparing as compared with the conventional approach. Conclusions: BEVD-guidance facilitates AMAT treatment planning and provides a comprehensive tool to maximally use the technical capacity of the new arc therapeutic modality.

  8. 77 FR 60907 - Approval and Promulgation of Implementation Plans; Vermont: Prevention of Significant...

    Science.gov (United States)

    2012-10-05

    ... Promulgation of Implementation Plans; Vermont: Prevention of Significant Deterioration; Greenhouse Gas... February 14, 2011. The SIP revision modifies Vermont's Prevention of Significant Deterioration (PSD... at the U.S. Environmental Protection Agency, EPA New England Regional Office, Office of Ecosystem...

  9. 77 FR 5700 - Approval and Promulgation of Implementation Plans; New Hampshire: Prevention of Significant...

    Science.gov (United States)

    2012-02-06

    ... Promulgation of Implementation Plans; New Hampshire: Prevention of Significant Deterioration; Greenhouse Gas... revision modifies New Hampshire's Prevention of Significant Deterioration (PSD) program to establish... of Ecosystem Protection, Air Permits, Toxics, and Indoor Programs Unit, 5 Post Office Square--Suite...

  10. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs.

    Science.gov (United States)

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Graves, Yan Jiang; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

    2013-12-21

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using

  11. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs

    Science.gov (United States)

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Jiang Graves, Yan; Gautier, Quentin; Mell, Loren; Zhou, Linghong; Jia, Xun; Jiang, Steve

    2013-12-01

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose-volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30 s using

  12. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs

    International Nuclear Information System (INIS)

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Graves, Yan Jiang; Gautier, Quentin; Mell, Loren; Jia, Xun; Jiang, Steve; Zhou, Linghong

    2013-01-01

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose–volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30

  13. Prevention That Works! A Guide for Developing School-Based Drug and Violence Prevention Programs.

    Science.gov (United States)

    Knowles, Cynthia R.

    This book helps educators produce assessments of their schools' drug and violence prevention programs. It contains over 30 separate resources that can be adapted to specific evaluations (e.g., sample youth and adult participant feedback sheets, sample classroom observation sheets and teacher implementation logs, sample en-route participant…

  14. Planning and Preparing for Emergency Response to Transport Accidents Involving Radioactive Material. Safety Guide

    International Nuclear Information System (INIS)

    2009-01-01

    This Safety Guide provides guidance on various aspects of emergency planning and preparedness for dealing effectively and safely with transport accidents involving radioactive material, including the assignment of responsibilities. It reflects the requirements specified in Safety Standards Series No. TS-R-1, Regulations for the Safe Transport of Radioactive Material, and those of Safety Series No. 115, International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. Contents: 1. Introduction; 2. Framework for planning and preparing for response to accidents in the transport of radioactive material; 3. Responsibilities for planning and preparing for response to accidents in the transport of radioactive material; 4. Planning for response to accidents in the transport of radioactive material; 5. Preparing for response to accidents in the transport of radioactive material; Appendix I: Features of the transport regulations influencing emergency response to transport accidents; Appendix II: Preliminary emergency response reference matrix; Appendix III: Guide to suitable instrumentation; Appendix IV: Overview of emergency management for a transport accident involving radioactive material; Appendix V: Examples of response to transport accidents; Appendix VI: Example equipment kit for a radiation protection team; Annex I: Example of guidance on emergency response to carriers; Annex II: Emergency response guide.

  15. Business Planning for Cultural Heritage Institutions. A Framework and Resource Guide to Assist Cultural Heritage Institutions with Business Planning for Sustainability of Digital Asset Management Programs

    Science.gov (United States)

    Bishoff, Liz; Allen, Nancy

    2004-01-01

    The purpose of this document is to present a framework and resource guide to help cultural heritage institutions plan sustainable access to their digital cultural assets and to do so by means that link their missions to planning modes and models. To aid cultural heritage organizations in the business-planning process, this resource will do the…

  16. Environmental Restoration Contractor Waste Minimization and Pollution Prevention Plan. Revision 1

    International Nuclear Information System (INIS)

    Lewis, R.A.

    1996-03-01

    This plan contains the Environmental Restoration Contractor (ERC) Waste Minimization and Pollution Prevention (WMin/P2) Program. The plan outlines the activities and schedules developed by the ERC to reduce the quantity and toxicity of waste dispositioned as a result of restoration and remediation activities. This plan satisfies US Department of Energy (DOE) requirements including the Pollution Prevention Awareness program required by DOE Order 5400.1 (DOE 1988). This plan is consistent with Executive Order 12856 and Secretary O'Leary's pollution prevention Policy Statement of December 27, 1994, which set US and DOE pollution prevention policies, respectively. It is also consistent with the DOE Pollution Prevention Crosscut Plan, 1994, which provides guidance in meeting the DOE goals in pollution prevention. The purpose of this plan is to aid ERC projects in meeting and documenting compliance with requirements for WMin/P2. This plan contains the objectives, strategy, and support activities of the ERC Team WMin/P2 program. The basic elements of the plan are pollution prevention goals, waste assessments of major waste streams, implementation of feasible waste minimization opportunities, and a process for reporting achievements. Wherever appropriate, the ERC will integrate the pollution prevention activities in this plan into regular program activities rather than establishing separate WMin/P2 activities. Moreover, wherever possible, existing documents, procedures, and activities will be used to meet WMin/P2 requirements

  17. Environmental Release Prevention and Control Plan (ERP and CP) annual review and update for 1993

    International Nuclear Information System (INIS)

    Jannik, G.T.; Mamatey, A.; Arnett, M.

    1993-01-01

    In the Environmental Release Prevention and Control Plan (ERP and CP), WSRC made a commitment to conduct the following follow-up activities and actions: (1) Complete the action items developed in response to the findings and recommendation of the Environmental Release Prevention Taskteam (WSRC-RP-92-356). (2) Complete all batch and continuous release procedure revisions to incorporate the attributes that WSRC senior management required of each procedure. (3) DOE-SR Assistance Managers and WSRC counterparts to reach consensus and closure on the identified engineered solutions documented in the ERP and CP, develop and drive implementation of facility changes per the agreements. (4) Continue to analyze releases and monitor performance in accordance with the ERP and CP, and utilize the ALARA Release Guides Committee to drive improvements. (5) Conduct annual re-evaluations of the cost benefit analyses of the identified engineered solutions, and identify new options and alternatives for each outfall in response to site mission and facility changes. This report documents the efforts that have been completed over the past year in response to these commitments

  18. The effectiveness of a parental guide for prevention of problematic video gaming in children: A public health randomized controlled intervention study.

    Science.gov (United States)

    Krossbakken, Elfrid; Torsheim, Torbjørn; Mentzoni, Rune Aune; King, Daniel Luke; Bjorvatn, Bjørn; Lorvik, Ingjerd Meen; Pallesen, Ståle

    2018-01-09

    Background and aims Excessive use of video games among children and adolescents is a growing concern. The aim of this study was to investigate the effectiveness of a brief parental guide with advices and strategies for regulating video gaming in children. Methods A random sample of guardians of children between the age of 8-12 years old (N = 5,864) was drawn from the Norwegian Population Registry and equally randomized into an intervention and a control condition. A parental guide based on clinical and research literature was distributed by postal mail to those in the intervention condition. A 4-month follow-up survey comprising questions about problematic video gaming, gaming behavior, sleep activity, and parental video game regulation behavior was administered. Results Independent t-tests revealed no significant differences between the two conditions (N = 1,657, response rate 30.1%) on any outcome measure. An ANOVA with planned comparisons showed that respondents who reported that they had read and followed the parental guide reported more video game problems and used more parental mediation strategies than those who did not read and follow the guide. Conclusions We found no evidence for the effectiveness of the psychoeducational parental guide on preventing problematic video gaming in children. However, the guide was read and positively assessed by a significant proportion of guardians. Differences between those who studied the guide and those who did not may indicate that parental guides are better aimed at providing important information to those who already have problems rather than as a mean of primary prevention.

  19. 77 FR 74662 - Federal Acquisition Regulation; Submission for OMB Review; Accident Prevention Plans and...

    Science.gov (United States)

    2012-12-17

    ... contractors to keep records of accidents incident to work performed under the contract that result in death... Regulation; Submission for OMB Review; Accident Prevention Plans and Recordkeeping AGENCIES: Department of... extension of a previously approved ] information collection requirement concerning Accident Prevention Plans...

  20. Analysis guide - Nuclear criticality risks and their prevention in plants and laboratories

    International Nuclear Information System (INIS)

    Galet, C.; Le Bars, I.

    2011-01-01

    This report first describes the nuclear criticality risks and the prevention principles adopted in plants and laboratories, and reminds the French Basic Safety Rule (BSR) No. I.3.c. Diagrams are then used to introduce (i) the methodology recommended by this BSR, and (ii), for the reference fissile medium and each criticality control mode, the parameters to be considered 'conventionally' in a analysis, the 'typical' failures to be investigated, and the 'standard' scenarios associated with these failures. These diagrams, developed by IRSN and subject to change as feedback is received from experience in operating facilities or in implementation analyses and assessments, constitute a guide to the analysis of nuclear criticality risks, whether this is for compiling safety documents or for assessing them. As regards the possibility of modifying this guide, a sheet to be used for suggesting changes, intended for users of the guide, is provided on the last page of this report. Lastly, this guide is nothing more than the compilation of the 'conventional' and 'essential' precautions for preventing nuclear criticality risks. Although these precautions must always be kept in mind, the reader should never forget that each configuration is a special case and that there may be scenarios that apply only to this particular case. It is therefore appropriate to remind here that all criticality accidents are the result of failures and incident scenarios that have not been considered in the analysis. This guide is therefore a tool which is not intended to be exhaustive, and does not replace the necessary analysis to adapt to every situation

  1. Indicator based controlling of cantonal guiding planning in Switzerland: A model for more efficient sustainable planning instruments at the regional level

    Directory of Open Access Journals (Sweden)

    Keiner Marco

    2003-01-01

    Full Text Available In the actual Swiss cantonal planning practice every 10 years in general, there is a review of the guiding plan. The plan’s evaluation typically takes place shortly before the revision process. In the interstitial time, the guiding plan’s effectiveness can only be anticipated. In the review, a survey of both, the desired and unwanted spatial effects are often absent. As a result, a thorough analysis of the effects and the direction of the spatial development cannot be accomplished. A spatial plan that is geared to the principle of sustainability needs the outputs of such an analysis. Development assessments are required to verify the plans’ effects, well-defined goals to assist in rectifying deviations, key indicators to identify efficiency potentials, and precautionary measures to allow for an adaptable and responsive planning methodology. The instruments, which might assist in the cantonal guiding plan objectives implementation, do exist. Such instruments are monitoring, controlling and benchmarking (with the support of indicators. These tools can assist in ensuring the plan’s overall value and the effectiveness and appropriateness of the ensuing development. By using these tools and a sound planning methodology, unsustainable spatial development can be tracked early and rectified with appropriated measures. The control as this system’s central instrument is presented here and its application opportunities in the cantonal guiding planning are discussed. In order to achieve a sustainable spatial development and a more dynamic guiding planning, the application of control and benchmarking is crucial.

  2. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

    PLACE, B.G.

    2000-11-01

    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).

  4. Uses of data to plan cancer prevention and control programs.

    OpenAIRE

    Boss, L P; Suarez, L

    1990-01-01

    Seven State health departments, those in Illinois, Nebraska, New Jersey, New York, North Carolina, Texas, and Wisconsin, have participated in an effort to utilize a variety of State-specific cancer-related data to describe the cancer burden in their State's population. The data were then used to develop a statewide cancer plan or supplement an existing plan to address the defined problems. Cancer data have not been well utilized in the planning of intervention programs in the past, and the ef...

  5. Strategic planning and action on climate change: A guide for Canadian mining companies

    International Nuclear Information System (INIS)

    2000-01-01

    This Guide has been developed by the Pembina Institute for Appropriate Development of Drayton Valley, Alberta and Stratos Inc., of Ottawa, as a project for the Mining Association of Canada, in an effort to assist senior executives in the Canadian mining industry in developing corporate strategic responses to the risks and opportunities associated with climate change and sustainable development. Section One of the Guide provides an introduction to the scientific, political and legal issues involved in climate change. Section Two outlines the implications of this issue for Canadian mining companies. Section Three and Four provide senior managers with a strategic framework to help understand the scope of a comprehensive response and assist them in developing and integrating climate change policies into their overall corporate strategy and business plan. Section Five outlines the major components of a generic climate change strategy and action plan, while Section Six looks at specific technical opportunity areas where mining companies can reduce greenhouse gas emissions. Section Seven focuses on business opportunities related to greenhouse gas emission reductions that can be implemented domestically or internationally outside of Canadian mining operations. Section Eight concludes the Guide with a comprehensive list of references and additional sources of information to assist users in follow-up and implementation. The accompanying companion handbook, entitled 'Guide to inventorying, measuring and reporting on climate change actions for MAC member companies' is designed to be used by energy managers and technical support staff who are responsible for implementing greenhouse gas measurement reporting systems. In addition to the Guide, the Mining Association and the Pembina Institute also developed three versions of a climate change strategy workshop designed for mining company personnel at different levels and different responsibilities. These workshops can also be

  6. Computer-guided implant planning using a preexisting removable partial dental prosthesis.

    Science.gov (United States)

    Kim, Jong-Eun; Shim, June-Sung

    2017-01-01

    Converting a conventional removable partial dental prosthesis (RPDP) into an implant-assisted removable partial dental prosthesis (IARPDP) may be facilitated by using data from the intaglio surface of the RPDP for proper implant placement. This procedure can be done by connecting the data from the intaglio surface of the RPDP to the residual ridge data of the cone beam computed tomography scan with implant planning software. However, although a misplaced implant under an RPDP can cause various complications, as yet, no technique has connected the information on a patient's existing RPDP to the implant planning software. This article presents computer-guided implant planning, using a patient's existing RPDP. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Guia de ideas para la Planificacion y Aplicacion de Proyectos Intergeneracionales (Guide of Ideas for Planning and Implementing Intergenerational Projects)

    Science.gov (United States)

    Pinto, Teresa Almeida; Marreel, Iris; Hatton-Yeo, Alan

    2009-01-01

    This version of "Guide of Ideas for Planning and Implementing Intergenerational Projects," written in Spanish, is for all professionals that are or wish to be enrolled in the development of intergenerational activities. This "Guide" is the main product of the Project MATES--Mainstreaming Intergenerational Solidarity,…

  8. Guia de Ideias para Planear e Implementar Projectos Intergeracionais (Guide of Ideas for Planning and Implementing Intergenerational Projects)

    Science.gov (United States)

    Pinto, Teresa Almeida; Marreel, Iris; Hatton-Yeo, Alan

    2009-01-01

    This version of "Guide of Ideas for Planning and Implementing Intergenerational Projects," written in Portuguese, is for all professionals that are or wish to be enrolled in the development of intergenerational activities. This "Guide" is the main product of the Project MATES--Mainstreaming Intergenerational Solidarity,…

  9. Event planning the ultimate guide to successful meetings, corporate events, fundraising galas, conferences, conventions, incentives and other special events

    CERN Document Server

    Allen, Judy

    2009-01-01

    This bestselling all–in–one guide to the event planning business is back and better than ever, fully updated and revised to reflect the very latest trends and best practices in the industry. This handy, comprehensive guide includes forms, checklists, and tips for managing events, as well as examples and case studies of both successful and unsuccessful events. Judy Allen (Toronto, ON, Canada) is founder and President of Judy Allen Productions, a full–service event planning production company.

  10. Obesity Prevention from Conception: A Workshop to Guide the Development of a Pan-Canadian Trial Targeting the Gestational Period

    Science.gov (United States)

    Adamo, Kristi B; Shen, Garry X; Mottola, Michelle; Nascimento, Simony; Jean-Philippe, Sonia; Ferraro, Zachary M; Nerenberg, Kara; Smith, Graeme; Chari, Radha; Gaudet, Laura; Piccinini-Vallis, Helena; McDonald, Sarah; Atkinson, Stephanie; Godbout, Ariane; Robitaille, Julie; Davidge, Sandra T; Gruslin, Andrée; Prud’homme, Denis; Stacey, Dawn; Rossiter, Melissa; Goldfield, Gary S; Dodd, Jodie

    2014-01-01

    This report summarizes a meeting, Obesity Prevention from Conception, held in Ottawa in 2012. This planning workshop was funded by the Canadian Institutes of Health Research (CIHR) to bring together researchers with expertise in the area of maternal obesity (OB) and weight gain in pregnancy and pregnancy-related disease to attend a one-day workshop and symposium to discuss the development of a cross-Canada lifestyle intervention trial for targeting pregnant women. This future intervention will aim to reduce downstream OB in children through encouraging appropriate weight gain during the mother’s pregnancy. The workshop served to (i) inform the development of a lifestyle intervention for women with a high pre-pregnancy body mass index (BMI), (ii) identify site investigators across Canada, and (iii) guide the development of a grant proposal focusing on the health of mom and baby. A brief summary of the presentations as well as the focus groups is presented for use in planning future research.

  11. Obesity Prevention from Conception: A Workshop to Guide the Development of a Pan-Canadian Trial Targeting the Gestational Period

    Directory of Open Access Journals (Sweden)

    Kristi B. Adamo

    2014-01-01

    Full Text Available This report summarizes a meeting, Obesity Prevention from Conception , held in Ottawa in 2012. This planning workshop was funded by the Canadian Institutes of Health Research (CIHR to bring together researchers with expertise in the area of maternal obesity (OB and weight gain in pregnancy and pregnancy-related disease to attend a one-day workshop and symposium to discuss the development of a cross-Canada lifestyle intervention trial for targeting pregnant women. This future intervention will aim to reduce downstream OB in children through encouraging appropriate weight gain during the mother's pregnancy. The workshop served to (i inform the development of a lifestyle intervention for women with a high pre-pregnancy body mass index (BMI, (ii identify site investigators across Canada, and (iii guide the development of a grant proposal focusing on the health of mom and baby. A brief summary of the presentations as well as the focus groups is presented for use in planning future research.

  12. Public health program planning logic model for community engaged type 2 diabetes management and prevention.

    Science.gov (United States)

    West, Joseph F

    2014-02-01

    Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Your Game Plan to Prevent Type 2 Diabetes

    Science.gov (United States)

    ... plans this week, I’ll watch a movie. Pick one step to try this week. Add one ... FAQs About NIDDK Meet the Director Offices & Divisions Staff Directory Budget & Legislative Information Advisory & Coordinating Committees Strategic ...

  14. Stormwater Pollution Prevention Plan - TA-60 Roads and Grounds Facility and Associated Sigma Mesa Staging Area

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-01-31

    This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector P-Land Transportation and Warehousing as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA-60 Roads and Grounds and Associated Sigma Mesa Staging Area at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-60 Roads and Grounds and Associated Sigma Mesa Staging Area. The current permit expires at midnight on June 4, 2020.

  15. Hanford site guide for preparing and maintaining generator group pollution prevention program documentation

    International Nuclear Information System (INIS)

    1995-12-01

    This manual provides the necessary guidance to contractor generator groups for developing and maintaining documentation of their pollution prevention (P2) program activities. Preparation of program documentation will demonstrate compliance with contractor and U.S. Department of Energy (DOE) requirements, as well as state and federal regulations. Contractor waste generator groups are no longer required to prepare and update facility waste minimization plans. Developing and maintaining program documentation replace this requirement

  16. Environmental Restoration Program pollution prevention checklist guide for the facility characterization project phase

    International Nuclear Information System (INIS)

    1993-09-01

    A facility characterization (FC) is conducted to determine the nature and extent contamination at a potential hazardous facility waste site. The information gathered during an FC includes (1) data on the volume and chemical nature of the waste, (2) information on the extent of contamination and the migration potential of the contaminants, (3) preliminary information on evaluation of alternative concepts that can or cannot be considered, and (4)supportive technical and cost data. For the purposes of identification, the following operational phases will be used for definition for this phase of the decommissioning and decontamination process (1) facility characterization before clean up, (2) characterization during clean up, (3) characterization of waste materials, and (4) site characterization after clean up. A key consideration in this process is the prevention of any waste to be generated from these characterization activities. The purpose of this checklist guide is to assist users with incorporating pollution prevention/waste minimization (PP/WM) in all FC phase projects of the Environmental Restoration (ER) Program. This guide will help users document PP/WM activities for technology transfer and reporting requirements. Automated computer screens will be created from the checklist data to assist users with implementing and evaluating waste reduction

  17. Critical issues in preparing for a mass casualty event: highlights from a new community planning guide.

    Science.gov (United States)

    2007-09-01

    To assist community planners in allocating scarce resources in a mass casualty event, the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Preparedness and Response collaborated with leading experts on a series of issue papers on preparedness and response. These papers were presented at an expert meeting in Washington, DC, in June 2006. The papers, revised based on meeting discussions, have been published by AHRQ as Mass Medical Care with Scarce Resources: A Community Planning Guide.

  18. Stormwater Pollution Prevention Plan TA-60 Roads and Grounds Facility and Associated Sigma Mesa Staging Area

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-01

    This Stormwater Pollution Prevention Plan (SWPPP) is applicable to operations at the Technical Area -60 (TA-60) Roads and Grounds Facility and Associated Sigma Mesa Staging Area off Eniwetok Drive, in Los Alamos County, New Mexico.

  19. 76 FR 34630 - Approval and Promulgation of Implementation Plans; New Hampshire: Prevention of Significant...

    Science.gov (United States)

    2011-06-14

    ... Promulgation of Implementation Plans; New Hampshire: Prevention of Significant Deterioration; Greenhouse Gas... Deterioration (PSD) program to establish appropriate emission thresholds for determining which new stationary... Protection Agency, EPA New England Regional Office, Office of Ecosystem Protection, 5 Post Office Square...

  20. Library Spaces for 21st-Century Learners: A Planning Guide for Creating New School Library Concepts

    Science.gov (United States)

    Sullivan, Margaret

    2013-01-01

    "Library Spaces for 21st-Century Learners: A Planning Guide for Creating New School Library Concepts" focuses on planning contemporary school library spaces with user-based design strategies. The book walks school librarians and administrators through the process of gathering information from students and other stakeholders involved in…

  1. Application of preventive maintenance planning in a parquet ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-04-20

    Apr 20, 2009 ... extend the equipment life are lubrication, cleaning, ad- justing, and minor component replacement (Tomlingson,. 1993). This is realized based on a plan drawn up so as to decrease breakdown frequency (Karaoglan et al., 2007). In which maintenance times the machines will be maintained by pausing them ...

  2. Application of preventive maintenance planning in a parquet ...

    African Journals Online (AJOL)

    In this study, the process of a parquet enterprise's transition to preventive maintenance which has been implementing maintenance technique in case of breakdown was investigated. During that transition process, follow up forms for maintenance–repair, breakdown and spare parts were prepared and the implementation ...

  3. Modality planning for preventing tunnel vision in crisis management

    NARCIS (Netherlands)

    Cao, Y.; Nijholt, Antinus; Theune, Mariët; van der Sluis, Ielka; Bachvarova, Yulia; Andre, Elisabeth

    2008-01-01

    Crisis management is a time-critical task with high uncertainty and high risk. Stress and cognitive overload often result in a set of bias in crisis manager’s situation understanding and information confirming processes, known as 'tunnel vision'. Aiming at preventing tunnel vision, we propose an

  4. Knowledge management: an application to wildfire prevention planning

    Science.gov (United States)

    Daniel L Schmoldt

    1989-01-01

    Residential encroachment into wildland areas places an additional burden on fire management activities. Prevention programs, fuel management efforts, and suppression strategies, previously employed in wildland areas, require modification for protection of increased values at risk in this interface area. Knowledge-based computer systems are being investigated as...

  5. Atlas-guided generation of pseudo-CT images for MRI-only and hybrid PET-MRI-guided radiotherapy treatment planning

    NARCIS (Netherlands)

    Arabi, Hossein; Koutsouvelis, Nikolaos; Rouzaud, Michel; Miralbell, Raymond; Zaidi, Habib

    2016-01-01

    Magnetic resonance imaging (MRI)-guided attenuation correction (AC) of positron emission tomography (PET) data and/or radiation therapy (RT) treatment planning is challenged by the lack of a direct link between MRI voxel intensities and electron density. Therefore, even if this is not a trivial

  6. Visual Sample Plan Version 7.0 User's Guide

    Energy Technology Data Exchange (ETDEWEB)

    Matzke, Brett D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Newburn, Lisa LN [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hathaway, John E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bramer, Lisa M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wilson, John E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dowson, Scott T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sego, Landon H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pulsipher, Brent A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-03-01

    User's guide for VSP 7.0 This user's guide describes Visual Sample Plan (VSP) Version 7.0 and provides instructions for using the software. VSP selects the appropriate number and location of environmental samples to ensure that the results of statistical tests performed to provide input to risk decisions have the required confidence and performance. VSP Version 7.0 provides sample-size equations or algorithms needed by specific statistical tests appropriate for specific environmental sampling objectives. It also provides data quality assessment and statistical analysis functions to support evaluation of the data and determine whether the data support decisions regarding sites suspected of contamination. The easy-to-use program is highly visual and graphic. VSP runs on personal computers with Microsoft Windows operating systems (XP, Vista, Windows 7, and Windows 8). Designed primarily for project managers and users without expertise in statistics, VSP is applicable to two- and three-dimensional populations to be sampled (e.g., rooms and buildings, surface soil, a defined layer of subsurface soil, water bodies, and other similar applications) for studies of environmental quality. VSP is also applicable for designing sampling plans for assessing chem/rad/bio threat and hazard identification within rooms and buildings, and for designing geophysical surveys for unexploded ordnance (UXO) identification.

  7. Primary pre-service teachers' skills in planning a guided scientific inquiry

    Science.gov (United States)

    García-Carmona, Antonio; Criado, Ana M.; Cruz-Guzmán, Marta

    2017-10-01

    A study is presented of the skills that primary pre-service teachers (PPTs) have in completing the planning of a scientific inquiry on the basis of a guiding script. The sample comprised 66 PPTs who constituted a group-class of the subject Science Teaching, taught in the second year of an undergraduate degree in primary education at a Spanish university. The data was acquired from the responses of the PPTs (working in teams) to open-ended questions posed to them in the script concerning the various tasks involved in a scientific inquiry (formulation of hypotheses, design of the experiment, data collection, interpretation of results, drawing conclusions). Data were analyzed within the framework of a descriptive-interpretive qualitative research study with a combination of inter- and intra-rater methods, and the use of low-inference descriptors. The results showed that the PPTs have major shortcomings in planning the complete development of a guided scientific inquiry. The discussion of the results includes a number of implications for rethinking the Science Teaching course so that PPTs can attain a basic level of training in inquiry-based science education.

  8. 76 FR 752 - Approval and Promulgation of Implementation Plans; Connecticut: Prevention of Significant...

    Science.gov (United States)

    2011-01-06

    ... Promulgation of Implementation Plans; Connecticut: Prevention of Significant Deterioration; Greenhouse Gas... changes impacting Connecticut's New Source Review (NSR) Prevention of Significant Deterioration (PSD... Regional Office, Office of Ecosystem Protection, 5 Post Office Square-- Suite 100 (Mail code OEP05-2...

  9. Uranium Mill Tailings remedial action project waste minimization and pollution prevention awareness program plan

    International Nuclear Information System (INIS)

    1994-07-01

    The purpose of this plan is to establish a waste minimization and pollution prevention awareness (WM/PPA) program for the U.S. Department of Energy's (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project. The program satisfies DOE requirements mandated by DOE Order 5400.1. This plan establishes planning objectives and strategies for conserving resources and reducing the quantity and toxicity of wastes and other environmental releases

  10. Strategic Planning for Chronic Disease Prevention in Rural America: Looking Through a PRISM Lens.

    Science.gov (United States)

    Honeycutt, Amanda A; Wile, Kristina; Dove, Cassandra; Hawkins, Jackie; Orenstein, Diane

    2015-01-01

    Community-level strategic planning for chronic disease prevention. To share the outcomes of the strategic planning process used by Mississippi Delta stakeholders to prevent and reduce the negative impacts of chronic disease in their communities. A key component of strategic planning was participants' use of the Prevention Impacts Simulation Model (PRISM) to project the reduction, compared with the status quo, in deaths and costs from implementing interventions in Mississippi Delta communities. Participants in Mississippi Delta strategic planning meetings used PRISM, a user-friendly, evidence-based simulation tool that includes 22 categories of policy, systems, and environmental change interventions, to pose what-if questions that explore the likely short- and long-term effects of an intervention or any desired combination of the 22 categories of chronic disease intervention programs and policies captured in PRISM. These categories address smoking, air pollution, poor nutrition, and lack of physical activity. Strategic planning participants used PRISM outputs to inform their decisions and actions to implement interventions. Rural communities in the Mississippi Delta. A diverse group of 29 to 34 local chronic disease prevention stakeholders, known as the Mississippi Delta Strategic Alliance. Community plans and actions that were developed and implemented as a result of local strategic planning. Existing strategic planning efforts were complemented by the use of PRISM. The Mississippi Delta Strategic Alliance decided to implement new interventions to improve air quality and transportation and to expand existing interventions to reduce tobacco use and increase access to healthy foods. They also collaborated with the Department of Transportation to raise awareness and use of the current transportation network. The Mississippi Delta Strategic Alliance strategic planning process was complemented by the use of PRISM as a tool for strategic planning, which led to the

  11. The negative effect of financial constraints on planning prevention activities: some evidence from the Italian experience.

    Science.gov (United States)

    Rosso, Annalisa; De Vito, Corrado; Marzuillo, Carolina; Massimi, Azzurra; D'Andrea, Elvira; Villari, Paolo

    2015-12-01

    This study was aimed to assess the association between regional financial deficits and Recovery Plans and the quality of the 702 projects developed by the Italian Regions within the National Prevention Plan 2010-13. Multivariate analyses showed significant associations between Recovery Plans and low quality of projects, possibly due to weak regional public health capacities. Regions with Recovery Plans are likely to focus mainly on short-term issues with a high impact on health care costs, leaving few resources available for prevention. A different approach to financial deficit focused on long-term strategies, including those for health promotion and disease prevention, is needed. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. Preventing Restricted Space Inference in Online Route Planning Services

    Directory of Open Access Journals (Sweden)

    Florian Dorfmeister

    2016-03-01

    Full Text Available Online route planning services compute routes from any given location to a desired destination address. Unlike offline implementations, they do so in a traffic-aware fashion by taking into consideration up-to-date map data and real-time traffic information. In return, users have to provide precise location information about a route’s endpoints to a not necessarily trusted service provider. As suchlike leakage of personal information threatens a user’s privacy and anonymity, this paper presents PrOSPR, a comprehensive approach for using current online route planning services in a privacy-preserving way, and introduces the concept of k-immune route requests to avert inference attacks based on restricted space information. Using a map-based approach for creating cloaked regions for the start and destination addresses, our solution queries the online service for routes between subsets of points from these regions. This, however, might result in the returned path deviating from the optimal route. By means of empirical evaluation on a real road network, we demonstrate the feasibility of our approach regarding quality of service and communication overhead.

  13. Coping planning: a patient-centred and strengths-focused approach to suicide prevention training.

    Science.gov (United States)

    Stallman, Helen M

    2018-04-01

    Suicide is a leading cause of premature death and, despite significant investment, the prevalence rate has remained relatively stable for more than a decade. Theoretically, the use of 'safety planning' as a response to suicidality likely maintains suicide as a potential solution for vulnerable people. This paper describes a theoretically-supported paradigm shift from safety planning to 'coping planning' to improve patient outcomes and improve the confidence and competence of clinicians working with people with suicidality. Coping planning is a strategy used to support people with acute distress. Its components of 'caring', 'collaborating' and 'connecting' reinforce existing strengths, promote self-efficacy and link people with more intensive supports, as needed. Coping planning overcomes the limitations of existing approaches. It reframes suicide prevention from managing patients disclosing suicidality to ensuring patients have minimally sufficient temporary support to help them cope. This approach has the potential to promote coping self-efficacy and prevent deterioration that leads to suicide.

  14. Approaches to evaluating climate change impacts on species: a guide to initiating the adaptation planning process.

    Science.gov (United States)

    Rowland, Erika L; Davison, Jennifer E; Graumlich, Lisa J

    2011-03-01

    Assessing the impact of climate change on species and associated management objectives is a critical initial step for engaging in the adaptation planning process. Multiple approaches are available. While all possess limitations to their application associated with the uncertainties inherent in the data and models that inform their results, conducting and incorporating impact assessments into the adaptation planning process at least provides some basis for making resource management decisions that are becoming inevitable in the face of rapidly changing climate. Here we provide a non-exhaustive review of long-standing (e.g., species distribution models) and newly developed (e.g., vulnerability indices) methods used to anticipate the response to climate change of individual species as a guide for managers grappling with how to begin the climate change adaptation process. We address the limitations (e.g., uncertainties in climate change projections) associated with these methods, and other considerations for matching appropriate assessment approaches with the management questions and goals. Thorough consideration of the objectives, scope, scale, time frame and available resources for a climate impact assessment allows for informed method selection. With many data sets and tools available on-line, the capacity to undertake and/or benefit from existing species impact assessments is accessible to those engaged in resource management. With some understanding of potential impacts, even if limited, adaptation planning begins to move toward the development of management strategies and targeted actions that may help to sustain functioning ecosystems and their associated services into the future.

  15. PSINET: Assisting HIV Prevention Amongst Homeless Youth by Planning Ahead.

    Science.gov (United States)

    Yadav, A; Marcolino, L S; Rice, E; Petering, R; Winetrobe, H; Rhoades, H; Tambe, M; Carmichael, H

    2016-01-01

    Homeless youth are prone to Human Immunodeficiency Virus (HIV) due to their engagement in high risk behavior such as unprotected sex, sex under influence of drugs, etc. Many non-profit agencies conduct interventions to educate and train a select group of homeless youth about HIV prevention and treatment practices and rely on word-of-mouth spread of information through their social network. Previous work in strategic selection of intervention participants does not handle uncertainties in the social network's structure and evolving network state, potentially causing significant shortcomings in spread of information. Thus, we developed PSINET, a decision support system to aid the agencies in this task. PSINET includes the following key novelties: (i) it handles uncertainties in network structure and evolving network state; (ii) it addresses these uncertainties by using POMDPs in influence maximization; and (iii) it provides algorithmic advances to allow high quality approximate solutions for such POMDPs. Simulations show that PSINET achieves ~ 60% more information spread over the current state-of-the-art. PSINET was developed in collaboration with My Friend's Place (a drop-in agency serving homeless youth in Los Angeles) and is currently being reviewed by their officials.

  16. Plan of the day selection for online image-guided adaptive post-prostatectomy radiotherapy.

    Science.gov (United States)

    Gill, Suki; Pham, Daniel; Dang, Kim; Bressel, Mathias; Kron, Tomas; Siva, Shankar; Tran, Phillip K; Tai, Keen Hun; Foroudi, Farshad

    2013-05-01

    To compare the cone-beam CT (CBCT) soft tissue localization disparity between radiation oncologists (RO) and radiation therapy technologists (RTT) in a novel online protocol of image-guided adaptive radiotherapy to the postoperative prostate bed. Using the planning CT and pre-treatment CBCTs from the first week of radiotherapy, four adaptive plans of different sizes were derived for each of eight post-prostatectomy patients. Four ROs collectively defined the reference answer, i.e. the plan of the day and isocentre correction for 40 CBCTs taken in weeks 2-6 of treatment for each patient. RTTs were randomly assigned five of these CBCTs; and asked to record their plan of the day selection and isocentre correction. RTT selection and reference answers were compared. The distance between the RTT selection and the reference answer was calculated. A total of 33 RTTs took part in this study. The average difference in CTV volume (reference answer-RTT selection) was 1.32 cm(3) (SD 29 cm(3)) overall. The average difference between reference answer and RTT isocentre coordinates was SI 1mm (SD 4.8mm), LR 1.1mm (SD 4.0mm) and AP -0.2mm (SD 3.9 mm). Distance of superior 8mm, inferior 6mm, left 4mm, right 2mm, anterior 6mm and posterior 6mm covered 100% of the CTV in 90% of fractions. The difference between RTT and RO selection of adaptive volumes is small and can be accounted for in a clinically acceptable CTV to PTV margin. Adaptive post-prostatectomy radiotherapy is feasible, in the setting of an academic center although at the moment, we have insufficient evidence to suggest that margins can yet be reduced with IGART with the current protocol. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Satisfaction of mountain guides with high sun protection as a tool to prevent non-melanoma skin cancer.

    Science.gov (United States)

    Tizek, L; Krause, J; Biedermann, T; Zink, A

    2017-11-01

    Non-melanoma skin cancer (NMSC) is an occupational disease for outdoor workers in Germany since 2015. Sustainable prevention is demanded and sunscreen promoted as an effective tool. However, studies on the satisfaction of sunscreen users are rare. To evaluate the satisfaction of mountain guides using a high SPF sunscreen product as an appropriate prevention tool for mountain guides. Motivating mountain and ski guides in Germany to use very high protection sunscreen (SPF50+, Actinica Lotion) during a 4- to 8-h workday followed by the completion of a self-filled paper-based questionnaire about their experience and satisfaction with the product. Of 88 mountain and ski guides (61 men, 27 women) included in the study, 61.4% reported regular sunscreen use with the application of very high protection (SPF50+) in 18.6% of all cases. At the end of the workday, 78.6% found the product convenient and easy to include into their daily work and 79.3% felt sufficiently protected against the sun. Overall satisfaction with the use of high SPF products during work is high in mountain and ski guides and could be an effective tool in prevention campaigns. © 2017 European Academy of Dermatology and Venereology.

  18. Plan of disaster prevention in district of Shizuoka Prefecture countermeasures to nuclear power. 1984 ed.

    International Nuclear Information System (INIS)

    1984-01-01

    Based on the basic act for disaster countermeasures, this plan aimes at establishing the necessary system concerning the countermeasures for preventing the disaster due to the release of a large quantity of radioactive substances from the Hamaoka Nuclear Power Station, Chubu Electric Power Co., Inc., determining the measures to be taken for disaster prevention, and striving for the safety of inhabitants by executing the deskworks and services of the disaster prevention related to nuclear power synthetically and purposefully. The general matters concerning the disaster prevention in the district of Shizuoka Prefecture are determined in the ''Plan of disaster prevention in the district of Shizuoka Prefecture (General countermeasures)'', but in view of the peculiarity of nuclear power disaster, the peculiar matters are to be determined in this plan. The general rules on the works of respective disaster prevention organizations, the countermeasures for preventing nuclear power disaster, the emergency countermeasures to nuclear power disaster, the countermeasures to Tokai earthquakes and the countermeasures for restoration after nuclear power disaster are stipulated. (Kako, I.)

  19. Enhanced Severe Transient Analysis for Prevention Technical Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Gougar, Hans [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-09-01

    This document outlines the development of a high fidelity, best estimate nuclear power plant severe transient simulation capability that will complement or enhance the integral system codes historically used for licensing and analysis of severe accidents. As with other tools in the Risk Informed Safety Margin Characterization (RISMC) Toolkit, the ultimate user of Enhanced Severe Transient Analysis and Prevention (ESTAP) capability is the plant decision-maker; the deliverable to that customer is a modern, simulation-based safety analysis capability, applicable to a much broader class of safety issues than is traditional Light Water Reactor (LWR) licensing analysis. Currently, the RISMC pathway’s major emphasis is placed on developing RELAP-7, a next-generation safety analysis code, and on showing how to use RELAP-7 to analyze margin from a modern point of view: that is, by characterizing margin in terms of the probabilistic spectra of the “loads” applied to systems, structures, and components (SSCs), and the “capacity” of those SSCs to resist those loads without failing. The first objective of the ESTAP task, and the focus of one task of this effort, is to augment RELAP-7 analyses with user-selected multi-dimensional, multi-phase models of specific plant components to simulate complex phenomena that may lead to, or exacerbate, severe transients and core damage. Such phenomena include: coolant crossflow between PWR assemblies during a severe reactivity transient, stratified single or two-phase coolant flow in primary coolant piping, inhomogeneous mixing of emergency coolant water or boric acid with hot primary coolant, and water hammer. These are well-documented phenomena associated with plant transients but that are generally not captured in system codes. They are, however, generally limited to specific components, structures, and operating conditions. The second ESTAP task is to similarly augment a severe (post-core damage) accident integral analyses code

  20. A user's guide to coping with estuarine management bureaucracy: An Estuarine Planning Support System (EPSS) tool.

    Science.gov (United States)

    Lonsdale, Jemma; Nicholson, Rose; Weston, Keith; Elliott, Michael; Birchenough, Andrew; Sühring, Roxana

    2018-02-01

    Estuaries are amongst the most socio-economically and ecologically important environments however, due to competing and conflicting demands, management is often challenging with a complex legislative framework managed by multiple agencies. To facilitate the understanding of this legislative framework, we have developed a GISbased Estuarine Planning Support System tool. The tool integrates the requirements of the relevant legislation and provides a basis for assessing the current environmental state of an estuary as well as informing and assessing new plans to ensure a healthy estuarine state. The tool ensures that the information is easily accessible for regulators, managers, developers and the public. The tool is intended to be adaptable, but is assessed using the Humber Estuary, United Kingdom as a case study area. The successful application of the tool for complex socio-economic and environmental systems demonstrates that the tool can efficiently guide users through the complex requirements needed to support sustainable development. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  1. Trajectory planning method for reduced patient risk in image-guided neurosurgery: concept and preliminary results

    Science.gov (United States)

    Shamir, Reuben R.; Joskowicz, Leo; Antiga, Luca; Foroni, Roberto I.; Shoshan, Yigal

    2010-02-01

    We present a new preoperative planning method to quantify and help reduce the risk associated with needle and tool insertion trajectories in image-guided keyhole neurosurgery. The goal is to quantify the risk of a proposed straight trajectory, and/or to find the trajectory with the lowest risk to nearby brain structures based on pre-operative CT/MRI images. The method automatically computes the risk associated with a given trajectory, or finds the trajectory with the lowest risk to nearby brain structures based on preoperative image segmentation and on a risk volume map. The surgeon can revise the suggested trajectory, add a new one using interactive 3D visualization, and obtain a quantitative risk measure. The trajectory risk is evaluated based on the tool placement uncertainty, on the proximity of critical brain structures, and on a predefined table of quantitative geometric risk measures. Our preliminary results on a clinical dataset with eight targets show a significant reduction in trajectory risk and a shortening of the preoperative planning time as compared to the conventional method.

  2. Elaboration and modification of the waste zoning plan in basic nuclear installations. ASN Guide Nr 23, Release of the 2016/08/30

    International Nuclear Information System (INIS)

    2016-01-01

    After having recalled the relevant regulatory texts and guides, this guide aims at detailing conditions of elaboration and of modification of the waste zoning plan which is defined in one of these texts, and applies requirements and recommendations of others of them. It first recalls the general doctrine of waste management in basic nuclear installations. It describes how the waste zoning plan and the reference waste zoning map are elaborated and justified, how the relevancy of this plan and this map are confirmed through radiological controls and based on general operation rules and periodic assessments. It also describes how contamination transfers and material activation are prevented, and discusses waste radiological controls to be performed. The next part addressed waste zoning and ways of management for wastes coming from conventional waste areas, and from areas of possible production of nuclear wastes. Issues of waste zoning downgrading or reclassification are then addressed by distinguishing temporary and definitive modifications (in one way or the other). Some peculiar cases are addressed: delimitation of waste zoning at the level of equipments, conventional processing of some wastes, radioactive waste warehousing, outdoor areas of possible production of nuclear wastes

  3. Development of the DVH management software for the biologically-guided evaluation of radiotherapy plan

    International Nuclear Information System (INIS)

    Kim, Bo Kyung; Park, Hee Chul; Oh, Dong Ryul; Shin, Eun Hyuk; Ahn, Yong Chan; Kim, Jin Sung; Han, Young Yih

    2012-01-01

    To develop the dose volume histogram (DVH) management software which guides the evaluation of radiotherapy (RT) plan of a new case according to the biological consequences of the DVHs from the previously treated patients. We determined the radiation pneumonitis (RP) as an biological response parameter in order to develop DVH management software. We retrospectively reviewed the medical records of lung cancer patients treated with curative 3-dimensional conformal radiation therapy (3D-CRT). The biological event was defined as RP of the Radiation Therapy Oncology Group (RTOG) grade III or more. The DVH management software consisted of three parts (pre-existing DVH database, graphical tool, and Pinnacle3 script). The pre-existing DVH data were retrieved from 128 patients. RP events were tagged to the specific DVH data through retrospective review of patients' medical records. The graphical tool was developed to present the complication histogram derived from the preexisting database (DVH and RP) and was implemented into the radiation treatment planning (RTP) system, Pinnacle3 v8.0 (Phillips Healthcare). The software was designed for the pre-existing database to be updated easily by tagging the specific DVH data with the new incidence of RP events at the time of patients' follow-up. We developed the DVH management software as an effective tool to incorporate the phenomenological consequences derived from the pre-existing database in the evaluation of a new RT plan. It can be used not only for lung cancer patients but also for the other disease site with different toxicity parameters.

  4. The How, What, Where, When and Why of Bilingual Education: A Concise and Objective Guide for School District Planning.

    Science.gov (United States)

    Alexander, David; Nava, Alfonso

    This book's purpose is to satisfy a perceived need for a straightforward, non-academic, non-bureaucratically worded guide to bilingual education planning and to provide objective information on compliance procedures and federal and state funding opportunities to school district policy planners, whether they be administrators, teachers, or parents.…

  5. Getting Started with Market Research for Out-of-School Time Planning: A Resource Guide for Communities

    Science.gov (United States)

    Pokela, Julianne; Steblea, Ingrid; Shea, Linda; Denny, Elizabeth

    2007-01-01

    Conducting market research for out-of-school-time planning can replace assumptions with facts, give kids and parents a voice to express their needs and preferences, and help build stakeholder buy-in and support. This practical guide shows community leaders, policymakers and out-of-school-time practitioners how to use market research to make more…

  6. 78 FR 44920 - Pacific Halibut Fisheries; Catch Sharing Plan for Guided Sport and Commercial Fisheries in Alaska...

    Science.gov (United States)

    2013-07-25

    ... Sport and Commercial Fisheries in Alaska; Extension of Comment Period AGENCY: National Marine Fisheries... proposed regulations to implement a catch sharing plan for the guided sport and commercial fisheries for... Docket Number NOAA-NMFS-2011-0180, by any of the following methods: Electronic Submission: Submit all...

  7. Oral diagnosis and treatment planning: part 6. Preventive and treatment planning for periodontal disease.

    Science.gov (United States)

    Corbet, E; Smales, R

    2012-09-01

    A high level of sustained personal plaque control is fundamental for successful treatment outcomes in patients with active periodontal disease and, hence, oral hygiene instructions are the cornerstone of periodontal treatment planning. Other risk factors for periodontal disease also should be identified and modified where possible. Many restorative dental treatments in particular require the establishment of healthy periodontal tissues for their clinical success. Failure by patients to control dental plaque because of inappropriate designs and materials for restorations and prostheses will result in the long-term failure of the restorations and the loss of supporting tissues. Periodontal treatment planning considerations are also very relevant to endodontic, orthodontic and osseointegrated dental implant conditions and proposed therapies.

  8. A 3-Component Approach Incorporating Focus Groups in Strategic Planning for Sexual Violence Prevention.

    Science.gov (United States)

    Cruz, Theresa H; Hess, Julia Meredith; Woelk, Leona; Bear, Samantha

    2016-01-01

    Sexual violence is of special concern in New Mexico because of the presence of large priority populations in which its prevalence is high. This article describes a 3-component approach to developing a strategic plan to prevent sexual violence in the state that consisted of an advisory group, subject matter experts, and focus groups from geographically and demographically diverse communities. Both common and community-specific themes emerged from the focus groups and were included in the strategic plan. By incorporating community needs and experiences, this approach fosters increased investment in plan implementation.

  9. Laboratory Guide for Residual Stress Sample Alignment and Experiment Planning-October 2011 Version

    International Nuclear Information System (INIS)

    Cornwell, Paris A.; Bunn, Jeffrey R.; Schmidlin, Joshua E.; Hubbard, Camden R.

    2012-01-01

    The December 2010 version of the guide, ORNL/TM-2008/159, by Jeff Bunn, Josh Schmidlin, Camden Hubbard, and Paris Cornwell, has been further revised due to a major change in the GeoMagic Studio software for constructing a surface model. The Studio software update also includes a plug-in module to operate the FARO Scan Arm. Other revisions for clarity were also made. The purpose of this revision document is to guide the reader through the process of laser alignment used by NRSF2 at HFIR and VULCAN at SNS. This system was created to increase the spatial accuracy of the measurement points in a sample, reduce the use of neutron time used for alignment, improve experiment planning, and reduce operator error. The need for spatial resolution has been driven by the reduction in gauge volumes to the sub-millimeter level, steep strain gradients in some samples, and requests to mount multiple samples within a few days for relating data from each sample to a common sample coordinate system. The first step in this process involves mounting the sample on an indexer table in a laboratory set up for offline sample mounting and alignment in the same manner it would be mounted at either instrument. In the shared laboratory, a FARO ScanArm is used to measure the coordinates of points on the sample surface ('point cloud'), specific features and fiducial points. A Sample Coordinate System (SCS) needs to be established first. This is an advantage of the technique because the SCS can be defined in such a way to facilitate simple definition of measurement points within the sample. Next, samples are typically mounted to a frame of 80/20 and fiducial points are attached to the sample or frame then measured in the established sample coordinate system. The laser scan probe on the ScanArm can then be used to scan in an 'as-is' model of the sample as well as mounting hardware. GeoMagic Studio 12 is the software package used to construct the model from the point cloud the scan arm creates. Once

  10. Laboratory Guide for Residual Stress Sample Alignment and Experiment Planning-October 2011 Version

    Energy Technology Data Exchange (ETDEWEB)

    Cornwell, Paris A [ORNL; Bunn, Jeffrey R [ORNL; Schmidlin, Joshua E [ORNL; Hubbard, Camden R [ORNL

    2012-04-01

    The December 2010 version of the guide, ORNL/TM-2008/159, by Jeff Bunn, Josh Schmidlin, Camden Hubbard, and Paris Cornwell, has been further revised due to a major change in the GeoMagic Studio software for constructing a surface model. The Studio software update also includes a plug-in module to operate the FARO Scan Arm. Other revisions for clarity were also made. The purpose of this revision document is to guide the reader through the process of laser alignment used by NRSF2 at HFIR and VULCAN at SNS. This system was created to increase the spatial accuracy of the measurement points in a sample, reduce the use of neutron time used for alignment, improve experiment planning, and reduce operator error. The need for spatial resolution has been driven by the reduction in gauge volumes to the sub-millimeter level, steep strain gradients in some samples, and requests to mount multiple samples within a few days for relating data from each sample to a common sample coordinate system. The first step in this process involves mounting the sample on an indexer table in a laboratory set up for offline sample mounting and alignment in the same manner it would be mounted at either instrument. In the shared laboratory, a FARO ScanArm is used to measure the coordinates of points on the sample surface ('point cloud'), specific features and fiducial points. A Sample Coordinate System (SCS) needs to be established first. This is an advantage of the technique because the SCS can be defined in such a way to facilitate simple definition of measurement points within the sample. Next, samples are typically mounted to a frame of 80/20 and fiducial points are attached to the sample or frame then measured in the established sample coordinate system. The laser scan probe on the ScanArm can then be used to scan in an 'as-is' model of the sample as well as mounting hardware. GeoMagic Studio 12 is the software package used to construct the model from the point cloud the

  11. The Effects of Guided Careful Online Planning on Complexity, Accuracy and Fluency in Intermediate EFL Learners' Oral Production: The Case of English Articles

    Science.gov (United States)

    Ahmadian, Mohammad Javad

    2012-01-01

    The purpose of the study reported in this article was twofold: First, to see whether guided careful online planning assists intermediate learners of English as a foreign language (EFL) in accurate oral production of English articles ("an/a" and "the"); and, second, to see whether guided careful online planning has any effects…

  12. 34 CFR Appendix A to Subpart N of... - Sample Default Prevention Plan

    Science.gov (United States)

    2010-07-01

    ... implement when developing a default prevention plan. I. Core Default Reduction Strategies 1. Establish your.... Establish a process to ensure the accuracy of your rate. II. Additional Default Reduction Strategies 1... debt management activities. 2. Enhance the enrollment retention and academic persistence of borrowers...

  13. 77 FR 62452 - Approval and Promulgation of Implementation Plans; State of Arizona; Prevention of Air Pollution...

    Science.gov (United States)

    2012-10-15

    ... Promulgation of Implementation Plans; State of Arizona; Prevention of Air Pollution Emergency Episodes AGENCY... (SIP) revision submitted by the State of Arizona to address the requirements regarding air pollution... air pollution emergency episodes in CAA section 110(a)(2)(G). Section 110(a)(2)(G) requires that each...

  14. Re-Examining Participatory Research in Dropout Prevention Planning in Urban Communities

    Science.gov (United States)

    Irby, Decoteau; Mawhinney, Lynnette; Thomas, Kristopher

    2013-01-01

    This paper explores the concept of what a community-based participatory dropout prevention planning process might entail. Specifically, it looks at a year-long research project that brought together formerly incarcerated school non-completers, researchers, and local policy-makers (stakeholders) to address low high-school completion rates in the…

  15. 77 FR 22500 - Approval and Promulgation of State Implementation Plans; Missouri: Prevention of Significant...

    Science.gov (United States)

    2012-04-16

    ... Significant Deterioration; Greenhouse Gas Tailoring Rule; New Source Review Reform AGENCY: Environmental... Implementation Plan (SIP) relating to regulation of Greenhouse Gases (GHGs) under Missouri's Prevention of... thresholds established in EPA's ``PSD and Title V Greenhouse Gas Tailoring Final Rule,'' which EPA issued by...

  16. Using Action Planning to Build Organizational Capacity for the Prevention of Intimate Partner Violence

    Science.gov (United States)

    Schober, Daniel J.; Fawcett, Stephen B.

    2015-01-01

    The DELTA PREP Project aims to reduce risk for intimate partner violence (IPV). It engaged leadership and staff from 19 statewide domestic violence coalitions in building capacity to prevent IPV before it occurs (rather than solely responding to IPV). This article describes the process and outcomes associated with action planning to create…

  17. 76 FR 26933 - Approval and Promulgation of Implementation Plans; Connecticut: Prevention of Significant...

    Science.gov (United States)

    2011-05-10

    ... Promulgation of Implementation Plans; Connecticut: Prevention of Significant Deterioration; Greenhouse Gas... Significant Deterioration (PSD) program. First, the revision provides Connecticut with authority to issue PSD... Regional Office, Office of Ecosystem Protection, Air Permits, Toxics, and Indoor Air Programs Unit, 5 Post...

  18. 77 FR 21911 - Approval and Promulgation of Implementation Plans; State of Arizona; Prevention of Air Pollution...

    Science.gov (United States)

    2012-04-12

    ... Promulgation of Implementation Plans; State of Arizona; Prevention of Air Pollution Emergency Episodes AGENCY... pollution emergency episodes in Clean Air Act (CAA or Act) section 110(a)(2)(G). Section 110(a)(2)(G) of the... applicable, including section 110(a)(2)(G) regarding authority to address air pollution emergency episodes...

  19. HIV prevention policy and programme planning: What can mathematical modelling contribute?

    NARCIS (Netherlands)

    Hankins, C.A.

    2014-01-01

    This thesis explores the potential contribution of mathematical modelling to informed decision-making on policy and programme planning for novel HIV prevention tools. Its hypothesis is that, under certain conditions, modelling results can be a useful addition to the evidence and other factors that

  20. Reducing Patient Radiation Exposure From CT Fluoroscopy-Guided Lumbar Spine Pain Injections by Targeting the Planning CT.

    Science.gov (United States)

    Amrhein, Timothy J; Schauberger, J Scott; Kranz, Peter G; Hoang, Jenny K

    2016-02-01

    CT fluoroscopy-guided lumbar spine pain injections typically include a preprocedural planning CT that contributes considerably to patient dose. The purpose of this study was to quantify the degree of radiation exposure reduction achieved by modifying only the planning CT component of the examination. A retrospective review was performed of 80 CT fluoroscopy-guided lumbar spine injections. Forty patients were scanned with a standard protocol using automatic tube current modulation (method A). Another 40 patients were scanned using a new technique that fixed the tube current of the planning CT to either 50 or 100 mA on the basis of the patient's anteroposterior diameter and that reduced the z-axis coverage (method B). Dose-length products (DLPs) were compared for the two methods. The mean maximal tube current for the planning CT was 435.0 mA for method A and 67.5 mA for method B. The mean z-axis was shorter for method B at 6.5 cm than for method A at 9.6 cm (p fluoroscopy components) was reduced by 78%. There was no significant difference between methods A and B in CT fluoroscopy time (p = 0.37). All procedures were technically successful. A nearly fivefold reduction in radiation exposure can be achieved in CT fluoroscopy-guided lumbar spine pain injections through modifications to the planning CT alone.

  1. Plan for Prevention of Natural Hazards in Urban Areas. Case of the City of Constantine (Algeria

    Directory of Open Access Journals (Sweden)

    Ykhlef Boubakeur

    2014-04-01

    Full Text Available Natural hazards are caused by different phenomena: landslides, earthquakes, floods etc. All the manifestations of forces of nature are called phenomena. We are speaking then of natural risks when these problems are threatening, with varying degrees, human activities, causing significant damage to human life, property and the environment. The need to consider natural hazards in land use planning tasks has become a major concern. During these past years, Algeria has been hit by frequent natural disasters, with the most recent ones endangering the lives of people and causing priceless damage, faced with such a situation the company of adequate measures, capable of exercising effective prevention, is essential. In addition to the seismic risk, for which prevention still needs to be improved, Algeria must also face gravity processes such as landslides. By their suddenness, they can put people in danger and destroy entire buildings involving the evacuation of entire neighbourhoods where the financial impact is significant on the state budget and local government. The main interest of this paper is the feasibility of a plan for prevention of natural disasters related to landslides based on geological maps, topography, hydrogeological and on existing buildings and vulnerability, and eventually lead to a Zoning risk that would be considered for inclusion in the Master Plan of Urban Planning and Land Use Plan and provide support for decisions taken by local authorities for the selection of sites.

  2. Planning for pre-exposure prophylaxis to prevent HIV transmission: challenges and opportunities

    Science.gov (United States)

    2010-01-01

    There are currently several ongoing or planned trials evaluating the efficacy of pre-exposure prophylaxis (PrEP) as a preventative approach to reducing the transmission of HIV. PrEP may prove ineffective, demonstrate partial efficacy, or show high efficacy and have the potential to reduce HIV infection in a significant way. However, in addition to the trial results, it is important that issues related to delivery, implementation and further research are also discussed. As a part of the ongoing discussion, in June 2009, the Bill & Melinda Gates Foundation sponsored a Planning for PrEP conference with stakeholders to review expected trial results, outline responsible educational approaches, and develop potential delivery and implementation strategies. The conference reinforced the need for continued and sustained dialogue to identify where PrEP implementation may fit best within an integrated HIV prevention package. This paper identifies the key action points that emerged from the Planning for PrEP meeting. PMID:20624303

  3. How Peru introduced a plan for comprehensive HIV prevention and care for transwomen.

    Science.gov (United States)

    Salazar, Ximena; Núnez-Curto, Arón; Villayzán, Jana; Castillo, Regina; Benites, Carlos; Caballero, Patricia; Cáceres, Carlos F

    2016-01-01

    As a group, transwomen in Peru have the highest prevalence of HIV (>20%) in the country, but they have little access to HIV prevention, testing and care services. Until recently, Peru's national HIV programme did not recognize transwomen and had remained essentially static for decades. This changed in December 2014, when the Ministry of Health expressed its commitment to improve programming for transwomen and to involve transwomen organizations by prioritizing the development of a "Targeted Strategy Plan of STIs/HIV/AIDS Prevention and Comprehensive Care for Transwomen." A policy dialogue between key stakeholders - Peru's Ministry of Health, academic scientists, civil society, transgender leaders and international agencies - created the conditions for a change in Peru's national HIV policy for transwomen. Supported by the effective engagement of all sectors, the Ministry of Health launched a plan to provide comprehensive HIV prevention and care for transwomen. The five-year plan includes new national guidelines for HIV prevention, care and support, and country-level investments in infrastructure and equipment. In addition to new biomedical strategies, the plan also incorporates several strategies to address structural factors that contribute to the vulnerability of transwomen. We identified three key factors that created the right conditions for this change in Peru's HIV policy. These factors include (1) the availability of solid evidence, based on scientific research; (2) ongoing efforts within the transwomen community to become better advocates of their own rights; and (3) a dialogue involving honest discussions between stakeholders about possibilities of changing the nation's HIV policy. The creation of Peru's national plan for HIV prevention and care for transwomen shows that long-term processes, focused on human rights for transwomen in Peru, can lead to organizational and public-policy change.

  4. Psycho-oncology and primary prevention in cancer control plans: an absent voice?

    Science.gov (United States)

    Dunn, Jeff; Holland, Jimmie; Hyde, Melissa K; Watson, Maggie

    2015-07-27

    One third of cancer deaths are attributable to modifiable lifestyle, behaviour and psychosocial risk factors. Psycho-oncology can contribute significantly to prevention initiatives such as those described in national cancer control plans (NCCPs), to reduce or eliminate these risk factors. However, the extent to which psycho-oncology expertise has informed prevention objectives in plans is unclear. Accordingly, 35 English language NCCPs were located via existing databases and were searched using Adobe text searches ('psycho', 'social', 'behav' and 'intervention') to identify (a) representations of psycho-oncology, its dimensions (psychological, social and behavioural) and roles (e.g. psychologist); and (b) behaviour/lifestyle change interventions. A third of NCCPs included the term psycho- or psychosocial-oncology; approximately half referred to a psycho-oncology dimension regarding prevention and early detection and half included actions/objectives relating to health professionals and provision of psychosocial care. The majority of cancer plans included prevention outcomes and focussed primarily on smoking cessation and alcohol reduction. Interventions commonly proposed were education, regulation and service provision; however, many were aspirational statements of intent rather than specific interventions. Psycho-oncology was represented in NCCPs but was limited in reference to prevention with few behavioural interventions utilised. Psycho-oncology input is needed to prescribe evidence-based interventions in cancer plans that not only educate, regulate and provide resources but also motivate, empower and create a supportive normative environment for behaviour change. In this manuscript, and throughout this Special Issue on Cancer Prevention, important principles, ideas and evidence within psycho-oncology are outlined which, if properly implemented, can help reduce the global cancer burden. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley

  5. UCAV path planning in the presence of radar-guided surface-to-air missile threats

    Science.gov (United States)

    Zeitz, Frederick H., III

    This dissertation addresses the problem of path planning for unmanned combat aerial vehicles (UCAVs) in the presence of radar-guided surface-to-air missiles (SAMs). The radars, collocated with SAM launch sites, operate within the structure of an Integrated Air Defense System (IADS) that permits communication and cooperation between individual radars. The problem is formulated in the framework of the interaction between three sub-systems: the aircraft, the IADS, and the missile. The main features of this integrated model are: The aircraft radar cross section (RCS) depends explicitly on both the aspect and bank angles; hence, the RCS and aircraft dynamics are coupled. The probabilistic nature of IADS tracking is accounted for; namely, the probability that the aircraft has been continuously tracked by the IADS depends on the aircraft RCS and range from the perspective of each radar within the IADS. Finally, the requirement to maintain tracking prior to missile launch and during missile flyout are also modeled. Based on this model, the problem of UCAV path planning is formulated as a minimax optimal control problem, with the aircraft bank angle serving as control. Necessary conditions of optimality for this minimax problem are derived. Based on these necessary conditions, properties of the optimal paths are derived. These properties are used to discretize the dynamic optimization problem into a finite-dimensional, nonlinear programming problem that can be solved numerically. Properties of the optimal paths are also used to initialize the numerical procedure. A homotopy method is proposed to solve the finite-dimensional, nonlinear programming problem, and a heuristic method is proposed to improve the discretization during the homotopy process. Based upon the properties of numerical solutions, a method is proposed for parameterizing and storing information for later recall in flight to permit rapid replanning in response to changing threats. Illustrative examples are

  6. A Quantitative Index to Support Recurrence Prevention Plans of Human-Related Events

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yochan; Park, Jinkyun; Jung, Wondea [KAERI, Daejeon (Korea, Republic of); Kim, Do Sam; Lee, Durk Hun [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-05-15

    In Korea, HuRAM+ (Human related event Root cause Analysis Method plus) was developed to scrutinize the causes of the human-related events. The information of the human-related events investigated by the HuRAM+ method has been also managed by a database management system, R-tracer. It is obvious that accumulating data of human error causes aims to support plans that reduce recurrences of similar events. However, in spite of the efforts for the development of the human error database, it was indicated that the database does not provide useful empirical basis for establishment of the recurrence prevention plans, because the framework to interpret the collected data and apply the insights from the data into the prevention plants has not been developed yet. In this paper, in order to support establishment of the recurrence prevention plans, a quantitative index, Human Error Repeat Interval (HERI), was proposed and its applications to human error prevention were introduced. In this paper, a quantitative index, the HERI was proposed and the statistics of HERIs were introduced. These estimations can be employed to evaluate effects of recurrence prevention plans to human errors. If a mean HERI score is low and the linear trend is not positive, it can be suspected that the recurrence prevention plans applied every human-related event has not been effectively propagated. For reducing repetitive error causes, the system design or operational culture can be reviewed. If there is a strong and negative trend, systematic investigation of the root causes behind these trends is required. Likewise, we expect that the HERI index will provide significant basis for establishing or adjusting prevention plans of human errors. The accurate estimation and application of HERI scores is expected to be done after accumulating more data. When a scatter plot of HERIs is fitted by two or more models, a statistical model selection method can be employed. Some criteria have been introduced by

  7. A Quantitative Index to Support Recurrence Prevention Plans of Human-Related Events

    International Nuclear Information System (INIS)

    Kim, Yochan; Park, Jinkyun; Jung, Wondea; Kim, Do Sam; Lee, Durk Hun

    2015-01-01

    In Korea, HuRAM+ (Human related event Root cause Analysis Method plus) was developed to scrutinize the causes of the human-related events. The information of the human-related events investigated by the HuRAM+ method has been also managed by a database management system, R-tracer. It is obvious that accumulating data of human error causes aims to support plans that reduce recurrences of similar events. However, in spite of the efforts for the development of the human error database, it was indicated that the database does not provide useful empirical basis for establishment of the recurrence prevention plans, because the framework to interpret the collected data and apply the insights from the data into the prevention plants has not been developed yet. In this paper, in order to support establishment of the recurrence prevention plans, a quantitative index, Human Error Repeat Interval (HERI), was proposed and its applications to human error prevention were introduced. In this paper, a quantitative index, the HERI was proposed and the statistics of HERIs were introduced. These estimations can be employed to evaluate effects of recurrence prevention plans to human errors. If a mean HERI score is low and the linear trend is not positive, it can be suspected that the recurrence prevention plans applied every human-related event has not been effectively propagated. For reducing repetitive error causes, the system design or operational culture can be reviewed. If there is a strong and negative trend, systematic investigation of the root causes behind these trends is required. Likewise, we expect that the HERI index will provide significant basis for establishing or adjusting prevention plans of human errors. The accurate estimation and application of HERI scores is expected to be done after accumulating more data. When a scatter plot of HERIs is fitted by two or more models, a statistical model selection method can be employed. Some criteria have been introduced by

  8. Ultrasonography-guided percutaneous radiofrequency ablation of hepatocellular carcinomas: A feasibility scoring system for planning sonography

    Energy Technology Data Exchange (ETDEWEB)

    Rhim, Hyunchul, E-mail: rhimhc@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choi, Dongil; Kim, Young-sun; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choe, Bong-Keun [Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    Purpose: This study was designed to evaluate whether a feasibility scoring system for planning sonography is a reliable predictor of a safe and complete ablation in ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) of hepatocellular carcinomas (HCCs). Materials and methods: We retrospectively evaluated the therapeutic outcomes of 108 consecutive patients (M:F, 78:30; mean age, 57.4 years) with a single nodular HCC (mean diameter, 2.0 cm) treated by percutaneous RFA. All patients were assessed for the feasibility of performing an RFA at planning sonography prior to the ablation. The feasibility scoring system consisted of five categories: the safe electrode path (P); the vital organs adjacent to the RFA zone (O); tumor size (S); tumor conspicuity (C); and the heat-sink effect (H). Each category was divided into a four-point scale [1-4]. If a score of 4 in any category was determined, the patient was not considered to be a suitable candidate for percutaneous RFA. We assessed if the score of each category, safety score (P + O), and curability score (S + C + H) correlated with a safe and complete ablation using the chi-squared test and likelihood ratio test for trend. Results: The technical success rate was 100% (108/108) based on CT images obtained immediately after ablation. There was no 30-day mortality after RFA. There were major complications (one case of severe vasovagal reflex, one case of hemoperitoneum and one case of a pseudoaneurysm) in three (2.7%) patients, and minor complications (one case of a biloma, one case of subsegmental infarction and one case of abscess) in three (2.7%) patients. Post-ablation syndrome as a side effect was noted in 38 (35.1%) of 108 patients. The primary technique effectiveness rate at 1 month was 95.1% (105/108). Local tumor progression was noted in eight (7.6%) of 105 patients during the follow-up period (range, 3.0-11.5 months; median, 5.8 months; mean, 5.7 months). There was no significant single category

  9. Westinghouse Hanford Company waste minimization and pollution prevention awareness program plan

    International Nuclear Information System (INIS)

    Craig, P.A.; Nichols, D.H.; Lindsey, D.W.

    1991-08-01

    The purpose of this plan is to establish the Westinghouse Hanford Company's Waste Minimization Program. The plan specifies activities and methods that will be employed to reduce the quantity and toxicity of waste generated at Westinghouse Hanford Company (Westinghouse Hanford). It is designed to satisfy the US Department of Energy (DOE) and other legal requirements that are discussed in Subsection C of the section. The Pollution Prevention Awareness Program is included with the Waste Minimization Program as permitted by DOE Order 5400.1 (DOE 1988a). This plan is based on the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan, which directs DOE Field Office, Richland contractors to develop and maintain a waste minimization program. This waste minimization program is an organized, comprehensive, and continual effort to systematically reduce waste generation. The Westinghouse Hanford Waste Minimization Program is designed to prevent or minimize pollutant releases to all environmental media from all aspects of Westinghouse Hanford operations and offers increased protection of public health and the environment. 14 refs., 2 figs., 1 tab

  10. Environmental implementation plan: Chapter 5, Chemical management, pollution prevention and other compliance programs

    International Nuclear Information System (INIS)

    Peterson, G.L.

    1993-01-01

    Compliance with environmental regulations and US Department of Energy Orders (DOE) relating to environmental protection is an important part of SRS's program. Over the past few years, the number of environmental regulations has increased. The strategy to comply with new and existing environmental regulations and DOE orders is described in chapter two. In this chapter, the following environmental programs are described: Toxic Substances Control Act (TSCA); Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA); Emergency Planning and Community Right-to-Know Act (EPCRA); and SPCC/BMP/Pollution Prevention Plans;The implementation section identifies issues and those responsible to achieve defined objectives

  11. Prevent, Counter, and Respond - A Strategic Plan to Reduce Global Nuclear Threats (FY 2016-FY2020)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-03-01

    NNSA’s second core mission is reducing global nuclear dangers by preventing the acquisition of nuclear weapons or weapons-usable materials, countering efforts to acquire such weapons or materials, and responding to nuclear or radiological incidents. In 2015, NNSA reorganized its nonproliferation activities based on core competencies and realigned its counterterrorism and counterproliferation functions to more efficiently address both current and emerging threats and challenges. The reorganization accompanied the March 2015 release of the first ever Prevent, Counter, and Respond – A Strategic Plan to Reduce Global Nuclear Threats. This report, which NNSA will update annually, highlights key nuclear threat trends and describes NNSA’s integrated threat reduction strategy.

  12. Previniendo el Uso de Drogas entre Ninos y Adolescentes: Una Guia Basada en Investigaciones (Preventing Drug Use among Children and Adolescents: A Research-Based Guide).

    Science.gov (United States)

    Sloboda, Zili; David, Susan L.

    This question and answer guide provides an overview of the research on the origins and pathways of drug abuse, the basic principles derived from effective drug abuse prevention research, and the application of research results to the prevention of drug use among young people. The basic principles derived from drug abuse prevention research are…

  13. Adherence to the USDA Food Guide, DASH Eating Plan, and Mediterranean dietary pattern reduces risk of colorectal adenoma.

    Science.gov (United States)

    Dixon, L Beth; Subar, Amy F; Peters, Ulrike; Weissfeld, Joel L; Bresalier, Robert S; Risch, Adam; Schatzkin, Arthur; Hayes, Richard B

    2007-11-01

    The 2005 Dietary Guidelines for Americans include quantitative recommendations for 2 eating patterns, the USDA Food Guide and the Dietary Approaches to Stop Hypertension (DASH) Eating Plan, to promote optimal health and reduce disease risk. A Mediterranean dietary pattern has also been promoted for health benefits. Our objective was to determine whether adherence to the USDA Food Guide recommendations, the DASH Eating Plan, or a Mediterranean dietary pattern is associated with reduced risk of distal colorectal adenoma. In the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, men and women aged 55-74 y were screened for colorectal cancer by sigmoidoscopy at 10 centers in the U.S. After adjusting for potential confounders, men who most complied with the USDA Food Guide recommendations had a 26% reduced risk of colorectal adenoma compared with men who least complied with the recommendations (OR USDA score >or= 5 vs. dietary pattern. Women who most complied with the USDA Food Guide recommendations had an 18% reduced risk for colorectal adenoma, but subgroup analyses revealed protective associations only for current smokers (OR USDA score >or= 5 vs. or= 5 vs. dietary recommendations or a Mediterranean dietary pattern is associated with reduced risk of colorectal adenoma, especially in men.

  14. A heterogeneous tissue model for treatment planning for magnetic resonance-guided laser interstitial thermal therapy.

    Science.gov (United States)

    Mitchell, Drew; Fahrenholtz, Samuel; MacLellan, Christopher; Bastos, Dhiego; Rao, Ganesh; Prabhu, Sujit; Weinberg, Jeffrey; Hazle, John; Stafford, Jason; Fuentes, David

    2018-02-05

    We evaluated a physics-based model for planning for magnetic resonance-guided laser interstitial thermal therapy for focal brain lesions. Linear superposition of analytical point source solutions to the steady-state Pennes bioheat transfer equation simulates laser-induced heating in brain tissue. The line integral of the photon attenuation from the laser source enables computation of the laser interaction with heterogeneous tissue. Magnetic resonance thermometry data sets (n = 31) were used to calibrate and retrospectively validate the model's thermal ablation prediction accuracy, which was quantified by the Dice similarity coefficient (DSC) between model-predicted and measured ablation regions (T > 57 °C). A Gaussian mixture model was used to identify independent tissue labels on pre-treatment anatomical magnetic resonance images. The tissue-dependent optical attenuation coefficients within these labels were calibrated using an interior point method that maximises DSC agreement with thermometry. The distribution of calibrated tissue properties formed a population model for our patient cohort. Model prediction accuracy was cross-validated using the population mean of the calibrated tissue properties. A homogeneous tissue model was used as a reference control. The median DSC values in cross-validation were 0.829 for the homogeneous model and 0.840 for the heterogeneous model. In cross-validation, the heterogeneous model produced a DSC higher than that produced by the homogeneous model in 23 of the 31 brain lesion ablations. Results of a paired, two-tailed Wilcoxon signed-rank test indicated that the performance improvement of the heterogeneous model over that of the homogeneous model was statistically significant (p < 0.01).

  15. Image-guided surgical planning using anatomical landmarks in the retrosigmoid approach.

    Science.gov (United States)

    da Silva, Erasmo Barros; Leal, André G; Milano, Jerônimo B; da Silva, Luis F Moura; Clemente, Rogério S; Ramina, Ricardo

    2010-05-01

    The suboccipital lateral or retrosigmoid approach is the main neurosurgical approach to the cerebellopontine angle (CPA). It is mainly used in the treatment of CPA tumors and vascular decompression of cranial nerves. A prospective study using navigation registered with anatomical landmarks in order to identify the transverse and sigmoid sinuses junction (TSSJ) was carried out in a series of 30 retrosigmoid craniotomies. The goal of this study was to determine the accuracy of this navigation technique and to establish the relationship between the location of the asterion and the TSSJ. From March through November 2008, 30 patients underwent a retrosigmoid craniotomy for removal of CPA tumors or for surgical treatment of neurovascular syndromes. Magnetic resonance imaging (MRI) T1 sequences with gadolinium (FSPGR with FatSst, 1.5 T GE Signa) and frameless navigation (Vector vision, Brainlab) were used for surgical planning. Registration was performed using six anatomical landmarks. The position of the TSSJ indicated by navigation was the landmark to guide the craniotomy. The location of the asterion was compared with the position of the TSSJ. After craniotomy, the real TSSJ position was compared with the virtual position, as demonstrated by navigation. There were 19 cases of vestibular schwannomas, 5 petroclival meningiomas, 3 trigeminal neuralgias, 1 angioblastoma, 1 epidermoid cyst and 1 hemifacial spasm. In all cases, navigation enabled the location of the TSSJ and the emissary vein, with an accuracy flaw below 2 mm. The asterion was located directly over the TSSJ in only seven cases. One patient had a laceration of the sigmoid sinus during the craniotomy. Navigation using anatomical landmarks for registration is a reliable method in the localization of the TSSJ for retrosigmoid craniotomies and thereby avoiding unnecessary sinus exposure. In addition, the method proved to be fast and accurate. The asterion was found to be a less accurate landmark for the

  16. Interactive contour delineation and refinement in treatment planning of image-guided radiation therapy.

    Science.gov (United States)

    Zhou, Wu; Xie, Yaoqin

    2014-01-06

    The accurate contour delineation of the target and/or organs at risk (OAR) is essential in treatment planning for image-guided radiation therapy (IGRT). Although many automatic contour delineation approaches have been proposed, few of them can fulfill the necessities of applications in terms of accuracy and efficiency. Moreover, clinicians would like to analyze the characteristics of regions of interests (ROI) and adjust contours manually during IGRT. Interactive tool for contour delineation is necessary in such cases. In this work, a novel approach of curve fitting for interactive contour delineation is proposed. It allows users to quickly improve contours by a simple mouse click. Initially, a region which contains interesting object is selected in the image, then the program can automatically select important control points from the region boundary, and the method of Hermite cubic curves is used to fit the control points. Hence, the optimized curve can be revised by moving its control points interactively. Meanwhile, several curve fitting methods are presented for the comparison. Finally, in order to improve the accuracy of contour delineation, the process of the curve refinement based on the maximum gradient magnitude is proposed. All the points on the curve are revised automatically towards the positions with maximum gradient magnitude. Experimental results show that Hermite cubic curves and the curve refinement based on the maximum gradient magnitude possess superior performance on the proposed platform in terms of accuracy, robustness, and time calculation. Experimental results of real medical images demonstrate the efficiency, accuracy, and robustness of the proposed process in clinical applications.

  17. We have the programme, what next? Planning the implementation of an injury prevention programme.

    Science.gov (United States)

    Donaldson, Alex; Lloyd, David G; Gabbe, Belinda J; Cook, Jill; Finch, Caroline F

    2017-08-01

    The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Healthcare spending and preventive care in high-deductible and consumer-directed health plans.

    Science.gov (United States)

    Beeuwkes Buntin, Melinda; Haviland, Amelia M; McDevitt, Roland; Sood, Neeraj

    2011-03-01

    To investigate the effects of high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs) on healthcare spending and on the use of recommended preventive care. Retrospective study. We analyzed claims and enrollment data for 808,707 households from 53 large US employers, 28 of which offered HDHPs or CDHPs. We estimated the effects of HDHP or CDHP enrollment on healthcare cost growth between 2004 and 2005 using a difference-in-difference method that compared cost growth for families who were enrolled in HDHPs or CDHPs for the first time in 2005 with cost growth for families who were not offered HDHPs or CDHPs. Control families were weighted using propensity score weights to match the treatment families. Using similar methods, we examined the effects of HDHP or CDHP enrollment on the use of preventive care and the effects of HDHP or CDHP offering by employers on the mean cost growth. Families enrolling in HDHPs or CDHPs for the first time spent 14% less than similar families enrolled in conventional plans. Families in firms offering an HDHP or a CDHP spent less than those in other firms. Significant savings for enrollees were realized only for plans with deductibles of at least $1000, and savings decreased with generous employer contributions to healthcare accounts. Enrollment in HDHPs or CDHPs was also associated with moderate reductions in the use of preventive care. The HDHPs or CDHPs with at least a $1000 deductible significantly reduced healthcare spending, but they also reduced the use of preventive care in the first year. This merits additional study because of concerns about enrollee health.

  19. Effectiveness of Anabolic Steroid Preventative Intervention among Gym Users: Applying Theory of Planned Behavior

    OpenAIRE

    Jalilian, Farzad; Allahverdipour, Hamid; Moeini, Babak; Moghimbeigi, Abbas

    2011-01-01

    Background: Use of anabolic androgenic steroids (AAS) has been associated with adversephysical and psychiatric effects and it is known as rising problem among youth people. Thisstudy was conducted to evaluate anabolic steroids preventative intervention efficiency amonggym users in Iran and theory of planned behaviour was applied as theoretical framework.Methods: Overall, 120 male gym users participated in this study as intervention and controlgroup. This was a longitudinal randomized pretest ...

  20. Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

    Directory of Open Access Journals (Sweden)

    Korevaar Erik W

    2008-01-01

    Full Text Available Abstract Background The shift from conventional two-dimensional (2D to three-dimensional (3D-conformal target definition and dose-planning seems to have introduced volumetric as well as geometric changes. The purpose of this study was to compare coverage of computed tomography (CT-based breast and boost planning target volumes (PTV, absolute volumes irradiated, and dose delivered to the organs at risk with conventional 2D and 3D-conformal breast conserving radiotherapy. Methods Twenty-five patients with left-sided breast cancer were subject of CT-guided target definition and 3D-conformal dose-planning, and conventionally defined target volumes and treatment plans were reconstructed on the planning CT. Accumulated dose-distributions were calculated for the conventional and 3D-conformal dose-plans, taking into account a prescribed dose of 50 Gy for the breast plans and 16 Gy for the boost plans. Results With conventional treatment plans, CT-based breast and boost PTVs received the intended dose in 78% and 32% of the patients, respectively, and smaller volumes received the prescribed breast and boost doses compared with 3D-conformal dose-planning. The mean lung dose, the volume of the lungs receiving > 20 Gy, the mean heart dose, and volume of the heart receiving > 30 Gy were significantly less with conventional treatment plans. Specific areas within the breast and boost PTVs systematically received a lower than intended dose with conventional treatment plans. Conclusion The shift towards CT-guided target definition and planning as the golden standard for breast conserving radiotherapy has resulted in improved target coverage at the cost of larger irradiated volumes and an increased dose delivered to organs at risk. Tissue is now included into the breast and boost target volumes that was never explicitly defined or included with conventional treatment. Therefore, a coherent definition of the breast and boost target volumes is needed, based on

  1. Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

    International Nuclear Information System (INIS)

    Laan, Hans Paul van der; Dolsma, Wil V; Maduro, John H; Korevaar, Erik W; Langendijk, Johannes A

    2008-01-01

    The shift from conventional two-dimensional (2D) to three-dimensional (3D)-conformal target definition and dose-planning seems to have introduced volumetric as well as geometric changes. The purpose of this study was to compare coverage of computed tomography (CT)-based breast and boost planning target volumes (PTV), absolute volumes irradiated, and dose delivered to the organs at risk with conventional 2D and 3D-conformal breast conserving radiotherapy. Twenty-five patients with left-sided breast cancer were subject of CT-guided target definition and 3D-conformal dose-planning, and conventionally defined target volumes and treatment plans were reconstructed on the planning CT. Accumulated dose-distributions were calculated for the conventional and 3D-conformal dose-plans, taking into account a prescribed dose of 50 Gy for the breast plans and 16 Gy for the boost plans. With conventional treatment plans, CT-based breast and boost PTVs received the intended dose in 78% and 32% of the patients, respectively, and smaller volumes received the prescribed breast and boost doses compared with 3D-conformal dose-planning. The mean lung dose, the volume of the lungs receiving > 20 Gy, the mean heart dose, and volume of the heart receiving > 30 Gy were significantly less with conventional treatment plans. Specific areas within the breast and boost PTVs systematically received a lower than intended dose with conventional treatment plans. The shift towards CT-guided target definition and planning as the golden standard for breast conserving radiotherapy has resulted in improved target coverage at the cost of larger irradiated volumes and an increased dose delivered to organs at risk. Tissue is now included into the breast and boost target volumes that was never explicitly defined or included with conventional treatment. Therefore, a coherent definition of the breast and boost target volumes is needed, based on clinical data confirming tumour control probability and normal

  2. Planning for the Future: A Model for Using the Principles of Transition to Guide the Development of Behavior Intervention Plans

    Science.gov (United States)

    Mueller, Tracy Gershwin; Bassett, Diane S.; Brewer, Robin D.

    2012-01-01

    The Individuals with Disabilities Education Act (IDEA) mandates the implementation of a behavior intervention plan based on a functional behavioral assessment when a student's behavior necessitates disciplinary actions. However, IDEA does not provide any clear guidelines as to what the plans should contain nor how they can address behaviors that…

  3. [National plan for prevention in agriculture state of art and prosecution].

    Science.gov (United States)

    Ariano, Eugenio

    2013-01-01

    Agricultural work submits to high risks for safety and health. In 2009, in execution of "workplace health protection pact" (DPCM 17.12.2007), has been defined the National Plan for prevention in agriculture and forestry, whose first three-year program ended in 2012. Goals were: to Systematize and to standardize direction and control activity, defining the number of factories to control, in most italian regions, for high and ubiquitous risks applying homogeneous standards, spending special attention to risks of fatal and serious injury; to develop agricultural machinery trade control, for new and second-hand machinery, for normalizing the whole fleet; to contribute to monitoring of risk factors and injury dynamics, for a better definition of prevention policies; to increase the knowledge of public health agency officers; to identify and to promote technical solutions, helping to define, in proper way, good practices for complex problems; to promote coordination between economic develop policies and prevention policies for agriculture, breeding and forestry, paying attention also to financial helps. The plan, divided in regional plans, obtained most of defined goals and allowed to build a permanent interregional net of referents and expert officers. Next years perspective is to enhance in developing the faced themes and objectives.

  4. Storm water pollution prevention plan for the Oak Ridge Y-12 Plant

    International Nuclear Information System (INIS)

    1995-09-01

    The Environmental Protection Agency (EPA) published the final storm water regulation on November 16, 1990. The storm water regulation is included in the National Pollutant Discharge Elimination System (NPDES) regulations. An NPDES permit was issued for the Y-12 Plant on April 28, 1995, and was effective on July 1, 1995. The permit requires that a Storm Water Pollution Prevention Plan (SWP3) be developed by December 28, 1995, and be fully implemented by July 1, 1996; this plan has been developed to fulfill that requirement. The outfalls and monitoring points described in this plan contain storm water discharges associated with industrial activities as defined in the NPDES regulations. For storm water discharges associated with industrial activity, including storm water discharges associated with construction activity, that are not specifically monitored or limited in this permit, Y-12 Plant personnel will meet conditions of the General Storm Water Rule 1200-4-10. This document presents the programs and physical controls that are in place to achieve the following objectives: ensure compliance with Section 1200-4-10-.04(5) of the TDEC Water Quality Control Regulations and Part 4 of the Y-12 Plant NPDES Permit (TN0002968); provide operating personnel with guidance relevant to storm water pollution prevention and control requirements for their facility and/or project; and prevent or reduce pollutant discharge to the environment, in accordance with the Clean Water Act (CWA) and the Tennessee Water Quality Control Act

  5. Storm water pollution prevention plan for the Oak Ridge Y-12 Plant

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The Environmental Protection Agency (EPA) published the final storm water regulation on November 16, 1990. The storm water regulation is included in the National Pollutant Discharge Elimination System (NPDES) regulations. An NPDES permit was issued for the Y-12 Plant on April 28, 1995, and was effective on July 1, 1995. The permit requires that a Storm Water Pollution Prevention Plan (SWP3) be developed by December 28, 1995, and be fully implemented by July 1, 1996; this plan has been developed to fulfill that requirement. The outfalls and monitoring points described in this plan contain storm water discharges associated with industrial activities as defined in the NPDES regulations. For storm water discharges associated with industrial activity, including storm water discharges associated with construction activity, that are not specifically monitored or limited in this permit, Y-12 Plant personnel will meet conditions of the General Storm Water Rule 1200-4-10. This document presents the programs and physical controls that are in place to achieve the following objectives: ensure compliance with Section 1200-4-10-.04(5) of the TDEC Water Quality Control Regulations and Part 4 of the Y-12 Plant NPDES Permit (TN0002968); provide operating personnel with guidance relevant to storm water pollution prevention and control requirements for their facility and/or project; and prevent or reduce pollutant discharge to the environment, in accordance with the Clean Water Act (CWA) and the Tennessee Water Quality Control Act.

  6. 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

  7. Theory of Planned Behavior in School-Based Adolescent Problem Gambling Prevention: A Conceptual Framework.

    Science.gov (United States)

    St-Pierre, Renée A; Temcheff, Caroline E; Derevensky, Jeffrey L; Gupta, Rina

    2015-12-01

    Given its serious implications for psychological and socio-emotional health, the prevention of problem gambling among adolescents is increasingly acknowledged as an area requiring attention. The theory of planned behavior (TPB) is a well-established model of behavior change that has been studied in the development and evaluation of primary preventive interventions aimed at modifying cognitions and behavior. However, the utility of the TPB has yet to be explored as a framework for the development of adolescent problem gambling prevention initiatives. This paper first examines the existing empirical literature addressing the effectiveness of school-based primary prevention programs for adolescent gambling. Given the limitations of existing programs, we then present a conceptual framework for the integration of the TPB in the development of effective problem gambling preventive interventions. The paper describes the TPB, demonstrates how the framework has been applied to gambling behavior, and reviews the strengths and limitations of the model for the design of primary prevention initiatives targeting adolescent risk and addictive behaviors, including adolescent gambling.

  8. Household waste compositional analysis variation from insular communities in the framework of waste prevention strategy plans.

    Science.gov (United States)

    Zorpas, Antonis A; Lasaridi, Katia; Voukkali, Irene; Loizia, Pantelitsa; Chroni, Christina

    2015-04-01

    Waste management planning requires reliable data regarding waste generation, affecting factors on waste generation and forecasts of waste quantities based on facts. In order to decrease the environmental impacts of waste management the choice of prevention plan as well as the treatment method must be based on the features of the waste that are produced in a specific area. Factors such as culture, economic development, climate, and energy sources have an impact on waste composition; composition influences the need of collecting waste more or less frequently of waste collection and disposition. The research question was to discover the main barriers concerning the compositional analysis in Insular Communities under warm climate conditions and the findings from this study enabled the main contents of a waste management plan to be established. These included advice to residents on waste minimisation, liaison with stakeholders and the expansion of kerbside recycling schemes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Household waste compositional analysis variation from insular communities in the framework of waste prevention strategy plans

    Energy Technology Data Exchange (ETDEWEB)

    Zorpas, Antonis A., E-mail: antonis.zorpas@ouc.ac.cy [Cyprus Open University, Faculty of Pure and Applied Science, Environmental Conservation and Management, P.O. Box 12794, 2252 Latsia, Nicosia (Cyprus); Lasaridi, Katia, E-mail: klasaridi@hua.gr [Harokopio University, Department of Geography, 70 El. Venizelou, 176 71 Athens, Kallithea (Greece); Voukkali, Irene [Institute of Environmental Technology and Sustainable Development, ENVITECH LTD, Department of Research and Development, P.O. Box 34073, 5309 (Cyprus); Loizia, Pantelitsa, E-mail: irenevoukkali@envitech.org [Institute of Environmental Technology and Sustainable Development, ENVITECH LTD, Department of Research and Development, P.O. Box 34073, 5309 (Cyprus); Chroni, Christina [Harokopio University, Department of Geography, 70 El. Venizelou, 176 71 Athens, Kallithea (Greece)

    2015-04-15

    Highlights: • Waste framework directive has set clear waste prevention procedures. • Household Compositional analysis. • Waste management plans. • Zero waste approach. • Waste generation. - Abstract: Waste management planning requires reliable data regarding waste generation, affecting factors on waste generation and forecasts of waste quantities based on facts. In order to decrease the environmental impacts of waste management the choice of prevention plan as well as the treatment method must be based on the features of the waste that are produced in a specific area. Factors such as culture, economic development, climate, and energy sources have an impact on waste composition; composition influences the need of collecting waste more or less frequently of waste collection and disposition. The research question was to discover the main barriers concerning the compositional analysis in Insular Communities under warm climate conditions and the findings from this study enabled the main contents of a waste management plan to be established. These included advice to residents on waste minimisation, liaison with stakeholders and the expansion of kerbside recycling schemes.

  10. Household waste compositional analysis variation from insular communities in the framework of waste prevention strategy plans

    International Nuclear Information System (INIS)

    Zorpas, Antonis A.; Lasaridi, Katia; Voukkali, Irene; Loizia, Pantelitsa; Chroni, Christina

    2015-01-01

    Highlights: • Waste framework directive has set clear waste prevention procedures. • Household Compositional analysis. • Waste management plans. • Zero waste approach. • Waste generation. - Abstract: Waste management planning requires reliable data regarding waste generation, affecting factors on waste generation and forecasts of waste quantities based on facts. In order to decrease the environmental impacts of waste management the choice of prevention plan as well as the treatment method must be based on the features of the waste that are produced in a specific area. Factors such as culture, economic development, climate, and energy sources have an impact on waste composition; composition influences the need of collecting waste more or less frequently of waste collection and disposition. The research question was to discover the main barriers concerning the compositional analysis in Insular Communities under warm climate conditions and the findings from this study enabled the main contents of a waste management plan to be established. These included advice to residents on waste minimisation, liaison with stakeholders and the expansion of kerbside recycling schemes

  11. The Decision Maker's Guide to Applied Planning, Organization, Administration, Research, Evaluation, Information Processing and Analysis Techniques.

    Science.gov (United States)

    Dumas, Neil S.

    This guide is an attempt to eliminate the need for decision makers to suffer from many of their future errors. It is an attempt to insure that the "right" decision is made the first time. Briefly, the theory is that one can learn from other peoples' experience and thus avoid making future mistakes. This volume is a guide to other…

  12. A Guide for Planning Facilities for Occupational Preparation Programs in Metallurgy Technology. Interim Report. Research 28.

    Science.gov (United States)

    German, Carl, Jr.

    The major purpose of this guide is to elicit the information necessary for writing educational specifications for facilities to house technical education programs in metallurgy. It is organized in these parts: (1) Part I discusses the major purpose, underlying assumptions, recent instructional trends, and guiding principles utilized in the…

  13. Workflow efficiency for the treatment planning process in CT-guided high-dose-rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Michaud, Anthony L; Benedict, Stanley; Montemayor, Eliseo; Hunt, Jon Paul; Wright, Cari; Mathai, Mathew; Mayadev, Jyoti S

    2016-01-01

    To investigate process efficiency, we present a prospective investigation of the treatment planning phase of image-guided brachytherapy (BT) for cervical cancer using a specific checklist. From October 2012 to January 2014, 76 BT procedures were consecutively performed. Prospective data on the CT-based treatment planning process was collected using a specific checklist which details the following steps: (1) dosimetry planning, (2) physician review start, (3) physician review time, (4) dosimetry processing, (5) physics review start, (6) physics review, and (7) procedural pause. Variables examined included the use of a pre-BT MRI, clinic duty conflicts, resident teaching, and the use of specific BT planners. Analysis was performed using descriptive statistics, t-test, and analysis of variance. Seventy-five prospectively gathered checklists comprised this analysis. The mean time for treatment planning was 95 minutes (med 94, std 18). The mean intervals in the above steps were (1) = 42, (2) = 5, (3) = 19, (4) = 10, (5) = 6, (6) = 13, and (7) = 26 minutes. There was no statistical difference in patients who had a pre-BT MRI. Resident teaching did not influence time, p = 0.17. Treatment planning time was decreased with a specific planner, p = 0.0015. A skillful team approach is required for treatment planning efficiency in image-guided BT. We have found that the specific BT planners can have a significant effect on the overall planning efficiency. We continue to examine clinical and workflow-related factors that will enhance our safety and workflow process with BT. Published by Elsevier Inc.

  14. Quality Assurance/Quality Control Issues for Intraoperative Planning and Adaptive Repeat Planning of Image-Guided Prostate Implants

    International Nuclear Information System (INIS)

    Zaider, Marco; Cohen, Gilad; Meli, Jerome; Rosenfeld, Anatoly B.

    2008-01-01

    The quality assurance/quality control purpose is this. We design a treatment plan, and we wish to be as certain as reasonably possible that the treatment is delivered as planned. In the case of conventionally planned prostate brachytherapy, implementing to the letter the implantation plan is rarely attainable and therefore can require adaptive replanning (a quality control issue). The reasons for this state of affairs include changes in the prostate shape and volume during implantation and treatment delivery (e.g., edema resolution) and unavoidable inaccuracy in the placement of the seeds in the prostate. As a result, quality-control activities (e.g., the need to monitor-ideally, on the fly-the target and urethral and rectal dosage) must be also addressed

  15. Two-dimensional inverse planning and delivery with a preclinical image guided microirradiator

    International Nuclear Information System (INIS)

    Stewart, James M. P.; Lindsay, Patricia E.; Jaffray, David A.

    2013-01-01

    profiles taken through the sock distribution of 3.9%. Mean absolute delivery error across the 0–1 Gy linear dose gradient over 7.5 mm was 0.01 Gy.Conclusions: The work presented here demonstrates the potential for complex dose distributions to be planned and automatically delivered with millimeter scale heterogeneity at submillimeter accuracy. This capability establishes the technical foundation for preclinical validation of biologically guided radiotherapy investigations and development of unique radiobiological experiments

  16. Defibrillation beliefs of rural nurses: focus group discussions guided by the Theory of Planned Behaviour.

    Science.gov (United States)

    Dwyer, T A; Mosel Williams, L; Mummery, K

    2005-01-01

    The endorsement of the chain of survival concept and early defibrillation has challenged health professionals to reconsider their beliefs about how they respond to in-hospital resuscitation. In the rural context, where 24 hour coverage is not available nurse-initiated defibrillation is expected. Despite literature and policy change in Australia to allow nurses to initiate defibrillation, there is no current research that uses a systemic theoretical approach to investigate the specific beliefs of nurses and their use of defibrillators. The purpose of this study was to elicit a beginning understanding of the defibrillation beliefs of rural nurses. This research used focus groups within the framework of the Theory of Planned Behavior to describe the defibrillation beliefs of rural registered nurses. The sites selected for this study were two acute care hospitals in rural Australia (RRMA Classification). Each of these hospitals was in located 'other rural areas' (RRMA Classification) in separate towns and had 25 and 30 beds. The study sample consisted of 10 females and two males. Focus group questions were designed to elicit salient beliefs within the theoretical framework. Three constructs of behavioral, normative and control beliefs guided the development of the question and analysis of the discussions. In accordance with the authors of the theoretical framework, content analysis was used to analyse the data from the study. Two behavioral beliefs, four control beliefs and four normative belief categories were elicited. Two behavioral beliefs categories emerged from the open-ended question: 'What, if any are the advantages of you being able to use a defibrillator?' Participants were congruent when discussing the advantages of nurses initiating defibrillation. The two categories were 'quicker response times' (15 responses) and 'increased success with resuscitation' (8 responses). Participants were asked to identify any events that might influence their decision to use

  17. Tribal Decisions-Makers Guide to Solid Waste Management: Chapter 2 - Developing Solid Waste Management Plans

    Science.gov (United States)

    Solid waste management plans offer a host of benefits for tribes and Alaskan Native villages. Through the preparation of these plans, you can assess your cur-rent and future waste management needs, set priorities, and allocate resources accordingly.

  18. The spill prevention, control, and countermeasures (SPCC) plan for the Y-12 Plant. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

    This spill prevention, control and countermeasures (SPCC) Plan is divided into two volumes. Volume I addresses Y-12`s compliance with regulations pertinent to the content of SPCC Plans. Volume II is the SPCC Hazardous Material Storage Data Base, a detailed tabulation of facility-specific information and data on potential spill sources at the Y-12 Plant. Volume I follows the basic format and subject sequence specified in 40 CFR 112.7. This sequence is prefaced by three additional chapters, including this introduction and brief discussions of the Y-12 Plant`s background/environmental setting and potential spill source categories. Two additional chapters on containers and container storage areas and PCB and PCB storage for disposal facilities are inserted into the required sequence. The following required subjects are covered in this volume: Spill history, site drainage; secondary containment/diversion structures and equipment; contingency plans; notification and spill response procedures; facility drainage; bulk storage tanks; facility transfer operations, pumping, and in-plant processes; transfer stations (facility tank cars/tank tracks); inspections and records; security, and personnel, training, and spill prevention procedures.

  19. The spill prevention, control, and countermeasures (SPCC) plan for the Y-12 Plant

    International Nuclear Information System (INIS)

    1992-08-01

    This spill prevention, control and countermeasures (SPCC) Plan is divided into two volumes. Volume I addresses Y-12's compliance with regulations pertinent to the content of SPCC Plans. Volume II is the SPCC Hazardous Material Storage Data Base, a detailed tabulation of facility-specific information and data on potential spill sources at the Y-12 Plant. Volume I follows the basic format and subject sequence specified in 40 CFR 112.7. This sequence is prefaced by three additional chapters, including this introduction and brief discussions of the Y-12 Plant's background/environmental setting and potential spill source categories. Two additional chapters on containers and container storage areas and PCB and PCB storage for disposal facilities are inserted into the required sequence. The following required subjects are covered in this volume: Spill history, site drainage; secondary containment/diversion structures and equipment; contingency plans; notification and spill response procedures; facility drainage; bulk storage tanks; facility transfer operations, pumping, and in-plant processes; transfer stations (facility tank cars/tank tracks); inspections and records; security, and personnel, training, and spill prevention procedures

  20. A Survey on E-Guide to Educational Tour Planning in Environmental Science among Standard Six Primary School Students the Ministry of Education Malaysia

    OpenAIRE

    A. Halim Sahelan; Mohd Halid Abu; Jamaluddin Hashim; Zulisman Maksom; Mohd Afif Md Nasir

    2015-01-01

    This study aims to assess the students' needs for the tour planning e-guide. The study is developing on the contribution and importance of the Educational Tour Planning Guide (ETP) is a multimedia course ware as one of the effective methods in teaching and learning of environmental science among the students in primary schools of the Ministry of Education, Malaysia. It is to provide the student with knowledge and experience about tourism, environmental science activities ...

  1. The experience of a nationwide Community of Practice to set up Regional Prevention Plans in Italy.

    Science.gov (United States)

    Giusti, Angela; Perra, Alberto; Lombardo, Flavia

    2017-07-27

    In 2010, the Italian Ministry of Health decided to start the planning process to elaborate the National Plan of Prevention 2010-2012 jointly with the 21 Regions. The National Institute of Health was responsible for supporting regional planners (RPs) by an original participatory approach of a web-based Community of Practice (CoP) to set up their own Regional Plans of Prevention. In this paper, we summarise the theoretical framework adopted, the main phases characterising the lifecycle of the nationwide CoP, the evaluation approach adopted and its findings. Following the CoP theoretical framework from Wenger, an initial group of RPs were trained on Project Cycle Management as a planning method and thereafter they started interacting on a web-based Moodle platform for 8 months. The CoP evaluation mainly took into account aspects of 'immediate value', such as members interactions within the website, and several quantitative and qualitative tools were used to monitor changes over time. Data were retrieved from Moodle statistics or directly from the RPs by the means of a Knowledge, Attitude and Practice survey, a reaction survey, SWOT analysis and focus groups. The level of individual RPs knowledge increased after the initial course from 55.7% to 75%, attitudes and competence perception about the planning process method also showed an overall favourable change. During the CoP life span, the number of members increased from the original 98 RPs to include up to 600 new members on the basis of spontaneous demand. From April 2010 to January 2011, the 'vital signs' of the CoP were monitored, including RP logins (13,450 total logins and 3744 unique logins), views (27,522) and posts (1606) distributed in 326 forum discussion threads. Data and information retrieved from quantitative and qualitative evaluation approaches proved to be useful for the management and follow-up of the CoP. The CoP experience was successful as 19 out of 20 Regions submitted their Regional Preventive

  2. The Effects of Guided vs. Unguided Pressured Planning on EFL Learners' Writing Fluency

    Science.gov (United States)

    Mohammadnia, Zhila; Ayaz, Parisa

    2015-01-01

    Task-based planning can be conceptualized as the opportunity to work out task performance before the actual performance. It allows learners to process the content and language of their planned production at a deeper and more meaningful level. In the face of the wide range of research conducted on the effects of pre-task planning on L2 production,…

  3. Practical Guide for Emergency Crime Prevention and Penal System Alternatives in Crisis Relocation Planning.

    Science.gov (United States)

    1982-09-01

    ballet . the oau- vot eor olaf, Setae. them totd-mw thel alllteia mil hiert lim, of d smus vo hr in allI pension VOor ta - be~ ba O u pedsrlloant -a"i fo...Docisent Library lundesainisteriam des Innern Los Almos, New Mexico 8754 (1 copy) theindorfer Strase 196 Bonn, 53, West Germany (U copy) The DAM Corporation

  4. Action Planning for Prevention and Recovery: A Self-Help Guide

    Science.gov (United States)

    ... the children  paying the bills  taking out the garbage or trash  doing the laundry You may also want to ... Further Resources Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services Web site: ...

  5. Observing with HST V: an Observer's Guide to the Long Range Plan

    Science.gov (United States)

    Bullock, M.; Martinez, M. Shea; Kinzel, W.

    1995-12-01

    The HST Long Range Plan (LRP) is a timeline containing the planned scheduling opportunities for most HST observations. An accurate, stable LRP is important in that it allows observers and observatory staff to effectively allocate their work. In addition, it provides a comparative baseline for the execution progress of the science program and can be used to assess the impact of spacecraft and instrument anomalies. In November of 1993, the PRESTO began the task of re-engineering the LRP system in an effort to increase the stability and accuracy of the plan. Prior to cycle five, the HST LRP assigned each observation to a specific week during the cycle. However, due to a variety of reasons many observations could not be scheduled in their planned week and had to be re-planned, causing the plan to be unstable. The new method that has been implemented assigns a plan window to each observation rather than a restrictive one week interval. The plan window is a subset of the observing opportunities dictated by the scientific and spacecraft constraints. For most observations, the plan window is a continuous eight week interval. But because of its constraints, a particular observation's plan window can be shorter than eight weeks or it may be a set of several small windows within an eight week interval. This paper focuses on the practical issues of plan windows that are relevant to the HST observer. The topics that are discussed include which observations receive plan windows, how plan windows are assigned, what can cause changes to the plan windows, and how to access plan window information via the World Wide Web.

  6. Atlas-guided generation of pseudo-CT images for MRI-only and hybrid PET-MRI-guided radiotherapy treatment planning

    DEFF Research Database (Denmark)

    Arabi, H.; Koutsouvelis, N.; Rouzaud, M.

    2016-01-01

    Magnetic resonance imaging (MRI)-guided attenuation correction (AC) of positron emission tomography (PET) data and/or radiation therapy (RT) treatment planning is challenged by the lack of a direct link between MRI voxel intensities and electron density. Therefore, even if this is not a trivial...... the conventional MRI segmentation technique and a recently proposed multi-atlas approach. The clinical studies consisted of pelvic CT, PET and MRI scans of 12 patients with loco-regionally advanced rectal disease. In the first step, bone segmentation of the target image is optimized through local weighted atlas...... voting. The obtained bone map is then used to assess the quality of deformed atlases to perform voxel-wise weighted atlas fusion. To evaluate the performance of the method, a leave-one-out cross-validation (LOOCV) scheme was devised to find optimal parameters for the model. Geometric evaluation...

  7. Preventing Teen Pregnancy. Learning Guide 4. Project Connect. Linking Self-Family-Work.

    Science.gov (United States)

    Emily Hall Tremaine Foundation, Inc., Hartford, CT.

    This learning guide is designed to connect personal, family, and job responsibilities for adults and out-of-school youth in economically depressed areas of the state (including transitional ex-offenders and corrections populations) so that these individuals learn to manage and balance these aspects of their lives in order to prepare for or…

  8. An Ounce of Prevention: An Administrative Guide for Day Care Center Directors.

    Science.gov (United States)

    Gray, Norma; Hall, Don

    One of three training manuals developed for day care center staff, this administrative guide was written to assist day care center directors in developing policies and procedures aimed at improving all aspects of the day care program, and thus reducing the risk of child abuse. Four chapters focus on (1) selection of staff, including recruiting,…

  9. Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans.

    Science.gov (United States)

    Wojcieszynski, Andrzej P; Hill, Patrick M; Rosenberg, Stephen A; Hullett, Craig R; Labby, Zacariah E; Paliwal, Bhudatt; Geurts, Mark W; Bayliss, R Adam; Bayouth, John E; Harari, Paul M; Bassetti, Michael F; Baschnagel, Andrew M

    2017-06-01

    Magnetic resonance imaging-guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motion management is important to address. We hypothesize that magnetic resonance imaging-guided tri-cobalt-60 radiation therapy can be used to generate clinically acceptable stereotactic body radiation therapy treatment plans. Here, we report on a dosimetric comparison between magnetic resonance imaging-guided radiation therapy plans and internal target volume-based plans utilizing volumetric-modulated arc therapy. Ten patients with early-stage non-small cell lung cancer who underwent radiation therapy planning and treatment were studied. Following 4-dimensional computed tomography, patient images were used to generate clinically deliverable plans. For volumetric-modulated arc therapy plans, the planning tumor volume was defined as an internal target volume + 0.5 cm. For magnetic resonance imaging-guided plans, a single mid-inspiratory cycle was used to define a gross tumor volume, then expanded 0.3 cm to the planning tumor volume. Treatment plan parameters were compared. Planning tumor volumes trended larger for volumetric-modulated arc therapy-based plans, with a mean planning tumor volume of 47.4 mL versus 24.8 mL for magnetic resonance imaging-guided plans ( P = .08). Clinically acceptable plans were achievable via both methods, with bilateral lung V20, 3.9% versus 4.8% ( P = .62). The volume of chest wall receiving greater than 30 Gy was also similar, 22.1 versus 19.8 mL ( P = .78), as were all other parameters commonly used for lung stereotactic body radiation therapy. The ratio of the 50% isodose volume to planning tumor volume was lower in volumetric-modulated arc therapy plans, 4.19 versus 10.0 ( P guided tri-cobalt-60 radiation therapy is capable of delivering lung high

  10. Intentions to seek (preventive) psychological help among older adults: An application of the theory of planned behaviour

    NARCIS (Netherlands)

    Westerhof, Gerben Johan; Maessen, Mia; de Bruijn, Renske; Smets, Bianca

    2008-01-01

    Objectives: This article examines the intentions to seek (preventive) psychological help among older persons. The study is carried out from the theory of planned behaviour and distinguishes attitudes (psychological openness), subjective norms (indifference to stigma), and perceived behavioural

  11. The Long Term Effects of “Consumer-Directed” Health Plans on Preventive Care Use1

    Science.gov (United States)

    Eisenberg, Matthew D.; Haviland, Amelia M.; Mehrotra, Ateev; Huckfeldt, Peter J.; Sood, Neeraj

    2017-01-01

    “Consumer-Directed” Health Plans (CDHPs), those with high deductibles and personal medical accounts, have been shown to reduce health care spending. The impact of CDHPs on preventive care is unclear. On the one hand CDHPs might increase use of preventive care as such care is exempt from the deductible. However, CDHPs also decrease visits to physicians which might results in less screening. Prior research has found conflicting results. In this study, using data from 37 employers we examine the effects of CDHPs on the use of cancer screenings up to three years after the initial CDHP offering with ITT and LATE approaches. Being offered a CDHP or enrolling in a CDHP had little or no effect on cancer screening rates but individuals increase screenings prior to enrolling in a CDHP. Our findings suggest the importance of examining CDHP effects on periodic care over the longer-term and carefully controlling for anticipatory stockpiling. PMID:28712437

  12. Effectiveness of Anabolic Steroid Preventative Intervention among Gym Users: Applying Theory of Planned Behavior.

    Science.gov (United States)

    Jalilian, Farzad; Allahverdipour, Hamid; Moeini, Babak; Moghimbeigi, Abbas

    2011-01-01

    Use of anabolic androgenic steroids (AAS) has been associated with adverse physical and psychiatric effects and it is known as rising problem among youth people. This study was conducted to evaluate anabolic steroids preventative intervention efficiency among gym users in Iran and theory of planned behaviour was applied as theoretical framework. Overall, 120 male gym users participated in this study as intervention and control group. This was a longitudinal randomized pretest - posttest series control group design panel study to implement a behaviour modification based intervention to prevent AAS use. Cross -tabulation and t-test by using SPSS statistical package, version 13 was used for the statistical analysis. It was found significant improvements in average response for knowledge about side effects of AAS (Pgym users and ado-lescences would be effective to improve adolescents' healthy behaviors and intend them not to use AAS.

  13. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    Science.gov (United States)

    Brodin, N P; Björk-Eriksson, T; Birk Christensen, C; Kiil-Berthelsen, A; Aznar, M C; Hollensen, C; Markova, E; Munck af Rosenschöld, P

    2015-01-01

    Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT. PMID:25494657

  14. Energy Systems Test Area (ESTA) Pyrotechnic Operations: User Test Planning Guide

    Science.gov (United States)

    Hacker, Scott

    2012-01-01

    The Johnson Space Center (JSC) has created and refined innovative analysis, design, development, and testing techniques that have been demonstrated in all phases of spaceflight. JSC is uniquely positioned to apply this expertise to components, systems, and vehicles that operate in remote or harsh environments. We offer a highly skilled workforce, unique facilities, flexible project management, and a proven management system. The purpose of this guide is to acquaint Test Requesters with the requirements for test, analysis, or simulation services at JSC. The guide includes facility services and capabilities, inputs required by the facility, major milestones, a roadmap of the facility s process, and roles and responsibilities of the facility and the requester. Samples of deliverables, facility interfaces, and inputs necessary to define the cost and schedule are included as appendices to the guide.

  15. Target volume delineation and treatment planning for particle therapy a practical guide

    CERN Document Server

    Leeman, Jonathan E; Cahlon, Oren; Sine, Kevin; Jiang, Guoliang; Lu, Jiade J; Both, Stefan

    2018-01-01

    This handbook is designed to enable radiation oncologists to treat patients appropriately and confidently by means of particle therapy. The orientation and purpose are entirely practical, in that the focus is on the physics essentials of delivery and treatment planning , illustration of the clinical target volume (CTV) and associated treatment planning for each major malignancy when using particle therapy, proton therapy in particular. Disease-specific chapters provide guidelines and concise knowledge on CTV selection and delineation and identify aspects that require the exercise of caution during treatment planning. The treatment planning techniques unique to proton therapy for each disease site are clearly described, covering beam orientation, matching/patching field techniques, robustness planning, robustness plan evaluation, etc. The published data on the use of particle therapy for a given disease site are also concisely reported. In addition to fully meeting the needs of radiation oncologists, this "kn...

  16. Atlas-guided generation of pseudo-CT images for MRI-only and hybrid PET-MRI-guided radiotherapy treatment planning

    Science.gov (United States)

    Arabi, Hossein; Koutsouvelis, Nikolaos; Rouzaud, Michel; Miralbell, Raymond; Zaidi, Habib

    2016-09-01

    Magnetic resonance imaging (MRI)-guided attenuation correction (AC) of positron emission tomography (PET) data and/or radiation therapy (RT) treatment planning is challenged by the lack of a direct link between MRI voxel intensities and electron density. Therefore, even if this is not a trivial task, a pseudo-computed tomography (CT) image must be predicted from MRI alone. In this work, we propose a two-step (segmentation and fusion) atlas-based algorithm focusing on bone tissue identification to create a pseudo-CT image from conventional MRI sequences and evaluate its performance against the conventional MRI segmentation technique and a recently proposed multi-atlas approach. The clinical studies consisted of pelvic CT, PET and MRI scans of 12 patients with loco-regionally advanced rectal disease. In the first step, bone segmentation of the target image is optimized through local weighted atlas voting. The obtained bone map is then used to assess the quality of deformed atlases to perform voxel-wise weighted atlas fusion. To evaluate the performance of the method, a leave-one-out cross-validation (LOOCV) scheme was devised to find optimal parameters for the model. Geometric evaluation of the produced pseudo-CT images and quantitative analysis of the accuracy of PET AC were performed. Moreover, a dosimetric evaluation of volumetric modulated arc therapy photon treatment plans calculated using the different pseudo-CT images was carried out and compared to those produced using CT images serving as references. The pseudo-CT images produced using the proposed method exhibit bone identification accuracy of 0.89 based on the Dice similarity metric compared to 0.75 achieved by the other atlas-based method. The superior bone extraction resulted in a mean standard uptake value bias of  -1.5  ±  5.0% (mean  ±  SD) in bony structures compared to  -19.9  ±  11.8% and  -8.1  ±  8.2% achieved by MRI segmentation-based (water

  17. Planning the diffusion of a neck-injury prevention programme among community rugby union coaches.

    Science.gov (United States)

    Donaldson, Alex; Poulos, Roslyn G

    2014-01-01

    This paper describes the development of a theory-informed and evidence-informed, context-specific diffusion plan for the Mayday Safety Procedure (MSP) among community rugby coaches in regional New South Wales, Australia. Step 5 of Intervention Mapping was used to plan strategies to enhance MSP adoption and implementation. Coaches were identified as the primary MSP adopters and implementers within a system including administrators, players and referees. A local advisory group was established to ensure context relevance. Performance objectives (eg, attend MSP training for coaches) and determinants of adoption and implementation behaviour (eg, knowledge, beliefs, skills and environment) were identified, informed by Social Cognitive Theory. Adoption and implementation matrices were developed and change-objectives for coaches were identified (eg, skills to deliver MSP training to players). Finally, intervention methods and specific strategies (eg, coach education, social marketing and policy and by-law development) were identified based on advisory group member experience, evidence of effective coach safety behaviour-change interventions and Diffusion of Innovations theory. This is the first published example of a systematic approach to plan injury prevention programme diffusion in community sports. The key strengths of this approach were an effective researcher-practitioner partnership; actively engaging local sports administrators; targeting specific behaviour determinants, informed by theory and evidence; and taking context-related practical strengths and constraints into consideration. The major challenges were the time involved in using a systematic diffusion planning approach for the first time; and finding a planning language that was acceptable and meaningful to researchers and practitioners.

  18. Social marketing to plan a fall prevention program for Latino construction workers.

    Science.gov (United States)

    Menzel, Nancy N; Shrestha, Pramen P

    2012-08-01

    Latino construction workers experience disparities in occupational death and injury rates. The Occupational Safety and Health Administration funded a fall prevention training program at the University of Nevada, Las Vegas in response to sharp increases in fall-related accidents from 2005 to 2007. The grant's purpose was to improve fall protection for construction workers, with a focus on Latinos. This study assessed the effectiveness of social marketing for increasing fall prevention behaviors. A multi-disciplinary team used a social marketing approach to plan the program. We conducted same day class evaluations and follow-up interviews 8 weeks later. The classes met trainee needs as evidenced by class evaluations and increased safety behaviors. However, Spanish-speaking Latinos did not attend in the same proportion as their representation in the Las Vegas population. A social marketing approach to planning was helpful to customize the training to Latino worker needs. However, due to the limitations of behavior change strategies, future programs should target employers and their obligation to provide safer workplaces. Copyright © 2012 Wiley Periodicals, Inc.

  19. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    DEFF Research Database (Denmark)

    Kornerup, Josefine S.; Brodin, N. P.; Bjork-Eriksson, T.

    2015-01-01

    scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP......) and estimated risk of secondary cancer (SC). RESULTS: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target...... volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. CONCLUSION: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing...

  20. Career Mobility: A Guide for Program Planning in Health Occupations; and Career Mobility Profiles.

    Science.gov (United States)

    American Hospital Association, Chicago, IL.

    One means of dealing with manpower problems is to develop career mobility programs which give employees the opportunity to advance, in terms of responsibility and income, to jobs where there are manpower shortages. The material developed in this publication is designed to guide health care institutions, educational institutions, and other…

  1. Homes for Wildlife: A Planning Guide for Habitat Enhancement on School Grounds.

    Science.gov (United States)

    Wyzga, Marilyn C.

    This guide for enhancing wildlife habitats on school grounds provides students and teachers the opportunity for direct, hands-on learning in the environment of their schoolyard. Geared towards grades K-8, all activities are developmentally appropriate to involve students on every level, resulting in student ownership of the project and a greater…

  2. Economic data for wildland planning and management in the western United States: a source guide

    Science.gov (United States)

    Eric Eisenman; Lee C. Wensel; Edward C. Thor; Thomas W. Stuart

    1980-01-01

    This guide identifies and describes sources of economic data useful to wildland managers and planners in the Western United States. The data are categorized by six types of management activities: outdoor recreation and wilderness; wildlife and fish; range; timber; land and water; and minerals and energy. For each type of activity, data sources are identified as to...

  3. Better Science: How To Plan and Manage the Curriculum. Curriculum Guide 5.

    Science.gov (United States)

    Heaney, John, Comp.

    This publication is one in a series of 12 giving the recommendations that were made for a broad and balanced education program in science for young people. Section one of this guide discusses consulting and negotiating both with colleagues and others. Sections two and three address the timetabling issue. Section four explains a strategy that a…

  4. Plan, Save, Succeed! Financial Literacy Poster/Teaching Guide. Expect the Unexpected with Math[R

    Science.gov (United States)

    Actuarial Foundation, 2013

    2013-01-01

    "Plan, Save, Succeed!" is a new program aligned with Jumpstart Coalition National Standards in K-12 Personal Finance Education, National Council of Teachers of Mathematics (NCTM) Standards, and Common Core Standards for Mathematical Practice. "Plan, Save, Succeed!" is designed to help students understand key financial literacy topics including…

  5. Strategy and Business Planning for Artificial Intelligence Companies: A Guide for Entrepreneurs

    OpenAIRE

    Friedenberg, Robert A.; Hensler, Ralph L.

    1986-01-01

    This article provides some basic assistance to entrepreneurs involved in artificial intelligence, offering a synthesis of standard business-planning and capital-raising practices. Three main areas are discussed: (1) developing a corporate strategy, (2) developing a business plan that works, and (3) approaching sources of capital.

  6. Data collection instrument and procedure for systematic reviews in the Guide to Community Preventive Services. Task Force on Community Preventive Services.

    Science.gov (United States)

    Zaza, S; Wright-De Agüero, L K; Briss, P A; Truman, B I; Hopkins, D P; Hennessy, M H; Sosin, D M; Anderson, L; Carande-Kulis, V G; Teutsch, S M; Pappaioanou, M

    2000-01-01

    A standardized abstraction form and procedure was developed to provide consistency, reduce bias, and improve validity and reliability in the Guide to Community Preventive Services: Systematic Reviews and Evidence-Based Recommendations (the Guide). The content of the abstraction form was based on methodologies used in other systematic reviews; reporting standards established by major health and social science journals; the evaluation, statistical and meta-analytic literature; expert opinion and review; and pilot-testing. The form is used to classify and describe key characteristics of the intervention and evaluation (26 questions) and assess the quality of the study's execution (23 questions). Study procedures and results are collected and specific threats to the validity of the study are assessed across six categories (intervention and study descriptions, sampling, measurement, analysis, interpretation of results and other execution issues). Each study is abstracted by two independent reviewers and reconciled by the chapter development team. Reviewers are trained and provided with feedback. What to abstract and how to summarize the data are discretionary choices that influence conclusions drawn on the quality of execution of the study and its effectiveness. The form balances flexibility for the evaluation of papers with different study designs and intervention types with the need to ask specific questions to maximize validity and reliability. It provides a structured format that researchers and others can use to review the content and quality of papers, conduct systematic reviews, or develop manuscripts. A systematic approach to developing and evaluating manuscripts will help to promote overall improvement of the scientific literature.

  7. Economics of vector-borne diseases prevention: The case of the Tiger Mosquito control and Chikungunya and Dengue prevention plan in the Emilia-Romagna region (Northern Italy)

    OpenAIRE

    Rivas Morales, Stefano

    2016-01-01

    Aedes albopictus is considered one of the most invasive mosquito species in the world. It has proved capacity for local transmission of Chikungunya and Dengue within Europe. This research evaluated public costs related to the implementation of the plan for Ae. albopictus control and Chikungunya and Dengue prevention set up in Emilia-Romagna region (Northern Italy), where a Chikungunya epidemic outbreak occurred in 2007, with 217 confirmed cases. The management plan started in 2008 by involvin...

  8. Implementation and planning of preventive and multi-layered contaminated water treatment

    International Nuclear Information System (INIS)

    Takahashi, Takeshi; Arai, Tomoyuki

    2014-01-01

    In Fukushima Daiichi D and D activities, one of the most challenging issues is contaminated water management. In order to control ground water inflow into the buildings so that amount of contaminated water does not increase and prevent contaminated water spread out to the environment including into the ocean, TEPCO are taking various measures: In order to remove contamination sources, the removal of the highly contaminated water in the seaside trenches are being implemented. And also, the acceleration of water purification is planned by contaminated water clean-up facility. For the purpose of Isolating water from contaminated sources, construction of the frozen-soil land-side wall started in order to prevent the groundwater from flowing in the area and contaminated water from flowing out from the area. In order to prevent leakage of contaminated water into the ocean, soil improvement with sodium silicate (liquid glass) and Installation of the sea-side impermeable walls are implemented. Furthermore, replacement of the flange-type tanks with welded-joint tanks to mitigate leakage risks is underway. (author)

  9. Ocular Manifestations of Ebola Virus Disease: An Ophthalmologist’s Guide to Prevent Infection and Panic

    Directory of Open Access Journals (Sweden)

    Enzo Maria Vingolo

    2015-01-01

    Full Text Available Ebola virus disease (EVD—formerly known as Ebola hemorrhagic fever is a severe hemorrhagic fever caused by lipid-enveloped, nonsegmented, negative-stranded RNA viruses belonging to the genus Ebolavirus. Case fatality rates may reach up to 76% of infected individuals, making this infection a deadly health problem in the sub-Saharan population. At the moment, there are still no indications on ophthalmological clinical signs and security suggestions for healthcare professionals (doctors and nurses or cooperative persons. This paper provides a short but complete guide to reduce infection risks.

  10. Ocular Manifestations of Ebola Virus Disease: An Ophthalmologist's Guide to Prevent Infection and Panic.

    Science.gov (United States)

    Vingolo, Enzo Maria; Messano, Giuseppe Alessio; Fragiotta, Serena; Spadea, Leopoldo; Petti, Stefano

    2015-01-01

    Ebola virus disease (EVD--formerly known as Ebola hemorrhagic fever) is a severe hemorrhagic fever caused by lipid-enveloped, nonsegmented, negative-stranded RNA viruses belonging to the genus Ebolavirus. Case fatality rates may reach up to 76% of infected individuals, making this infection a deadly health problem in the sub-Saharan population. At the moment, there are still no indications on ophthalmological clinical signs and security suggestions for healthcare professionals (doctors and nurses or cooperative persons). This paper provides a short but complete guide to reduce infection risks.

  11. Ocular Manifestations of Ebola Virus Disease: An Ophthalmologist's Guide to Prevent Infection and Panic

    Science.gov (United States)

    Vingolo, Enzo Maria; Messano, Giuseppe Alessio; Fragiotta, Serena; Petti, Stefano

    2015-01-01

    Ebola virus disease (EVD—formerly known as Ebola hemorrhagic fever) is a severe hemorrhagic fever caused by lipid-enveloped, nonsegmented, negative-stranded RNA viruses belonging to the genus Ebolavirus. Case fatality rates may reach up to 76% of infected individuals, making this infection a deadly health problem in the sub-Saharan population. At the moment, there are still no indications on ophthalmological clinical signs and security suggestions for healthcare professionals (doctors and nurses or cooperative persons). This paper provides a short but complete guide to reduce infection risks. PMID:26557674

  12. Forklift safety a practical guide to preventing powered industrial truck incidents and injuries

    CERN Document Server

    Swartz, George

    1999-01-01

    Written for the more than 1.5 million powered industrial truck operators and supervisors in general industry, as well as those in the construction and marine industries, this Second Edition provides an updated guide to training operators in safety and complying with OSHA's 1999 forklift standard. This edition of Forklift Safety includes a new chapter devoted to the new OSHA 1910.178 standard and new information regarding dock safety, narrow aisle trucks, off-dock incidents, tip-over safety, pallet safety, and carbon monoxide.

  13. Planning and installing micro-hydro systems a guide for designers, installers and engineers

    CERN Document Server

    Elliott, Chris

    2014-01-01

    An essential addition to the Earthscan Planning & Installing series, Planning and Installing Micro-Hydro Systems provides vital diagrams, pictures and tables detailing the planning and installing of a micro-hydro system, including information on the maintenance and economics once an installation is running. The book covers subjects such as measuring head and flow, ecological impacts, scheme layouts, practical advice, calculations and turbine choice. Archimedes screws are also covered in detail, as well as the main conventional choices relevant to small sites.Micro-hydro refers to hydropower sy

  14. Improving Prevention, Early Recognition and Management of Acute Kidney Injury after Major Surgery: Results of a Planning Meeting with Multidisciplinary Stakeholders

    Directory of Open Access Journals (Sweden)

    Matthew T James

    2014-08-01

    Full Text Available Purpose of review: Acute kidney injury (AKI is common after major surgery, and is associated with morbidity, mortality, increased length of hospital stay, and high health care costs. Although recent guidelines for AKI provide recommendations for identification of patients at risk, monitoring, diagnosis, and management of AKI, there is lack of understanding to guide successful implementation of these recommendations into clinical practice. Sources of information: We held a planning meeting with multidisciplinary stakeholders to identify barriers, facilitators, and strategies to implement recommendations for prevention, early identification, and management of AKI after major surgery. Barriers and facilitators to knowledge use for peri-operative AKI prevention and care were discussed. Findings: Stakeholders identified barriers in knowledge (how to identify high-risk patients, what criteria to use for diagnosis of AKI, attitudes (self-efficacy in preventive care and management of AKI, and behaviors (common use of diuretics, non-steroidal anti-inflammatory drugs, withholding of intravenous fluids, and competing time demands in peri-operative care. Educational, informatics, and organizational interventions were identified by stakeholders as potentially useful elements for future interventions for peri-operative AKI. Limitation: Meeting participants were from a single centre. Implications: The information and recommendations obtained from this stakeholder's meeting will be useful to design interventions to improve prevention and early care for AKI after major surgery.

  15. Integrated resource planning and the environment: A guide to the use of multi-criteria decision methods

    Energy Technology Data Exchange (ETDEWEB)

    Hobbs, B.F.; Meier, P. [IDEA, Inc., Washington, DC (United States)

    1994-07-01

    This report is intended as a guide to the use of multi-criteria decision-making methods (MCDM) for incorporating environmental factors in electric utility integrated resource planning (IRP). Application of MCDM is emerging as an alternative and complementary method to explicit economic valuation for weighting environmental effects. We provide a step-by-step guide to the elements that are common to all MCDM applications. The report discusses how environmental attributes should be selected and defined; how options should be selected (and how risk and uncertainty should be accounted for); how environmental impacts should be quantified (with particular attention to the problems of location); how screening should be conducted; the construction and analysis of trade-off curves; dominance analysis, which seeks to identify clearly superior options, and reject clearly inferior options; scaling of impacts, in which we translate social, economic and environmental impacts into value functions; the determination of weights, with particular emphasis on ensuring that the weights reflect the trade-offs that decision-makers are actually willing to make; the amalgamation of attributes into overall plan rankings; and the resolution of differences among methods, and between individuals. There are many MCDM methods available for accomplishing these steps. They can differ in their appropriateness, ease of use, validity, and results. This report also includes an extensive review of past applications, in which we use the step-by-step guide to examine how these applications satisfied the criteria of appropriateness, ease of use, and validity. Case material is drawn from a wide field of utility applications, ranging from project-level environmental impact statements to capacity bidding programs, and from the results of two case studies conducted as part of this research.

  16. A cone beam CT-guided online plan modification technique to correct interfractional anatomic changes for prostate cancer IMRT treatment

    International Nuclear Information System (INIS)

    Fu Weihua; Yang Yong; Yue, Ning J; Heron, Dwight E; Huq, M Saiful

    2009-01-01

    The purpose of this work is to develop an online plan modification technique to compensate for the interfractional anatomic changes for prostate cancer intensity-modulated radiation therapy (IMRT) treatment based on daily cone beam CT (CBCT) images. In this proposed technique, pre-treatment CBCT images are acquired after the patient is set up on the treatment couch using an in-room laser with the guidance of the setup skin marks. Instead of moving the couch to rigidly align the target or re-planning using the CBCT images, we modify the original IMRT plan to account for the interfractional target motion and deformation based on the daily CBCT image feedback. The multileaf collimator (MLC) leaf positions for each subfield are automatically adjusted in the proposed algorithm based on the position and shape changes of target projection in the beam's eye view (BEV). Three typical prostate cases were adopted to evaluate the proposed technique, and the results were compared with those obtained with bony-structure-based rigid translation correction, prostate-based correction and CBCT-based re-planning strategies. The study revealed that the proposed modification technique is superior to the bony-structure-based and prostate-based correction techniques, especially when interfractional target deformation exists. Its dosimetric performance is closer to that of the re-planned strategy, but with much higher efficiency, indicating that the introduced online CBCT-guided plan modification technique may be an efficient and practical method to compensate for the interfractional target position and shape changes for prostate IMRT.

  17. Guiding principles for durable structures; urban and regional planning tools for sustainable development

    NARCIS (Netherlands)

    Tjallingii, S.P.

    2000-01-01

    Richtlijnen voor meer duurzaamheid in de stedelijke planning met als praktijkvoorbeeld een integraal waterhuishoudingsplan voor Delft. Tot slot een discussie over de bruikbaarheid van het concept en de richtlijnen

  18. Systems-based guiding principles for risk modeling, planning, assessment, management, and communication.

    Science.gov (United States)

    Haimes, Yacov Y

    2012-09-01

    This article is grounded on the premise that the complex process of risk assessment, management, and communication, when applied to systems of systems, should be guided by universal systems-based principles. It is written from the perspective of systems engineering with the hope and expectation that the principles introduced here will be supplemented and complemented by principles from the perspectives of other disciplines. Indeed, there is no claim that the following 10 guiding principles constitute a complete set; rather, the intent is to initiate a discussion on this important subject that will incrementally lead us to a more complete set of guiding principles. The 10 principles are as follows: First Principle: Holism is the common denominator that bridges risk analysis and systems engineering. Second Principle: The process of risk modeling, assessment, management, and communication must be systemic and integrated. Third Principle: Models and state variables are central to quantitative risk analysis. Fourth Principle: Multiple models are required to represent the essence of the multiple perspectives of complex systems of systems. Fifth Principle: Meta-modeling and subsystems integration must be derived from the intrinsic states of the system of systems. Sixth Principle: Multiple conflicting and competing objectives are inherent in risk management. Seventh Principle: Risk analysis must account for epistemic and aleatory uncertainties. Eighth Principle: Risk analysis must account for risks of low probability with extreme consequences. Ninth Principle: The time frame is central to quantitative risk analysis. Tenth Principle: Risk analysis must be holistic, adaptive, incremental, and sustainable, and it must be supported with appropriate data collection, metrics with which to measure efficacious progress, and criteria on the basis of which to act. The relevance and efficacy of each guiding principle is demonstrated by applying it to the U.S. Federal Aviation

  19. Choosing Effective Youth-Focused Prevention Strategies: A Practical Guide for Applied Family Professionals

    Science.gov (United States)

    Olson, Jonathan R.

    2010-01-01

    Advances in the field of prevention science have resulted in strategies that target various youth outcomes. In recent years, numerous "best practices" lists have been developed to help professionals identify such strategies. Some scholars have questioned the quality of these lists and cautioned that there are flaws in evaluations of many…

  20. Preventing Tooth Decay: A Guide for Implementing Self-Applied Fluoride in Schools.

    Science.gov (United States)

    National Inst. of Dental Research (NIH), Bethesda, MD.

    This guidebook was developed to assist citizens in initiating programs to prevent tooth decay in young children through the use of fluoridation. It contains outlines for determining the needs of the school and community for fluoride in drinking water, and presents the various steps and activities that are necessary for developing and implementing…

  1. The Effect of Training on Adopting Behaviors Preventing from Knee Osteoarthritis Based on Planned Behavior Theory

    Directory of Open Access Journals (Sweden)

    S

    2015-05-01

    Full Text Available Introduction: the arthritis is believed to be among common diseases which prevail in the developed and developing countries, including Iran. In demographic studies, the prevalence of knee arthritis which stands at %15/3 in the population above 15-years old was shown. Owing to the fact that societies are about to be aged than before, the issue has become a growing significance in the subject matter of public health. The present study is conducted with an aim to investigate into the effect of training based on the planned behavior model on preventing the teachers of preliminary schools from getting knee arthritis. Methods: the study as an intervention research is of quasi-experimental kind. The population in question included 114 individuals among female teachers of preliminary schools who were brought to the study randomly and divided into two groups intervention and non-intervention. Based on the primary results, the educational contents were designed and submitted in the intervention group. After two months of executing the training program, the post test was carried out. The data was analyzed by SPSS version 18. Due to the loss of normality in data distribution, non- parametric tests were used. Results: the study demonstrated that the components of the planned behavior theory (i.e. the attitudes, subjective norms and the control of perceived behavior could altogether estimate %37 of intention and %43 of behavior. Meanwhile, the role of subjective norms (β =56/0 in predicting intention was overriding, In this study,after the educational program, control of perceived behavior scores increased of 32/50 ± 4/05 to 34/82 ± 5/66. indicating that the major obstacles in adopting behaviors preventing from knee arthritis are the lack of regular physical activity (%72/4 and failure to use western-style toilet (%57. Conclusion: In this Study the effect theory of planned behavior support in predicting exercise intentions and behavior in the prevention of

  2. Clinton outlines principles guiding health care reform plan as detractors weigh in.

    Science.gov (United States)

    1993-08-24

    A summary is provided of President Clinton's address on health insurance before the August meeting of the National Governor's Association (NGA). Enactment would probably occur in 1994. Health care reform is expected to be difficult, and White House aides working on this issue have moved appropriately into the White House "war room". The President identified the basic components of the plan as 1) universal coverage, 2) simplification of administration and expenses, and 3) coast containment, but he declined to provide details of the plan. The speech was well received, and action was urged by governors to respect state discretion and allow for state efforts in health care reform before national enactment of a flexible framework. Employer mandates received considerable attention. Governor Pete Wilson of California was concerned about the effect on small businesses and suggested that the program be voluntary. Opponents of the plan are already preparing a multimillion lobbying effort. President Clinton has received a letter endorsed by 41 Republican congressmen which stated their strong opposition to employer mandates. Republicans in both the House and Senate are preparing their own plans. House Minority Leader Robert Michel of Illinois is planning to introduce, in the fall, a proposal, without universal coverage. A Senate proposal by John Chafee of Rhode Island would provide universal coverage. Health care advisor Ira Magaziner had leaked that the plan would include coverage of abortion- related services, and a conscience clause for those morally or religiously opposed to providing abortion-related care. States would be allowed to set conditions on abortions, such as the parental request restrictions or waiting periods. Support for abortion related services came from 33 women congressional representatives on behalf of the bipartisan Congressional Caucus for Women's Issues. Comprehensive reproductive health care was also requested as a necessary provision in the plan.

  3. Climate change in Nova Scotia : a background paper to guide Nova Scotia's climate change action plan

    International Nuclear Information System (INIS)

    2007-10-01

    Climate change causes changes in the temperature of the earth, the level of the sea, and the frequency of extreme weather conditions. The province of Nova Scotia recently released an act related to environmental goals and sustainable prosperity. Addressing climate change is a key element in achieving Nova Scotia's sustainable prosperity goals outlined in the act. The Nova Scotia Department of Energy is working towards developing both policy and action, to help meet its target of a 10 per cent reduction in greenhouse gases from 1990 levels by the year 2020. Two major plans are underway, notably a climate change action plan and a renewed energy strategy. This report provided background information on Nova Scotia's climate change action plan. It discussed climate change issues affecting Nova Scotia, air pollutants, energy sources in Nova Scotia, energy consumers in the province, and Nova Scotia's approach to climate change. The report also discussed actions underway and funding sources. It was concluded that in order for the climate change action plan to be successful, Nova Scotians must use energy more efficiently; use renewable energy; use cleaner energy; and plan for change. 13 refs., 2 tabs., 6 figs., 4 appendices

  4. Patient Selection and Activity Planning Guide for Selective Internal Radiotherapy With Yttrium-90 Resin Microspheres

    Energy Technology Data Exchange (ETDEWEB)

    Lau, Wan-Yee, E-mail: josephlau@surgery.cuhk.edu.hk [Faculty of Medicine, Chinese University of Hong Kong, Shatin, New Territories (Hong Kong); Kennedy, Andrew S. [Wake Radiology Oncology, Cary, NC (United States); Department of Biomedical Engineering, North Carolina State University, Raleigh, NC (United States); Kim, Yun Hwan [Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Lai, Hee Kit [Nuclear Medicine and PET Centre, Mount Elizabeth Hospital, Singapore (Singapore); Lee, Rheun-Chuan [Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan (China); Leung, Thomas W.T. [Comprehensive Oncology Centre, Hong Kong Sanatorium and Hospital (Hong Kong); Liu, Ching-Sheng [Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (China); Salem, Riad [Division of Interventional Radiology, Northwestern University, Chicago, IL (United States); Sangro, Bruno [Liver Unit, Clinica Universitaria de Navarra and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas, Pamplona (Spain); Shuter, Borys [Department of Diagnostic Imaging, National University Hospital, Singapore (Singapore); Wang, Shih-Chang [Parker-Hughes Professor of Diagnostic Radiology, University of Sydney, Sydney, NSW (Australia)

    2012-01-01

    Purpose: Selective internal radiotherapy (SIRT) with yttrium-90 ({sup 90}Y) resin microspheres can improve the clinical outcomes for selected patients with inoperable liver cancer. This technique involves intra-arterial delivery of {beta}-emitting microspheres into hepatocellular carcinomas or liver metastases while sparing uninvolved structures. Its unique mode of action, including both {sup 90}Y brachytherapy and embolization of neoplastic microvasculature, necessitates activity planning methods specific to SIRT. Methods and Materials: A panel of clinicians experienced in {sup 90}Y resin microsphere SIRT was convened to integrate clinical experience with the published data to propose an activity planning pathway for radioembolization. Results: Accurate planning is essential to minimize potentially fatal sequelae such as radiation-induced liver disease while delivering tumoricidal {sup 90}Y activity. Planning methods have included empiric dosing according to degree of tumor involvement, empiric dosing adjusted for the body surface area, and partition model calculations using Medical Internal Radiation Dose principles. It has been recommended that at least two of these methods be compared when calculating the microsphere activity for each patient. Conclusions: Many factors inform {sup 90}Y resin microsphere SIRT activity planning, including the therapeutic intent, tissue and vasculature imaging, tumor and uninvolved liver characteristics, previous therapies, and localization of the microsphere infusion. The influence of each of these factors has been discussed.

  5. A research agenda to guide progress on childhood obesity prevention in Latin America.

    Science.gov (United States)

    Kline, L; Jones-Smith, J; Jaime Miranda, J; Pratt, M; Reis, R S; Rivera, J A; Sallis, J F; Popkin, B M

    2017-07-01

    Childhood obesity rates in Latin America are among the highest in the world. This paper examines and evaluates the many efforts underway in the region to reduce and prevent further increases in obesity, identifies and discusses unique research challenges and opportunities in Latin America, and proposes a research agenda in Latin America for the prevention of childhood obesity and concomitant non-communicable diseases. Identified research gaps include biological challenges to healthy growth across the life cycle, diet and physical activity dynamics, community interventions promoting healthy child growth, and rigorous evaluation of national food and activity programs and regulatory actions. Addressing these research gaps is critical to advance the evidence-based policy and practice in childhood obesity tailored to the Latin American context that will be effective in addressing obesity. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

  6. Narrative communication in cancer prevention and control: a framework to guide research and application.

    Science.gov (United States)

    Kreuter, Matthew W; Green, Melanie C; Cappella, Joseph N; Slater, Michael D; Wise, Meg E; Storey, Doug; Clark, Eddie M; O'Keefe, Daniel J; Erwin, Deborah O; Holmes, Kathleen; Hinyard, Leslie J; Houston, Thomas; Woolley, Sabra

    2007-06-01

    Narrative forms of communication-including entertainment education, journalism, literature, testimonials, and storytelling-are emerging as important tools for cancer prevention and control. To stimulate critical thinking about the role of narrative in cancer communication and promote a more focused and systematic program of research to understand its effects, we propose a typology of narrative application in cancer control. We assert that narrative has four distinctive capabilities: overcoming resistance, facilitating information processing, providing surrogate social connections, and addressing emotional and existential issues. We further assert that different capabilities are applicable to different outcomes across the cancer control continuum (e.g., prevention, detection, diagnosis, treatment, survivorship). This article describes the empirical evidence and theoretical rationale supporting propositions in the typology, identifies variables likely to moderate narrative effects, raises ethical issues to be addressed when using narrative communication in cancer prevention and control efforts, and discusses potential limitations of using narrative in this way. Future research needs based on these propositions are outlined and encouraged.

  7. United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.

    Science.gov (United States)

    Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J

    2016-05-01

    The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US family planning providers' knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning. Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed. Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives or physicians assistants). Among potential prescribers, 38% correctly defined PrEP [95% confidence interval (CI): 32.5-42.8], 37% correctly stated the efficacy of PrEP (95% CI: 32.0-42.4), and 36% chose the correct HIV test after a recent exposure (95% CI: 30.6-40.8). Characteristics of those who answered knowledge questions correctly included age less than 35 years, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education. To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing. US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods

  8. Medical planning and response for a nuclear detonation: a practical guide.

    Science.gov (United States)

    Coleman, C Norman; Adams, Steven; Adrianopoli, Carl; Ansari, Armin; Bader, Judith L; Buddemeier, Brooke; Caro, J Jaime; Casagrande, Rocco; Case, Cullen; Caspary, Kevin; Chang, Arthur S; Chang, H Florence; Chao, Nelson; Cliffer, Kenneth D; Confer, Dennis; Deitchman, Scott; Derenzo, Evan G; Dobbs, Allen; Dodgen, Daniel; Donnelly, Elizabeth H; Gorman, Susan; Grace, Marcy Beth; Hatchett, Richard; Hick, John L; Hrdina, Chad; Jones, Robert; Kane, Elleen; Knebel, Ann; Koerner, John F; Laffan, Alison M; Larson, Leon; Livinski, Alicia; Mackinney, John; Maidment, Bert W; Manning, Ronald; Marinissen, Maria J; Martin, Colleen; Michael, Gretchen; Murrain-Hill, Paula; Nemhauser, Jeffrey B; Norwood, Ann E; Nystrom, Scott; Raheem, Murad; Redlener, Irwin; Sheehan, Kevin; Simon, Steven L; Taylor, Tammy P; Toner, Eric; Wallace, Katherine S; Wieder, Jessica; Weinstock, David M; Wiley, Albert L; Yeskey, Kevin; Miller, Charles W; Whitcomb, Robert C

    2012-12-01

    This article summarizes major points from a newly released guide published online by the Office of the Assistant Secretary for Preparedness and Response (ASPR). The article reviews basic principles about radiation and its measurement, short-term and long-term effects of radiation, and medical countermeasures as well as essential information about how to prepare for and respond to a nuclear detonation. A link is provided to the manual itself, which in turn is heavily referenced for readers who wish to have more detail.

  9. Indoor Radio Planning A Practical Guide for GSM, DCS, UMTS, HSPA and LTE

    CERN Document Server

    Tolstrup, Morten

    2011-01-01

    Why is indoor coverage needed, and how it is best implemented? As the challenge of providing higher data speeds and quality for mobile applications intensifies, ensuring adequate in-building and tunnel coverage and capacity is increasingly important. A unique, single-source reference on the theoretical and practical knowledge behind indoor and tunnel radio planning, Indoor Radio Planning, Second Edition provides an overview of mobile networks systems and coverage solutions with GSM, UMTS, HSPA and LTE cellular systems technologies as a backdrop. All of the available solutions, from basic passi

  10. Prevention of respiratory complications of the surgical patient: actionable plan for continued process improvement.

    Science.gov (United States)

    Ruscic, Katarina J; Grabitz, Stephanie D; Rudolph, Maíra I; Eikermann, Matthias

    2017-06-01

    Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders. Preoperatively, patients should be risk-stratified for PRCs to individualize intraoperative choices and postoperative pathways. Laparoscopic compared with open surgery improves respiratory outcomes. High-risk patients should be treated by experienced providers based on locally developed bundle-interventions to optimize intraoperative treatment and ICU bed utilization. Intraoperatively, lung-protective ventilation (procedure-specific positive end-expiratory pressure utilization, and low driving pressure) and moderately restrictive fluid therapy should be used. To achieve surgical relaxation, high-dose neuromuscular blocking agents (and reversal agents) as well as high-dose opioids should be avoided; inhaled anesthetics improve surgical conditions while protecting the lungs. Patients should be extubated in reverse Trendelenburg position. Postoperatively, continuous positive airway pressure helps prevent airway collapse and protocolized, early mobilization improves cognitive and respiratory function.

  11. Risk Prevention Strategies and the SWOT Analysis for the Implementation of the SMEs’ Business Plan

    Directory of Open Access Journals (Sweden)

    Ionica Oncioiu

    2014-10-01

    Full Text Available This theme is targeting the importance of implementing the business plan of a small and medium company that has as aim the creation of the added value through research and innovation in the management of human resources performance based on information technology domain. The objective is to increase the economic competitiveness and development of knowledge-based economy whereas by the implementation of the project, it increases the company‟s profitability, creating a competitive advantage resulting in innovative products, as well as the effectiveness of companies that use human resources evaluation platform. The need identified on the market to which the SMEs wish to answer by implementing the plan is represented by the nationwide lack of a complex solution covering both the evaluation and the management of human resources performances. The used methodology can be found in the analysis, developing a strategy for preventing financial, human, market, marketing - image risks and also the physical ones. With the SWOT analysis it was observed one of the strengths i.e. the existence of a single management system of employee performance that includes assessment specific features. In conclusion, there are no software solutions at national level, which would assess the human resources of an organization, following specific indicators of that organization, which could combine the assessment methods in order to achieve more a more efficient and versatile assessment.

  12. A review of treatment planning for precision image-guided photon beam pre-clinical animal radiation studies.

    Science.gov (United States)

    Verhaegen, Frank; van Hoof, Stefan; Granton, Patrick V; Trani, Daniela

    2014-12-01

    Recently, precision irradiators integrated with a high-resolution CT imaging device became available for pre-clinical studies. These research platforms offer significant advantages over older generations of animal irradiators in terms of precision and accuracy of image-guided radiation targeting. These platforms are expected to play a significant role in defining experiments that will allow translation of research findings to the human clinical setting. In the field of radiotherapy, but also others such as neurology, the platforms create unique opportunities to explore e.g. the synergy between radiation and drugs or other agents. To fully exploit the advantages of this new technology, accurate methods are needed to plan the irradiation and to calculate the three-dimensional radiation dose distribution in the specimen. To this end, dedicated treatment planning systems are needed. In this review we will discuss specific issues for precision irradiation of small animals, we will describe the workflow of animal treatment planning, and we will examine several dose calculation algorithms (factorization, superposition-convolution, Monte Carlo simulation) used for animal irradiation with kilovolt photon beams. Issues such as dose reporting methods, photon scatter, tissue segmentation and motion will also be discussed briefly. Copyright © 2014. Published by Elsevier GmbH.

  13. New inverse planning technology for image-guided cervical cancer brachytherapy: Description and evaluation within a clinical frame

    International Nuclear Information System (INIS)

    Trnkova, Petra; Poetter, Richard; Baltas, Dimos; Karabis, Andreas; Fidarova, Elena; Dimopoulos, Johannes; Georg, Dietmar; Kirisits, Christian

    2009-01-01

    Purpose: To test the feasibility of a new inverse planning technology based on the Hybrid Inverse treatment Planning and Optimisation (HIPO) algorithm for image-guided cervical cancer brachytherapy in comparison to conventional manual optimisation as applied in recent clinical practice based on long-term intracavitary cervical cancer brachytherapy experience. Materials and methods: The clinically applied treatment plans of 10 tandem/ring (T/R) and 10 cases with additional needles (T/R + N) planned with PLATO v14.3 were included. Standard loading patterns were manually optimised to reach an optimal coverage with 7 Gy per fraction to the High Risk CTV and to fulfil dose constraints for organs at risk. For each of these patients an inverse plan was retrospectively created with Oncentra GYN v0.9.14. Anatomy based automatic source activation was based on the topography of target and organs. The HIPO algorithm included individual gradient and modification restrictions for the T/R and needle dwell times to preserve the spatial high-dose distribution as known from the long-term clinical experience in the standard cervical cancer brachytherapy and with manual planning. Results: HIPO could achieve a better target coverage (V100) for all T/R and 7 T/R + N patients. Changes in the shape of the overdose volume (V200/400) were limited. The D 2cc per fraction for bladder, rectum and sigmoid colon was on average lower by 0.2 Gy, 0.4 Gy, 0.2 Gy, respectively, for T/R patients and 0.6 Gy, 0.3 Gy, 0.3 Gy for T/R + N patients (a decrease from 4.5 to 4 Gy per fraction means a total dose reduction of 5 Gy EQD2 for a 4-fraction schedule). In general the dwell times in the additional needles were lower compared to manual planning. The sparing factors were always better for HIPO plans. Additionally, in 7 T/R and 7 T/R + N patients all three D 0.1cc , D 1cc and D 2cc for vagina wall were lower and a smaller area of vagina was covered by the reference dose in HIPO plans. Overall loading

  14. The long term effects of "Consumer-Directed" health plans on preventive care use.

    Science.gov (United States)

    Eisenberg, Matthew D; Haviland, Amelia M; Mehrotra, Ateev; Huckfeldt, Peter J; Sood, Neeraj

    2017-09-01

    "Consumer-Directed" Health Plans (CDHPs), those with high deductibles and personal medical accounts, have been shown to reduce health care spending. The impact of CDHPs on preventive care is unclear. On the one hand CDHPs might increase use of preventive care as such care is exempt from the deductible. However, CDHPs also decrease visits to physicians which might results in less screening. Prior research has found conflicting results. In this study, using data from 37 employers we examine the effects of CDHPs on the use of cancer screenings up to three years after the initial CDHP offering with ITT and LATE approaches. Being offered a CDHP or enrolling in a CDHP had little or no effect on cancer screening rates but individuals increase screenings prior to enrolling in a CDHP. Our findings suggest the importance of examining CDHP effects on periodic care over the longer-term and carefully controlling for anticipatory stockpiling. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Slovenian National Landslide DataBase – A promising approach to slope mass movement prevention plan

    Directory of Open Access Journals (Sweden)

    Mihael Ribičič

    2007-12-01

    Full Text Available The Slovenian territory is, geologically speaking, very diverse and mainly composed of sediments or sedimentary rocks. Slope mass movements occur almost in all parts of the country. In the Alpine carbonate areas of the northern part of Slovenia rock falls, rock slides and even debris flows can be triggered.In the mountainous regions of central Slovenia composed from different clastic rocks, large soil landslides are quite usual, and in the young soil sediments of eastern part of Slovenia there is a large density of small soil landslides.The damage caused by slope mass movements is high, but still no common strategy and regulations to tackle this unwanted event, especially from the aspect of prevention, have been developed. One of the first steps towards an effective strategy of struggling against landslides and other slope mass movements is a central landslide database, where (ideally all known landslide occurrences would be reported, and described in as much detail as possible. At the end of the project of National Landslide Database construction which ended in May 2005 there were more than 6600 registered landslides, of which almost half occurred at a known location and were accompanied with the main characteristic descriptions.The erected database is a chance for Slovenia to once and for all start a solid slope mass movement prevention plan. The only part which is missing and which is the most important one is adopting a legal act that will legalise the obligation of reporting slope mass movement events to the database.

  16. Integrating cervical cancer screening and preventive treatment with family planning and HIV-related services.

    Science.gov (United States)

    White, Heather L; Meglioli, Alejandra; Chowdhury, Raveena; Nuccio, Olivia

    2017-07-01

    Cervical cancer is a leading cause of mortality in Sub-Saharan Africa-in large part because of inadequate coverage of screening and preventive treatment services. A number of programs have begun integrating cervical cancer prevention services into existing family planning or HIV/AIDS service delivery platforms, to rapidly expand "screen and treat" programs and mitigate cervical cancer burden. Drawing upon a review of literature and our experiences, we consider benefits and challenges associated with such programs in Sub-Saharan Africa. We then outline steps that can optimize uptake and sustainability of integrated sexual and reproductive health services. These include increasing coordination among implementing organizations for efficient use of resources; task shifting for services that can be provided by nonphysicians; mobilizing communities via trusted frontline health workers; strengthening management information systems to allow for monitoring of multiple services; and prioritizing an operational research agenda to provide further evidence on the cost-effectiveness and benefits of integrated service delivery. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  17. Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.

    Science.gov (United States)

    Mueller, Stephanie K; Schnipper, Jeffrey L; Giannelli, Kyla; Roy, Christopher L; Boxer, Robert

    2016-09-01

    Dispersion of inpatient care teams across different medical units impedes effective team communication, potentially leading to adverse events (AEs). To regionalize 3 inpatient general medical teams to nursing units and examine the association with communication and preventable AEs. Pre-post cohort analysis. A 700-bed academic medical center. General medicine patients on any of the participating nursing units before and after implementation of regionalized care. Regionalizing 3 general medical physician teams to 3 corresponding nursing units. Concordance of patient care plan between nurse and intern, and adjusted odds of preventable AEs. Of the 414 included nurse and intern paired surveys, there were no significant differences pre- versus postregionalization in total mean concordance scores (0.65 vs 0.67, P = 0.26), but there was significant improvement in agreement on expected discharge date (0.56 vs 0.68, P = 0.003), knowledge of the other provider's name (0.56 vs 0.86,P communication and lead to patient safety improvements. Journal of Hospital Medicine 2016;11:620-627. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  18. Effectiveness of Anabolic Steroid Preventative Intervention among Gym Users: Applying Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Abbas Moghimbeigi

    2011-07-01

    Full Text Available Background: Use of anabolic androgenic steroids (AAS has been associated with adversephysical and psychiatric effects and it is known as rising problem among youth people. Thisstudy was conducted to evaluate anabolic steroids preventative intervention efficiency amonggym users in Iran and theory of planned behaviour was applied as theoretical framework.Methods: Overall, 120 male gym users participated in this study as intervention and controlgroup. This was a longitudinal randomized pretest - posttest series control group design panelstudy to implement a behaviour modification based intervention to prevent AAS use. Cross -tabulation and t-test by using SPSS statistical package, version 13 was used for the statisticalanalysis.Results: It was found significant improvements in average response for knowledge about sideeffects of AAS (P<0.001, attitude toward, and intention not to use AAS. Additionally afterintervention, the rate of AAS and supplements use was decreased among intervention group.Conclusion: Comprehensive implementation against AAS abuse among gym users and adolescenceswould be effective to improve adolescents’ healthy behaviors and intend them notto use AAS.

  19. Environmental Restoration Progam Waste Minimization and Pollution Prevention Awareness Program Plan

    International Nuclear Information System (INIS)

    1991-01-01

    In response to DOE Order 5400.1 this plan outlines the requirements for a Waste Minimization and Pollution Prevention Awareness Program for the Environmental Restoration (ER) Program at Martin Marietta Energy System, Inc. Statements of the national, Department of Energy, Energy Systems, and Energy Systems ER Program policies on waste minimization are included and reflect the attitudes of these organizations and their commitment to the waste minimization effort. Organizational responsibilities for the waste minimization effort are clearly defined and discussed, and the program objectives and goals are set forth. Waste assessment is addressed as being a key element in developing the waste generation baseline. There are discussions on the scope of ER-specific waste minimization techniques and approaches to employee awareness and training. There is also a discussion on the process for continual evaluation of the Waste Minimization Program. Appendixes present an implementation schedule for the Waste Minimization and Pollution Prevention Program, the program budget, an organization chart, and the ER waste minimization policy

  20. Syracuse urban forest master plan: guiding the city's forest resource into the 21st century

    Science.gov (United States)

    David J. Nowak; Paul R. O' Connor; [Compilers

    2001-01-01

    The Syracuse Urban Forest Master Plan is one of the most comprehensive urban forest assessments ever developed for a city. This report combines a high-resolution digital urban cover map with field vegetation sampling data from all land uses, a 100-percent street-tree inventory, a survey of city residents regarding desirable and undesirable tree characteristics and...

  1. Succession Planning and Management: A Guide to Organizational Systems and Practices

    Science.gov (United States)

    Berke, David

    2005-01-01

    The purpose of succession-related practices is to ensure that there are ready replacements for key positions in an organization so that turnover will not negatively affect the organization's performance. CCL first published an annotated bibliography on succession planning in 1995. That bibliography focused primarily on the link between succession…

  2. Approaches to evaluating climate change impacts on species: A guide to initiating the adaptation planning process

    Science.gov (United States)

    Erika L. Rowland; Jennifer E. Davison; Lisa J. Graumlich

    2011-01-01

    Assessing the impact of climate change on species and associated management objectives is a critical initial step for engaging in the adaptation planning process. Multiple approaches are available. While all possess limitations to their application associated with the uncertainties inherent in the data and models that inform their results, conducting and incorporating...

  3. Wrong-site nerve blocks: A systematic literature review to guide principles for prevention.

    Science.gov (United States)

    Deutsch, Ellen S; Yonash, Robert A; Martin, Donald E; Atkins, Joshua H; Arnold, Theresa V; Hunt, Christina M

    2018-03-02

    Wrong-site nerve blocks (WSBs) are a significant, though rare, source of perioperative morbidity. WSBs constitute the most common type of perioperative wrong-site procedure reported to the Pennsylvania Patient Safety Authority. This systematic literature review aggregates information about the incidence, patient consequences, and conditions that contribute to WSBs, as well as evidence-based methods to prevent them. A systematic search of English-language publications was performed, using the PRISMA process. Seventy English-language publications were identified. Analysis of four publications reporting on at least 10,000 blocks provides a rate of 0.52 to 5.07 WSB per 10,000 blocks, unilateral blocks, or "at risk" procedures. The most commonly mentioned potential consequence was local anesthetic toxicity. The most commonly mentioned contributory factors were time pressure, personnel factors, and lack of site-mark visibility (including no site mark placed). Components of the block process that were addressed include preoperative nerve-block verification, nerve-block site marking, time-outs, and the healthcare facility's structure and culture of safety. A lack of uniform reporting criteria and divergence in the data and theories presented may reflect the variety of circumstances affecting when and how nerve blocks are performed, as well as the infrequency of a WSB. However, multiple authors suggest three procedural steps that may help to prevent WSBs: (1) verify the nerve-block procedure using multiple sources of information, including the patient; (2) identify the nerve-block site with a visible mark; and (3) perform time-outs immediately prior to injection or instillation of the anesthetic. Hospitals, ambulatory surgical centers, and anesthesiology practices should consider creating site-verification processes with clinician input and support to develop sustainable WSB-prevention practices. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Prediction of Alzheimer's Disease Dementia: Data from the GuidAge Prevention Trial.

    Science.gov (United States)

    Di Stefano, Francesca; Epelbaum, Stephane; Coley, Nicola; Cantet, Christelle; Ousset, Pierre-Jean; Hampel, Harald; Bakardjian, Hovagim; Lista, Simone; Vellas, Bruno; Dubois, Bruno; Andrieu, Sandrine

    2015-01-01

    In therapeutic trials, it is crucial to identify Alzheimer's disease (AD) at its prodromal stage. We assessed the accuracy of the free and cued selective reminding test (FCSRT) compared to other cognitive tests to predict AD dementia in subjects with subjective cognitive decline or mild cognitive impairment. Subjects from the placebo group of the GuidAge trial over 70 years old and without clinical signs of dementia at baseline who completed the 5-year follow-up free of dementia (n = 840) or developed AD dementia (n = 73) were included in our study. Among all the tests, the sum of the 3 free recall of the FCSRT (FCSRT-FR) and the sum of free and cued recall (FCSRT-TR) yielded the best results to predict AD dementia occurrence (all p values <0.05 for comparison of FCSRT-FR ROC and MMSE, CDRsb, and CVF ROCs). FCSRT-FR had an area under the ROC curve of 0.799 (95% CI 0.738-0.85) and the optimal cut-off was 20 (se 68.06% , sp 81.43% , PPV 23.90% , NPV 96,75%). Concerning FCSRT-TR, the AUC was 0.776 and the optimal cut-off was 42 (se 62.5% , sp 82.26% , PPV 23.20% and NPV 96.24%). This study sets the framework for implementing the FCSRT in clinical and therapeutic trials for efficient subject selection.

  5. Prevention of bladder tumor implantion after fluorescence-guided TUR with photodynamic therapy

    Science.gov (United States)

    Berrahmoune, Saoussen; Bezdetnaya, Lina; de Witte, Peter; Leroux, Agnès; Dumas, Dominique; Guillemin, François; D'Hallewin, Marie Ange

    2009-06-01

    The prevalence of bladder cancer is very high, due to its high recurrence rate in superficial bladder cancer (30 to 85%), which is the staging of approximately 80% of the patients at first diagnosis. Risk of recurrence and progression is associated with grade, stage, presence of concomitant carcinoma in situ, size and number of lesions, as well as time to first recurrence. Recurrences can be partly attributed to new occurrences but also to residual tumors after resection. Incomplete tumor removal has been observed in 30 to 50% of TUR's, especially when dealing with T1 or poorly visible malignant or pre-malignant disease1. Fluorescence guided resection with 5 amino levulinic acid (ALA) or its hexyl ester derivative (Hexvix, has now unequivocally been demonstrated to increase detection rate and a growing number of studies indicate this has a positive impact on recurrence and progression ratesImplantation of viable tumor cells, dispersed during resection, is a third factor influencing bladder cancer recurrence. The aim of early intravesical therapy is to interfere with cell viability and thus reduce implantation risks.

  6. Robust plan optimization for electromagnetic transponder guided hypo-fractionated prostate treatment using volumetric modulated arc therapy

    Science.gov (United States)

    Zhang, Pengpeng; Hunt, Margie; Happersett, Laura; Yang, Jie; Zelefsky, Michael; Mageras, Gig

    2013-11-01

    To develop an optimization algorithm for volumetric modulated arc therapy which incorporates an electromagnetic tracking (EMT) guided gating strategy and is robust to residual intra-fractional motion uncertainties. In a computer simulation, intra-fractional motion traces from prior treatments with EMT were converted to a probability distribution function (PDF), truncated using a patient specific action volume that encloses allowed deviations from the planned position, and renormalized to yield a new PDF with EMT-gated interventions. In lieu of a conventional planning target volume (PTV), multiple instances of clinical target volume (CTV) and organs at risk (OARs) were replicated and displaced to extreme positions inside the action volume representing possible delivery scenarios. When optimizing the volumetric modulated arc therapy plan, doses to the CTV and OARs were calculated as a sum of doses to the replicas weighted by the PDF to account for motion. A treatment plan meeting the clinical constraints was produced and compared to the counterpart conventional margin (PTV) plan. EMT traces from a separate testing database served to simulate motion during gated delivery. Dosimetric end points extracted from dose accumulations for each motion trace were utilized to evaluate potential clinical benefit. Five prostate cases from a hypofractionated protocol (42.5 Gy in 5 fractions) were retrospectively investigated. The patient specific gating window resulted in tight anterior and inferior action levels (∼1 mm) to protect rectal wall and bladder wall, and resulted in an average of four beam interruptions per fraction in the simulation. The robust-optimized plans achieved the same average CTV D95 coverage of 40.5 Gy as the PTV-optimized plans, but with reduced patient-averaged rectum wall D1cc by 2.2 Gy (range 0.7 to 4.7 Gy) and bladder wall mean dose by 2.9 Gy (range 2.0 to 3.4 Gy). Integration of an intra-fractional motion management strategy into the robust

  7. Creating community action plans for obesity prevention using the ANGELO (Analysis Grid for Elements Linked to Obesity) Framework.

    Science.gov (United States)

    Simmons, A; Mavoa, H M; Bell, A C; De Courten, M; Schaaf, D; Schultz, J; Swinburn, B A

    2009-12-01

    Community-based interventions are an important component of obesity prevention efforts. The literature provides little guidance on priority-setting for obesity prevention in communities, especially for socially and culturally diverse populations. This paper reports on the process of developing prioritized, community-participatory action plans for obesity prevention projects in children and adolescents using the ANGELO (Analysis Grid for Elements Linked to Obesity) Framework. We combined stakeholder engagement processes, the ANGELO Framework (scans for environmental barriers, targeted behaviours, gaps in skills and knowledge) and workshops with key stakeholders to create action plans for six diverse obesity prevention projects in Australia (n = 3), New Zealand, Fiji and Tonga from 2002 to 2005. Some sites included sociocultural contextual analyses in the environmental scans. Target groups were under-5-year-olds (Australia), 4-12-year-olds (Australia) and 13-18-year-olds (all four countries). Over 120 potential behavioural, knowledge, skill and environmental elements were identified for prioritization leading into each 2-day workshop. Many elements were common across the diverse cultural communities; however, several unique sociocultural elements emerged in some cultural groups which informed their action plans. Youth were actively engaged in adolescent projects, allowing their needs to be incorporated into the action plans initiating the process of ownership. A common structure for the action plan promoted efficiencies in the process while allowing for community creativity and innovation. The ANGELO is a flexible and efficient way of achieving an agreed plan for obesity prevention with diverse communities. It is responsive to community needs, combines local and international knowledge and creates stakeholder ownership of the action plan.

  8. Creating community action plans for obesity prevention using the ANGELO (Analysis Grid for Elements Linked to Obesity) Framework

    DEFF Research Database (Denmark)

    Simmons, A; Mavoa, H M; Bell, A C

    2009-01-01

    Community-based interventions are an important component of obesity prevention efforts. The literature provides little guidance on priority-setting for obesity prevention in communities, especially for socially and culturally diverse populations. This paper reports on the process of developing...... prioritized, community-participatory action plans for obesity prevention projects in children and adolescents using the ANGELO (Analysis Grid for Elements Linked to Obesity) Framework. We combined stakeholder engagement processes, the ANGELO Framework (scans for environmental barriers, targeted behaviours......, gaps in skills and knowledge) and workshops with key stakeholders to create action plans for six diverse obesity prevention projects in Australia (n = 3), New Zealand, Fiji and Tonga from 2002 to 2005. Some sites included sociocultural contextual analyses in the environmental scans. Target groups were...

  9. Smart fusion vs. double scan: a comparison between two data-matching protocols for a computer guided implant planning.

    Science.gov (United States)

    Arcuri, L; De Vico, G; Ottria, L; Condò, R; Cerroni, L; Mancini, M; Barlattani, A

    2016-01-01

    To make a comparison between two different approaches of data matching during the preparation of a computer guided implant planning. Electronic and manual literature searches were performed to collect information about the double-scan protocol and the smart fusion protocol. The two systems were then tested to identify or confirm their advantages and disadvantages. The double scan protocol is a reliable and well-known process to obtain a fusion between the anatomical data (CBCT) and the prosthetic data (radiographic template). It is possible to use this protocol both in dentate and edentulous patients. The newly developed smart fusion technique offers the possibility to superimpose the anatomical data (CBCT) onto the prosthetic data (cast + wax-up scan) without the production of a radiographic template. This system is still being tested by the clinicians even though dental manufacturers already consider it as the best solution for the dentate patients selected for a static computer guided implant surgery. Smart fusion protocol offers a reasonable time and cost reduction even though its application is limited to dentate patients. A noticeable drawback of the workflow is the matching step: often a manual intervention is necessary to obtain a correct alignment of the CBCT data with the lab scan of the cast. This issue is partially due to the use of non-volume stable materials during the preparation of the cast. Future improvements could be made by combining CBCT data with direct optical scans of patient dental arches in order to create the so-called 'virtual patient'.

  10. Integrating predictive information into an agro-economic model to guide agricultural planning

    Science.gov (United States)

    Block, Paul; Zhang, Ying; You, Liangzhi

    2017-04-01

    Seasonal climate forecasts can inform long-range planning, including water resources utilization and allocation, however quantifying the value of this information on the economy is often challenging. For rain-fed farmers, skillful season-ahead predictions may lead to superior planning, as compared to business as usual strategies, resulting in additional benefits or reduced losses. In this study, regional-level probabilistic precipitation forecasts of the major rainy season in Ethiopia are fed into an agro-economic model, adapted from the International Food Policy Research Institute, to evaluate economic outcomes (GDP, poverty rates, etc.) as compared with a no-forecast approach. Based on forecasted conditions, farmers can select various actions: adjusting crop area and crop type, purchasing drought resistant seed, or applying additional fertilizer. Preliminary results favor the forecast-based approach, particularly through crop area reallocation.

  11. Navy Planning, Programming, Budgeting, and Execution: A Reference Guide for Senior Leaders, Managers, and Action Officers

    Science.gov (United States)

    2016-01-01

    Secretariat , including the Sec- retary of the Navy (who owns the department POM) and his or her deputy; the Assis- tant Secretary for Research, Development, and...Planning, Programming, Budgeting, and Execution processes, particularly the Navy’s process. We have taken their com- ments to heart , and the document is...requirements, programming, and acquisition. Acquisition has been the responsibility of the Navy Secretariat ,2 through the SYSCOMs, PEOs, program offices

  12. Identifying Unique Neighborhood Characteristics to Guide Health Planning for Stroke and Heart Attack: Fuzzy Cluster and Discriminant Analyses Approaches

    Science.gov (United States)

    Pedigo, Ashley; Seaver, William; Odoi, Agricola

    2011-01-01

    Background Socioeconomic, demographic, and geographic factors are known determinants of stroke and myocardial infarction (MI) risk. Clustering of these factors in neighborhoods needs to be taken into consideration during planning, prioritization and implementation of health programs intended to reduce disparities. Given the complex and multidimensional nature of these factors, multivariate methods are needed to identify neighborhood clusters of these determinants so as to better understand the unique neighborhood profiles. This information is critical for evidence-based health planning and service provision. Therefore, this study used a robust multivariate approach to classify neighborhoods and identify their socio-demographic characteristics so as to provide information for evidence-based neighborhood health planning for stroke and MI. Methods and Findings The study was performed in East Tennessee Appalachia, an area with one of the highest stroke and MI risks in USA. Robust principal component analysis was performed on neighborhood (census tract) socioeconomic and demographic characteristics, obtained from the US Census, to reduce the dimensionality and influence of outliers in the data. Fuzzy cluster analysis was used to classify neighborhoods into Peer Neighborhoods (PNs) based on their socioeconomic and demographic characteristics. Nearest neighbor discriminant analysis and decision trees were used to validate PNs and determine the characteristics important for discrimination. Stroke and MI mortality risks were compared across PNs. Four distinct PNs were identified and their unique characteristics and potential health needs described. The highest risk of stroke and MI mortality tended to occur in less affluent PNs located in urban areas, while the suburban most affluent PNs had the lowest risk. Conclusions Implementation of this multivariate strategy provides health planners useful information to better understand and effectively plan for the unique

  13. Greening the Department of Energy through waste prevention, recycling, and Federal acquisition. Strategic plan to implement Executive Order 13101

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-11-01

    This Plan provides strategies and milestones to implement Executive Order 13101, Greening the Government Through Waste Prevention, Recycling, and Federal Acquisition, and to achieve the new Secretarial goals for 2005 and 2010. It serves as the principal Secretarial guidance to Department of Energy (DOE) Headquarters, Field Offices, and laboratory and contractor staff to improve sanitary waste prevention, recycling, and the purchase and use of recycled content and environmentally preferable products and services in the DOE.

  14. Epidemiologic Evidence to Guide the Understanding and Prevention of Gun Violence.

    Science.gov (United States)

    Webster, Daniel W; Cerdá, Magdalena; Wintemute, Garen J; Cook, Philip J

    2016-01-01

    Gunfire from assaults, suicides, and unintentional shootings exacts an enormous burden on public health globally. The epidemiologic reviews in this special issue enhance our understanding of various forms of gun violence, inform interventions, and help chart directions for future research. The available science, however, is limited to answer many important questions necessary for mounting successful efforts to reduce gun violence. Certain data are lacking, and there are numerous analytical challenges to deriving unbiased estimates of policy impacts. Significant investments in research over the long term are warranted to answer questions central to successful prevention of gun violence. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Cost and economic benefit of clinical decision support systems for cardiovascular disease prevention: a community guide systematic review.

    Science.gov (United States)

    Jacob, Verughese; Thota, Anilkrishna B; Chattopadhyay, Sajal K; Njie, Gibril J; Proia, Krista K; Hopkins, David P; Ross, Murray N; Pronk, Nicolaas P; Clymer, John M

    2017-05-01

    This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSSs) to prevent cardiovascular disease (CVD). Methods developed for the Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion. It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSSs to prevent CVD from the available studies ( n  = 12) due to considerable heterogeneity. Several studies ( n  = 11) indicated that health care costs were averted by using CDSSs but many were partial assessments that did not consider all components of health care. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSSs based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold. Intervention costs were not negligible, but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted health care cost could not be determined with confidence because many studies did not fully account for all components of health care. We were unable to conclude whether CDSSs for CVD prevention is either cost-beneficial or cost-effective. Several evidence gaps are identified, most prominently a lack of information about major drivers of cost and benefit, a lack of standard metrics for the cost of CDSSs, and not allowing for useful life of a CDSS that generally extends beyond one accounting period. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

  16. The World Health Organization (WHO) dataset for guiding suicide prevention policies: A 3-decade French national survey.

    Science.gov (United States)

    Fond, Guillaume; Zendjidjian, Xavier; Boucekine, Mohamed; Brunel, Lore; Llorca, Pierre-Michel; Boyer, Laurent

    2015-12-01

    Public health policies aim to prevent suicide in the general population. Assessing their effectiveness is required to further guide public health policies. The present article focuses on the French paradox. The French health care system was classified as the best in the world according the World Health Organization (WHO). However, suicide rates in France remain high compared to other European countries. The aim of the present article was to analyze (i) the evolution of suicide Age-Standardized Death (ASDRs) in France during the last three decades and the associations with socio-economic parameters and (ii) to understand which populations may specifically benefit from further targeted suicide prevention policies. The database of the World Health Organization (WHO), freely available, was explored in April 2015. ASDRs were calculated each year by ratio between the number of deaths by suicide and the total population (per 100,000 inhabitants). Number of deaths by gender and age were also analyzed. Overall, ASDR suicide has decreased since 1987 in France (-32.8% between 1987 and 2010). However, France kept the same rank (10/26) when compared to other European countries between 1987 and 2010. The relative burden of suicide in all-causes mortality increased during the same period (+28.2%) while the total number of deaths by suicide increased only slightly (+3.9%). More specifically, the number of deaths by suicide increased substantially in [35-54] years old (+40%) and 75+ years old (+27%) males, and in [35-54] (+41%) years old females. Between 2000 and 2010, suicide rates significantly decreased when yearly mean income increased, and when general and psychiatric care beds decreased. Although ASDR suicide has decreased in France since 1987, this decline is quite modest when considering its universal access to care, the prevention of depression and suicide public policies. Suicide prevention public policies should focus on evaluation and improvement of prevention and care

  17. Fluoroscopy-Guided Sacroplasty: Special Focus on Preoperative Planning from Three-Dimensional Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Gjertsen, Oe.; Schellhorn, T.; Nakstad, P.H. (Dept. of Neuroradiology, Division of Medical Services, Ullevl Univ. Hospital, Univ. of Oslo, Oslo (Norway))

    2008-11-15

    Background: Osteoporotic sacral insufficiency fractures are usually spontaneous or caused by discrete traumas. The fluoroscopic anatomy of the sacrum can be difficult to understand, and this is why sacroplasty is considered more challenging than ordinary vertebroplasties. Purpose: To demonstrate the planning of the procedure and the effectiveness of treatment with sacroplasty by means of three-dimensional computed tomography (3D CT) by combining multiplanar reconstructions (MPR) and volume-rendering technique (VRT). Material and Methods: Five elderly, osteoporotic patients with intense pelvic and hip pain underwent weeks of inconclusive clinical and radiological diagnostic efforts. Correct diagnosis was finally attained with magnetic resonance imaging (MRI) and CT. Plain radiographs rarely show fractures, and MR or CT examinations are necessary to demonstrate longitudinal fractures. The procedures were performed with digital biplane equipment using preoperative 3D CT planning procedures. Polymethyl methacrylate (PMMA) was injected to fill the fracture sites. Results: The fractures were successfully treated with sacroplasty using PMMA. A new technique, which involves placing the needles along the long axis of the sacrum, was optimized to the individual patients' fractures and sacral anatomy by meticulous planning on a workstation with 3D CT data sets. It was technically successful in all five cases. Four of the five patients had sustained pain relief. Conclusion: Sacral insufficiency fractures are not uncommon and should be considered in the elderly population with low back pain. Sacroplasty using the optimized 'long-axis technique' gave almost immediate pain relief for all five patients in our study material. No complications were observed.

  18. Indoor radio planning a practical guide for 2G, 3G and 4G

    CERN Document Server

    Tolstrup, Morten

    2015-01-01

    Why is high performance indoor wireless service needed, and how is it best implemented? As the challenge of providing better service and higher data speeds and quality for mobile applications intensifies, ensuring adequate in-building and tunnel coverage and capacity is increasingly important. A unique, single-source reference on the theoretical and practical knowledge behind indoor and tunnel radio planning, this book provides a detailed overview of mobile networks systems, coverage and capacity solutions with 2G, 3G and 4G cellular system technologies as a backdrop.  All of the available s

  19. Launch marketing communications planning guide : case: service industry franchise chain X

    OpenAIRE

    Kivinummi, Rosanna

    2016-01-01

    The thesis content and scope is built around the needs of the franchise chain X which had over 50 stores in Finland and a few stores in Europe and North America in late 2015. The internalization of the chain created new challenges for the launch marketing planning. The launch activities play always a crucial role in the future success of a store but are even more important for a franchise chain as the success or failure of one shop affects the image of the whole chain. The target of the thesi...

  20. Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Vincenzo Luca Zizzari

    2018-01-01

    Full Text Available The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.

  1. Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up

    OpenAIRE

    Zizzari, Vincenzo Luca; Tacconelli, Gianmarco

    2018-01-01

    The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR) with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.

  2. Writing of the Medical Physics Organisation Plan (POPM). Guide nr 20 - Version of 2013/04/19

    International Nuclear Information System (INIS)

    Le Du, Dominique; Mazal, Alejandro; Perrin, Benedicte; Sarrade, Catherine; Fau, Pierre; Isambert, Aurelie; Valero, Marc; Rousse, Carole

    2013-01-01

    The medical physicist (also called expert in medical physics) mentioned in this guide belongs to the field of experts in medical radio-physics as they are defined in the French Health Code, and who intervene in radiotherapy, nuclear medicine (diagnosis and therapy), radiology and in radiation protection. After a more precise definition of these professions, this document aims at providing guidelines for the elaboration and assessment of a medical physics organisation plan (POPM) while taking recommendations made by the MeaH (the French national mission of hospital expertise and audit) and IRSN into account. More precisely, it describes how to write such a plan for establishments using ionizing radiations for medical purposes. It first formulates methodological recommendations for the development of the POPM, and then describes the content of this POPM: elements to be present, role of nuclear physics in the establishment general organisation, establishment activities related to the use of ionizing radiations, fields of nuclear physics, presentation of equipment involved in the implementation of radiological activities, medical physics organisation and personnel, medical physics tasks performed by non medical physicist personnel, and new projected techniques and practice. The last part addresses the update, assessment and reviewing of a POPM

  3. The prevention and treatment of biliary complications occurred after CT-guided percutaneous radiofrequency ablation for hepatic neoplasms

    International Nuclear Information System (INIS)

    Li Jianjun; Zheng Jiasheng; Cui Xiongwei; Cui Shichang; Sun Bin

    2011-01-01

    Objective: To discuss the prevention and treatment of biliary complications occurred after CT-guided percutaneous radiofrequency ablation (RFA) for hepatic neoplasms. Methods: A total of 1136 patients, including 920 males and 216 females, with hepatic neoplasms were enrolled in this study. The hepatic tumors consisted of primary hepatocellular carcinoma (n=1037), hepatic metastasis (n=83) and hepatic cavernous hemangioma (n=16). The diameters of the tumors ranged from 0.5 to 16 cm. A total of 1944 RFA procedures were carried out in all patients. Results: Thirty-five patients developed biliary complication (35/1944, 1.80%). Twelve patients developed asymptomatic bile duct dilatation and no special treatment was given. Obstructive jaundice occurred in two patients and percutaneous transhepatic cholangiocholecystic drainage (PTCD) together with subsequent inner stent implantation had to be carried out. Eighteen patients developed biloma, and liver abscess formation secondary to biloma infection occurred in seven of them. Percutaneous transhepatic biloma drainage (PTBD) was adopted in all these patients. One patient suffered from obstructive jaundice complicated by biloma, and both PTCD and PTBD combined with inner stent implantation were simultaneously performed. One patient had the biloma secondary to obstructive jaundice, and PTCD followed by PTBD was conducted in turn. One patient developed obstructive jaundice secondary to biloma, and PTBD followed by PTCD was employed in turn. Conclusion: Obstructive jaundice and biloma are severe biliary complications occurred after CT-guided percutaneous radiofrequency ablation for hepatic tumors, and PTCD and/or PTBD should be carried out without delay to treat these complications. The clinical symptoms can be relieved, or even completely disappear, after treatment. (authors)

  4. Predictors of dentists' behaviours in delivering prevention in primary dental care in England: using the theory of planned behaviour.

    Science.gov (United States)

    Yusuf, Huda; Kolliakou, Anna; Ntouva, Antiopi; Murphy, Marie; Newton, Tim; Tsakos, Georgios; Watt, Richard G

    2016-02-08

    To explore the factors predicting preventive behaviours among NHS dentists in Camden, Islington and Haringey in London, using constructs from the Theory of Planned Behaviour. A cross-sectional survey of NHS dentists working in North Central London was conducted. A self-completed questionnaire based on the theoretical framework of the Theory of Planned Behaviour was developed. It assessed dentists' attitudes, current preventive activities, subjective norms and perceived behavioural control in delivering preventive care. In model 1, logistic regression was conducted to assess the relationship between a range of preventive behaviours (diet, smoking and alcohol) and the three TPB constructs attitude, subjective norms and perceived behavioural control. Model 2 was adjusted for intention. Overall, 164 questionnaires were returned (response rate: 55.0%). Dentists' attitudes were important predictors of preventive behaviours among a sample of dentists in relation to asking and providing diet, alcohol and tobacco advice. A dentist was 3.73 times (95 % CI: 1.70, 8.18) more likely ask about a patient's diet, if they had a positive attitude towards prevention, when adjusted for age, sex and intention. A similar pattern emerged for alcohol advice (OR 2.35, 95 % CI 1.12, 4.96). Dentists who had a positive attitude were also 2.59 times more likely to provide smoking cessation advice. The findings of this study have demonstrated that dentists' attitudes are important predictors of preventive behaviours in relation to delivery of diet, smoking and alcohol advice.

  5. Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

    Science.gov (United States)

    Desrosiers, Lyne; Saint-Jean, Micheline; Breton, Jean-Jacques

    2015-06-01

    The aim of this study was to gain a broader appreciation of processes involved in treatment dropout in adolescents with borderline personality disorder (BPD). A constructivist grounded theory was chosen using a multiple-case research design with three embedded levels of analysis (adolescent, parent, and care setting). Theoretical sampling and the different stages of analysis specific to grounded theory were performed according to the iterative process of constant comparative analysis. Twelve cases were examined (nine dropouts among adolescents with BPD and for the purpose of falsification, one dropout of suicidal adolescent without BPD and two completed treatments among adolescents with BPD). To document the cases, three groups of informants were recruited (adolescents, parents, and therapists involved in the treatment) and 34 interviews were conducted. Psychological characteristics, perception of mental illness and mental health care, and help-seeking context were the specific treatment dropout vulnerabilities identified in adolescents with BPD and in their parents. However, their disengagement became an issue only when care-setting response--including mitigation of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and concern for clinicians' disposition to treat--was ill-suited to these treatment dropout vulnerabilities. Treatment planning proves to be a key milestone to properly engage adolescents with BPD and their parent. Systematic assessment of treatment dropout vulnerabilities before the intervention plan is laid out could foster better-suited responses of the care setting thus decreasing the incidence of treatment discontinuation in adolescents with BPD. Treatment dropout vulnerabilities specific to adolescents with BPD and their parents can be detected before the beginning of treatment. Premature treatment termination may be prevented if the care setting considers these vulnerabilities at treatment

  6. Developing a culturally competent health network: a planning framework and guide.

    Science.gov (United States)

    Gertner, Eric J; Sabino, Judith N; Mahady, Erica; Deitrich, Lynn M; Patton, Jarret R; Grim, Mary Kay; Geiger, James F; Salas-Lopez, Debbie

    2010-01-01

    The number of cultural competency initiatives in healthcare is increasing due to many factors, including changing demographics, quality improvement and regulatory requirements, equitable care missions, and accreditation standards. To facilitate organization-wide transformation, a hospital or healthcare system must establish strategic goals, objectives, and implementation tasks for culturally competent provision of care. This article reports the largely successful results of a cultural competency program instituted at a large system in eastern Pennsylvania. Prior to the development of its cultural competency initiative, Lehigh Valley Health Network, Allentown, Pennsylvania, saw isolated activities producing innovative solutions to diversity and culture issues in the provision of equitable care. But it took a transformational event to support an organization-wide program in cultural competency by strengthening leadership buy-in and providing a sense of urgency, excitement, and shared vision among multiple stakeholders. A multidisciplinary task force, including senior leaders and a diverse group of employees, was created with the authority and responsibility to enact changes. Through a well-organized strategic planning process, existing patient and community demographic data were reviewed to describe existing disparities, a baseline assessment was completed, a mission statement was created, and clear metrics were developed. The strategic plan, which focused on five key areas (demographics, language-appropriate services, employees, training, and education/communication), was approved by the network's chief executive officer and senior managers to demonstrate commitment prior to implementation. Strategic plan implementation proceeded through a project structure consisting of subproject teams charged with achieving the following specific objectives: develop a cultural material repository, enhance employee recruitment/retention, establish a baseline assessment

  7. 36 CFR 223.113 - Modification of contracts to prevent environmental damage or to conform to forest plans.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Modification of contracts to prevent environmental damage or to conform to forest plans. 223.113 Section 223.113 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM...

  8. The Application of the Theory of Reasoned Action and Planned Behavior to Prevention Science in Counseling Psychology

    Science.gov (United States)

    Romano, John L.; Netland, Jason D.

    2008-01-01

    The theory of reasoned action and planned behavior (TRA/PB) is a model of behavior change that has been extensively studied in the health sciences but has had limited exposure in the counseling psychology literature. The model offers counseling psychologists a framework to conceptualize prevention research and practice. The model is important to…

  9. Comparative evaluation of two dose optimization methods for image-guided, highly-conformal, tandem and ovoids cervix brachytherapy planning

    Science.gov (United States)

    Ren, Jiyun; Menon, Geetha; Sloboda, Ron

    2013-04-01

    Although the Manchester system is still extensively used to prescribe dose in brachytherapy (BT) for locally advanced cervix cancer, many radiation oncology centers are transitioning to 3D image-guided BT, owing to the excellent anatomy definition offered by modern imaging modalities. As automatic dose optimization is highly desirable for 3D image-based BT, this study comparatively evaluates the performance of two optimization methods used in BT treatment planning—Nelder-Mead simplex (NMS) and simulated annealing (SA)—for a cervix BT computer simulation model incorporating a Manchester-style applicator. Eight model cases were constructed based on anatomical structure data (for high risk-clinical target volume (HR-CTV), bladder, rectum and sigmoid) obtained from measurements on fused MR-CT images for BT patients. D90 and V100 for HR-CTV, D2cc for organs at risk (OARs), dose to point A, conformation index and the sum of dwell times within the tandem and ovoids were calculated for optimized treatment plans designed to treat the HR-CTV in a highly conformal manner. Compared to the NMS algorithm, SA was found to be superior as it could perform optimization starting from a range of initial dwell times, while the performance of NMS was strongly dependent on their initial choice. SA-optimized plans also exhibited lower D2cc to OARs, especially the bladder and sigmoid, and reduced tandem dwell times. For cases with smaller HR-CTV having good separation from adjoining OARs, multiple SA-optimized solutions were found which differed markedly from each other and were associated with different choices for initial dwell times. Finally and importantly, the SA method yielded plans with lower dwell time variability compared with the NMS method.

  10. Planning and installing photovoltaic systems a guide for installers, architects and engineers

    CERN Document Server

    Deutsche Gesellschaft für Sonnenenergie (DGS)

    2013-01-01

    New third edition of the bestselling manual from the German Solar Energy Society (DGS), showing you the essential steps to plan and install a solar photovoltaic system. With a global focus, it has been updated to include sections on new technology and concepts, new legislation and the current PV market.Updates cover:new developments in inverter and module technologymarket situation worldwide and outlookintegration to the grid (voltage stabilization, frequency, remote control)new legal requirements for installation and planningoperational costs for dismantling and recyclingfeed-in managementnew requirements for fire protectionnew requirements in Europe for electric waste (Waste Electrical and Electronic Equipment, WEEE) and the restriction of the use of certain hazardous substances (RoHS).Also providing information on current developments in system design, economic analysis, operation and maintenance of PV systems, as well as new software tools, hybrid and tracking systems.An essential manual for installers, e...

  11. Atmospheric studies in complex terrain: a planning guide for future studies

    Energy Technology Data Exchange (ETDEWEB)

    Orgill, M.M.

    1981-02-01

    The objective of this study is to assist the US Department of Energy in Conducting its atmospheric studies in complex terrain (ASCOT0 by defining various complex terrain research systems and relating these options to specific landforms sites. This includes: (1) reviewing past meteorological and diffusion research on complex terrain; (2) relating specific terrain-induced airflow phenomena to specific landforms and time and space scales; (3) evaluating the technical difficulty of modeling and measuring terrain-induced airflow phenomena; and (4) avolving severdal research options and proposing candidate sites for continuing and expanding field and modeling work. To evolve research options using variable candidate sites, four areas were considered: site selection, terrain uniqueness and quantification, definition of research problems and research plans. 36 references, 111 figures, 20 tables.

  12. MO-FG-BRA-01: Development of An Image-Guided Dosimetric Planning System for Injectable Brachytherapy Using ELP Nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Lafata, K [Duke University, Durham, North Carolina (United States); Duke University Medical Center, Durham, NC (United States); Schaal, J; Liu, W [Duke University, Durham, North Carolina (United States); Cai, J [Duke University Medical Center, Durham, NC (United States)

    2015-06-15

    Purpose: To develop, validate, and evaluate a methodology for determining dosimetry for intratumoral injections of elastin-like-polypeptide (ELP) brachytherapy nanoparticles. These organic-polymer-based nanoparticles are injectable, biodegradable, and genetically tunable. We present a genetically encoded polymer-solution, composed of novel radiolabeled-ELP nanoparticles that are custom-designed to self-assemble into a local source upon intratumoral injection. Our preliminary results of a small animal study demonstrate 100% tumor response, effective radionuclide retention-rates, strong in vivo stability, and no polymer-induced toxicities. While our approach is therefore highly promising for improved brachytherapy, the current workflow lacks a dosimetry framework. Methods: We are developing a robust software framework that provides image-guided dosimetric-planning capabilities for ELP brachytherapy. The user graphically places ELP injection sites within a µCT-planning-image, and independently defines each injection volume, concentration, and radioisotope to be used. The resulting internal dosimetry is then pre-determined by first modeling post-injection ELP advection-diffusion, and then calculating the resulting dose distribution based on a point- dose-kernel-convolution algorithm. We have experimentally measured ELP steady-state concentrations via µSPECT acquisition, and validated our dose calculation algorithm against Monte Carlo simulations of several radioactivity distributions. Finally, we have investigated potential advantages and limitations of various ELP injection parameters. Results: The µSPECT results demonstrated inhomogeneous steady-state distributions of ELP in tissue, and Monte Carlo radioactivity distributions were designed accordingly. Our algorithm yielded a root-mean-square-error of less than 2% for each distribution tested (average root-mean-square-error was 0.73%). Dose-Volume-Histogram analysis of five different plans showed how strategic

  13. How to approach the acute respiratory distress syndrome: Prevention, plan, and prudence.

    Science.gov (United States)

    Koh, Younsuck

    2017-05-01

    The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition. The clinician׳s considerate prudence is required in decisions of when to apply intensive measures for an ARDS treatment. Mechanical ventilator support should be carefully used depending on the patient׳s severity and pathological phase. Decreasing inappropriate alveolar strain through a low tidal volume under optimal positive end-expiratory pressure is key for ventilator support in ARDS. The extracorporeal membrane oxygenation applied in the experienced centers seems to improve the survival of patients with severe ARDS. A constellation of physical and psychological problems can develop or persist for up to 5 years in patients with ARDS. Therefore, an early mobilization with rehabilitation, even during an intensive care unit stay, should be seriously considered whenever feasible. Lastly, prevention of aspiration, stress ulcers, deep vein thrombosis, catheter-related infection, overhydration, and heavy sedation is essential to achieve better outcomes in ARDS. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  14. Achieving multiple compliance objectives through a storm water pollution prevention plan

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, K.J.; Cataldo, R. [ENSR, Acton, MA (United States)

    1997-09-01

    All across the US, facility managers and environmental staff are trying to keep up with proliferating regulations and associated filing and reporting requirements. Added to the already full plate of regulations is the National Pollutant Discharge Elimination System (NPDES) program for storm water management. The NPDES program requires a permit for the discharge of runoff from facilities based on Standard Industrial Classification (SIC) code. Some businesses do not yet need to comply with NPDES, as not all types of facilities were included in the Phase 1 list of regulated activities (September 1992). However, most businesses will be included as part of Phase 2 by 2002. Furthermore, states adopting administration of the NPDES program have the option of accelerating the process. In addition to filing for a permit, the NPDES storm water program requires the preparation and implementation of a Storm Water Pollution Prevention Plan (SWPPP). A properly prepared SWPPP can help facilities more easily comply with regulatory requirements and serve as an overall facility management tool.

  15. 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.

  16. Human-caused wildfire risk rating for prevention planning in Spain.

    Science.gov (United States)

    Martínez, Jesús; Vega-Garcia, Cristina; Chuvieco, Emilio

    2009-02-01

    This paper identifies human factors associated with high forest fire risk in Spain and analyses the spatial distribution of fire occurrence in the country. The spatial units were 6,066 municipalities of the Spanish peninsular territory and Balearic Islands. The study covered a 13-year series of fire occurrence data. One hundred and eight variables were generated and input to a dedicated Geographic Information System (GIS) to model different factors related to fire ignition. After exploratory analysis, 29 were selected to build a predictive model of human fire ignition using logistic regression analysis. The binary model estimated the probability of high or low occurrence of forest fires, as defined by an ignition danger index that is currently used by the Spanish forest service (number of fires divided by forest area in each municipality). Thirteen explanatory variables were identified by the model. They were related to agricultural landscape fragmentation, agricultural abandonment and development processes. The prediction agreement found between the model binary outputs and the historical fire data was 85.3% for the model building dataset (60% of municipalities). A slightly lower predictive power (76.2%) was found for the validation data (the remaining 40%). The probabilistic output of the logistic was significantly related to the raw ignition index (Spearman correlation of 0.710) used by the Spanish Forest Service. Therefore, the model can be considered a good predictor of human-caused fire risk, aiding spatial decisions related to prevention planning in Spanish municipalities.

  17. Active prevention of postpartum endometritis in pregnant women with anaerobic dysbiosis and planned cesarian section

    Directory of Open Access Journals (Sweden)

    Voronin K,V.

    2015-09-01

    Full Text Available In the structure of inflammatory di¬seases postpartum endometritis (PE retains its leading position. The likelihood of postpartum endometritis deve¬lopment after cesarean section increases by 5-10 times compared with spontaneous labor and its frequency has no tendency to decrease. The urgency of PE problem is determined not only by its high prevalence, economic losses, but its possible complications (uterine suture failure and generalization of infection as well. Clinical picture of PE currently is characterized by late manifastation, presence of atypical and asymptomatic forms with mismatched general reaction of the organism and severity of the local pathological process. The leading role in the etiology of PE belongs to conditionaly pathogenic microflora, in the most cases (90% presence of strict anaerobic nonsporeforming mic¬roorganisms, composing part of the normal flora of the genital tract in women. The aim of the study was the development of the principles of active prevention of postpartum endometritis in women with severe vaginal anaerobic dysbiosis while planning cesarean section.

  18. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  19. Guide to hazardous industrial activities: handbook for the cataloguing and selection of industrial activities for which an Emergency Management Plan ought to be drafted

    NARCIS (Netherlands)

    Ham, J.M.; Blom-Bruggeman, J.M.

    1989-01-01

    A methodology has been developed for the cataloguing of hazardous (industrial) activities and the evaluation of these activities as part of the process of formulating an emergency management plan. This guide will enable priorities to be set at local level (district, region) for the drafting of

  20. Allowing for MSD prevention during facilities planning for a public service: an a posteriori analysis of 10 library design projects.

    Science.gov (United States)

    Bellemare, Marie; Trudel, Louis; Ledoux, Elise; Montreuil, Sylvie; Marier, Micheline; Laberge, Marie; Vincent, Patrick

    2006-01-01

    Research was conducted to identify an ergonomics-based intervention model designed to factor in musculoskeletal disorder (MSD) prevention when library projects are being designed. The first stage of the research involved an a posteriori analysis of 10 recent redesign projects. The purpose of the analysis was to document perceptions about the attention given to MSD prevention measures over the course of a project on the part of 2 categories of employees: librarians responsible for such projects and personnel working in the libraries before and after changes. Subjects were interviewed in focus groups. Outcomes of the analysis can guide our ergonomic assessment of current situations and contribute to a better understanding of the way inclusion or improvement of prevention measures can support the workplace design process.

  1. Health Department HIV Prevention Programs That Support the National HIV/AIDS Strategy: The Enhanced Comprehensive HIV Prevention Planning Project, 2010-2013.

    Science.gov (United States)

    Fisher, Holly H; Hoyte, Tamika; Purcell, David W; Van Handel, Michelle; Williams, Weston; Krueger, Amy; Dietz, Patricia; Stratford, Dale; Heitgerd, Janet; Dunbar, Erica; Wan, Choi; Linley, Laurie A; Flores, Stephen A

    2016-01-01

    The Enhanced Comprehensive HIV Prevention Planning project was the first initiative of the Centers for Disease Control and Prevention (CDC) to address the goals of the National HIV/AIDS Strategy (NHAS). Health departments in 12 U.S. cities with a high prevalence of AIDS conducted comprehensive program planning and implemented cost-effective, scalable HIV prevention interventions that targeted high-risk populations. We examined trends in health department HIV prevention programs in these cities during the project. We analyzed the number of people who received partner services, condoms distributed, and people tested for HIV, as well as funding allocations for selected HIV prevention programs by year and by site from October 2010 through September 2013. We assessed trends in the proportional change in services and allocations during the project period using generalized estimating equations. We also conducted thematic coding of program activities that targeted people living with HIV infection (PLWH). We found significant increases in funding allocations for HIV testing and condom distribution. All HIV partner services indicators, condom distribution, and HIV testing of African American and Hispanic/Latino populations significantly increased. HIV tests associated with a new diagnosis increased significantly among those self-identifying as Hispanic/Latino but significantly decreased among African Americans. For programs targeting PLWH, health department activities included implementing new program models, improving local data use, and building local capacity to enhance linkage to HIV medical care, retention in care, and treatment adherence. Overall, these findings indicate that health departments in areas with a high burden of AIDS successfully shifted their HIV prevention resources to scale up important HIV programs and make progress toward NHAS goals.

  2. 3D printed abdominal aortic aneurysm phantom for image guided surgical planning with a patient specific fenestrated endovascular graft system

    Science.gov (United States)

    Meess, Karen M.; Izzo, Richard L.; Dryjski, Maciej L.; Curl, Richard E.; Harris, Linda M.; Springer, Michael; Siddiqui, Adnan H.; Rudin, Stephen; Ionita, Ciprian N.

    2017-03-01

    Following new trends in precision medicine, Juxatarenal Abdominal Aortic Aneurysm (JAAA) treatment has been enabled by using patient-specific fenestrated endovascular grafts. The X-ray guided procedure requires precise orientation of multiple modular endografts within the arteries confirmed via radiopaque markers. Patient-specific 3D printed phantoms could familiarize physicians with complex procedures and new devices in a risk-free simulation environment to avoid periprocedural complications and improve training. Using the Vascular Modeling Toolkit (VMTK), 3D Data from a CTA imaging of a patient scheduled for Fenestrated EndoVascular Aortic Repair (FEVAR) was segmented to isolate the aortic lumen, thrombus, and calcifications. A stereolithographic mesh (STL) was generated and then modified in Autodesk MeshMixer for fabrication via a Stratasys Eden 260 printer in a flexible photopolymer to simulate arterial compliance. Fluoroscopic guided simulation of the patient-specific FEVAR procedure was performed by interventionists using all demonstration endografts and accessory devices. Analysis compared treatment strategy between the planned procedure, the simulation procedure, and the patient procedure using a derived scoring scheme. Results: With training on the patient-specific 3D printed AAA phantom, the clinical team optimized their procedural strategy. Anatomical landmarks and all devices were visible under x-ray during the simulation mimicking the clinical environment. The actual patient procedure went without complications. Conclusions: With advances in 3D printing, fabrication of patient specific AAA phantoms is possible. Simulation with 3D printed phantoms shows potential to inform clinical interventional procedures in addition to CTA diagnostic imaging.

  3. Family psychosocial risk screening guided by the Pediatric Psychosocial Preventative Health Model (PPPHM) using the Psychosocial Assessment Tool (PAT).

    Science.gov (United States)

    Kazak, Anne E; Schneider, Stephanie; Didonato, Stephen; Pai, Ahna L H

    2015-05-01

    Although families of children with cancer and other serious medical conditions have documented psychosocial needs, the systematic identification of needs and delivery of evidence-based care remain challenges. Screening for multifaceted family psychosocial risk is a means by which psychosocial treatment needs for pediatric patients and their families can be identified in an effective and inclusive manner. The Pediatric Psychosocial Preventative Health Model (PPPHM) is a model that can guide systematic assessment of family psychosocial risk. The Psychosocial Assessment Tool (PAT) is a brief parent report screener of psychosocial risk based on the PPPHM that can be used for families of infants through adolescents. The PPPHM and the PAT are described in this paper, along with a summary of data supporting systematic risk assessment. The PPPHM outlines three tiers of family psychosocial risk - Universal (low), Targeted (medium), and Clinical (high). The PAT is a validated measure of psychosocial risk. Scores on the PAT, derived from multiple sites and disease conditions, map on to the PPPHM with indications that one-half to two-thirds of families score at the Universal level of risk based on the PAT. The PAT is a unique screener of psychosocial risk, both in terms of its breadth and underlying model (PPPHM), and its length and format. As an example of a means by which families can be screened early in the treatment process, PAT scores and corresponding PPPHM levels can provide direction for the delivery of evidence-based psychosocial care.

  4. Image-guided lateral suboccipital approach: part 1-individualized landmarks for surgical planning.

    Science.gov (United States)

    Gharabaghi, Alireza; Rosahl, Steffen K; Feigl, Günther C; Liebig, Thomas; Mirzayan, Javad M; Heckl, Stefan; Shahidi, Ramin; Tatagiba, Marcos; Samii, Madjid

    2008-03-01

    Being situated close to the transverse and sigmoid sinus, the asterion has traditionally been viewed as a landmark for surgical approaches to the posterior fossa. Cadaveric studies, however, have shown its variability in relation to underlying anatomic structures. We have used an image-guidance technology to determine the precise anatomic relationship between the asterion and the underlying transverse-sigmoid sinus transition (TST) complex in patients scheduled for posterior fossa surgery. The applicability of three-dimensional (3-D) volumetric image-rendering for presurgical anatomic identification and individualization of a surgical landmark was evaluated. One-millimeter computed tomographic slices were combined with venous computed tomographic angiography in 100 patients, allowing for 3-D volumetric image-rendering of the cranial bone and the dural vasculature at the same time. The spatial relationship between the asterion and the TST was recorded bilaterally by using opacity modulation of the bony surface. The location of both the asterion and the TST could be confirmed during surgery in all of these patients. It was possible to accurately visualize the asterion and the sinuses in a single volumetrically rendered 3-D image in more than 90% of the patients. The variability in the anatomic position of the asterion as shown in cadaveric studies was confirmed, providing an individualized landmark for the patients. In this series, the asterion was located from 2 mm medial to 7 mm lateral and from 10 mm inferior to 17 mm superior to the TST, respectively. Volumetric image-rendering allows for precise in vivo measurements of anatomic distances in 3-D space. It is also a valuable tool for assessing the validity of traditional surgical landmarks and individualizing them for surgical planning.

  5. Analysing Time to Event Data in Dementia Prevention Trials: The Example of the GuidAge Study of EGb761.

    Science.gov (United States)

    Scherrer, B; Andrieu, S; Ousset, P J; Berrut, G; Dartigues, J F; Dubois, B; Pasquier, F; Piette, F; Robert, P; Touchon, J; Garnier, P; Mathiex-Fortunet, H; Vellas, B

    2015-12-01

    Time-to-event analysis is frequently used in medical research to investigate potential disease-modifying treatments in neurodegenerative diseases. Potential treatment effects are generally evaluated using the logrank test, which has optimal power and sensitivity when the treatment effect (hazard ratio) is constant over time. However, there is generally no prior information as to how the hazard ratio for the event of interest actually evolves. In these cases, the logrank test is not necessarily the most appropriate to use. When the hazard ratio is expected to decrease or increase over time, alternative statistical tests such as the Fleming-Harrington test, provide a better sensitivity. An example of this comes from a large, five-year randomised, placebo-controlled prevention trial (GuidAge) in 2854 community-based subjects making spontaneous memory complaints to their family physicians, which evaluated whether treatment with EGb761 can modify the risk of developing AD. The primary outcome measure was the time to conversion from memory complaint to Alzheimer's type dementia. Although there was no significant difference in the hazard function of conversion between the two treatment groups according to the preplanned logrank test, a significant treatment-by-time interaction for the incidence of AD was observed in a protocol-specified subgroup analysis, suggesting that the hazard ratio is not constant over time. For this reason, additional post hoc analyses were performed using the Fleming-Harrington test to evaluate whether there was a signal of a late effect of EGb761. Applying the Fleming-Harrington test, the hazard function for conversion to dementia in the placebo group was significantly different from that in the EGb761 treatment group (p = 0.0054), suggesting a late effect of EGb761. Since this was a post hoc analysis, no definitive conclusions can be drawn as to the effectiveness of the treatment. This post hoc analysis illustrates the interest of performing

  6. Local heat stroke prevention plans in Japan: characteristics and elements for public health adaptation to climate change.

    Science.gov (United States)

    Martinez, Gerardo Sanchez; Imai, Chisato; Masumo, Kanako

    2011-12-01

    The adverse health effects from hot weather and heat waves represent significant public health risks in vulnerable areas worldwide. Rising temperatures due to climate change are aggravating these risks in a context of fast urbanization, population growth and societal ageing. However, environmental heat-related health effects are largely preventable through adequate preparedness and responses. Public health adaptation to climate change will often require the implementation of heat wave warning systems and targeted preventive activities at different levels. While several national governments have established such systems at the country level, municipalities do not generally play a major role in the prevention of heat disorders. This paper analyzes selected examples of locally operated heat-health prevention plans in Japan. The analysis of these plans highlights their strengths, but also the need of local institutions for assistance to make the transition towards an effective public health management of high temperatures and heat waves. It can also provide useful elements for municipal governments in vulnerable areas, both in planning their climate change and health adaptation activities or to better protect their communities against current health effects from heat.

  7. The contribution of family planning towards the prevention of vertical HIV transmission in Uganda.

    Directory of Open Access Journals (Sweden)

    Wolfgang Hladik

    Full Text Available BACKGROUND: Uganda has one of the highest total fertility rates (TFR worldwide. We compared the effects of antiretroviral (ARV prophylaxis for the prevention of mother-to-child HIV transmission (PMTCT to that of existing family planning (FP use and estimated the burden of pediatric HIV disease due to unwanted fertility. METHODOLOGY/PRINCIPAL FINDINGS: Using the demographic software Spectrum, a baseline mathematical projection to estimate the current pediatric HIV burden in Uganda was compared to three hypothetical projections: 1 without ARV-PMTCT (to estimate the effect of ARV-PMTCT, 2 without contraception (effect of existing FP use, 3 without unwanted fertility (effect of unmet FP needs. Key input parameters included HIV prevalence, ARV-PMTCT uptake, MTCT probabilities, and TFR. We estimate that in 2007, an estimated 25,000 vertical infections and 17,000 pediatric AIDS deaths occurred (baseline projection. Existing ARV-PMTCT likely averted 8.1% of infections and 8.5% of deaths. FP use likely averted 19.7% of infections and 13.1% of deaths. Unwanted fertility accounted for 21.3% of infections and 13.4% of deaths. During 2008-2012, an estimated 131,000 vertical infections and 71,000 pediatric AIDS deaths will occur. The projected scale up of ARV-PMTCT (from 39%-57% may avert 18.1% of infections and 24.5% of deaths. Projected FP use may avert 21.6% of infections and 18.5% of deaths. Unwanted fertility will account for 24.5% of infections and 19.8% of deaths. CONCLUSIONS: Existing FP use contributes as much or more than ARV-PMTCT in mitigating pediatric HIV in Uganda. Expanding FP services can substantially contribute towards PMTCT.

  8. 76 FR 44155 - Pacific Halibut Fisheries; Catch Sharing Plan for Guided Sport and Commercial Fisheries in Alaska

    Science.gov (United States)

    2011-07-22

    ... Halibut Fisheries II. History of Management in the Guided Sport Halibut Fisheries III. Proposed Catch... this additional management measure in the Area 2C charter fishery to limit guided sport halibut harvest... comprehensive management program for the guided sport halibut fisheries in Area 2C and Area 3A. If approved, the...

  9. Implementation of an image guided intensity-modulated protocol for post-prostatectomy radiotherapy: planning data and acute toxicity outcomes.

    Science.gov (United States)

    Chua, Benjamin; Min, Myo; Wood, Maree; Edwards, Sarah; Hoffmann, Matthew; Greenham, Stuart; Kovendy, Andrew; McKay, Michael J; Shakespeare, Thomas P

    2013-08-01

    There is substantial interest in implementation of image-guided intensity-modulated radiotherapy (IG-IMRT) in the post-prostatectomy setting. We describe our implementation of IG-IMRT, and examine how often published organ-at-risk (OAR) constraints were met. Furthermore, we evaluate the incidence of acute genitourinary and gastrointestinal toxicities when patients were treated according to our protocol. Patients were eligible if they received post-prostatectomy radiotherapy (PPRT). Planning data were collected prospectively, and toxicity assessments were collected before, during and after treatment. Seventy-five eligible patients received either 64 Gy (19%) or 66 Gy (81%) in a single phase to the prostate bed. Suggested rectal dose-constraints of V40Gy image guidance. Non-IMRT OAR constraints were met in most cases. IMRT-specific constraints were less often achieved despite margin reductions, suggesting the need for review of guidelines. Severe toxicity was rare, and most patients did not experience deterioration in urinary or bowel function attributable to radiotherapy. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

  10. Optimizing production and imperfect preventive maintenance planning's integration in failure-prone manufacturing systems

    International Nuclear Information System (INIS)

    Aghezzaf, El-Houssaine; Khatab, Abdelhakim; Tam, Phuoc Le

    2016-01-01

    This paper investigates the issue of integrating production and maintenance planning in a failure-prone manufacturing system. It is assumed that the system's operating state is stochastically predictable, in terms of its operating age, and that it can accordingly be preventively maintained during preplanned periods. Preventive maintenance is assumed to be imperfect, that is when performed, it brings the manufacturing system to an operating state that lies between ‘as bad as old’ and ‘as good as new’. Only an overhauling of the system brings it to a ‘as good as new’ operating state again. A practical integrated production and preventive maintenance planning model, that takes into account the system's manufacturing capacity and its operational reliability state, is developed. The model is naturally formulated as a mixed-integer non-linear optimization problem, for which an extended mixed-integer linear reformulation is proposed. This reformulation, while it solves the proposed integrated planning problem to optimality, remains quite demanding in terms of computational time. A fix-and-optimize procedure, that takes advantage of some properties of the original model, is then proposed. The reformulation and the fix-and-optimize procedure are tested on some test instances adapted from those available in the literature. The results show that the proposed fix-and-optimize procedure performs quite well and opens new research direction for future improvements. - Highlights: • Integration of production planning and imperfect preventive maintenance is explored. • Imperfect maintenance is modeled using a fitting age reduction hybrid hazard rate. • A practical approximate optimization model for this integration is proposed. • The resulting naturally MINL optimization model is reformulated and solved as a MILP. • An effective fix-and-optimize procedure is proposed for large instances of this MILP.

  11. The Action Plan for Preventing Homelessness in Finland 2016-2019 : The Culmination of an Integrated Strategy to End Homelessness?

    OpenAIRE

    Pleace, Nicholas

    2017-01-01

    The integrated Finnish National Homelessness Strategy is often seen as the envy of the economically developed world. Challenges remain and progress is not always even, but Finland is approaching a point at which recurrent and long-term homelessness will be nearly eradicated and experi- ence of any form of homelessness will become uncommon. The 2016-2019 Action Plan for Preventing Homelessness in Finland is the third stage of the implementation of an integrated homelessness strategy, which beg...

  12. Plan to Prevent and Respond to Sexual Assault of Military Men

    Science.gov (United States)

    2016-10-01

    males is limited. The Department is now working to increase research-informed, gender -specific prevention techniques that address male specific...training must aim to prevent the broad range of sexual misconduct and unlawful discrimination . Gap between Standard and Existing Practices The Services...supervisor training to engage leaders in preventing male victimization and reducing associated stigma (objective 2) 11 • Gender -responsive treatment (to

  13. Prevention

    Science.gov (United States)

    ... Contact Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... Prevention Hearing Loss Heart Attack High Blood Pressure Nutrition Osteoporosis Shingles Skin Cancer Related News Quitting Smoking, ...

  14. Test/QA Plan For Verification Of Anaerobic Digester For Energy Production And Pollution Prevention

    Science.gov (United States)

    The ETV-ESTE Program conducts third-party verification testing of commercially available technologies that improve the environmental conditions in the U.S. A stakeholder committee of buyers and users of such technologies guided the development of this test on anaerobic digesters...

  15. Dinosaurs and Power Plants. Energy from the Past for the Future. Teacher's Lesson Plan and Activity Guide; Teacher's Guide Supplement of Reproducible Graphics.

    Science.gov (United States)

    Department of Energy, Washington, DC. Office of Fossil Energy.

    This teacher's guide and its accompanying supplement were prepared for use with the U.S. Department of Energy's Dinosaurs and Power Plants, a publication designed for students in grades 5-8 about the history, detection, extraction, transportation, use, environmental problem/solutions, and future of fossil energy. The study of energy science shows…

  16. Enjoy writing your science thesis or dissertation! a step-by-step guide to planning and writing a thesis or dissertation for undergraduate and graduate science students

    CERN Document Server

    Fisher, Elizabeth

    2014-01-01

    This book is a step by step illustrated guide to planning and writing dissertations and theses for undergraduate and graduate science students. Topics covered include advice on writing each section of a thesis as well as general discussions on collecting and organizing references, keeping records, presenting data, interacting with a supervisor and avoiding academic misconduct. Recommendations about how to use word processors and other software packages effectively are included, as well as advice on the use of other resources. A concise summary of important points of English grammar is given, along with appendices listing frequently confused words and wordy phrases to avoid. Further appendices are provided, including one on Si units. The aim is to provide an easy-to-read guide that gives students practical advice about all aspects of writing a science thesis or dissertation, starting from writing a thesis plan and finishing with the viva and corrections to the thesis.

  17. How best can we plan & implement HIV prevention? A review of successful evidence based practices & research

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Chattu

    2014-07-01

    Full Text Available Context: Around 2.5 million people become infected with HIV each year and its impact on human life and public health can only be tackled and reversed only by sound prevention strategies. Aim: This paper aims to provide the reader about different types of prevention strategies that are effective and practiced in various countries with special emphasis on evidence for success. It also highlights the importance of to the evidence based medicine& strategies. It describes about the importance of combination prevention, which encompasses complementary behavioral, biomedical and structural prevention strategies. Methods & Materials: Searches for peer reviewed journal articles was conducted using the search engines to gather the information from databases of medicine, health sciences and social sciences. Information for each strategy is organized & presented systematically with detailed discussion. Results: For a successful reduction in HIV transmission, there is a great need for combined effects of radical & sustainable behavioral changes among individuals who are potentially at risk. Second, combination prevention is essential for HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts. A mix of communication channels are essential to disseminate messages to motivate people to engage in various methods of risk reduction. Conclusions: The effect of behavioral strategies could be increased by aiming for many goals that are achieved by use of multilevel approaches with populations both uninfected and infected with HIV. Combination prevention programs operate on different levels to address the specific, but diverse needs of the populations at risk of HIV infection.

  18. 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....

  19. A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews.

    Science.gov (United States)

    Bennett, Kathryn; Rhodes, Anne E; Duda, Stephanie; Cheung, Amy H; Manassis, Katharina; Links, Paul; Mushquash, Christopher; Braunberger, Peter; Newton, Amanda S; Kutcher, Stanley; Bridge, Jeffrey A; Santos, Robert G; Manion, Ian G; Mclennan, John D; Bagnell, Alexa; Lipman, Ellen; Rice, Maureen; Szatmari, Peter

    2015-06-01

    We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision

  20. NOTE: Patient-specific planning for prevention of mechanical collisions during radiotherapy

    Science.gov (United States)

    Nioutsikou, Elena; Bedford, James L.; Webb, Steve

    2003-11-01

    A common unwanted difficulty in treatment planning, especially in non-coplanar radiotherapy set-ups, is the potential collision of the rotating gantry with the couch and/or the patient's body. A technique and computer program that detects these and signals avoidance of such beam directions is presented. The problem was approached using analytical geometry. The separate components within the treatment room have either been measured and modelled for an Elekta linear accelerator, or read out from a Pinnacle3 treatment planning system and are represented as an integer grid of points in three-dimensional (3D) space. The module is attached to the treatment planning system and can provide rejection or acceptance of unwanted beam directions in a plan. In contrast to previous work that has only used patient models, each individual patient's outlines are considered here in their actual treatment position inclusive of any immobilization device. The extremities of the patient superiorly and inferiorly to the scanned region are simulated by an expanded version of the RANDO phantom. In this way, 'potential' collisions can be detected in addition to the certain ones. Patient position is not a limiting factor for the accuracy of the collision detection anymore, as each set-up is always created around the isocentre. Maps of allowed and forbidden zones within the treatment suite have been created by running the code for all possible gantry and couch angles for three commonly arising cases: a head and neck plan utilizing a small stereotactic collimator, a prostate plan with multileaf collimators and an abdominal plan with the lead tray attached. In the last case, the 3D map permitted significantly fewer set-up combinations. Good agreement between prediction and experiment confirmed the capability of the program and introduces a promising add-on for treatment planning.

  1. Fact Sheet: Clean Air Act Section 112(r): Accidental Release Prevention / Risk Management Plan Rule

    Science.gov (United States)

    EPA is required to publish regulations and guidance for chemical accident prevention at facilities that pose the greatest risk of harm from accidental releases of regulated flammable and toxic substances above threshold quantities.

  2. 40 CFR 112.7 - General requirements for Spill Prevention, Control, and Countermeasure Plans.

    Science.gov (United States)

    2010-07-01

    ... PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Applicability, Definitions, and General... described in § 112.1(b) that are the result of natural disasters, acts of war or terrorism); and (2...

  3. 40 CFR 112.9 - Spill Prevention, Control, and Countermeasure Plan Requirements for onshore oil production...

    Science.gov (United States)

    2010-07-01

    ... PROGRAMS OIL POLLUTION PREVENTION Requirements for Petroleum Oils and Non-Petroleum Oils, Except Animal Fats and Oils and Greases, and Fish and Marine Mammal Oils; and Vegetable Oils (Including Oils from...

  4. Stormwater Pollution Prevention Plan TA-60 Asphalt Batch Plant Revision 2: January 2017

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-01

    The Stormwater Pollution Prevention Team (PPT) is applicable to operations at the Technical Area (TA)- 60 Asphalt Batch Plant (ABP) located on Eniwetok Drive/Sigma Mesa, in Los Alamos County, New Mexico at Los Alamos National Laboratory (LANL).

  5. Incorporating economic valuation into fire prevention planning and management in Southern European countries

    Directory of Open Access Journals (Sweden)

    Elsa Varela

    2015-08-01

    Full Text Available Aim of study: This article describes and analyzes the links between the fire-based scientific knowledge, the social perception of fire prevention and forest fires and the economic valuation requirements to assess social preferences for fire prevention measures. Area of study: Southern European countries. Material and Methods: For that purpose, we develop a critical revision of the existing literature on economic valuation of social preferences for fire risk reduction and fire prevention in terms of its links with fire science and social perceptions and the applicability of these results in fire management policies. Research highlights: The assessment of social preferences for fire related issues is challenging due to the difficulty of setting sound valuation scenarios that can simultaneously be relevant for the respondents and derive conclusions useful for fire management. Most of the revised studies set up valuation scenarios focused on the final management outcome e.g. number of burnt hectares, what is easier for the respondents to evaluate but weakens the scientific relationship with fire management, making difficult reaching conclusions for sound management advice. A more recent set of valuation studies has been developed where risk perception of homeowners is further assessed as a key variable determining their preferences in valuation scenarios. These studies are relevant for mangers setting fire prevention programs in wildland urban interface areas as understanding the factors that may promote or hinder the enrolment of these homeowners in fire prevention activities may have direct implication in addressing communication programs to promote fire prevention management.

  6. Stormwater Pollution Prevention Plan for the TA-60-01 Heavy Equipment Shop, Los Alamos National Laboratory, Revision 3, January 2018

    Energy Technology Data Exchange (ETDEWEB)

    Burgin, Jillian Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-02-01

    This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector P-Land Transportation and Warehousing as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA-60-01 Heavy Equipment Shop at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-60-01 Heavy Equipment Shop and associated areas. The current permit expires at midnight on June 4, 2020.

  7. Stormwater Pollution Prevention Plan for the TA-03-22 Power and Steam Plant, Los Alamos National Laboratory, Revision 3, January 2018

    Energy Technology Data Exchange (ETDEWEB)

    Burgin, Jillian Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-02-01

    This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector O-Steam Electric Generating Facilities as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA-03-22 Power and Steam Plant at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-03-22 Power and Steam Plant and associated areas. The current permit expires at midnight on June 4, 2020.

  8. Stormwater Pollution Prevention Plan for the TA-03-38 Metals Fabrication Shop, Los Alamos National Laboratory, Revision 3, January 2018

    Energy Technology Data Exchange (ETDEWEB)

    Burgin, Jillian Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-02-01

    This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector AA-Fabricated Metal Products as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA-03-38 Metals Fabrication Shop at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-03-38 Metals Fabrication Shop and associated areas. The current permit expires at midnight on June 4, 2020.

  9. Stormwater Pollution Prevention Plan for the TA-03-38 Carpenter's Shop, Los Alamos National Laboratory, Revision 3, January 2018

    Energy Technology Data Exchange (ETDEWEB)

    Burgin, Jillian Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-02-01

    This Storm Water Pollution Prevention Plan (SWPPP) was developed in accordance with the provisions of the Clean Water Act (33 U.S.C. §§1251 et seq., as amended), and the Multi-Sector General Permit for Storm Water Discharges Associated with Industrial Activity (U.S. EPA, June 2015) issued by the U.S. Environmental Protection Agency (EPA) for the National Pollutant Discharge Elimination System (NPDES) and using the industry specific permit requirements for Sector A–Timber Products, Subsector A4 (Wood Products Facilities not elsewhere classified) as a guide. This SWPPP applies to discharges of stormwater from the operational areas of the TA-03-38 Carpenter’s Shop at Los Alamos National Laboratory. Los Alamos National Laboratory (also referred to as LANL or the “Laboratory”) is owned by the Department of Energy (DOE), and is operated by Los Alamos National Security, LLC (LANS). Throughout this document, the term “facility” refers to the TA-03-38 Carpenter’s Shop and associated areas. The current permit expires at midnight on June 4, 2020.

  10. Pregnancy prevention and condom use practices among HIV-infected women on antiretroviral therapy seeking family planning in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Lisa B Haddad

    Full Text Available Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART clinic.200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010.Most women (95% did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy. Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage.High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.

  11. National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic.

    Science.gov (United States)

    Peykari, Niloofar; Hashemi, Hassan; Dinarvand, Rasoul; Haji-Aghajani, Mohammad; Malekzadeh, Reza; Sadrolsadat, Ali; Sayyari, Ali Akbar; Asadi-Lari, Mohsen; Delavari, Alireza; Farzadfar, Farshad; Haghdoost, Aliakbar; Heshmat, Ramin; Jamshidi, Hamidreza; Kalantari, Naser; Koosha, Ahmad; Takian, Amirhossein; Larijani, Bagher

    2017-01-01

    Emerging Non-communicable diseases burden move United Nation to call for 25% reduction by 2025 in premature mortality from non-communicable diseases (NCDs). The World Health Organization (WHO) developed global action plan for prevention and control NCDs, but the countries' contexts, priorities, and health care system might be different. Therefore, WHO expects from countries to meet national commitments to achieve the 25 by 25 goal through adapted targets and action plan. In this regards, sustainable high-level political statement plays a key role in rules and regulation support, and multi-sectoral collaborations to NCDs' prevention and control by considering the sustainable development goals and universal health coverage factors. Therefore, Iran established the national authority's structure as Iranian Non Communicable Diseases Committee (INCDC) and developed NCDs' national action plan through multi-sectoral approach and collaboration researchers and policy makers. Translation Iran's expertise could be benefit to mobilizing leadership in other countries for practical action to save the millions of peoples.

  12. Security guide for subcontractors

    Energy Technology Data Exchange (ETDEWEB)

    Adams, R.C.

    1993-06-01

    This guide is provided to aid in the achievement of security objectives in the Department of Energy (DOE) contractor/subcontractor program. The objectives of security are to protect information that, if released, would endanger the common defense and security of the nation and to safeguard plants and installations of the DOE and its contractors to prevent the interruption of research and production programs. The security objective and means of achieving the objective are described. Specific security measures discussed in this guide include physical barriers, personnel identification systems, personnel and vehicular access control, classified document control, protection of classified matter in use, storing classified matter, and repository combinations. Means of dealing with security violations and security infractions are described. Maintenance of a security education program is discussed. Also discussed are methods of handling clearance terminations, visitor control, travel to sensitive countries, and shipment security. The Technical Surveillance Countermeasures Program (TSCM), the Computer Security Program, and the Operations Security Plan (OPSEC) are examined.

  13. Functional Image-Guided Radiotherapy Planning in Respiratory-Gated Intensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Tomoki, E-mail: tkkimura@hiroshima-u.ac.jp [Department of Radiation Oncology, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima City (Japan); Nishibuchi, Ikuno; Murakami, Yuji; Kenjo, Masahiro; Kaneyasu, Yuko; Nagata, Yasushi [Department of Radiation Oncology, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima City (Japan)

    2012-03-15

    Purpose: To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD). Methods and Materials: Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values of less than than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung. Two respiratory-gated radiotherapy plans (70 Gy/35 fractions) were designed and compared in each patient as follows: Plan A was an anatomical IMRT or VMAT plan based on the total lung; Plan F was a functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (percentage of total lung volume irradiated with {>=}20 Gy [V20], and mean dose of total lung [MLD]) of the two plans were compared. Results: V20 was lower in Plan F than in Plan A (mean 1.5%, p = 0.025 in IMRT, mean 1.6%, p = 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p = 0.083 in IMRT, mean 0.5 Gy, p = 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses. Conclusions: Functional IGRT planning based on LAA in respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.

  14. Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project, northwestern Zambia.

    Science.gov (United States)

    Knoblauch, Astrid M; Divall, Mark J; Owuor, Milka; Nduna, Kennedy; Ng'uni, Harrison; Musunka, Gertrude; Pascall, Anna; Utzinger, Jürg; Winkler, Mirko S

    2017-07-04

    surveillance data to track HIV transmission in this specific context. Guided by the health impact assessment, the HIV prevention and control programme was readily adapted to the current setting through the identification of socioeconomic and environmental determinants of health.

  15. Nuisance Wildlife Education and Prevention Plan for the Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Giffen, Neil R [ORNL

    2007-05-01

    This document outlines a plan for management of nuisance wildlife at the Oak Ridge National Laboratory (ORNL). Nuisance wildlife management includes wildlife population control through hunting, trapping, removal, and habitat manipulation; wildlife damage control; and law enforcement. This plan covers the following subjects: (1) roles and responsibilities of individuals, groups, and agencies; (2) the general protocol for reducing nuisance wildlife problems; and (3) species-specific methodologies for resolving nuisance wildlife management issues for mammals, birds, snakes, and insects. Achievement of the objectives of this plan will be a joint effort between the Tennessee Wildlife Resources Agency (TWRA); U. S. Department of Agriculture (USDA), Animal and Plant Health Inspection Service (APHIS)-Wildlife Services (WS); and ORNL through agreements between TWRA and the U.S. Department of Energy (DOE); DOE and UT-Battelle, LLC; and UT-Battelle, LLC; and USDA, APHIS-WS.

  16. Use of geographic information systems for planning HIV prevention interventions for high-risk youths.

    Science.gov (United States)

    Geanuracos, Catherine G; Cunningham, Shayna D; Weiss, George; Forte, Draco; Reid, Lisa M Henry; Ellen, Jonathan M

    2007-11-01

    Geographic information system (GIS) analysis is an emerging tool for public health intervention planning. Connect to Protect, a researcher-community collaboration working in 15 cities to reduce HIV infection among youths, developed GIS databases of local health, crime, and demographic data to evaluate the geographic epidemiology of sexually transmitted infections and HIV risk among adolescents. We describe the process and problems of data acquisition, analysis, and mapping in the development of structural interventions, demonstrating how program planners can use this technology to inform and improve planning decisions. The Connect to Protect project's experience suggests strategies for incorporating public data and GIS technology into the next generation of public health interventions.

  17. T1-weighted MRI as a substitute to CT for refocusing planning in MR-guided focused ultrasound

    International Nuclear Information System (INIS)

    Wintermark, Max; Sumer, Suna; Lau, Benison; Cupino, Alan; Tustison, Nicholas J; Demartini, Nicholas; Elias, William J; Kassell, Neal; Patrie, James T; Xin, Wenjun; Eames, Matt; Snell, John; Hananel, Arik; Aubry, Jean-Francois

    2014-01-01

    Precise focusing is essential for transcranial MRI-guided focused ultrasound (TcMRgFUS) to minimize collateral damage to non-diseased tissues and to achieve temperatures capable of inducing coagulative necrosis at acceptable power deposition levels. CT is usually used for this refocusing but requires a separate study (CT) ahead of the TcMRgFUS procedure. The goal of this study was to determine whether MRI using an appropriate sequence would be a viable alternative to CT for planning ultrasound refocusing in TcMRgFUS. We tested three MRI pulse sequences (3D T1 weighted 3D volume interpolated breath hold examination (VIBE), proton density weighted 3D sampling perfection with applications optimized contrasts using different flip angle evolution and 3D true fast imaging with steady state precision T2-weighted imaging) on patients who have already had a CT scan performed. We made detailed measurements of the calvarial structure based on the MRI data and compared those so-called ‘virtual CT’ to detailed measurements of the calvarial structure based on the CT data, used as a reference standard. We then loaded both standard and virtual CT in a TcMRgFUS device and compared the calculated phase correction values, as well as the temperature elevation in a phantom. A series of Bland–Altman measurement agreement analyses showed T1 3D VIBE as the optimal MRI sequence, with respect to minimizing the measurement discrepancy between the MRI derived total skull thickness measurement and the CT derived total skull thickness measurement (mean measurement discrepancy: 0.025; 95% CL (−0.22–0.27); p = 0.825). The T1-weighted sequence was also optimal in estimating skull CT density and skull layer thickness. The mean difference between the phase shifts calculated with the standard CT and the virtual CT reconstructed from the T1 dataset was 0.08 ± 1.2 rad on patients and 0.1 ± 0.9 rad on phantom. Compared to the real CT, the MR-based correction showed a 1 °C drop on the

  18. Choosing the route to traveler information systems deployment : decision factors for creating public-private business plans : an action guide

    Science.gov (United States)

    1998-01-01

    This document presents a guide designed to help public private partnerships in their efforts to provide Advanced Traveler Information Systems (ATIS) services. It first examines why ATIS can be useful in managing transportation networks and increasing...

  19. Using the Concept of "Population Dose" in Planning and Evaluating Community-Level Obesity Prevention Initiatives

    Science.gov (United States)

    Cheadle, Allen; Schwartz, Pamela M.; Rauzon, Suzanne; Bourcier, Emily; Senter, Sandra; Spring, Rebecca; Beery, William L.

    2013-01-01

    When planning and evaluating community-level initiatives focused on policy and environment change, it is useful to have estimates of the impact on behavioral outcomes of particular strategies (e.g., building a new walking trail to promote physical activity). We have created a measure of estimated strategy-level impact--"population dose"--based on…

  20. 76 FR 66882 - Approval and Promulgation of State Implementation Plans; Missouri: Prevention of Significant...

    Science.gov (United States)

    2011-10-28

    ... Significant Deterioration; Greenhouse Gas Tailoring Rule; New Source Review Reform AGENCY: Environmental... Missouri State Implementation Plan (SIP) relating to regulation of Greenhouse Gases (GHGs) under Missouri's... Greenhouse Gas Tailoring Final Rule,'' which EPA issued by notice dated June 3, 2010. These revisions were...

  1. 75 FR 81858 - Approval and Promulgation of Implementation Plans; Mississippi: Prevention of Significant...

    Science.gov (United States)

    2010-12-29

    ... Regulatory Development Section, Air Planning Branch, Air, Pesticides and Toxics Management Division, U.S..., Air, Pesticides and Toxics Management Division, U.S. Environmental Protection Agency, Region 4, 61...; Greenhouse Gas Tailoring Rule Revision AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule...

  2. Intention to Enact and Enactment of Gatekeeper Behaviors for Suicide Prevention: an Application of the Theory of Planned Behavior.

    Science.gov (United States)

    Kuhlman, Shane T W; Walch, Susan E; Bauer, Kristina N; Glenn, April D

    2017-08-01

    Gatekeeper training for suicide prevention was evaluated on a college campus to examine the impact of training on gatekeeper enactment of behaviors in support of suicide prevention and identify predictors of enactment of gatekeeper behaviors. Trained gatekeepers (N = 216) displayed greater perceived knowledge and self-efficacy for suicide prevention and reported higher rates of self-reported actual gatekeeper behaviors, including inquiring about suicidal ideation and referring for mental health treatment when they encountered someone in distress, compared to their untrained counterparts (N = 169). Consistent with the Theory of Planned Behavior, SEM results indicated that attitudes, self-efficacy, and perceived knowledge explained intentions to engage in gatekeeper behaviors, accounting for 59% of the variance in intentions to inquire about suicidal ideation and supporting the role of attitudes and perceived behavioral control in intentions to act. These intentions explained self-reported actual gatekeeper behaviors among participants who encountered someone in distress, with each one-point increase in intention associated with nearly twice the likelihood of both inquiring about suicidal ideation and referring someone for mental health care. On the other hand, self-reported situational barriers were associated with a decreased likelihood of referral behavior, indicating the role of actual behavioral control over volitional actions. Findings support the value of gatekeeper training for promoting factors that influence the likelihood of action on behalf of suicide prevention.

  3. Wildfire Prevention and Suppression plans enhancing: a first overview on strength and weakness in Italian stakeholders experiences and perception.

    Science.gov (United States)

    Bonora, Laura; Conese, Claudio; Barbati, Anna

    2014-05-01

    Fires and wildfires represent an element of vulnerability for forests, considering that have now reached a level beyond which further burning would seriously endanger the ecosystem services and their sustainable management. It is fundamental to support fire-fighting Centres by giving them tools, useful to faces future trends; in this sense the first step is to examine technical and operative procedures to evaluate their strong and weak aspects, in collaboration with personnel responsible of risk management, suppression coordination and patrol responsible of direct attack. The aims this work is to identify present elements of strength ad problematic aspects to tuning the wildfire suppression actions to future changes; this is a crucial challenge both for policy and territory planners and managers. Historical investigation lines on forest fire covered the basilar and fundamental dynamics which understanding was necessary to confine and fight the wildfire phenomenon. At the present all the competences, knowledge and connections acquired are translating and including in the Plans, sharing innovative strategies -with the "direct involved actors"- trying to decrease the fire trend. Stakeholders underlined that collaboration between research and territorial Institutions are producing positive results, showing the conceptual rightness and the well-run of the in-progress implementations. The Italian framework of wildfire prevention plans is very peculiar because the Plans related to prevention and active intervention procedure are coincident. Normative, procedural, economic and logistic aspects are considered and handled in the same general document; each year the local structures, designed by the Regions, have in charge the draft of the operative plan, defining and managing the means and patrols distribution and turnover. In the present work 3 Italian Regions (Tuscany, Puglia and Sardinia, with different territorial and vegetation characteristics and affected by different

  4. Preventing baby bottle tooth decay in American Indian and Alaska native communities: a model for planning.

    Science.gov (United States)

    Bruerd, B; Kinney, M B; Bothwell, E

    1989-01-01

    Baby bottle tooth decay (BBTD) is a preventable dental disease which surveys have shown affects more than 50 percent of Native American children. An experimental program to prevent BBTD was implemented in 12 Native American communities. The project represented a cooperative effort by three Department of Health and Human Service agencies: Administration for Children, Youth, and Families, Head Start Bureau; Indian Health Service, Dental Program; and Centers for Disease Control, Dental Disease Prevention Activity. Intervention strategies included the training of parent volunteers, health professionals, and the tribal employees who counseled caretakers of young children and made group presentations. There was also a media campaign in each community that ran for a 3-year period. Numerous educational materials were developed including training manuals, counseling booklets, tippee cups, posters, and bumper stickers. The BBTD project's planners encouraged tailoring the education materials and strategies to fit each community. Preliminary results documented statistically significant decreases in the prevalence of BBTD at the pilot sites. This multidisciplinary, comprehensive intervention offers a model for organizing members of minority communities to prevent health problems. Images p634-a p635-a p635-b PMID:2511598

  5. 40 CFR 112.11 - Spill Prevention, Control, and Countermeasure Plan requirements for offshore oil drilling...

    Science.gov (United States)

    2010-07-01

    ... POLLUTION PREVENTION Requirements for Petroleum Oils and Non-Petroleum Oils, Except Animal Fats and Oils and Greases, and Fish and Marine Mammal Oils; and Vegetable Oils (Including Oils from Seeds, Nuts, Fruits, and... equipped with dump valves which predominantly fail in the closed position and where pollution risk is high...

  6. 40 CFR 112.8 - Spill Prevention, Control, and Countermeasure Plan requirements for onshore facilities (excluding...

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Requirements for Petroleum Oils and Non-Petroleum Oils, Except Animal Fats and Oils and Greases, and Fish and Marine Mammal Oils; and Vegetable Oils (Including Oils from Seeds, Nuts, Fruits, and Kernels) § 112.8...

  7. Setting up Suicide Prevention Plans at the Local Level: The Methodology of Focus Groups with Stakeholders

    Science.gov (United States)

    Poma, Stefano Zanone; Grossi, Antonello; Venturini, Monica; Cristina, Contessa; Toniolo, Emanuele

    2011-01-01

    In the prevention of suicide, there is a need to transform clinical studies into health promotion by a cooperation with territorial agencies. A survey on a group of stakeholders was performed with the methodology of focus group. The evaluation criteria used by the participants were practical and not methodological and were closely linked to the…

  8. 75 FR 68272 - Approval and Promulgation of Implementation Plans; Kentucky: Prevention of Significant...

    Science.gov (United States)

    2010-11-05

    ... two changes impacting the Commonwealth of Kentucky's New Source Review (NSR) Prevention of Significant... revision. A. What are GHGs and their sources? A detailed explanation of GHGs, climate change and the impact... years old, as well as anthropogenic CO 2 emissions from land-use changes such as deforestation, perturb...

  9. Non-alcohol fatty liver disease in Asia: Prevention and planning.

    Science.gov (United States)

    Ashtari, Sara; Pourhoseingholi, Mohamad Amin; Zali, Mohamad Reza

    2015-07-08

    To review all of epidemiological aspects of non-alcoholic fatty liver disease (NAFLD) and also prevent this disease is examined. We conducted a systematic review according to the PRISMA guidelines. All searches for writing this review is based on the papers was found in PubMed (MEDLINE), Cochrane database and Scopus in August and September 2014 for topic of NAFLD in Asia and the way of prevention of this disease, with no language limitations. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. NAFLD is the most common liver disorder in worldwide, with an estimated with 20%-30% prevalence in Western countries and 2%-4% worldwide. The prevalence of NAFLD in Asia, depending on location (urban vs rural), gender, ethnicity, and age is variable between 15%-20%. According to the many studies in the world, the relationship between NAFLD, obesity, diabetes mellitus, and metabolic syndrome (MS) is quiet obvious. Prevalence of NAFLD in Asian countries seems to be lower than the Western countries but, it has increased recently due to the rise of obesity, type 2 diabetes and MS in this region. One of the main reasons for the increase in obesity, diabetes and MS in Asia is a lifestyle change and industrialization. Today, NAFLD is recognized as a major chronic liver disease in Asia. Therefore, prevention of this disease in Asian countries is very important and the best strategy for prevention and control of NAFLD is lifestyle modifications. Lifestyle modification programs are typically designed to change bad eating habits and increase physical activity that is associated with clinically significant improvements in obesity, type 2 diabetes and MS. Prevention of NAFLD is very important in Asian countries particularly in Arab countries because of high prevalence of obesity, diabetes and MS.

  10. Beam’s-eye-view dosimetrics (BEVD) guided rotational station parameter optimized radiation therapy (SPORT) planning based on reweighted total-variation minimization

    Science.gov (United States)

    Kim, Hojin; Li, Ruijiang; Lee, Rena; Xing, Lei

    2015-03-01

    Conventional VMAT optimizes aperture shapes and weights at uniformly sampled stations, which is a generalization of the concept of a control point. Recently, rotational station parameter optimized radiation therapy (SPORT) has been proposed to improve the plan quality by inserting beams to the regions that demand additional intensity modulations, thus formulating non-uniform beam sampling. This work presents a new rotational SPORT planning strategy based on reweighted total-variation (TV) minimization (min.), using beam’s-eye-view dosimetrics (BEVD) guided beam selection. The convex programming based reweighted TV min. assures the simplified fluence-map, which facilitates single-aperture selection at each station for single-arc delivery. For the rotational arc treatment planning and non-uniform beam angle setting, the mathematical model needs to be modified by additional penalty term describing the fluence-map similarity and by determination of appropriate angular weighting factors. The proposed algorithm with additional penalty term is capable of achieving more efficient and deliverable plans adaptive to the conventional VMAT and SPORT planning schemes by reducing the dose delivery time about 5 to 10 s in three clinical cases (one prostate and two head-and-neck (HN) cases with a single and multiple targets). The BEVD guided beam selection provides effective and yet easy calculating methodology to select angles for denser, non-uniform angular sampling in SPORT planning. Our BEVD guided SPORT treatment schemes improve the dose sparing to femoral heads in the prostate and brainstem, parotid glands and oral cavity in the two HN cases, where the mean dose reduction of those organs ranges from 0.5 to 2.5 Gy. Also, it increases the conformation number assessing the dose conformity to the target from 0.84, 0.75 and 0.74 to 0.86, 0.79 and 0.80 in the prostate and two HN cases, while preserving the delivery efficiency, relative to conventional single-arc VMAT plans.

  11. Beam’s-eye-view dosimetrics (BEVD) guided rotational station parameter optimized radiation therapy (SPORT) planning based on reweighted total-variation minimization

    International Nuclear Information System (INIS)

    Kim, Hojin; Li, Ruijiang; Xing, Lei; Lee, Rena

    2015-01-01

    Conventional VMAT optimizes aperture shapes and weights at uniformly sampled stations, which is a generalization of the concept of a control point. Recently, rotational station parameter optimized radiation therapy (SPORT) has been proposed to improve the plan quality by inserting beams to the regions that demand additional intensity modulations, thus formulating non-uniform beam sampling. This work presents a new rotational SPORT planning strategy based on reweighted total-variation (TV) minimization (min.), using beam’s-eye-view dosimetrics (BEVD) guided beam selection. The convex programming based reweighted TV min. assures the simplified fluence-map, which facilitates single-aperture selection at each station for single-arc delivery. For the rotational arc treatment planning and non-uniform beam angle setting, the mathematical model needs to be modified by additional penalty term describing the fluence-map similarity and by determination of appropriate angular weighting factors. The proposed algorithm with additional penalty term is capable of achieving more efficient and deliverable plans adaptive to the conventional VMAT and SPORT planning schemes by reducing the dose delivery time about 5 to 10 s in three clinical cases (one prostate and two head-and-neck (HN) cases with a single and multiple targets). The BEVD guided beam selection provides effective and yet easy calculating methodology to select angles for denser, non-uniform angular sampling in SPORT planning. Our BEVD guided SPORT treatment schemes improve the dose sparing to femoral heads in the prostate and brainstem, parotid glands and oral cavity in the two HN cases, where the mean dose reduction of those organs ranges from 0.5 to 2.5 Gy. Also, it increases the conformation number assessing the dose conformity to the target from 0.84, 0.75 and 0.74 to 0.86, 0.79 and 0.80 in the prostate and two HN cases, while preserving the delivery efficiency, relative to conventional single-arc VMAT plans

  12. Use of Geographic Information Systems for Planning HIV Prevention Interventions for High-Risk Youths

    Science.gov (United States)

    Geanuracos, Catherine G.; Cunningham, Shayna D.; Weiss, George; Forte, Draco; Henry Reid, Lisa M.; Ellen, Jonathan M.

    2007-01-01

    Geographic information system (GIS) analysis is an emerging tool for public health intervention planning. Connect to Protect, a researcher–community collaboration working in 15 cities to reduce HIV infection among youths, developed GIS databases of local health, crime, and demographic data to evaluate the geographic epidemiology of sexually transmitted infections and HIV risk among adolescents. We describe the process and problems of data acquisition, analysis, and mapping in the development of structural interventions, demonstrating how program planners can use this technology to inform and improve planning decisions. The Connect to Protect project’s experience suggests strategies for incorporating public data and GIS technology into the next generation of public health interventions. PMID:17901452

  13. Reproductive justice & preventable deaths: State funding, family planning, abortion, and infant mortality, US 1980–2010

    Directory of Open Access Journals (Sweden)

    Nancy Krieger

    2016-12-01

    Full Text Available Introduction: Little current research examines associations between infant mortality and US states’ funding for family planning services and for abortion, despite growing efforts to restrict reproductive rights and services and documented associations between unintended pregnancy and infant mortality. Material and methods: We obtained publicly available data on state-only public funding for family planning and abortion services (years available: 1980, 1987, 1994, 2001, 2006, and 2010 and corresponding annual data on US county infant death rates. We modeled the funding as both fraction of state expenditures and per capita spending (per woman, age 15–44. State-level covariates comprised: Title X and Medicaid per capita funding, fertility rate, and percent of counties with no abortion services; county-level covariates were: median family income, and percent: black infants, adults without a high school education, urban, and female labor force participation. We used Possion log-linear models for: (1 repeat cross-sectional analyses, with random state and county effects; and (2 panel analysis, with fixed state effects. Results: Four findings were robust to analytic approach. First, since 2000, the rate ratio for infant death comparing states in the top funding quartile vs. no funding for abortion services ranged (in models including all covariates between 0.94 and 0.98 (95% confidence intervals excluding 1, except for the 2001 cross-sectional analysis, whose upper bound equaled 1, yielding an average 15% reduction in risk (range: 8–22%. Second, a similar risk reduction for state per capita funding for family planning services occurred in 1994. Third, the excess risk associated with lower county income increased over time, and fourth, remained persistently high for counties with a high percent of black infants. Conclusions: Insofar as reducing infant mortality is a government priority, our data underscore the need, despite heightened contention

  14. Legionellosis prevention in building water and HVAC systems a practical guide for design, operation and maintenance to minimize the risk

    CERN Document Server

    Joppolo, Cesare Maria; Pitera, Luca Alberto; Angermann, Jean Pierre; Izard, Mark

    2013-01-01

    This Guidebook is a practical guide for design, operation and maintenance to minimize the risk of legionellosis in building water and HVAC systmes. It is devided into several themes such as: Air conditioning of the air (by water – humidification), Production of hot water for washing (fundamentally but not only hot water for washing) and Evaporative cooling tower.

  15. Corrosion Prevention and Control Planning Guidebook for Military Systems and Equipment

    Science.gov (United States)

    2014-04-02

    Sacrificial coatings (e.g., galvanizing)  Surface modification (e.g., weld overlays , electro-plating)  Sealants (e.g., wet installed fasteners...operational environment should be avoided. Consider compatibility when using multiple materials. If dissimilar materials cannot be avoided, isolate those... Dissimilar Metals.  MIL-HDBK-1568, Military Handbook: Materials and Processes for Corrosion Prevention and Control in Aerospace Weapons Systems (18 July

  16. RESPONSE PROTOCOL TOOLBOX: PLANNING FOR AND RESPONDING TO DRINKING WATER CONTAMINATION THREATS AND INCIDENTS. MODULE 1: WATER UTILITIES PLANNING GUIDE - INTERIM FINAL - DECEMBER 2003

    Science.gov (United States)

    The interim final Response Protocol Toolbox: Planning for and Responding to Contamination Threats to Drinking Water Systems is designed to help the water sector effectively and appropriately respond to intentional contamination threats and incidents. It was produced by EPA, buil...

  17. International tax planning & prevention of abuse under domestic tax law, tax treaties & EC-law

    OpenAIRE

    De Broe, Luc

    2007-01-01

    PART ONE:THE USE OF CONDUIT & BASE COMPANIES IN INTERNATIONAL TAX PLANNING 1 1. CONDUIT COMPANIES 1 1.1. Treaty shopping 1 1.1.1. Description of the term “Treaty shopping” in relation to conduit companies 1 1.1.2. Basic features of “Treaty Shopping” in relation to conduit companies 6 1.1.2.1. Form of the conduit: company or partnership ? 6 1.1.2.2. Tax considerations in setting up the conduit 8 1.2. Directive shopping 11 1.2.1. Description of the term ...

  18. Prevenir y Combatir El Acoso en La Escuela: Guia de Recursoso para Educadores de los Grados "K" al Grado "12" (Preventing and Countering School-Based Harassment: A Resource Guide for K-12 Educators).

    Science.gov (United States)

    Steineger, Melissa

    This guide focuses on the issue of school-based harassment. It is intended to help educators prevent or curtail all forms of harassment by highlighting school-based harassment issues, by describing remedies and prevention strategies, and by providing additional resources. It details some of the problems school-based harassment engenders, and it…

  19. 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

    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...

  20. Orientation to pollution prevention for facility design

    Energy Technology Data Exchange (ETDEWEB)

    Raney, E.A.; Whitehead, J.K.; Encke, D.B. [Westinghouse Hanford Co., Richland, WA (United States); Dorsey, J.A. [Kaiser Engineers Hanford Co., Richland, WA (United States)

    1994-01-01

    This material was developed to assist engineers in incorporating pollution prevention into the design of new or modified facilities within the U.S. Department of Energy (DOE). The material demonstrates how the design of a facility can affect the generation of waste throughout a facility`s entire life and it offers guidance on how to prevent the generation of waste during design. Contents include: Orientation to pollution prevention for facility design training course booklet; Pollution prevention design guideline; Orientation to pollution prevention for facility design lesson plan; Training participant survey and pretest; and Training facilitator`s guide and schedule.

  1. SU-F-T-29: The Important of Each Fraction Image-Guided Planning for Postoperative HDR-Brachytherapy in Endometrial Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Piriyasang, D; Pattaranutaporn, P; Manokhoon, K [Ramathibodi Hospital, Rachatewi, Bangkok (Thailand)

    2016-06-15

    Purpose: Cylindrical applicators are often used for postoperative HDRbrachytherapy in endometrial carcinoma. It has been considered that dosimetric variation between fractions for this treatment is minimal and might not be necessary to perform treatment planning for every fractions. At our institute, it is traditional to perform treatment planning with CT simulation on the first fraction and uses this plan for the rest of treatment. This study was aim to evaluate the errors of critical structure doses between the fractions when simulation and planning were done for first fraction only. Methods: Treatment plans of 10 endometrial carcinoma patients who received postoperative HDR-brachytherapy and underwent CT-simulation for every HDR-fractions at our department were retrospectively reviewed. All of these patients were treated with cylindrical applicator and prescribed dose 15Gy in 3 fractions to 0.5cm from vaginal surface. The treatment plan from the first fraction was used to simulate in second and third CT-simulation. Radiation dose for critical structures in term of Dose-to-2cc (D2cc) were evaluated and compared between planning CT. Results: The D2cc for bladder and rectum were evaluated. For bladder, the mean error of D2cc estimation for second and third fractions was 7.6% (0.1–20.1%, SD=5.7). And the mean error for D2cc of rectum was 8.5% (0.1–29.4%, SD=8.5). Conclusion: The critical structure doses could be significant difference between fractions which may affects treatment outcomes or toxicities. From our data, image-guided brachytherapy at least with CT-Simulation should be done for every treatment fractions.

  2. Participation of Students from Under-Represented Groups in Gifted Programs. A Planning Guide To Implement Gifted Rule 6A-6.03019, FAC, As Revised on 9-12-91.

    Science.gov (United States)

    Florida State Dept. of Education, Tallahassee. Bureau of Education for Exceptional Students.

    This planning guide is intended to facilitate flexibility in meeting the needs of under-represented groups in Florida programs for gifted students. An introduction defines these students (racial or ethnic minorities, limited English proficient, or from a low socioeconomic background), lists the required components of a district plan for increasing…

  3. 78 FR 75843 - Pacific Halibut Fisheries; Catch Sharing Plan for Guided Sport and Commercial Fisheries in Alaska

    Science.gov (United States)

    2013-12-12

    ... management measures has been around March 15. Thus, the period between the February 1 opening of the sport... 1 opening for the sport fishing season. However, implementation of the annual management measures in... annual allocations and guided sport catch limits are adopted by the Commission as annual management...

  4. Institutional Effectiveness Manual: A Practitioner's Guide to Planning and Assessment for Sante Fe Community College. First Edition.

    Science.gov (United States)

    Santa Fe Community Coll., Gainesville, FL. Office of Institutional Research and Planning.

    Santa Fe Community College (Florida) published this guide as a means of addressing the 1983 and 1984 U.S. Department of Education reports that called for a "renaissance in higher education in America." This manual aims to define institutional effectiveness for the college, with the quality of student learning as the major focus. It also…

  5. Energy efficiency and urbanism: Guide for urbanism planning energetically efficiency; Eficiencia energetica y urbanismo: Guia del planeamiento urbanistico energeticamente eficiente

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The present book summarizes the urbanism in the context of energy efficiency. the book has 4 chapters and 3 annexes: The energy in the context of substantiality, the soil planning, recommendations for the urbanism planning with substantiality criteria and small description URBE project.

  6. Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

    Directory of Open Access Journals (Sweden)

    Hilliard S

    2014-12-01

    Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

  7. Clinical Informatics and Its Usefulness for Assessing Risk and Preventing Falls and Pressure Ulcers in Nursing Home Environments

    National Research Council Canada - National Science Library

    Teigland, Christie; Gardiner, Richard; Li, Hailing; Byrne, Colene

    2005-01-01

    .... It does so by providing timely Web-based reports alerting staff to the likelihood of an adverse outcome, along with individualized resident risk profiles to guide preventive care plan development...

  8. Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation

    Directory of Open Access Journals (Sweden)

    Ramin Jaberi

    2017-12-01

    Full Text Available Purpose : Intra-fractional organs at risk (OARs deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT. The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods : Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. Results : A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in ‘organs-applicators’, while maintaining target dose at the original level. Conclusions : There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients’ plans to be able to serve as a clinical tool.

  9. The risks of liability for former mine operators: the implementation of a plan for preventing legal risks

    International Nuclear Information System (INIS)

    Martinet, Y.

    2004-01-01

    Shutting down mines has 'mechanically' increased the risks of cave-ins. The local (communal and/or departmental) administrations responsible for supervising the situation do not necessarily have the means for managing shafts and tunnels. For this reason, two acts were passed in 1994 and 1999 to reform how mines are managed after shutdowns. Managing post-mining operations has spawned lawsuits against former operators, even though they shut down their mines in compliance with the laws and regulations in force at the time. By virtue of these two acts, administrative authorities are now trying to make the former operators fill in shafts and tunnels. Moreover, individuals often try to obtain compensation for the damages caused by shut-down mines. This situation causes uncertainty for various parties; and the legal settlements being proposed are not sufficiently clear. Information is provided for thinking about how to implement a 'legal risk prevention plan', which former mine operators should bear in mind. (author)

  10. Prevention of Major Accident Hazards (MAHs) in major Hazard Installation (MHI) premises via land use planning (LUP): a review

    Science.gov (United States)

    Khudbiddin, M. Q.; Rashid, Z. A.; Yeong, A. F. M. S.; Alias, A. B.; Irfan, M. F.; Fuad, M.; Hayati, H.

    2018-03-01

    For a number of years, there is a concern about the causes of major hazards, their identification, risk assessment and the process of its management from the global perspective on the activities of the industries due to the protection of the environment, human and property. Though, industries cannot take pleasure in their business by harming the nature of the land, there are a number of measures that need to be put into consideration by the industries. Such measures are in terms of management and safety for the businesses, lives, properties, as well as the environment. The lack of consideration in the selected appropriate criteria can result in major accidental hazards (MAHs). This paper will review the land use planning (LUP) methods used in the past and present to prevent major accident hazards at major hazard installation (MHI).

  11. Preventing Halloween arson in an urban setting: a model for multisectoral planning and community participation.

    Science.gov (United States)

    Maciak, B J; Moore, M T; Leviton, L C; Guinan, M E

    1998-04-01

    Arson is a violent crime and a public health problem that causes injuries and deaths, destroys homes, and destabilizes neighborhoods. During the late 1970s, pre-Halloween pranks in Detroit, Michigan, turned destructive when hundreds of fires were set deliberately throughout the city; in 1984, a record of 810 fires were set during the Halloween period. In 1985, a city wide anti-arson campaign that involved the mobilization and training of thousands of community volunteers was begun in Detroit. This report describes the multiple components of the anti-arson intervention from 1985 through 1996 and changes in the incidence of Halloween fires. Both the decrease in annual Halloween arson fires after the intervention began and the inverse relationship between the number of volunteers and the number of fires suggest a causal effect. This study illustrates the capacity of an urban community to mobilize its residents and stakeholders, the importance of community participation and multisectoral partnerships in program planning and implementation, and the challenges faced in retrospectively evaluating an apparently successful, complex, community-based intervention.

  12. Tuning a High Transmission Ion Guide to Prevent Gas-Phase Proton Exchange During H/D Exchange MS Analysis

    Science.gov (United States)

    Guttman, Miklos; Wales, Thomas E.; Whittington, Dale; Engen, John R.; Brown, Jeffery M.; Lee, Kelly K.

    2016-04-01

    Hydrogen/deuterium exchange (HDX) mass spectrometry (MS) for protein structural analysis has been adopted for many purposes, including biopharmaceutical development. One of the benefits of examining amide proton exchange by mass spectrometry is that it can readily resolve different exchange regimes, as evidenced by either binomial or bimodal isotope patterns. By careful analysis of the isotope pattern during exchange, more insight can be obtained on protein behavior in solution. However, one must be sure that any observed bimodal isotope patterns are not artifacts of analysis and are reflective of the true behavior in solution. Sample carryover and certain stationary phases are known as potential sources of bimodal artifacts. Here, we describe an additional undocumented source of deuterium loss resulting in artificial bimodal patterns for certain highly charged peptides. We demonstrate that this phenomenon is predominantly due to gas-phase proton exchange between peptides and bulk solvent within the initial stages of high-transmission conjoined ion guides. Minor adjustments of the ion guide settings, as reported here, eliminate the phenomenon without sacrificing signal intensity. Such gas-phase deuterium loss should be appreciated for all HDX-MS studies using such ion optics, even for routine studies not focused on interpreting bimodal spectra.

  13. Economic perspective on strategic human capital management and planning for the Centers for Disease Control and Prevention.

    Science.gov (United States)

    Roy, Kakoli; Chen, Zhuo Adam; Crawford, Carol A Gotway

    2009-11-01

    An organization's workforce--or human capital--is its most valuable asset. The 2002 President's Management Agenda emphasizes the importance of strategic human capital management by requiring all federal agencies to improve performance by enhancing personnel and compensation systems. In response to these directives, the Centers for Disease Control and Prevention (CDC) drafted its strategic human capital management plan to ensure that it is aligned strategically to support the agency's mission and its health protection goals. In this article, we explore the personnel economics literature to draw lessons from research studies that can help CDC enhance its human capital management and planning. To do so, we focus on topics that are of practical importance and empirical relevance to CDC's internal workforce and personnel needs with an emphasis on identifying promising research issues or methodological approaches. The personnel economics literature is rich with theoretically sound and empirically rigorous approaches for shaping an evidence-based approach to human capital management that can enhance incentives to attract, retain, and motivate a talented federal public health workforce, thereby promoting the culture of high-performance government.

  14. Application of Theory of Planned Behavior to Improve Obesity-Preventive Lifestyle among Students: A School-based Interventional Study

    Directory of Open Access Journals (Sweden)

    Alireza Didarloo

    2017-11-01

    Full Text Available Background: Obesity is regarded as the epidemic of diseases correlated with an unhealthy lifestyle. The avoidance of inactivity could prevent obesity and its relevant issues. The present study aimed to explore the effectiveness of the theory of planned behavior (TPB to improve obesity-preventive lifestyle among Iranian students. Materials and Methods: The current study was a quasi-experimental study. Using multistage sampling, 100 Junior High-school students in Khoy, Iran in 2016 were selected and assigned to two groups, namely intervention (n=50 and control (n=50. To collect the study data, researchers utilized a researcher-made questionnaire including items about demographic information and TPB constructs such as attitudes, subjective norms, perceived behavioral control (PBC, behavioral intention, and behaviors related to physical activities, television watching, and computer-game playing. The data were analyzed using SPSS software version 20.0. Results: The mean age of the intervention group was 13.88 ± 0.79 and that of the control group was 14.12 ± 0.77 years. Prior to the intervention, there was no significant difference between the two groups in the mean of the scores of both the TPB constructs and their health performances. However, three months after the intervention, the mean score of attitudes, subjective norms, perceived behavioral control and behavior of students changed, and all these changes were statistically significant between two groups (p

  15. Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (the SToP-BPD study): statistical analysis plan.

    Science.gov (United States)

    Onland, Wes; Merkus, Maruschka P; Nuytemans, Debbie H; Jansen-van der Weide, Marijke C; Holman, Rebecca; van Kaam, Anton H

    2018-03-09

    Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth with short-term and long-term adverse consequences. Although the glucocorticoid dexamethasone has been proven to be beneficial for the prevention of BPD, there are concerns about an increased risk of adverse neurodevelopmental outcome. Hydrocortisone has been suggested as an alternative therapy. The aim of the Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (SToP-BPD) trial is to assess the efficacy and safety of postnatal hydrocortisone administration for the reduction of death or BPD in ventilator-dependent preterm infants. The SToP-BPD study is a multicentre, double-blind, placebo-controlled hydrocortisone trial in preterm infants at risk for BPD. After parental informed consent is obtained, ventilator-dependent infants are randomly allocated to hydrocortisone or placebo treatment during a 22-day period. The primary outcome measure is the composite outcome of death or BPD at 36 weeks postmenstrual age. Secondary outcomes are short-term effects on pulmonary condition and long-term neurodevelopmental sequelae assessed at 2 years corrected age. Complications of treatment, other serious adverse events and suspected unexpected serious adverse reactions are reported as safety outcomes. This pre-specified statistical analysis plan was written and submitted without knowledge of the unblinded data. Netherlands Trial Register, NTR2768 . Registered on 17 February 2011. EudraCT, 2010-023777-19. Registered on 2 November 2010.

  16. A Knowledge-Based System For Analysis, Intervention Planning and Prevention of Defects in Immovable Cultural Heritage Objects and Monuments

    Science.gov (United States)

    Valach, J.; Cacciotti, R.; Kuneš, P.; ČerÅanský, M.; Bláha, J.

    2012-04-01

    The paper presents a project aiming to develop a knowledge-based system for documentation and analysis of defects of cultural heritage objects and monuments. The MONDIS information system concentrates knowledge on damage of immovable structures due to various causes, and preventive/remedial actions performed to protect/repair them, where possible. The currently built system is to provide for understanding of causal relationships between a defect, materials, external load, and environment of built object. Foundation for the knowledge-based system will be the systemized and formalized knowledge on defects and their mitigation acquired in the process of analysis of a representative set of cases documented in the past. On the basis of design comparability, used technologies, materials and the nature of the external forces and surroundings, the developed software system has the capacity to indicate the most likely risks of new defect occurrence or the extension of the existing ones. The system will also allow for a comparison of the actual failure with similar cases documented and will propose a suitable technical intervention plan. The system will provide conservationists, administrators and owners of historical objects with a toolkit for defect documentation for their objects. Also, advanced artificial intelligence methods will offer accumulated knowledge to users and will also enable them to get oriented in relevant techniques of preventive interventions and reconstructions based on similarity with their case.

  17. STD/HIV prevention in Turkey: planning a sequence of interventions.

    Science.gov (United States)

    Aral, S O; Fransen, L

    1995-12-01

    This study was initiated to assess which mix of early STD/HIV prevention interventions would potentially be effective, cost-effective and sustainable in Turkey; and to program an intervention sequence to maximize synergy among the interventions. During rapid assessment we: 1) reviewed past issues of 3 leading newspapers; 2) collected information on TV coverage; 3) interviewed key informants including taxicab drivers, hotel employees, grocery store owners, academicians in public health and law, investigators of STD/HIV and reproductive tract infections, and officials in the ministry of health; 4) reviewed available evidence on STD/HIV morbidity, sexual behavior patterns, migration patterns and same/opposite gender sex trade. We found: 1) discrepancies between decision makers' perceptions and social realities with respect to the epidemiology of sexual behavior and STDs, and the state of public health programs; 2) discrepancies between sexual practices and public expression regarding sexual practices; 3) economic, demographic, and political pressures in Turkey and in surrounding countries for the expansion of prostitution; 4) a sexual double standard and gender specific migration patterns which sustain a high demand for commercial sex; 5) patterns of health care seeking behaviors and provision of STD clinical services which indicate other STDs may play a very important role in spread of HIV infection; 6) an important mass media role in opinion formation; 7) consensual denial of risk for the majority based on beliefs embedded in machismo, nationalism and religion, and a resulting marginalization and externalization of STD/HIV risk; 8) high prevalence of syphilis among both Turkish and immigrant female prostitutes in Istanbul (early latent 8 and 13%; late latent 0 and 4%; previous history 9 and 22%) 9) and high rates of syphilis among male prostitutes (early latent 11%, late latent 21% and previous history 58%). We concluded that interventions should initially include

  18. Rehabilitation of a dentate mandible requiring a full arch rehabilitation. Immediate loading of a fixed complete denture on 8 implants placed with a bone-supported surgical computer-planned guide: a case report.

    Science.gov (United States)

    Amorfini, Leonardo; Storelli, Stefano; Romeo, Eugenio

    2011-03-01

    The use of technologies that merge computerized tomography X-ray imaging and 3-dimensional (3D) planning software allow the surgeon to digitally elaborate on the computer the position, length, and diameter of every implant to be placed. Following this approach, the placement is guided in a 3D digital model, and the implants are placed in the final position avoiding eventual anatomic structures. In this case report, the patient's remaining mandibular teeth were extracted, and the patient received 8 implants with the help of a computer surgical guide. The case was planned using SimPlant and a bone-supported guide. Because of the high precision of the planning, it was possible to realize a provisional rehabilitation before the actual surgery. The planning allows placement of parallel implants to optimize the prosthetic procedure and outcome. An immediate provisional implant was fixed with a flow composite on the temporary abutments and then refined in the dental laboratory. The patient received the provisional rehabilitation the same day of the surgery. After 6 weeks of healing, the final impression was taken and the prosthesis was finalized with a computer-aided design/computer-aided manufacturing titanium full-arch screwed framework with composite veneering. A 6-month follow-up showed good integration of the prostheses and success of all 8 implants. The use of surgical computer-guided planning changes the surgeon's approach: whereas before the use of conventional guides permitted a certain degree of offset from what was planned, the use of computer guides allows the implant to be inserted in a far more precise way. It is obvious that careful planning is the key factor to avoid implant misplacement.

  19. The Effect of Sensory Uncertainty Due to Amblyopia (Lazy Eye) on the Planning and Execution of Visually-Guided 3D Reaching Movements

    Science.gov (United States)

    Niechwiej-Szwedo, Ewa; Goltz, Herbert C.; Chandrakumar, Manokaraananthan; Wong, Agnes M. F.

    2012-01-01

    Background Impairment of spatiotemporal visual processing in amblyopia has been studied extensively, but its effects on visuomotor tasks have rarely been examined. Here, we investigate how visual deficits in amblyopia affect motor planning and online control of visually-guided, unconstrained reaching movements. Methods Thirteen patients with mild amblyopia, 13 with severe amblyopia and 13 visually-normal participants were recruited. Participants reached and touched a visual target during binocular and monocular viewing. Motor planning was assessed by examining spatial variability of the trajectory at 50–100 ms after movement onset. Online control was assessed by examining the endpoint variability and by calculating the coefficient of determination (R2) which correlates the spatial position of the limb during the movement to endpoint position. Results Patients with amblyopia had reduced precision of the motor plan in all viewing conditions as evidenced by increased variability of the reach early in the trajectory. Endpoint precision was comparable between patients with mild amblyopia and control participants. Patients with severe amblyopia had reduced endpoint precision along azimuth and elevation during amblyopic eye viewing only, and along the depth axis in all viewing conditions. In addition, they had significantly higher R2 values at 70% of movement time along the elevation and depth axes during amblyopic eye viewing. Conclusion Sensory uncertainty due to amblyopia leads to reduced precision of the motor plan. The ability to implement online corrections depends on the severity of the visual deficit, viewing condition, and the axis of the reaching movement. Patients with mild amblyopia used online control effectively to compensate for the reduced precision of the motor plan. In contrast, patients with severe amblyopia were not able to use online control as effectively to amend the limb trajectory especially along the depth axis, which could be due to their

  20. Usefulness of lung impedance-guided pre-emptive therapy to prevent pulmonary edema during ST-elevation myocardial infarction and to improve long-term outcomes.

    Science.gov (United States)

    Shochat, Michael; Shotan, Avraham; Blondheim, David S; Kazatsker, Mark; Dahan, Iris; Asif, Aya; Shochat, Ilia; Rabinovich, Paul; Rozenman, Yoseph; Meisel, Simcha R

    2012-07-15

    Patients sustaining an ST-segment elevation myocardial infarction (STEMI) frequently develop pulmonary congestion or pulmonary edema (PED). We previously showed that lung impedance (LI) threshold decrease of 12% to 14% from baseline during admission for STEMI marks the onset of the transition zone from interstitial to alveolar edema and predicts evolution to PED with 98% probability. The aim of this study was to prove that pre-emptive LI-guided treatment may prevent PED and improve clinical outcomes. Five hundred sixty patients with STEMI and no signs of heart failure underwent LI monitoring for 84 ± 36 hours. Maximal LI decrease throughout monitoring did not exceed 12% in 347 patients who did not develop PED (group 1). In 213 patients LI reached the threshold level and, although still asymptomatic (Killip class I), these patients were then randomized to conventional (group 2, n = 142) or LI-guided (group 3, n = 71) pre-emptive therapy. In group 3, treatment was initiated at randomization (LI = -13.8 ± 0.6%). In contrast, conventionally treated patients (group 2) were treated only at onset of dyspnea occurring 4.1 ± 3.1 hours after randomization (LI = -25.8 ± 4.3%, p <0.001). All patients in group 2 but only 8 patients in group 3 (11%) developed Killip class II to IV PED (p <0.001). Unadjusted hospital mortality, length of stay, 1-year readmission rate, 6-year mortality, and new-onset heart failure occurred less in group 3 (p <0.001). Multivariate analysis adjusted for age, left ventricular ejection fraction, risk factors, peak creatine kinase, and admission creatinine and hemoglobin levels showed improved clinical outcome in group 3 (p <0.001). In conclusion, LI-guided pre-emptive therapy in patients with STEMI decreases the incidence of in-hospital PED and results in better short- and long-term outcomes. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Guide: Monitoring Programme for unannounced inspections undertaken against the National Standards for the Prevention and Control of Healthcare Associated Infections

    LENUS (Irish Health Repository)

    Kabir, Zubair

    2007-01-01

    BACKGROUND: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)). METHODS: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD. RESULTS: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland. Overall smoking prevalence declined by 14% between 1985 and 2000, resulting in about 685 fewer deaths (minimum estimate 330, maximum estimate 1,285) attributable to smoking cessation: about 275 in healthy people and 410 in known CHD patients. Population total cholesterol concentrations fell by 4.6%, resulting in approximately 1,300 (minimum estimate 1,115, maximum estimate 1,660) fewer deaths attributable to dietary changes(1,185 in healthy people and 115 in CHD patients) plus 305 fewer deaths attributable to statin treatment (45 in people without CHD and 260 in CHD patients). Mean population diastolic blood pressure fell by 7.2%, resulting in approximately 170 (minimum estimate 105, maximum estimate 300) fewer deaths attributable to secular falls in blood pressure (140 in healthy people and 30 in CHD patients), plus approximately 70 fewer deaths attributable to antihypertensive treatments in people without CHD. Of all the deaths attributable to risk factor falls, some 1,715 (68%) occurred in people without recognized CHD and 815(32%) in CHD patients. CONCLUSION: Compared with secondary prevention, primary prevention achieved a two-fold larger reduction in CHD deaths. Future national CHD policies should therefore prioritize nationwide interventions to promote healthy diets and reduce smoking.

  2. An image-guided system for optimized volumetric treatment planning and execution for radiofrequency ablation of liver tumors

    International Nuclear Information System (INIS)

    Banovac, F.; Popa, T.; Cheng, P.; Cleary, K.; Abeledo, H.; Campos-Nanez, E.; Wood, B.J.

    2007-01-01

    Radiofrequency ablation of liver tumors is becoming an increasingly popular option for the treatment of cancer. However, the procedure has several technical challenges, mostly associated with precision targeting of the tumor and ensuring complete ablation coverage. In this paper we describe an image-guided system that we are developing for improved visualization and probe placement during these procedures. The system will include a pre-procedure optimization module and an intra-procedure guidance component. The system concept is explained and some preliminary results are given. While this system is designed for radiofrequency ablation of liver tumors, the methods are applicable to other organs and treatment methods. (orig.)

  3. Le problème du mal dans le Guide des Perplexes et son arrière-plan talmudique

    Directory of Open Access Journals (Sweden)

    Costa, José

    2010-12-01

    Full Text Available At first sight, the question of evil is regarded in the Guide for the Perplexed in a paradoxical manner. Thus, in Guide I, 2, Maimonides examines the notions of good and evil as subjective evaluations possessing neither the rigour not the exactness of the notions of true and false. However, the question of evil occupies an essential place in the Guide, as various modern authors have shown. This question is important to Maimonides because he is, in this respect, the heir of the rabbinic tradition and his conception of evil is largely based on an interaction with the Talmudic and Midrašic texts. Therefore, we would like to review thirty-nine rabbinic ‘quotes’ which appear in chapters 8 to 24 in the third part of the Guide and deal with the origin of evil, the meaning of suffering and the evil inclination. Maimonides reappropriates the midrašim that are susceptible of being in agreement with his rationalist positions and also quotes some rabbinic traditions that are too close to mu ͑tazilism, undoubtedly aware of the more profound resemblance that exists between the rabbinic and mu ͑tazilite doctrines of evil and retribution.A primera vista, el problema del mal es abordado en la Guía de Perplejos de manera paradójica. Para Maimónides, las nociones de bien y mal son subjetivas y no resultan ni rigorosas ni exactas, a la inversa de las nociones de verdad y falsedad (Guía I, 2. Sin embargo, el problema del mal es muy importante en la Guía, como lo demostraran varios autores. Maimónides es el heredero de la tradición rabínica y existe en la Guía una interacción entre la filosofia de Maimónides y los textos talmúdicos y midrásicos. Es particularmente el caso de las treinta y nueve citas rabínicas de la Guía II, 8-24, que tratan del origen del mal, del significado del sufrimiento y de la inclinación al mal. Maimónides cita los midrašim que concuerdan con sus posiciones racionalistas y evoca también algunas tradiciones rab

  4. Effect of a web-based guided self-help intervention for prevention of major depression in adults with subthreshold depression

    DEFF Research Database (Denmark)

    Buntrock, C.; Ebert, D. D.; Lehr, D.

    2016-01-01

    -employee contributions). Participants included 406 self-selected adults with subthreshold depression (Centre for Epidemiologic Studies Depression Scale score≥16, no current MDD according to Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition, Text Revision] criteria). INTERVENTIONS All participants had...... AND MEASURES The primary outcome was time to onset of MDD in the intervention group relative to the control group over a 12-month follow-up period as assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6-and 12-month follow......Importance Evidence-based treatments for major depressive disorder (MDD) are not very successful in improving functional and health outcomes. Attention has increasingly been focused on the prevention of MDD. OBJECTIVE To evaluate the effectiveness of a web-based guided self-help intervention...

  5. Treatment of Brodie's Syndrome using parasymphyseal distraction through virtual surgical planning and RP assisted customized surgical osteotomy guide-A mock surgery report

    Science.gov (United States)

    Dahake, Sandeep; Kuthe, Abhaykumar; Mawale, Mahesh

    2017-10-01

    This paper aims to describe virtual surgical planning (VSP), computer aided design (CAD) and rapid prototyping (RP) systems for the preoperative planning of accurate treatment of the Brodie's Syndrome. 3D models of the patient's maxilla and mandible were separately generated based on computed tomography (CT) image data and fabricated using RP. During the customized surgical osteotmy guide (CSOG) design process, the correct position was identified and the geometry of the CSOG was generated based on affected mandible of the patient and fabricated by a RP technique. Surgical approach such as preoperative planning and simulation of surgical procedures was performed using advanced software. The VSP and RP assisted CSOG was used to avoid the damage of the adjacent teeth and neighboring healthy tissues. Finally the mock surgery was performed on the biomodel (i.e. diseased RP model) of mandible with reference to the normal maxilla using osteotomy bur with the help of CSOG. Using this CSOG the exact osteotomy of the mandible and the accurate placement of the distractor were obtained. It ultimately improved the accuracy of the surgery in context of the osteotomy and distraction. The time required in cutting the mandible and placement of the distractor was found comparatively less than the regular free hand surgery.

  6. Poster — Thur Eve — 69: Computational Study of DVH-guided Cancer Treatment Planning Optimization Methods

    International Nuclear Information System (INIS)

    Ghomi, Pooyan Shirvani; Zinchenko, Yuriy

    2014-01-01

    Purpose: To compare methods to incorporate the Dose Volume Histogram (DVH) curves into the treatment planning optimization. Method: The performance of three methods, namely, the conventional Mixed Integer Programming (MIP) model, a convex moment-based constrained optimization approach, and an unconstrained convex moment-based penalty approach, is compared using anonymized data of a prostate cancer patient. Three plans we generated using the corresponding optimization models. Four Organs at Risk (OARs) and one Tumor were involved in the treatment planning. The OARs and Tumor were discretized into total of 50,221 voxels. The number of beamlets was 943. We used commercially available optimization software Gurobi and Matlab to solve the models. Plan comparison was done by recording the model runtime followed by visual inspection of the resulting dose volume histograms. Conclusion: We demonstrate the effectiveness of the moment-based approaches to replicate the set of prescribed DVH curves. The unconstrained convex moment-based penalty approach is concluded to have the greatest potential to reduce the computational effort and holds a promise of substantial computational speed up

  7. Strategic Planning Information Online: A Step-by-Step Guide through Major Checkpoints. . . What Database to Use When.

    Science.gov (United States)

    Marsh, Sharon G.

    1984-01-01

    This article concentrates on the use of online searching to provide information needed by business for strategy formulation. The following steps are explained: environment analysis (structural analysis, trend analysis); business analysis; strategy formulation; strategic anticipation; strategic plan formalization; and implementation and control.…

  8. 78 FR 39121 - Pacific Halibut Fisheries; Catch Sharing Plan for Guided Sport and Commercial Fisheries in Alaska

    Science.gov (United States)

    2013-06-28

    ... Alaska). If approved, this catch sharing plan will replace the Guideline Harvest Level program, define an... necessary to achieve the halibut fishery management goals of the North Pacific Fishery Management Council.... SUPPLEMENTARY INFORMATION: Table of Contents I. Current Management of the Halibut Fisheries A. Regulatory...

  9. TH-AB-BRA-04: Dosimetric Evaluation of MR-Guided HDR Brachytherapy Planning for Cervical Cancer

    International Nuclear Information System (INIS)

    Kamio, Y; Barkati, M; Beliveau-Nadeau, D

    2016-01-01

    Purpose: To perform a retrospective study on 16 patients that had both CT and T2-weighted MR scans done at first fraction using the Utrecht CT/MR applicator (Elekta Brachytherapy) in order to evaluate uncertainties associated with an MR-only planning workflow. Methods: MR-workflow uncertainties were classified in three categories: reconstruction, registration and contouring. A systematic comparison of the CT and MR contouring, manual reconstruction and optimization process was performed to evaluate the impact of these uncertainties on the recommended GEC ESTRO DVH parameters: D90% and V100% for HR-CTV as well as D2cc for bladder, rectum, sigmoid colon and small bowel. This comparison was done using the following four steps: 1. Catheter reconstruction done on MR images with original CT-plan contours and dwell times. 2. OAR contours adjusted on MR images with original CT-plan reconstruction and dwell times. 3. Both reconstruction and contours done on MR images with original CT-plan dwell times. 4. Entire MR-based workflow optimized dwell times reimported to the original CT-plan. Results: The MR-based reconstruction process showed average D2cc deviations of 4.5 ± 3.0%, 1.5 ± 2.0%, 2.5 ± 2.0% and 2.0 ± 1.0% for the bladder, rectum, sigmoid colon and small bowels respectively with a maximum of 10%, 6%, 6% and 4%. The HR-CTV’s D90% and V100% average deviations was found to be 4.0 ± 3.0%, and 2.0 ± 2.0% respectively with a maximum of 10% and 6%. Adjusting contours on MR-images was found to have a similar impact. Finally, the optimized MR-based workflow dwell times were found to still give acceptable plans when re-imported to the original CT-plan which validated the entire workflow. Conclusion: This work illustrates a systematic validation method for centers wanting to move towards an MR-only workflow. This work will be expanded to model based reconstruction, PD-weighted images and other types of applicators.

  10. 78 FR 66948 - Request for Information on the Office of Disease Prevention Draft Strategic Plan for Fiscal Years...

    Science.gov (United States)

    2013-11-07

    ..., training, knowledge translation, and public education as they relate to prevention. Prevention research at... and regulations. Prevention research includes studies for: Identification and assessment of risk and... evaluation of interventions to reduce risk; Translation, implementation, and dissemination of effective...

  11. Implant treatment software planning and guided flapless surgery with immediate provisional prosthesis delivery in the fully edentulous maxilla. A retrospective analysis of 15 consecutively treated patients.

    Science.gov (United States)

    Meloni, Silvio Mario; De Riu, Giacomo; Pisano, Miena; Cattina, Gavino; Tullio, Antonio

    2010-01-01

    To evaluate the clinical outcome of fully edentulous patients in the maxilla, who were treated with immediately loaded implant-supported cross-arch bridges using computer-aided implant surgery. The clinical outcome of 15 consecutive patients (5 males and 10 females) with a mean age of 52 years (range 40 to 70), with edentulous arches and treated with implant-supported cross-arch bridges was evaluated. Two computed tomography scans were performed, the first with the patient wearing the denture/radiographic guide and the radiographic index, and the second of the denture alone. The guided flapless surgical procedure was performed under local anaesthesia. Ninety implants were placed. The implant length ranged from 10 to 13 mm and the implant diameter was either 4.3 or 5 mm. All implants were immediately loaded with screw-retained provisional acrylic prostheses prepared in advance and delivered immediately after surgery. Clinical and radiographic follow-up visits were scheduled at 6, 12 and 18 months from surgery; implant survival rate, marginal bone levels, patient satisfaction and any complications were recorded. After the follow-up period of 18 months, two patients each lost one implant. After 18 months, patients lost, on average, 1.6 mm of peri-implant marginal bone. A patient satisfaction questionnaire at 18 months revealed a very high level of satisfaction with the treatment. Although limited by the number of patients, it can be concluded that software- and computed tomography-guided surgical planning for completely edentulous arches provides reliable results with high success rates.

  12. Planning of the energetic operation based on storage guide-curves; Planejamento da operacao energetica baseado em curvas-guias de armazenamento

    Energy Technology Data Exchange (ETDEWEB)

    Zambelli, Monica de S.; Cicogna, Marcelo A.; Soares, Secundino [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Engenharia Eletrica

    2006-07-01

    The proposal of this work is to present a long term hydrothermal scheduling operating policy based on the concept of storage guide-curves. According to this policy, at each stage of the planning period the decision of the amount of water to be discharged by each hydrothermal unit must be such that keep its reservoir at levels pre-determined by curves obtained by an optimization method. The performance analysis for this operating policy is given by simulation with historical inflow data, considering a single hydrothermal system, constituted by a single hydro plant, and a composite system, constituted by hydro plants in cascade, adopting as performance criteria the minimization of the expected operating cost. The results demonstrate that, although simple and clear, this operating policy presents a competitive performance in the long term hydrothermal scheduling. (author)

  13. Application of digital diagnostic impression, virtual planning, and computer-guided implant surgery for a CAD/CAM-fabricated, implant-supported fixed dental prosthesis: a clinical report.

    Science.gov (United States)

    Stapleton, Brandon M; Lin, Wei-Shao; Ntounis, Athanasios; Harris, Bryan T; Morton, Dean

    2014-09-01

    This clinical report demonstrated the use of an implant-supported fixed dental prosthesis fabricated with a contemporary digital approach. The digital diagnostic data acquisition was completed with a digital diagnostic impression with an intraoral scanner and cone-beam computed tomography with a prefabricated universal radiographic template to design a virtual prosthetically driven implant surgical plan. A surgical template fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) was used to perform computer-guided implant surgery. The definitive digital data were then used to design the definitive CAD/CAM-fabricated fixed dental prosthesis. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  14. Prevention and control of noncommunicable diseases through evidence-based public health: implementing the NCD 2020 action plan.

    Science.gov (United States)

    Diem, Günter; Brownson, Ross C; Grabauskas, Vilius; Shatchkute, Aushra; Stachenko, Sylvie

    2016-09-01

    The control of noncommunicable diseases (NCDs) was addressed by the declaration of the 66th United Nations (UN) General Assembly followed by the World Health Organization's (WHO) NCD 2020 action plan. There is a clear need to better apply evidence in public health settings to tackle both behaviour-related factors and the underlying social and economic conditions. This article describes concepts of evidence-based public health (EBPH) and outlines a set of actions that are essential for successful global NCD prevention. The authors describe the importance of knowledge translation with the goal of increasing the effectiveness of public health services, relying on both quantitative and qualitative evidence. In particular, the role of capacity building is highlighted because it is fundamental to progress in controlling NCDs. Important challenges for capacity building include the need to bridge diverse disciplines, build the evidence base across countries and the lack of formal training in public health sciences. As brief case examples, several successful capacity-building efforts are highlighted to address challenges and further evidence-based decision making. The need for a more comprehensive public health approach, addressing social, environmental and cultural conditions, has led to government-wide and society-wide strategies that are now on the agenda due to efforts such as the WHO's NCD 2020 action plan and Health 2020: the European Policy for Health and Wellbeing. These efforts need research to generate evidence in new areas (e.g. equity and sustainability), training to build public health capacity and a continuous process of improvement and knowledge generation and translation. © The Author(s) 2015.

  15. Complications of image-guided radiofrequency ablation of renal cell carcinoma: causes, imaging features and prevention methods

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan; Kim, Chan Kyo [Sungkyunkwan University School of Medicine, The Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea)

    2009-09-15

    Radiofrequency (RF) ablation is an alternative treatment for renal cell carcinoma (RCC) in patients unable to undergo surgery. Although RF ablation has a low complication rate because of its minimally invasive nature, unintended heat may be conducted by several critical organs during ablation procedures, leading to a variety of complications. Major complications that usually require treatment include bowel injury, ureteral injury, massive bleeding and residual or recurrent tumour. Minor complications that may require only observation include pain, haematoma, haematuria, neuromuscular injury, pneumothorax, infarction and inflammatory tract mass. The most common cause of complications is the tumour's proximity to neighbouring organs. In addition, careless electrode manipulation and the patient's comorbidities may also lead to complications. To avoid many of these complications, the distance between the tumour and neighbouring organs should be widened using methods such as changing the patient's position, using the RF electrode as a lever and hydrodissection. Furthermore, carefully manipulating the RF electrode and assessing the patient's general condition help to prevent complications. In this review, we discuss the complications resulting from RF ablation of RCC with an emphasis on causes, imaging features and prevention methods. (orig.)

  16. Implant Restoration of Edentulous Jaws with 3D Software Planning, Guided Surgery, Immediate Loading, and CAD-CAM Full Arch Frameworks

    Directory of Open Access Journals (Sweden)

    Silvio Mario Meloni

    2013-01-01

    Full Text Available Purpose. The aim of this study was to analyze the clinical and radiographic outcomes of 23 edentulous jaws treated with 3D software planning, guided surgery, and immediate loading and restored with CAD-CAM full arch frameworks. Materials and Methods. This work was designed as a prospective case series clinical study. Twenty patients have been consecutively rehabilitated with an immediately loaded implant supported fixed full prosthesis. A total of 120 fixtures supporting 23 bridges were placed. 117 out of 120 implants were immediately loaded. Outcome measures were implants survival, radiographic marginal bone levels and remodeling, soft tissue parameters, and complications. Results. 114 of 117 implants reached a 30 months follow-up, and no patients dropped out from the study. The cumulative survival rate was 97.7%; after 30 months, mean marginal bone level was  mm, mean marginal bone remodeling value was , mean PPD value was  mm, and mean BOP value was 4% ± 2.8%. Only minor prosthetic complications were recorded. Conclusion. Within the limitations of this study, it can be concluded that computer-guided surgery and immediate loading seem to represent a viable option for the immediate rehabilitations of completely edentulous jaws with fixed implant supported restorations. This trial is registered with Clinicaltrials.gov NCT01866696.

  17. Zero TE-based pseudo-CT image conversion in the head and its application in PET/MR attenuation correction and MR-guided radiation therapy planning.

    Science.gov (United States)

    Wiesinger, Florian; Bylund, Mikael; Yang, Jaewon; Kaushik, Sandeep; Shanbhag, Dattesh; Ahn, Sangtae; Jonsson, Joakim H; Lundman, Josef A; Hope, Thomas; Nyholm, Tufve; Larson, Peder; Cozzini, Cristina

    2018-02-18

    To describe a method for converting Zero TE (ZTE) MR images into X-ray attenuation information in the form of pseudo-CT images and demonstrate its performance for (1) attenuation correction (AC) in PET/MR and (2) dose planning in MR-guided radiation therapy planning (RTP). Proton density-weighted ZTE images were acquired as input for MR-based pseudo-CT conversion, providing (1) efficient capture of short-lived bone signals, (2) flat soft-tissue contrast, and (3) fast and robust 3D MR imaging. After bias correction and normalization, the images were segmented into bone, soft-tissue, and air by means of thresholding and morphological refinements. Fixed Hounsfield replacement values were assigned for air (-1000 HU) and soft-tissue (+42 HU), whereas continuous linear mapping was used for bone. The obtained ZTE-derived pseudo-CT images accurately resembled the true CT images (i.e., Dice coefficient for bone overlap of 0.73 ± 0.08 and mean absolute error of 123 ± 25 HU evaluated over the whole head, including errors from residual registration mismatches in the neck and mouth regions). The linear bone mapping accounted for bone density variations. Averaged across five patients, ZTE-based AC demonstrated a PET error of -0.04 ± 1.68% relative to CT-based AC. Similarly, for RTP assessed in eight patients, the absolute dose difference over the target volume was found to be 0.23 ± 0.42%. The described method enables MR to pseudo-CT image conversion for the head in an accurate, robust, and fast manner without relying on anatomical prior knowledge. Potential applications include PET/MR-AC, and MR-guided RTP. © 2018 International Society for Magnetic Resonance in Medicine.

  18. Design of planning target volume margin using an active breathing control and Varian image-guided radiotherapy (IGRT) system in unresectable liver tumor

    International Nuclear Information System (INIS)

    Yue Jinbo; Yu Jinming; Liu Jing; Liu Tonghai; Yin Yong; Shi Xuetao; Song Jinlong

    2007-01-01

    Objective: To define the planning target volume(PTV) margin with an active breathing control (ABC) and the Varian image-guided radiotherapy (IGRT) system. Methods: Thirteen patients with liver cancer were treated with radiotherapy from May 2006 to September 2006. Prior to radiotherapy, all patients had undergone transarterial chemoembolization (TACE) by infusing a mixture of iodized oil contrast medium and chemotherapeutic agents, kV fluoroscopy was used to measure the potential motion of lipiodol spot positions during ABC breath-holds. ABC was used for planning CT scan and radiation delivery, with the breath held at the same phase of the respiratory cycle (near end-exhalation). Cone beam CT (CBCT) was taken using Varian IGRT system, which was then compared online with planning CT using a 3 D-3 D matching tool. Analysis relied on lipiodol spots on planning CT and CBCT manually. The treatment table was moved to produce acceptable setup before treatment delivery. Repeated CBCT image and another analysis were obtained after irradiation. Results: No motion of the intrahepatic tumor was observed on fluoroscopy during ABC breath-holds. The estimated required PTV margins, calculated according to the Stroom formula, were 4.4 mm, 5.3 mm and 7.8 mm in the x, y and z axis directions before radiotherapy. The corresponding parameters were 2.5m, 2.6 mm and 3.9 mm after radiotherapy. Conclusions: We have adopted a PTV margin of 5 mm, 6 mm and 8 mm in the x, y and z axis directions with ABC, and 3,3 and 4 mm with ABC and on-line kilovoltage CBCT. (authors)

  19. Use of science to guide city planning policy and practice: how to achieve healthy and sustainable future cities.

    Science.gov (United States)

    Sallis, James F; Bull, Fiona; Burdett, Ricky; Frank, Lawrence D; Griffiths, Peter; Giles-Corti, Billie; Stevenson, Mark

    2016-12-10

    Land-use and transport policies contribute to worldwide epidemics of injuries and non-communicable diseases through traffic exposure, noise, air pollution, social isolation, low physical activity, and sedentary behaviours. Motorised transport is a major cause of the greenhouse gas emissions that are threatening human health. Urban and transport planning and urban design policies in many cities do not reflect the accumulating evidence that, if policies would take health effects into account, they could benefit a wide range of common health problems. Enhanced research translation to increase the influence of health research on urban and transport planning decisions could address many global health problems. This paper illustrates the potential for such change by presenting conceptual models and case studies of research translation applied to urban and transport planning and urban design. The primary recommendation of this paper is for cities to actively pursue compact and mixed-use urban designs that encourage a transport modal shift away from private motor vehicles towards walking, cycling, and public transport. This Series concludes by urging a systematic approach to city design to enhance health and sustainability through active transport and a move towards new urban mobility. Such an approach promises to be a powerful strategy for improvements in population health on a permanent basis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Customized CT angiogram planning for intraoperative transesophageal echography-guided endovascular exclusion of thoracic aorta penetrating ulcer.

    Science.gov (United States)

    Piazza, Michele; Lupia, Mario; Grego, Franco; Antonello, Michele

    2015-04-01

    The technique is demonstrated in a 78-year-old man; the preoperative CT angiogram showed a descending thoracic aorta ulcer of 5.9 cm in maximum diameter and 3.8 cm longitudinal extension. A ZTEG-2P-36-127-PF (Cook Medical) single tubular endograft was planned to be deployed. From the preoperative CT angiogram we planned to land 4.7 cm above the midline of the descending thoracic aorta ulcer and 8.0 cm below. In the operating room, under radioscopic vision the centre of the transesophageal echography probe was used as marker to identify the correspondent midline of the descending thoracic aorta ulcer and a centimeter-sized pigtail catheter in the aorta was used to calculate the desired length above and below the ulcer midline. The endograft was introduced and placed in the desired position compared to the transesophageal echography probe and the catheter; under transesophageal echography vision the graft was finally deployed. The CT angiogram at 1 month showed the correct endograft position, descending thoracic aorta ulcer exclusion with no signs of endoleak. In selected cases, this method allows planning in advance safe stent graft positioning and deployment totally assisted by transesophageal echography, with no risk of periprocedural contrast-related renal failure and reduced radiation exposure for the patient and operators. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. A protocol for immediate placement of a prefabricated screw-retained provisional prosthesis using computed tomography and guided surgery and incorporating planned alveoplasty.

    Science.gov (United States)

    Balshi, Stephen F; Wolfinger, Glenn J; Balshi, Thomas J

    2011-02-01

    Computer-aided design/computer-assisted manufacture technology is changing the way clinicians are planning treatment and delivering dental implant therapy. Although the current technology is impressive and successful clinically, there are limitations in the design that prevent all patients from benefiting immediately from this computer-designed modality. This article describes a unique prosthetically driven protocol that will allow the delivery of a prefabricated screw-retained all-acrylic prosthesis immediately after an alveoplasty with the immediate placement of dental implants.

  2. Shifting Resources and Focus to Meet the Goals of the National HIV/AIDS Strategy: The Enhanced Comprehensive HIV Prevention Planning Project, 2010–2013

    Science.gov (United States)

    Purcell, David W.; Fisher, Holly H.; Belcher, Lisa; Carey, James W.; Courtenay-Quirk, Cari; Dunbar, Erica; Eke, Agatha N.; Galindo, Carla A.; Glassman, Marlene; Margolis, Andrew D.; Neumann, Mary Spink; Prather, Cynthia; Stratford, Dale; Taylor, Raekiela D.; Mermin, Jonathan

    2016-01-01

    In September 2010, CDC launched the Enhanced Comprehensive HIV Prevention Planning (ECHPP) project to shift HIV-related activities to meet goals of the 2010 National HIV/AIDS Strategy (NHAS). Twelve health departments in cities with high AIDS burden participated. These 12 grantees submitted plans detailing jurisdiction-level goals, strategies, and objectives for HIV prevention and care activities. We reviewed plans to identify themes in the planning process and initial implementation. Planning themes included data integration, broad engagement of partners, and resource allocation modeling. Implementation themes included organizational change, building partnerships, enhancing data use, developing protocols and policies, and providing training and technical assistance for new and expanded activities. Pilot programs also allowed grantees to assess the feasibility of large-scale implementation. These findings indicate that health departments in areas hardest hit by HIV are shifting their HIV prevention and care programs to increase local impact. Examples from ECHPP will be of interest to other health departments as they work toward meeting the NHAS goals. PMID:26843670

  3. Developing an intervention to prevent acute kidney injury: using the Plan, Do, Study, Act (PDSA) service improvement approach.

    Science.gov (United States)

    Byrne, Jo; Xu, Gang; Carr, Sue

    2015-03-01

    In the UK, recent National Institute for Health and Care Excellence guidelines for acute kidney injury point to the need for interventions to help prevent this condition. Effective medicines management is of prime importance in reducing the risk of AKI. Part of this challenge is to increase patients' awareness of their medicines and the possible need to temporarily withhold certain medications when acutely unwell. The objectives were to use a service improvement approach (the Plan, Do, Study, Act cycle) to develop an intervention and to evaluate current delivery of acute kidney injury management and to test and generate new ideas relating to patients' needs. A postal feedback form sent to a random sample of over 200 patients with chronic kidney disease. The feedback form collected information on: what patients know about acute kidney injury and managing medicines; where patients get their information from; whether patients want more information and where from; and what patients feel about self-managing their medicines. Completed feedback forms were received from 113 participants. Of these, 92% said they had received no advice, 77% of respondents wanted more advice but only 17% said they would feel comfortable to stop their own medication without medical consent. The PDSA cycle offered a very useful framework to evaluate the current service delivery and to test and generate new ideas for the development of an AKI intervention. Our findings highlighted that the current service is limited and more robust research is needed. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  4. Empowering members of a rural southern community in Nigeria to plan to take action to prevent maternal mortality: A participatory action research project.

    Science.gov (United States)

    Esienumoh, Ekpoanwan E; Allotey, Janette; Waterman, Heather

    2018-03-01

    To facilitate the empowerment of members of a rural community to plan to take action to prevent maternal mortality. Globally, about 300,000 maternal deaths occur yearly. Sub-Saharan Africa and Southern Asia regions account for almost all the deaths. Within those regions, India and Nigeria account for over a third of the global maternal deaths. Problem of maternal mortality in Nigeria is multifaceted. About 80% of maternal deaths are avoidable, given strategies which include skilled attendants, emergency obstetric care and community mobilization. In this article, a strategy of community empowerment to plan to take action to prevent maternal mortality is discussed. Participatory action research was utilized. Twelve volunteers were recruited as co-researchers into the study through purposive and snowball sampling who, following an orientation workshop, undertook participatory qualitative data collection with an additional 29 community members. Participatory thematic analysis of the data was undertaken which formed the basis of the plan of action. Community members attributed maternal morbidities and deaths to superstitious causes, delayed referrals by traditional birth attendants, poor transportation and poor resourcing of health facilities. Following critical reflection, actions were planned to empower the people to prevent maternal deaths through: community education and advocacy meetings with stakeholders to improve health and transportation infrastructures; training of existing traditional birth attendants in the interim and initiating their collaboration with skilled birth attendants. The community is a resource which if mobilized through the process of participatory action research, can be empowered to plan to take action in collaboration with skilled birth attendants to prevent maternal mortality. Interventions to prevent maternal deaths should include community empowerment to have better understanding of their circumstances as well as their collaboration with

  5. Cone beam computed tomography guided treatment delivery and planning verification for magnetic resonance imaging only radiotherapy of the brain

    DEFF Research Database (Denmark)

    Edmund, Jens M.; Andreasen, Daniel; Mahmood, Faisal

    2015-01-01

    CT (CBCT) can be used for MRI-only image-guided radiotherapy (IGRT) and for verifying the correctness of the corresponding pCT. Material and methods. Six patients receiving palliative cranial RT were included in the study. Each patient had three-dimensional (3D) T1W MRI, a CBCT and a CT for reference....... Further, a pCT was generated using a patch-based approach. MRI, pCT and CT were placed in the same frame of reference, matched to CBCT and the differences noted. Paired pCT-CT and pCT-CBCT data were created in bins of 10 HU and the absolute difference calculated. The data were converted to relative...... electron densities (RED) using the CT or a CBCT calibration curve. The latter was either based on a CBCT phantom (phan) or a paired CT-CBCT population (pop) of the five other patients. Results. Non-significant (NS) differences in the pooled CT-CBCT, MRI-CBCT and pCT-CBCT transformations were noted...

  6. A Comparison of Adaptive Behaviors among Mentally Retarded and Normal Individuals: A guide to Prevention and Treatment

    Directory of Open Access Journals (Sweden)

    Leyla Sadros

    2010-01-01

    Full Text Available Objectives: Because of the importance of adaptive behaviors in socialand domestic lives, this study aimed at a comparison of various domainsof adaptive behaviors, between mentally retarded and normalindividuals.Methods: A number of 246 normal and 74 mentally retarded individuals(7-18 years of age, mean: 12±3.5 years, participated this study inTehran, Iran. Their adaptive behaviors scores, were obtained using"Adaptive Behavioral Scale, Residential & Community" (ABS-RC: 2,consisting of 18 domains of behavior. The scale was first translatedinto Persian by the professionals and then retranslated into English byanother translator, to ensure content non-distortion.Results: The following domains were significantly lower in mentallyretarded than in normal individuals: independent functioning, economicactivity, language development, number & time, prevocational/vocational activity, self direction, responsibility, socialization,disturbing interpersonal behavior, domestic activity, social engagement,conformity and trustworthiness. No significant difference was documentedin the physical development, stereotype & hyperactive behaviors,sexual behavior as well as self abuse behavior domains, betweenthe two groups.Conclusions: As mentally deficient subjects did worse than normalones in terms of many adaptive behavioral domains, it implies that theadaptive behavioral issues in such people might need a great deal ofattention and intervention. For these retarded people to function betterin their social and residential environment, it would be necessary todevelop their adaptive behaviors. This study may shed light on theimportance of attention to the adaptive behavioral domains of mentallyretarded people and also indicates the necessity of preventive measures,even for normal individuals.

  7. FFTF operations procedures preparation guide. Revision 2

    International Nuclear Information System (INIS)

    1976-12-01

    The Guide is intended to provide guidelines for the initial preparation of FFTF Operating Procedures. The Procedures Preparation Guide was developed from the plan presented and approved in the FFTF Reactor Plant Procedures Plan, PC-1, Revision 3

  8. Local Action Plans for Forest Fire Prevention in Greece: Existing situation and a Proposed Template based on the Collaboration of Academics and Public Policy Makers

    Science.gov (United States)

    Papanikolaou, Dimitrios; Arvanitakis, Spyridon; Papanikolaou, , Ioannis; Lozios, Stylianos; Diakakis, Michalis; Deligiannakis, Georgios; Dimitropoulou, Margarita; Georgiou, Konstantinos

    2013-04-01

    Wildfires are a major hazard in Greece suffering on average 1,509 wildfires and 36,151 burned hectares of forestlands every year. Since 1998 the Greek Fire Service is responsible for wildfires suppression and response, while prevention and mitigation yearly directives are also being released by the General Secretariat of Civil Protection. The 3013/2002 Act introduced a major transfer of responsibilities from the national to local municipal and regional authorities, which are accompanied by supplementary financial support. Significant new features were established such as the operation of local coordination councils, the foundation of municipality civil protection offices, the establishment of the annually prevention planning for forest fires and the development of local action plans. The University of Athens has developed a Local Action Plan template for municipality administrative levels, integrating scientific techniques and technologies to public government management. The Local Action Plan for Forest Fire Prevention is the main handbook and primary tool of every municipality for reducing the risk of wildfires. Fire prevention and risk analysis are the principal aims of this Plan, which also emphasizes on the important role of the volunteer organizations on forest fire prevention. The 7 chapters of the Action Plan include the legal framework, the risk analysis parameters, the risk analysis using GIS, the prevention planning, the manpower and available equipment of services involved, along with operational planning and evaluation of the previous year's forest fire prevention actions. Multiple information layers, such as vegetation types, road network, power lines and landfills are combined in GIS environment and transformed into qualitative multiparameter as well as quantitative combinational fire hazard maps. These maps are essential in wildfire risk analysis as they display the areas that need the highest attention during the fire season. Moreover, the separate

  9. A comparison of adaptive behaviors among mentally retarded and normal individuals: A guide to prevention and treatment

    Directory of Open Access Journals (Sweden)

    Leyla Sadrossadat

    2010-01-01

    Full Text Available Objectives: Because of the importance of adaptive behaviors in social and domestic lives, this study aimed at a comparison of various domains of adaptive behaviors, between mentally retarded and normal individuals. Methods: A number of 246 normal and 74 mentally retarded in-dividuals (7-18 years of age, mean: 12±3.5 years, participated this study in Tehran, Iran. Their adaptive behaviors scores, were ob-tained using "Adaptive Behavioral Scale, Residential & Commu-nity" (ABS-RC: 2, consisting of 18 domains of behavior. The scale was first translated into Persian by the professionals and then re-translated into English by another translator, to ensure content non-distortion. Results: The following domains were significantly lower in men-tally retarded than in normal individuals: independent function-ing, economic activity, language development, number & time, prevocational/vocational activity, self direction, responsibility, socialization, disturbing interpersonal behavior, domestic activity, social engagement, conformity and trustworthiness. No significant difference was documented in the physical development, stereo-type & hyperactive behaviors, sexual behavior as well as self abuse behavior domains, between the two groups. Conclusions: As mentally deficient subjects did worse than nor-mal ones in terms of many adaptive behavioral domains, it implies that the adaptive behavioral issues in such people might need a great deal of attention and intervention. For these retarded people to function better in their social and residential environment, it would be necessary to develop their adaptive behaviors. This study may shed light on the importance of attention to the adap-tive behavioral domains of mentally retarded people and also indi-cates the necessity of preventive measures, even for normal indi-viduals.

  10. The planning target volume margins detected by cone-beam CT in head and neck cancer patients treated by image-guided intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    Liu Jun; Chen Hong; Zhang Guoqiao; Chen Fei; Zhang Li

    2011-01-01

    Objective: To determine the planning target volume margins of head and neck cancers treated by image guided radiotherapy (IGRT). Methods: 464 sets cone beam computed tomography (CBCT) images before setup correction and 126 sets CBCT images after correction were obtained from 51 head and neck cancer patients treated by IGRT in our department. The systematic and random errors were evaluated by either online or offline correction through registering the CBCT images to the planning CT. The data was divided into 3 groups according to the online correction times. Results: The isocenter shift were 0.37 mm ± 2.37 mm, -0.43 mm ± 2.30 mm and 0.47 mm ± 2.65 mm in right-left (RL), anterior-posterior (AP) and superior-inferior (SI) directions respectively before correction, and it reduced to 0.08 mm ± 0.68 mm, -0.03 mm ± 0.74 mm and 0.03 mm ± 0.80 mm when evaluated by 126 sets corrected CBCT images. The planning target volume (PTV) margin from clinical target volume (CTV) before correction were: 6.41 mm, 6.15 mm and 7.10 mm based on two parameter model, and it reduced to 1.78 mm, 1.80 mm and 1.97 mm after correction. The PTV margins were 3.8 mm, 3.8 mm, 4.0 mm; 4.0 mm, 4.0 mm, 5.0 mm and 5.4 mm, 5.2 mm, 6.1 mm in RL, AP and SI respectively when online-correction times were more than 15 times, 11-15 times, 5-10 times. Conclusions: CBCT-based on online correction reduce the PTV margin for head and neck cancers treated by IGRT and ensure more precise dose delivery and less normal tissue complications. (authors)

  11. Improving 4D plan quality for PBS-based liver tumour treatments by combining online image guided beam gating with rescanning

    Science.gov (United States)

    Zhang, Ye; Knopf, Antje-Christin; Weber, Damien Charles; Lomax, Antony John

    2015-10-01

    and layered rescanning have been observed as a function of increasing number of re-scans. However, once gating and rescanning is combined, HI to within 2% of the static plan could be achieved in the clinical target volume, with only moderately prolonged treatment times, irrespective of the rescanning strategy used. Moreover, these results are independent of the motion surrogate used. In conclusion, our results suggest image guided beam gating, combined with rescanning, is a feasible, effective and efficient motion mitigation approach for PBS-based liver tumour treatments.

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

    Science.gov (United States)

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

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

  13. Methodological guide for the integration of the evaluation in the study plan d at “Nancy Uranga Romagoza” Faculty

    Directory of Open Access Journals (Sweden)

    Bienvenido Emilio Viera-Sánchez

    2013-08-01

    Full Text Available The integrating evaluation conception in the Study Plan D of the Physical Culture career will be always a pertinent and current topic, according to the new orientations about evaluation which indicate the final test realization in all subjects. This fact demands from a revision of the integration as a way to establish an appropriate equilibration of the evaluation in the academic year, as well as the inclusion of the state test like a form of studies' ending, occasion when the student shall solve a physical culture problem in one of the professional performance fields, which solution will certainly have a remarkable integrating character. As a result of a carried out study there is an instructive material for the teachers that contains different ways to integrate the contents of the subjects, disciplines and academic years in the third school year integrating test of Physical Education Didactics. In this kind of evaluation it can be better seen the students' difficulties on professional competences. Besides the exam's numbers reduced and the self preparation time saving, as well as result's quality are improved.

  14. Career Education Instructional Guide.

    Science.gov (United States)

    State Univ. of New York, Oswego. Coll. at Oswego. Dept. of Industrial Arts and Technology.

    The guide is designed primarily for industrial arts teachers at the middle school level who wish to integrate career education into their curricula. The lessons and activities attempt to establish a balance among career information, technical information, and hands-on experience. The guide contains six lesson plans which cover the topics: the…

  15. Diabetes Prevention Program (DPP)

    Science.gov (United States)

    ... Recruiting Patients & Families Consortia, Networks & Centers Reports & Planning Diabetes Prevention Program (DPP) The NIDDK-sponsored Diabetes Prevention ... Diabetes Prevention Program for those who are eligible. Diabetes Prevention Program (DPP) DPP Goal The DPP looked ...

  16. A Randomized Controlled Trial to Investigate the Effectiveness of the Prevention of Aspiration Pneumonia Using Recommendations for Swallowing Care Guided by Ultrasound Examination.

    Science.gov (United States)

    Miura, Yuka; Nakagami, Gojiro; Yabunaka, Koichi; Tohara, Haruka; Noguchi, Hiroshi; Mori, Taketoshi; Sanada, Hiromi

    2018-02-12

    Prevention for aspiration pneumonia requires assessment of aspiration and adequate swallowing care. This randomized controlled trial aimed to investigate the effectiveness of ultrasound examination and recommendations for swallowing care for the reduction of aspiration and pharyngeal post-swallow residue as compared with standard swallowing care. Twenty-three participants were randomized to the intervention group and 23 to the control group. The intervention consisted of four ultrasound examinations during mealtimes and recommendations for swallowing care every 2 weeks during an 8 week period. No recommendations concerning swallowing care based on ultrasound examinations were provided to the control group. The frequency of aspiration or residue was defined as x/y × 100% when aspiration or residue were detected x times from y times concerning the total ultrasound measurements. The proportion of the residents with reduced frequency of aspiration which was detected by ultrasonography at eight weeks were 4.3% in the intervention group and 0% in the control group. The median reduction in the frequency of aspiration and residue in the intervention group was 31%, and that in the control group was 11%. In conclusion, swallowing care guided by frequent ultrasound examinations during mealtimes had a trend of reducing the frequency of aspiration and residue during an 8-week period in individuals relative to standard swallowing care alone.

  17. The INCA trial (Impact of NOD2 genotype-guided antibiotic prevention on survival in patients with liver Cirrhosis and Ascites): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Casper, Markus; Mengel, Martin; Fuhrmann, Christine; Herrmann, Eva; Appenrodt, Beate; Schiedermaier, Peter; Reichert, Matthias; Bruns, Tony; Engelmann, Cornelius; Grünhage, Frank; Lammert, Frank

    2015-03-08

    Patients with liver cirrhosis have a highly elevated risk of developing bacterial infections that significantly decrease survival rates. One of the most relevant infections is spontaneous bacterial peritonitis (SBP). Recently, NOD2 germline variants were found to be potential predictors of the development of infectious complications and mortality in patients with cirrhosis. The aim of the INCA (Impact of NOD2 genotype-guided antibiotic prevention on survival in patients with liver Cirrhosis and Ascites) trial is to investigate whether survival of this genetically defined high-risk group of patients with cirrhosis defined by the presence of NOD2 variants is improved by primary antibiotic prophylaxis of SBP. The INCA trial is a double-blind, placebo-controlled clinical trial with two parallel treatment arms (arm 1: norfloxacin 400 mg once daily; arm 2: placebo once daily; 12-month treatment and observational period). Balanced randomization of 186 eligible patients with stratification for the protein content of the ascites (INCA trial is first in the field of hepatology aimed at rapidly transferring and validating information on individual genetic risk into clinical decision algorithms. German Clinical Trials Register DRKS00005616 . Registered 22 January 2014. EU Clinical Trials Register EudraCT 2013-001626-26 . Registered 26 January 2015.

  18. The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy.

    Science.gov (United States)

    Damato, Antonio L; Buzurovic, Ivan; Bhagwat, Mandar S; Cormack, Robert A; Devlin, Phillip M; Friesen, Scott; Hansen, Jorgen; Lee, Larissa J; Manuel, Matthias M; Cho, Linda P; O'Farrell, Desmond; Viswanathan, Akila N

    To investigate the dose-volume histogram metrics and optimization results of the contoured bowel in cervical cancer brachytherapy. Treatment plans of cervical cancer patients treated with image-guided high dose rate were retrospectively analyzed with institutional review board approval. In addition to the clinical target volume, rectum, bladder, and sigmoid, the bowel was contoured at the time of planning (Group 1) or at the time of this analysis (Group 2). Thirty-two patients treated with 145 insertions were included. Before optimization, mean ± 1 standard deviation overall bowel minimum dose to the most irradiated 2 cm 3 volume of an organ (D 2cc ) was 67.8 Gy α/β3 ± 13.7 Gy α/β3 (Group 1: 72.6 ± 13.2 Gy α/β3 ; Group 2: 57.3 ± 8.0 Gy α/β3 ). Before optimization, one patient in Group 1 presented a bowel D 2cc metric exceeding 100 Gy α/β3 . After optimization, bowel D 2cc mean ± 1 standard deviation was 59.4 ± 6.7 Gy α/β3 (Group 1: 61.4 ± 6.0 Gy α/β3 , p bowel when bowel is present in the pelvis. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  19. Multimodal guided self-help exercise program to prevent speech, swallowing, and shoulder problems among head and neck cancer patients: a feasibility study.

    Science.gov (United States)

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Rinkel, Rico N P M; Aalders, Ijke J; de Goede, Cees J T; de Bree, Remco; Doornaert, Patricia; Rietveld, Derek H F; Langendijk, Johannes A; Witte, Birgit I; Leemans, C Rene; Verdonck-de Leeuw, Irma M

    2014-03-06

    During a 6-week course of (chemo)radiation many head and neck cancer patients have to endure radiotherapy-induced toxicity, negatively affecting patients' quality of life. Pretreatment counseling combined with self-help exercises could be provided to inform patients and possibly prevent them from having speech, swallowing, and shoulder problems during and after treatment. Our goal was to investigate the feasibility of a multimodal guided self-help exercise program entitled Head Matters during (chemo)radiation in head and neck cancer patients. Head and neck cancer patients treated with primary (chemo)radiation or after surgery were asked to perform Head Matters at home. This prophylactic exercise program, offered in three different formats, aims to reduce the risk of developing speech, swallowing, shoulder problems, and a stiff neck. Weekly coaching was provided by a speech and swallowing therapist. Patients filled out a diary to keep track of their exercise activity. To gain insight into possible barriers and facilitators to exercise adherence, reports of weekly coaching sessions were analyzed by 2 coders independently. Of 41 eligible patients, 34 patients were willing to participate (83% uptake). Of participating patients, 21 patients completed the program (64% adherence rate). The majority of participants (58%) had a moderate to high level of exercise performance. Exercise performance level was not significantly associated with age (P=.50), gender (P=.42), tumor subsite (P=1.00) or tumor stage (P=.20), treatment modality (P=.72), or Head Matters format (Web-based or paper) (P=1.00). Based on patients' diaries and weekly coaching sessions, patients' perceived barriers to exercise were a decreased physical condition, treatment-related barriers, emotional problems, lack of motivation, social barriers, and technical problems. Patients' perceived facilitators included an increased physical condition, feeling motivated, and social and technical facilitators. Head

  20. Using the Theory of Planned Behavior to Guide Focus Group Development of Messages Aimed at Increasing Compliance With a Tobacco-Free Policy.

    Science.gov (United States)

    Record, Rachael A; Harrington, Nancy G; Helme, Donald W; Savage, Matthew W

    2018-01-01

    This study details the persuasive message development for a theory-based campaign designed to increase compliance with a university's tobacco-free policy. The theory of planned behavior (TPB) guided message design and evaluation for focus group-tested messages that were adapted to the context of complying with a tobacco-free policy. The study was conducted at a university located in the tobacco belt. Undergraduate focus group participants (n = 65) were mostly male (69%), white (82%), and freshman (62%) who smoked at least 1 cigarette in the last 30 days; on-campus smoking percentages were never/rare (60%), occasionally (23%), and often/frequently (16%). Data analysis used a theoretical thematic approach to identify how the TPB constructs related to perceptions of message effectiveness. Participants responded favorably to attitudinal strategies about health, respect, and university figures; they rejected approaches they considered juvenile and offensive. They also discussed the impact of noncompliance and avoiding overgeneralized statements for addressing subjective norms, suggesting shortening text, adjusting picture location, and emphasizing the importance of compliance to increase perceptions of behavioral control. Applying theory to preexisting messages is challenging. The design approach in this study is an evidence-based strategy that can be used as a universal process for message adaptation. Results offer health promotion suggestions for designing messages aimed at improving undergraduate smokers' willingness to comply with tobacco-free campus policies.