Conservation Education and Environmental Communication in Great Ape Re-Introduction Projects: Two Cases from the Republic of Congo

Science.gov (United States)

Cartwright, Barbara J.; Wall, John E.; Kaya, J. A. Placide

2012-01-01

Among species recovery tools available, re-introduction of animals to the wild is one of the more complex. Since the mid-1990s two successful great ape re-introductions have taken place in the Republic of Congo, leading some conservationists to revisit re-introduction as a strategy. This research explored the role of conservation education and…

Ensemble ecosystem modeling for predicting ecosystem response to predator reintroduction.

Science.gov (United States)

Baker, Christopher M; Gordon, Ascelin; Bode, Michael

2017-04-01

Introducing a new or extirpated species to an ecosystem is risky, and managers need quantitative methods that can predict the consequences for the recipient ecosystem. Proponents of keystone predator reintroductions commonly argue that the presence of the predator will restore ecosystem function, but this has not always been the case, and mathematical modeling has an important role to play in predicting how reintroductions will likely play out. We devised an ensemble modeling method that integrates species interaction networks and dynamic community simulations and used it to describe the range of plausible consequences of 2 keystone-predator reintroductions: wolves (Canis lupus) to Yellowstone National Park and dingoes (Canis dingo) to a national park in Australia. Although previous methods for predicting ecosystem responses to such interventions focused on predicting changes around a given equilibrium, we used Lotka-Volterra equations to predict changing abundances through time. We applied our method to interaction networks for wolves in Yellowstone National Park and for dingoes in Australia. Our model replicated the observed dynamics in Yellowstone National Park and produced a larger range of potential outcomes for the dingo network. However, we also found that changes in small vertebrates or invertebrates gave a good indication about the potential future state of the system. Our method allowed us to predict when the systems were far from equilibrium. Our results showed that the method can also be used to predict which species may increase or decrease following a reintroduction and can identify species that are important to monitor (i.e., species whose changes in abundance give extra insight into broad changes in the system). Ensemble ecosystem modeling can also be applied to assess the ecosystem-wide implications of other types of interventions including assisted migration, biocontrol, and invasive species eradication. © 2016 Society for Conservation Biology.

Roles of survival and dispersal in reintroduction success of Griffon vulture (Gyps fulvus).

Science.gov (United States)

Le Gouar, Pascaline; Robert, Alexandre; Choisy, Jean-Pierre; Henriquet, Sylvain; Lecuyer, Philippe; Tessier, Christian; Sarrazin, François

2008-06-01

The success of reintroduction programs greatly depends on the amount of mortality and dispersal of the released individuals. Although local environmental pressures are likely to play an important role in these processes, they have rarely been investigated because of the lack of spatial replicates of reintroduction. In the present study, we analyzed a 25-year data set encompassing 272 individuals released in five reintroduction programs of Griffon Vultures (Gyps fulvus) in France to examine the respective roles of survival and dispersal in program successes and failures. We use recent developments in multi-strata capture-recapture models to take into account tag loss in survival estimates and to consider and estimate dispersal among release areas. We also examined the effects of sex, age, time, area, and release status on survival, and we tested whether dispersal patterns among release areas were consistent with habitat selection theories. Results indicated that the survival of released adults was reduced during the first year after release, with no difference between sexes. Taking into account local observations only, we found that early survival rates varied across sites. However when we distinguished dispersal from mortality, early survival rates became equal across release sites. It thus appears that among reintroduction programs difference in failure and success was due to differential dispersal among release sites. We revealed asymmetrical patterns of dispersal due to conspecific attraction: dispersers selected the closest and the largest population. We showed that mortality can be homogeneous from one program to another while, on the contrary, dispersal is highly dependent on the matrix of established populations. Dispersal behavior is thus of major interest for metapopulation restoration and should be taken into account in planning reintroduction designs.

Management Plan for Experimental Reintroduction of Sockeye into Skaha Lake; Proposed Implementation, Monitoring, and Evaluation, 2004 Technical Report.

Energy Technology Data Exchange (ETDEWEB)

Wright, Howie; Smith, Howard (Okanagan Nation Alliance, Fisheries Department, Westbank, BC, Canada)

2004-01-01

Okanagan River sockeye salmon, which spawn near the town of Oliver, B.C., have their farther upstream migration limited by several water control and diversion dams. Stock numbers have been declining for many years and the Okanagan Native Alliance Fisheries Department (ONAFD) has been the principal advocate of a program to restore their numbers and range by reintroducing them into upstream waters where they may once have occurred in substantial numbers Some investigators have warned that without effective intervention Okanagan sockeye are at considerable risk of extinction. Among a host of threats, the quality of water in the single nursery areas in Osoyoos Lake. is deteriorating and a sanctuary such as that afforded in larger lakes higher in the system could be essential. Because the proposed reintroduction upstream has implications for other fish species, (particularly kokanee, the so-called ''landlocked sockeye'' which reside in many Okanagan lakes), the proponents undertook a three-year investigation, with funding from the Bonneville Power Administration and the Confederated Tribes of the Colville Reservation, to identify possible problem areas, and they committed to an interim experimental reintroduction to Skaha Lake where any problems could be worked out before a more ambitious reintroduction, (e.g. to Okanagan Lake) could be formally considered. The three-year investigation was completed in the spring of 2003. It included an assessment of risks from disease or the possible introduction of unwanted exotic species. It also considered the present quality and quantity of sockeye habitat, and opportunities for expanding or improving it. Finally ecological complexity encouraged the development of a life history model to examine interactions of sockeye with other fishes and their food organisms. While some problem areas were exposed in the course of these studies, they appeared to be manageable and the concept of an experimental reintroduction

Parasite invasion following host reintroduction: a case study of Yellowstone's wolves.

Science.gov (United States)

Almberg, Emily S; Cross, Paul C; Dobson, Andrew P; Smith, Douglas W; Hudson, Peter J

2012-10-19

Wildlife reintroductions select or treat individuals for good health with the expectation that these individuals will fare better than infected animals. However, these individuals, new to their environment, may also be particularly susceptible to circulating infections and this may result in high morbidity and mortality, potentially jeopardizing the goals of recovery. Here, using the reintroduction of the grey wolf (Canis lupus) into Yellowstone National Park as a case study, we address the question of how parasites invade a reintroduced population and consider the impact of these invasions on population performance. We find that several viral parasites rapidly invaded the population inside the park, likely via spillover from resident canid species, and we contrast these with the slower invasion of sarcoptic mange, caused by the mite Sarcoptes scabiei. The spatio-temporal patterns of mange invasion were largely consistent with patterns of host connectivity and density, and we demonstrate that the area of highest resource quality, supporting the greatest density of wolves, is also the region that appears most susceptible to repeated disease invasion and parasite-induced declines. The success of wolf reintroduction appears not to have been jeopardized by infectious disease, but now shows signs of regulation or limitation modulated by parasites.

Parasite invasion following host reintroduction: a case of Yellowstone’s wolves

Science.gov (United States)

Cross, Paul C.; Almberg, Emily S.; Dobson, Andrew P.; Smith, Douglas W.; Hudson, Peter J.

2012-01-01

Wildlife reintroductions select or treat individuals for good health with the expectation that these individuals will fare better than infected animals. However, these individuals, new to their environment, may also be particularly susceptible to circulating infections and this may result in high morbidity and mortality, potentially jeopardizing the goals of recovery. Here, using the reintroduction of the grey wolf (Canis lupus) into Yellowstone National Park as a case study, we address the question of how parasites invade a reintroduced population and consider the impact of these invasions on population performance. We find that several viral parasites rapidly invaded the population inside the park, likely via spillover from resident canid species, and we contrast these with the slower invasion of sarcoptic mange, caused by the mite Sarcoptes scabiei. The spatio-temporal patterns of mange invasion were largely consistent with patterns of host connectivity and density, and we demonstrate that the area of highest resource quality, supporting the greatest density of wolves, is also the region that appears most susceptible to repeated disease invasion and parasite-induced declines. The success of wolf reintroduction appears not to have been jeopardized by infectious disease, but now shows signs of regulation or limitation modulated by parasites.

Mid-Columbia coho reintroduction feasibility project. Preliminary environmental assessment

International Nuclear Information System (INIS)

1999-01-01

Before the Bonneville Power Administration (BPA) decides whether to fund a program to reintroduce coho salmon to mid-Columbia River basin tributaries, research is needed to determine the ecological risks and biological feasibility of such an effort. Since the early 1900s, the native stock of coho has been decimated in the tributaries of the middle reach of the Columbia River. The four Columbia River Treaty Tribes identified coho reintroduction in the mid-Columbia as a priority in the Tribal Restoration Plan. It is a comprehensive plan put forward by the Tribes to restore the Columbia River fisheries. In 1996, the Northwest Power Planning Council (NPPC) recommended the tribal mid-Columbia reintroduction project for funding by BPA. It was identified as one of fifteen high-priority supplementation projects for the Columbia River basin, and was incorporated into the NPPC's Fish and Wildlife Program. The release of coho from lower Columbia hatcheries into mid-Columbia tributaries is also recognized in the Columbia River Fish Management Plan

Mid-Columbia Coho Salmon Reintroduction Feasibility Project : Environmental Assessment.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration; Washington (State) Department of Fish and Wildlife; Confederated Tribes and Bands of the Yakama Nation

1999-01-01

Before the Bonneville Power Administration (BPA) decides whether to fund a program to reintroduce coho salmon to mid-Columbia River basin tributaries, research is needed to determine the ecological risks and biological feasibility of such an effort. Since the early 1900s, the native stock of coho has been decimated in the tributaries of the middle reach of the Columbia River. The four Columbia River Treaty Tribes identified coho reintroduction in the mid-Columbia as a priority in the Tribal Restoration Plan. It is a comprehensive plan put forward by the Tribes to restore the Columbia River fisheries. In 1996, the Northwest Power Planning Council (NPPC) recommended the tribal mid-Columbia reintroduction project for funding by BPA. It was identified as one of fifteen high-priority supplementation projects for the Columbia River basin, and was incorporated into the NPPC`s Fish and Wildlife Program. The release of coho from lower Columbia hatcheries into mid-Columbia tributaries is also recognized in the Columbia River Fish Management Plan.

Comparison of historical bottleneck effects and genetic consequences of re-introduction in a critically endangered island passerine.

Science.gov (United States)

Bristol, Rachel M; Tucker, Rachel; Dawson, Deborah A; Horsburgh, Gavin; Prys-Jones, Robert P; Frantz, Alain C; Krupa, Andy; Shah, Nirmal J; Burke, Terry; Groombridge, Jim J

2013-09-01

Re-introduction is an important tool for recovering endangered species; however, the magnitude of genetic consequences for re-introduced populations remains largely unknown, in particular the relative impacts of historical population bottlenecks compared to those induced by conservation management. We characterize 14 microsatellite loci developed for the Seychelles paradise flycatcher and use them to quantify temporal and spatial measures of genetic variation across a 134-year time frame encompassing a historical bottleneck that reduced the species to ~28 individuals in the 1960s, through the initial stages of recovery and across a second contemporary conservation-introduction-induced bottleneck. We then evaluate the relative impacts of the two bottlenecks, and finally apply our findings to inform broader re-introduction strategy. We find a temporal trend of significant decrease in standard measures of genetic diversity across the historical bottleneck, but only a nonsignificant downward trend in number of alleles across the contemporary bottleneck. However, accounting for the different timescales of the two bottlenecks (~40 historical generations versus introduction. In some cases, the loss of genetic diversity per generation can, initially at least, be greater across re-introduction-induced bottlenecks. © 2013 John Wiley & Sons Ltd.

Performance measures for a Mississippi River reintroduction into the forested wetlands of Maurepas Swamp

Science.gov (United States)

Krauss, Ken W.; Shaffer, Gary P.; Keim, Richard F.; Chambers, Jim L.; Wood, William B.; Hartley, Stephen B.

2017-06-09

The use of freshwater diversions (river reintroductions) from the Mississippi River as a restoration tool to rehabilitate Louisiana coastal wetlands has been promoted widely since the first such diversion at Caernarvon became operational in the early 1990s. To date, aside from the Bonnet Carré Spillway (which is designed and operated for flood control), there are only four operational Mississippi River freshwater diversions (two gated structures and two siphons) in coastal Louisiana, and they all target salinity intrusion, shellfish management, and (or) the enhancement of the integrity of marsh habitat. River reintroductions carry small sediment loads for various design reasons, but they can be effective in delivering fresh­water to combat saltwater intrusion and increase the delivery of nutrients and suspended fine-grained sediments to receiving wetlands. River reintroductions may be an ideal restoration tool for targeting coastal swamp forest habitat; much of the area of swamp forest habitat in coastal Louisiana is undergo­ing saltwater intrusion, high rates of submergence, and lack of riverine flow leading to reduced concentrations of important nutrients and suspended sediments, which sustain growth and regeneration, help to aerate swamp soils, and remove toxic compounds from the rhizosphere.The State of Louisiana Coastal Protection and Restora­tion Authority (CPRA) has made it a priority to establish a small freshwater river diversion into a coastal swamp forest located between Baton Rouge and New Orleans, Louisiana, to reintroduce Mississippi River water to Maurepas Swamp. While a full understanding of how a coastal swamp forest will respond to new freshwater loading through a Mississippi River reintroduction is unknown, this report provides guidance based on the available literature for establishing performance measures that can be used for evaluating the effectiveness of a Mississippi River reintroduction into the forested wetlands of Maurepas Swamp

What limits the spread of two congeneric butterfly species after their reintroduction: quality or spatial arrangement of habitat?

NARCIS (Netherlands)

Langevelde, van F.; Wynhoff, I.

2009-01-01

Population growth and spread of recently reintroduced species is crucial for the success of their reintroduction. We analysed what limits the spread of two congeneric butterfly species Maculinea teleius and Maculinea nausithous, over 10 years following their reintroduction. During this time, their

Risk assessment for the reintroduction of anadromous salmonids upstream of Chief Joseph and Grand Coulee Dams, Northeastern Washington

Science.gov (United States)

Hardiman, Jill M.; Breyta, Rachel B.; Haskell, Craig A.; Ostberg, Carl O.; Hatten, James R.; Connolly, Patrick J.

2017-09-12

The Upper Columbia United Tribes (UCUT; Spokane, Colville, Kootenai, Coeur d’Alene, and Kalispel Tribes) and Washington Department of Fish and Wildlife want to reintroduce anadromous salmonids to their historical range to restore ecosystem function and lost cultural and spiritual relationships in the upper Columbia River, northeastern Washington. The UCUT contracted with the U.S. Geological Survey to assess risks to resident taxa (existing fish populations in the reintroduction area upstream of Chief Joseph and Grand Coulee Dams) and reintroduced salmon associated with reintroduction. We developed a risk assessment framework for reintroduction of anadromous salmonids upstream of Chief Joseph and Grand Coulee Dams. To accomplish this goal, we applied strategies identified in previous risk assessment frameworks for reintroduction. The risk assessment is an initial step towards an anadromous reintroduction strategy. An initial list of potential donor sources for reintroduction species was developed from previous published sources for Chinook Salmon (Oncorhynchus tshawytscha) donors in the Transboundary Reach of the Columbia River, British Columbia; an ecological risk assessment of upper Columbia River hatchery programs on non-target taxa of concern; and a review of existing hatchery programsDuring two workshops, we further identified and ranked potential donor sources of anadromous Redband Trout (steelhead; O. mykiss), Chinook Salmon, Sockeye Salmon (O. nerka), and Coho Salmon (O. kisutch). We also identified resident fish populations of interest and their primary habitat, location, status, and pathogen concerns to determine the potential risks of reintroduction. Species were deemed of interest based on resource management and potential interactions (that is, genetics, competition, and predation) with introduced species. We developed tables of potential donors by species and characterized potential sources (hatchery and natural origins), populations (individual runs

Leadership and management influences the outcome of wildlife reintroduction programs: findings from the Sea Eagle Recovery Project

Directory of Open Access Journals (Sweden)

Alexandra E. Sutton

2015-06-01

Full Text Available Wildlife reintroductions and translocations are statistically unlikely to succeed. Nevertheless, they remain a critical part of conservation because they are the only way to actively restore a species into a habitat from which it has been extirpated. Past efforts to improve these practices have attributed the low success rate to failures in the biological knowledge (e.g., ignorance of social behavior, poor release site selection, or to the inherent challenges of reinstating a species into an area where threats have already driven it to local extinction. Such research presumes that the only way to improve reintroduction outcomes is through improved biological knowledge. This emphasis on biological solutions may have caused researchers to overlook the potential influence of other factors on reintroduction outcomes. I employed a grounded theory approach to study the leadership and management of a successful reintroduction program (the Sea Eagle Recovery Project in Scotland, UK and identify four critical managerial elements that I theorize may have contributed to the successful outcome of this 50-year reintroduction. These elements are: 1. Leadership & Management: Small, dedicated team of accessible experts who provide strong political and scientific advocacy (“champions” for the project. 2. Hierarchy & Autonomy: Hierarchical management structure that nevertheless permits high individual autonomy. 3. Goals & Evaluation: Formalized goal-setting and regular, critical evaluation of the project’s progress toward those goals. 4. Adaptive Public Relations: Adaptive outreach campaigns that are open, transparent, inclusive (esp. linguistically, and culturally relevant.

Leadership and management influences the outcome of wildlife reintroduction programs: findings from the Sea Eagle Recovery Project.

Science.gov (United States)

Sutton, Alexandra E

2015-01-01

Wildlife reintroductions and translocations are statistically unlikely to succeed. Nevertheless, they remain a critical part of conservation because they are the only way to actively restore a species into a habitat from which it has been extirpated. Past efforts to improve these practices have attributed the low success rate to failures in the biological knowledge (e.g., ignorance of social behavior, poor release site selection), or to the inherent challenges of reinstating a species into an area where threats have already driven it to local extinction. Such research presumes that the only way to improve reintroduction outcomes is through improved biological knowledge. This emphasis on biological solutions may have caused researchers to overlook the potential influence of other factors on reintroduction outcomes. I employed a grounded theory approach to study the leadership and management of a successful reintroduction program (the Sea Eagle Recovery Project in Scotland, UK) and identify four critical managerial elements that I theorize may have contributed to the successful outcome of this 50-year reintroduction. These elements are: 1. Leadership & Management: Small, dedicated team of accessible experts who provide strong political and scientific advocacy ("champions") for the project. 2. Hierarchy & Autonomy: Hierarchical management structure that nevertheless permits high individual autonomy. 3. Goals & Evaluation: Formalized goal-setting and regular, critical evaluation of the project's progress toward those goals. 4. Adaptive Public Relations: Adaptive outreach campaigns that are open, transparent, inclusive (esp. linguistically), and culturally relevant.

Modeling habitat connectivity to inform reintroductions: a case study with the Chiricahua Leopard Frog

Science.gov (United States)

Jarchow, Christopher J.; Hossack, Blake R.; Sigafus, Brent H.; Schwalbe, Cecil R.; Muths, Erin L.

2016-01-01

Managing species with intensive tools such as reintroduction may focus on single sites or entire landscapes. For vagile species, long-term persistence will require colonization and establishment in neighboring habitats. Therefore, both suitable colonization sites and suitable dispersal corridors between sites are required. Assessment of landscapes for both requirements can contribute to ranking and selection of reintroduction areas, thereby improving management success. Following eradication of invasive American Bullfrogs (Lithobates catesbeianus) from most of Buenos Aires National Wildlife Refuge (BANWR; Arizona, United States), larval Chiricahua Leopard Frogs (Lithobates chiricahuensis) from a private pond were reintroduced into three stock ponds. Populations became established at all three reintroduction sites followed by colonization of neighboring ponds in subsequent years. Our aim was to better understand colonization patterns by the federally threatened L. chiricahuensis which could help inform other reintroduction efforts. We assessed the influence of four landscape features on colonization. Using surveys from 2007 and information about the landscape, we developed a habitat connectivity model, based on electrical circuit theory, that identified potential dispersal corridors after explicitly accounting for imperfect detection of frogs. Landscape features provided little insight into why some sites were colonized and others were not, results that are likely because of the uniformity of the BANWR landscape. While corridor modeling may be effective in more-complex landscapes, our results suggest focusing on local habitat will be more useful at BANWR. We also illustrate that existing data, even when limited in spatial or temporal resolution, can provide information useful in formulating management actions.

Evaluation of an Experimental Re-introduction of Sockeye Salmon into Skaha Lake; Year 1 of 3, 2000 Technical Report.

Energy Technology Data Exchange (ETDEWEB)

Hammell, Larry (University of Prince Edward Island, Atlantic Veterinary College, Charlottetown, PE, Canada); Machin, Deanna; Long, Karilyn (Okanagan National Fisheries Commission, Westbank, BC, Canada)

2001-06-01

summarized into a Draft Action Plan that recommended that sockeye be re-introduced to Skaha Lake as an experimental management strategy to resolve some of these uncertainties (Peters et al. 1998). The purpose of this project is to assess the risks and benefits of an experimental reintroduction of sockeye salmon into Skaha Lake. The assessment will be accomplished by completing the following six objectives over three years: (1) Disease Risk Assessment; (2) Exotic species Re-introduction risk Assessment; (3) Inventory of Existing Habitat and Opportunities for Habitat Enhancement; (4) Development of a life-cycle model of Okanagan salmonids, including interaction with resident kokanee; (5) Development of an experimental design and; (6) Finalize a plan for experimental re-introduction of sockeye salmon into Skaha Lake and associated monitoring programs.

Assessing Potential Habitat and Carrying Capacity for Reintroduction of Plains Bison (Bison bison bison in Banff National Park.

Directory of Open Access Journals (Sweden)

Robin Steenweg

Full Text Available Interest in bison (Bison bison, B. bonasus conservation and restoration continues to grow globally. In Canada, plains bison (B. b. bison are threatened, occupying less than 0.5% of their former range. The largest threat to their recovery is the lack of habitat in which they are considered compatible with current land uses. Fences and direct management make range expansion by most bison impossible. Reintroduction of bison into previously occupied areas that remain suitable, therefore, is critical for bison recovery in North America. Banff National Park is recognized as historical range of plains bison and has been identified as a potential site for reintroduction of a wild population. To evaluate habitat quality and assess if there is sufficient habitat for a breeding population, we developed a Habitat Suitability Index (HSI model for the proposed reintroduction and surrounding areas in Banff National Park (Banff. We then synthesize previous studies on habitat relationships, forage availability, bison energetics and snowfall scenarios to estimate nutritional carrying capacity. Considering constraints on nutritional carrying capacity, the most realistic scenario that we evaluated resulted in an estimated maximum bison density of 0.48 bison/km2. This corresponds to sufficient habitat to support at least 600 to 1000 plains bison, which could be one of the largest 10 plains bison populations in North America. Within Banff, there is spatial variation in predicted bison habitat suitability and population size that suggests one potential reintroduction site as the most likely to be successful from a habitat perspective. The successful reintroduction of bison into Banff would represent a significant global step towards conserving this iconic species, and our approach provides a useful template for evaluating potential habitat for other endangered species reintroductions into their former range.

The natural gas guideline... Finally a good agreement

International Nuclear Information System (INIS)

Beltrame-Devoti, M.C.

1998-01-01

After 18 months of intense negotiations, the European Energy Council came on December 8, 1997 to an agreement about the internal gas market. The essential point of this guideline is the possibility for some customers to deal with the supplier of their choice. This opening of national gas markets will lead to the disappearance of gas importation monopolies. This paper summarizes the final option retained for the opening of the European gas market, its schedule, the protection of take or pay contracts, and the future perspectives for industrialists (new operators for the storage, transport, terminals management, distribution and trade, diversification of services, competition..). (J.S.)

Conflicting and complementary ethics of animal welfare considerations in reintroductions.

Science.gov (United States)

Harrington, Lauren A; Moehrenschlager, Axel; Gelling, Merryl; Atkinson, Rob P D; Hughes, Joelene; Macdonald, David W

2013-06-01

Despite differences in focus, goals, and strategies between conservation biology and animal welfare, both are inextricably linked in many ways, and greater consideration of animal welfare, although important in its own right, also has considerable potential to contribute to conservation success. Nevertheless, animal welfare and animal ethics are not always considered explicitly within conservation practice. We systematically reviewed the recent scientific peer-reviewed and online gray literature on reintroductions of captive-bred and wild-caught animals (mammals, birds, amphibians, and reptiles) to quantify the occurrence of animal welfare issues. We considered monitoring that could be indicative of the animal's welfare status and supportive management actions that could improve animal welfare (regardless of whether the aim was explicitly animal-welfare orientated). Potential welfare issues (of variable nature and extent) were recorded in 67% of 199 projects reviewed; the most common were mortality >50%, dispersal or loss of animals, disease, and human conflict. Most (>70%) projects monitored survival, 18% assessed body condition, and 2% monitored stress levels. Animal welfare, explicitly, was referred to in 6% of projects. Supportive actions, most commonly use of on-site prerelease pens and provision of supplemental food or water, were implemented in 79% of projects, although the extent and duration of support varied. Practitioners can address animal-welfare issues in reintroductions by considering the potential implications for individual animals at all stages of the release process using the decision tree presented. We urge practitioners to report potential animal-welfare issues, describe mitigation actions, and evaluate their efficacy to facilitate transparent evaluation of common moral dilemmas and to advance communal strategies for dealing with them. Currently, comparative mortality rates, health risks, postrelease stress, effectiveness of supportive measures

Re-establishing the pecking order: Niche models reliably predict suitable habitats for the reintroduction of red-billed oxpeckers.

Science.gov (United States)

Kalle, Riddhika; Combrink, Leigh; Ramesh, Tharmalingam; Downs, Colleen T

2017-03-01

Distributions of avian mutualists are affected by changes in biotic interactions and environmental conditions driven directly/indirectly by human actions. The range contraction of red-billed oxpeckers ( Buphagus erythrorhynchus ) in South Africa is partly a result of the widespread use of acaracides (i.e., mainly cattle dips), toxic to both ticks and oxpeckers. We predicted the habitat suitability of red-billed oxpeckers in South Africa using ensemble models to assist the ongoing reintroduction efforts and to identify new reintroduction sites for population recovery. The distribution of red-billed oxpeckers was influenced by moderate to high tree cover, woodland habitats, and starling density (a proxy for cavity-nesting birds) with regard to nest-site characteristics. Consumable resources (host and tick density), bioclimate, surface water body density, and proximity to protected areas were other influential predictors. Our models estimated 42,576.88-98,506.98 km 2 of highly suitable habitat (0.5-1) covering the majority of Limpopo, Mpumalanga, North West, a substantial portion of northern KwaZulu-Natal (KZN) and the Gauteng Province. Niche models reliably predicted suitable habitat in 40%-61% of the reintroduction sites where breeding is currently successful. Ensemble, boosted regression trees and generalized additive models predicted few suitable areas in the Eastern Cape and south of KZN that are part of the historic range. A few southern areas in the Northern Cape, outside the historic range, also had suitable sites predicted. Our models are a promising decision support tool for guiding reintroduction programs at macroscales. Apart from active reintroductions, conservation programs should encourage farmers and/or landowners to use oxpecker-compatible agrochemicals and set up adequate nest boxes to facilitate the population recovery of the red-billed oxpecker, particularly in human-modified landscapes. To ensure long-term conservation success, we suggest that

Sewage Sludge Incinerators: Final Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources Final Rule Fact Sheets

Science.gov (United States)

This page contains a February 2011 fact sheet with information regarding the final NSPS and Emission Guidelines for Existing Sources for Sewage Sludge Incinerators (SSI). This document provides a summary of the information for these regulations.

Stream hydrology limits recovery of riparian ecosystems after wolf reintroduction.

Science.gov (United States)

Marshall, Kristin N; Hobbs, N Thompson; Cooper, David J

2013-04-07

Efforts to restore ecosystems often focus on reintroducing apex predators to re-establish coevolved relationships among predators, herbivores and plants. The preponderance of evidence for indirect effects of predators on terrestrial plant communities comes from ecosystems where predators have been removed. Far less is known about the consequences of their restoration. The effects of removal and restoration are unlikely to be symmetrical because removing predators can create feedbacks that reinforce the effects of predator loss. Observational studies have suggested that the reintroduction of wolves to Yellowstone National Park initiated dramatic restoration of riparian ecosystems by releasing willows from excessive browsing by elk. Here, we present results from a decade-long experiment in Yellowstone showing that moderating browsing alone was not sufficient to restore riparian zones along small streams. Instead, restoration of willow communities depended on removing browsing and restoring hydrological conditions that prevailed before the removal of wolves. The 70-year absence of predators from the ecosystem changed the disturbance regime in a way that was not reversed by predator reintroduction. We conclude that predator restoration may not quickly repair effects of predator removal in ecosystems.

Silvicultural and logistical considerations associated with the pending reintroduction of American chestnut

Science.gov (United States)

Douglass F. Jacobs

2010-01-01

Traditional breeding for blight resistance has led to the potential to restore American chestnut (Castanea dentata (Marsh.) Borkh.) to Eastern United States forests using a blight resistant hybrid chestnut tree. With prospects of pending wide-scale reintroduction, restoration strategies based on ecological and biological characteristics of the...

Viability and Risk Assessment in Species Restoration: Planning Reintroductions for the Wild Boar, a Potential Disease Reservoir

Directory of Open Access Journals (Sweden)

Néstor Fernández

2006-06-01

Full Text Available The reintroduction of large mammals is often considered a priority conservation action in highly industrialized countries in which many of these species have been depleted. However, species reintroduction after decades of absence may involve important risks for human activities and ecological communities, such as favoring the spread of diseases. An example of a potentially troublesome reintroduction is the wild boar, which may act as a reservoir of diseases, e.g., classical swine fever, and cause high economic losses, and has become a species of concern in several European countries for both ecological and recreational reasons. Failure to prevent the disease consequences of species restoration can negate its conservation benefits. Here we evaluated the probability of both successfully reintroducing wild boar into Denmark and limiting their contact with domestic pig farms to which they might spread disease. For this purpose, we developed a spatially explicit, individual-based population model that incorporates information on boar habitat and demography information from Central European populations. We then compared model predictions with the spatial distribution of farms to achieve a spatial assessment of the contact risk. The most restrictive model scenario predicted that nearly 6% of Denmark provides habitat conditions that would allow wild boar to reproduce. The best habitats for reintroduction were aggregated in seven different areas throughout the country in which the extinction probability was < 5%. However, the expected population expansion was very limited in most of these areas. Both the number of suitable areas and the potential for population expansion greatly increased when we relaxed our habitat assumptions about boar forest requirements; this provided a more conservative scenario for a cautious risk analysis. We additionally found that part of the risk of contact with piggeries was associated with the magnitude of the expansion

The genetic legacy of multiple beaver reintroductions in Central Europe.

Science.gov (United States)

Frosch, Christiane; Kraus, Robert H S; Angst, Christof; Allgöwer, Rainer; Michaux, Johan; Teubner, Jana; Nowak, Carsten

2014-01-01

The comeback of the Eurasian beaver (Castor fiber) throughout western and central Europe is considered a major conservation success. Traditionally, several subspecies are recognised by morphology and mitochondrial haplotype, each linked to a relict population. During various reintroduction programs in the 20th century, beavers from multiple source localities were released and now form viable populations. These programs differed in their reintroduction strategies, i.e., using pure subspecies vs. mixed source populations. This inhomogeneity in management actions generated ongoing debates regarding the origin of present beaver populations and appropriate management plans for the future. By sequencing of the mitochondrial control region and microsatellite genotyping of 235 beaver individuals from five selected regions in Germany, Switzerland, Luxembourg, and Belgium we show that beavers from at least four source origins currently form admixed, genetically diverse populations that spread across the study region. While regional occurrences of invasive North American beavers (n = 20) were found, all but one C. fiber bore the mitochondrial haplotype of the autochthonous western Evolutionary Significant Unit (ESU). Considering this, as well as the viability of admixed populations and the fact that the fusion of different lineages is already progressing in all studied regions, we argue that admixture between different beaver source populations should be generally accepted.

Assessing the suitability of central European landscapes for the reintroduction of Eurasian lynx

Czech Academy of Sciences Publication Activity Database

Schadt, S.; Revilla, E.; Wiegand, T.; Knauer, F.; Kaczensky, P.; Breitenmoser, U.; Bufka, L.; Červený, Jaroslav; Koubek, Petr; Huber, T.; Staniša, C.; Trepl, L.

2002-01-01

Roč. 39, č. 2 (2002), s. 189-203 ISSN 0021-8901 R&D Projects: GA AV ČR KSK6005114 Grant - others:Deutsche Bundesstiftung Umwelt(DE) AZ6000/596 Keywords : Lynx lynx * GIS * species reintroduction Subject RIV: EH - Ecology, Behaviour Impact factor: 2.902, year: 2002

Advanced lighting guidelines: 1993. Final report

Energy Technology Data Exchange (ETDEWEB)

Eley, C.; Tolen, T.M. [Eley Associates, San Francisco, CA (United States); Benya, J.R. [Luminae Souter Lighting Design, San Francisco, CA (United States); Rubinstein, F.; Verderber, R. [Lawrence Berkeley Lab., CA (United States)

1993-12-31

The 1993 Advanced Lighting Guidelines document consists of twelve guidelines that provide an overview of specific lighting technologies and design application techniques utilizing energy-efficient lighting practice. Lighting Design Practice assesses energy-efficient lighting strategies, discusses lighting issues, and explains how to obtain quality lighting design and consulting services. Luminaires and Lighting Systems surveys luminaire equipment designed to take advantage of advanced technology lamp products and includes performance tables that allow for accurate estimation of luminaire light output and power input. The additional ten guidelines -- Computer-Aided Lighting Design, Energy-Efficient Fluorescent Ballasts, Full-Size Fluorescent Lamps, Compact Fluorescent Lamps, Tungsten-Halogen Lamps, Metal Halide and HPS Lamps, Daylighting and Lumen Maintenance, Occupant Sensors, Time Scheduling Systems, and Retrofit Control Technologies -- each provide a product technology overview, discuss current products on the lighting equipment market, and provide application techniques. This document is intended for use by electric utility personnel involved in lighting programs, lighting designers, electrical engineers, architects, lighting manufacturers` representatives, and other lighting professionals.

Reintroduction of locally extinct vertebrates impacts arid soil fungal communities.

Science.gov (United States)

Clarke, Laurence J; Weyrich, Laura S; Cooper, Alan

2015-06-01

Introduced species have contributed to extinction of native vertebrates in many parts of the world. Changes to vertebrate assemblages are also likely to alter microbial communities through coextinction of some taxa and the introduction of others. Many attempts to restore degraded habitats involve removal of exotic vertebrates (livestock and feral animals) and reintroduction of locally extinct species, but the impact of such reintroductions on microbial communities is largely unknown. We used high-throughput DNA sequencing of the fungal internal transcribed spacer I (ITS1) region to examine whether replacing exotic vertebrates with reintroduced native vertebrates led to changes in soil fungal communities at a reserve in arid central Australia. Soil fungal diversity was significantly different between dune and swale (interdune) habitats. Fungal communities also differed significantly between sites with exotic or reintroduced native vertebrates after controlling for the effect of habitat. Several fungal operational taxonomic units (OTUs) found exclusively inside the reserve were present in scats from reintroduced native vertebrates, providing a direct link between the vertebrate assemblage and soil microbial communities. Our results show that changes to vertebrate assemblages through local extinctions and the invasion of exotic species can alter soil fungal communities. If local extinction of one or several species results in the coextinction of microbial taxa, the full complement of ecological interactions may never be restored. © 2015 John Wiley & Sons Ltd.

Assessing the feasibility of native fish reintroductions: a framework and example applied to bull trout in the Clackamas River, Oregon

Science.gov (United States)

Dunham, Jason B.; Gallo, Kirsten

2008-01-01

In a species conservation context, translocations can be an important tool, but they frequently fail to successfully establish new populations. We consider the case of reintroductions for bull trout (Salvelinus confluentus), a federally-listed threatened species with a widespread but declining distribution in western North America. Our specific objectives in this work were to: 1) develop a general framework for assessing the feasibility of reintroduction for bull trout, 2) provide a detailed example of implementing this framework to assess the feasibility of reintroducing bull trout in the Clackamas River, Oregon, and 3) discuss the implications of this effort in the more general context of fish reintroductions as a conservation tool. Review of several case histories and our assessment of the Clackamas River suggest that an attempt to reintroduce bull trout could be successful, assuming adequate resources are committed to the subsequent stages of implementation, monitoring, and evaluation.

Linear shrinkage test: justification for its reintroduction as a standard South African test method

CSIR Research Space (South Africa)

Sampson, LR

2009-06-04

Full Text Available Several problems with the linear shrinkage test specified in Method A4 of the THM 1 1979 were addressed as part of this investigation in an effort to improve the alleged poor reproducibility of the test and justify its reintroduction into THM 1. A...

Sphagnum re-introduction in degraded peatlands: the effects of aggregation, species and water table

NARCIS (Netherlands)

Robroek, B.J.M.; Ruijven, van J.; Schouten, M.G.C.; Breeuwer, A.J.G.; Crushell, P.H.; Berendse, F.; Limpens, J.

2009-01-01

In European peatlands which have been drained and cut-over in the past, re-vegetation often stagnates after the return of a species-poor Sphagnum community. Re-introduction of currently absent species may be a useful tool to restore a typical, and more diverse, Sphagnum vegetation and may ultimately

Main-coolant-pump shaft-seal guidelines. Volume 2. Operational guidelines. Final report

International Nuclear Information System (INIS)

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

1983-03-01

This report presents a set of guidelines and criteria for improving main coolant pump shaft seal operational reliability. The noted guidelines are developed from EPRI sponsored nuclear power plant seal operating experience studies. Usage procedures/practices and operational environment influence on seal life and reliability from the most recent such survey are summarized. The shaft seal and its auxiliary supporting systems are discussed both from technical and operational related viewpoints

REINTRODUCTION OF NOBLE CRAYFISH ASTACUS ASTACUS AFTER CRAYFISH PLAGUE IN NORWAY

Directory of Open Access Journals (Sweden)

TAUGBØL T.

2004-01-01

Full Text Available The Glomma and Halden watercourses in Norway were hit by crayfish plague in 1987 and 1989. Reintroduction of the noble crayfish started in 1989 in the Glomma and in 1995 in the Halden watercourse. Norway has especially good conditions for reintroduction of the native crayfish after crayfish plague, as there is no alien plague-carrying crayfish species in the country. In the Glomma watercourse, approx. 15 000 adult crayfish and 10 000 juveniles have been stocked while in the Halden watercourse the figures are 19 000 adults and 26 500 juveniles. All stocking sites were previously regarded as very good crayfish localities. Four years after stocking, natural recruitment was recorded at all adult crayfish stocking sites in the Glomma watercourse and at most sites in the Halden watercourse. Current crayfish density is, however, much lower than pre-plague densities even at the sites where population development has been in progress for more than 10 years. Extensive post-stocking movements were recorded among adult crayfish. Some sites seemed more suitable for settling, resulting in a great variation in CPUE between the different test-fishing sites. Juveniles seem more appropriate as stocking material if the goal is to re-establish a population in a particular area, due to their stationary behaviour, which seems to remain as they grow larger.

Feasibility and Risks of Coho Reintroduction in Mid-Columbia [Tributaries] Monitoring and Evaluation, 1999 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Dunnigan, James L. (Confederated Tribes and Bands of the Yakama Nation, Toppenish, WA)

1999-10-01

The long-term vision for the coho re-introduction project is to reestablish naturally reproducing coho salmon populations in mid-Columbia river basins, with numbers at or near carrying capacity that provide opportunities for significant harvest for Tribal and non-Tribal fishers.

Historical perspective on the reintroduction of the fisher and American marten in Michigan and Wisconsin

Science.gov (United States)

Bronwyn W. Williams; Jonathan H. Gilbert; Patrick A. Zollner

2007-01-01

Management of mustelid species such as fishers and martens requires an understanding of the history of local populations. This is particularly true in areas where populations were extirpated and restored through reintroduction efforts. During the late 19th and 20th centuries, fishers (Martes pennanti) and American martens (Martes americana...

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

International Nuclear Information System (INIS)

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

1983-03-01

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

Assessing the potential threat landscape of a proposed reintroduction site for carnivores.

Science.gov (United States)

Page, Samantha K; Parker, Daniel M; Peinke, Dean M; Davies-Mostert, Harriet T

2015-01-01

This study provides a framework to assess the feasibility of reintroducing carnivores into an area, using African wild dogs (Lycaon pictus) as an example. The Great Fish River Nature Reserve in the Eastern Cape Province, South Africa, has been identified as a potential reserve to reintroduce wild dogs, and we applied this framework to provide a threat assessment of the surrounding area to determine potential levels of human-wildlife conflict. Although 56% of neighbouring landowners and local communities were positive about a wild dog reintroduction, data collected from questionnaire surveys revealed that human-wild dog conflict is a potential threat to wild dog survival in the area. Additional potential threats include diseases, snaring, poaching and hunting wild dogs for the use of traditional medicine. A threat index was developed to establish which properties harboured the greatest threats to wild dogs. This index was significantly influenced by the respondent's first language (isiXhosa had more positive indices), education level (poorer education was synonymous with more positive threat indices), land use (wildlife ranching being the most negative) and land tenure (community respondents had more positive indices than private landowners). Although threats are present, they can be effectively mitigated through strategies such as carnivore education programs, vaccination campaigns and anti-snare patrols to promote a successful reintroduction of this endangered canid.

Assessing the potential threat landscape of a proposed reintroduction site for carnivores.

Directory of Open Access Journals (Sweden)

Samantha K Page

Full Text Available This study provides a framework to assess the feasibility of reintroducing carnivores into an area, using African wild dogs (Lycaon pictus as an example. The Great Fish River Nature Reserve in the Eastern Cape Province, South Africa, has been identified as a potential reserve to reintroduce wild dogs, and we applied this framework to provide a threat assessment of the surrounding area to determine potential levels of human-wildlife conflict. Although 56% of neighbouring landowners and local communities were positive about a wild dog reintroduction, data collected from questionnaire surveys revealed that human-wild dog conflict is a potential threat to wild dog survival in the area. Additional potential threats include diseases, snaring, poaching and hunting wild dogs for the use of traditional medicine. A threat index was developed to establish which properties harboured the greatest threats to wild dogs. This index was significantly influenced by the respondent's first language (isiXhosa had more positive indices, education level (poorer education was synonymous with more positive threat indices, land use (wildlife ranching being the most negative and land tenure (community respondents had more positive indices than private landowners. Although threats are present, they can be effectively mitigated through strategies such as carnivore education programs, vaccination campaigns and anti-snare patrols to promote a successful reintroduction of this endangered canid.

The reintroduction of boreal caribou as a conservation strategy: A long-term assessment at the southern range limit

Directory of Open Access Journals (Sweden)

Martin-Hugues St-Laurent

2012-03-01

Full Text Available Boreal caribou were extirpated from the Charlevoix region (Québec in the 1920s because of hunting and poaching. In 1965, the Québec government initiated a caribou reintroduction program in Charlevoix. During the winters of 1966 and 1967, a total of 48 boreal caribou were captured, translocated by plane, and released within enclosures; only their offspring (82 individuals were released in the wild. Between 1967 and 1980, a wolf control program was applied to support caribou population growth. The caribou population, however, remained relatively stable at 45–55 individuals during this period. During the 1980s, the population grew slowly at a rate of approximately 5% each year to reach a peak of 126 individuals in 1992. At that time, Bergerud & Mercer (1989 reported that the Charlevoix experiment was the only successful attempt at caribou reintroduction in the presence of predators (in North America. Afterwards, the population declined and since then it has been relatively stable at about 80 individuals. Here we reviewed the literature regarding the ecology and population dynamics of the Charlevoix caribou herd since its reintroduction, in an attempt to critically assess the value of reintroduction as a conservation tool for this species. Indeed, the Charlevoix caribou herd is now considered at very high risk of extinction mostly because of its small size, its isolation from other caribou populations, and low recruitment. The Charlevoix region has been heavily impacted by forestry activities since the early 1980s. Recent studies have indicated that these habitat modifications may have benefited populations of wolves and black bears—two predators of caribou—and that caribou range fidelity may have exposed caribou to higher predation risk via maladaptive habitat selection. As females are ageing, and females and calves suffer high predation pressure from wolves and bears respectively, we suggest that the future of this reintroduced herd is in

Behavioral responses of maned wolves (Chrysocyon brachyurus, Canidae) to different categories of environmental enrichment stimuli and their implications for successful reintroduction.

Science.gov (United States)

Coelho, Carlyle Mendes; de Azevedo, Cristiano Schetini; Young, Robert John

2012-01-01

The maned wolf (Chrysocyon brachyurus, Illiger, 1815, Canidae) is a threatened species that inhabits the cerrados of Brazil, Argentina, Peru, Bolivia, Paraguay, and Uruguay. Captive maned wolves could be potentially used in reintroduction programs for species conservation; however, it is necessary that their behavior and cognitive abilities are conserved. Environmental enrichment is a tool used to stimulate captive animals and maintain a natural behavioral repertoire. To compare the variation of captive maned wolves' behavioral responses to environmental enrichment, we studied three maned wolves held by Belo Horizonte Zoo, Brazil. Foraging, interspecific, and intraspecific stimuli were offered to the animals and their responses were compared with a baseline and postenrichment treatments. The test was used to help in choosing which one of the three individuals would participate in a reintroduction project. The results showed that stimuli type did influence the animal's responses, and that individually wolves responded differently to foraging, interspecific, and intraspecific enrichment items (P80.05 for some behaviors in each enrichment category). The individual's personality seemed to influence their behavioral responses, with animals showing bold and shy responses, and this trait should be considered during decision makings for reintroduction. © 2011 Wiley Periodicals, Inc.

78 FR 71676 - NUREG-1482, Revision 2, “Guidelines for Inservice Testing at Nuclear Power Plants, Final Report”

Science.gov (United States)

2013-11-29

... Testing at Nuclear Power Plants, Final Report'' AGENCY: Nuclear Regulatory Commission. ACTION: Notice of... entitled: NUREG-1482, Revision 2, ``Guidelines for Inservice Testing at Nuclear Power Plants,'' and... Restraints (Snubbers) at Nuclear Power Plants.'' In the previous Revisions 0 and 1 of NUREG-1482, the NRC...

Regulatory impact analysis of final effluent limitations guidelines and standards for the offshore oil and gas industry. Final report

International Nuclear Information System (INIS)

1993-01-01

For all major rulemaking actions, Executive Order 12291 requires a Regulatory Impact Analysis (RIA), in which benefits of the regulation are compared to costs imposed by the regulation. The report presents the Environmental Protection Agency's (EPA, or the Agency) RIA of the final rule on the effluent limitations guidelines for the Offshore Subcategory of the Oil and Gas Extraction Industry. The principal requirement of the Executive Order is that the Agency perform an analysis comparing the benefits of the regulation to the costs that the regulation imposes. Three types of benefits are analyzed in this RIA: quantified and monetized benefits; quantified and non-monetized benefits; and non-quantified and non-monetized benefits

Re-Introduction of Lower Columbia River Chum Salmon into Duncan Creek, 2002-2003 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Hillson, Todd D. (Washington Department of Fish and Wildlife, Olympia, WA)

2003-10-15

spawning refugias, supplementation if necessary and a habitat and fish monitoring and evaluation plan. If chum have been extirpated from previously utilized streams, develop re-introduction plans that utilize appropriate genetic donor stock(s) of LCR chum salmon and integrate habitat improvement and fry-to-adult survival evaluations. Third, reduce extinction risks to the Grays River chum salmon population by randomly capturing adults in the basin for use in a supplementation program and reintroduction into the Chinook River basin. The Duncan Creek project was developed using the same recovery strategy implemented for LCR chum. Biologists with the WDFW and Pacific States Marine Fisheries Commission (PSMFC) identified Duncan Creek as an ideal upriver location below Bonneville Dam for chum re-introduction. It has several attributes that make it a viable location for a re-introduction project: historically chum salmon were present, the creek is low gradient, has numerous springs/seeps, has a low potential for future development and is located close to a donor population of Lower Gorge chum. The Duncan Creek project has two goals: (1) re-introduction of chum into Duncan Creek by providing off channel high-quality spawning and incubation areas, and (2) to simultaneously evaluate natural recolonization and a supplementation strategy where adults are collected and spawned artificially at a hatchery. For supplementation, eggs are incubated and the fry reared at the Washougal Hatchery to be released back into Duncan Creek. The tasks associated with re-establishing a naturally self-sustaining population include: (1) removing mud, sand and organics present in four of the creek branches and replace with gravels expected to provide maximum egg-to-fry survival rates to a depth of at least two feet; (2) armoring the sides of these channels to reduce importation of sediment by fish spawning on the margins; (3) planting native vegetation adjacent to the channels to stabilize the banks, trap

An assessment of African lion Panthera leo sociality via social network analysis: prerelease monitoring for an ex situ reintroduction program.

Science.gov (United States)

Dunston, Emma J; Abell, Jackie; Doyle, Rebecca E; Kirk, Jacqui; Hilley, Victoria B; Forsyth, Andrew; Jenkins, Emma; Freire, Rafael

2017-06-01

The wild population of the African lion Panthera leo continues to decline, requiring alternate conservation programs to be considered. One such program is ex situ reintroduction. Prior to release, long-term monitoring and assessment of behavior is required to determine whether prides and coalitions behave naturally and are sufficiently adapted to a wild environment. Social network analysis (SNA) can be used to provide insight into how the pride as a whole and individuals within it, function. Our study was conducted upon 2 captive-origin prides who are part of an ex situ reintroduction program, and 1 wild pride of African lion. Social interactions were collected at all occurrence for each pride and categorized into greet, social grooming, play, and aggression. Betweenness centrality showed that offspring in each pride were central to the play network, whereas degree indicated that adults received (indegree) the greatest number of overall social interactions, and the adult males of each pride were least likely to initiate (outdegree) any interactions. Through the assessment of individual centrality and degree values, a social keystone adult female was identified for each pride. Social network results indicated that the 2 captive-origin prides had formed cohesive social units and possessed relationships and behaviors comparable with the wild pride for the studied behaviors. This study provided the first SNA comparison between captive-bred origin and a wild pride of lions, providing valuable information on individual and pride sociality, critical for determining the success of prides within an ex situ reintroduction program.

An assessment of African lion Panthera leo sociality via social network analysis: prerelease monitoring for an ex situ reintroduction program

Science.gov (United States)

Abell, Jackie; Doyle, Rebecca E.; Kirk, Jacqui; Hilley, Victoria B.; Forsyth, Andrew; Jenkins, Emma; Freire, Rafael

2017-01-01

Abstract The wild population of the African lion Panthera leo continues to decline, requiring alternate conservation programs to be considered. One such program is ex situ reintroduction. Prior to release, long-term monitoring and assessment of behavior is required to determine whether prides and coalitions behave naturally and are sufficiently adapted to a wild environment. Social network analysis (SNA) can be used to provide insight into how the pride as a whole and individuals within it, function. Our study was conducted upon 2 captive-origin prides who are part of an ex situ reintroduction program, and 1 wild pride of African lion. Social interactions were collected at all occurrence for each pride and categorized into greet, social grooming, play, and aggression. Betweenness centrality showed that offspring in each pride were central to the play network, whereas degree indicated that adults received (indegree) the greatest number of overall social interactions, and the adult males of each pride were least likely to initiate (outdegree) any interactions. Through the assessment of individual centrality and degree values, a social keystone adult female was identified for each pride. Social network results indicated that the 2 captive-origin prides had formed cohesive social units and possessed relationships and behaviors comparable with the wild pride for the studied behaviors. This study provided the first SNA comparison between captive-bred origin and a wild pride of lions, providing valuable information on individual and pride sociality, critical for determining the success of prides within an ex situ reintroduction program. PMID:29491989

Common issues raised during the quality assurance process of WHO guidelines: a cross-sectional study.

Science.gov (United States)

Porgo, Teegwendé V; Ferri, Mauricio; Norris, Susan L

2018-02-07

In 2007, WHO established the Guidelines Review Committee (GRC) to ensure that WHO guidelines adhere to the highest international standards. The GRC reviews guideline proposals and final guidelines. The objectives of this study were to examine the rates of and reasons for conditional approval and non-approval of documents submitted for the first time to the GRC, and calculate the time intervals and numbers of submissions to achieve approval for documents conditionally approved or not approved at first submission. All initial submissions to the GRC between 2014 and 2017 were examined. Data were extracted from the GRC's records of written comments and discussions. Of a total of 85 proposals and 88 final guidelines, 32 (37.6%) proposals and 37 (42.0%) final guidelines were conditionally approved, and 15 (17.6%) proposals and 28 (31.8%) final guidelines were not. For both conditionally approved and not approved proposals, the most frequent reasons were suboptimal composition or inadequate description of the guideline contributor groups (in all proposals), followed by inadequate formulation of key questions (in 90.6% of conditionally approved proposals and all not approved proposals). For both conditionally approved and not approved final guidelines, the most frequent reasons were problems with recommendations (in all final guidelines), followed by inappropriate methods for evidence retrieval or an inadequate description thereof (in all conditionally approved final guidelines and 75.0% of not approved final guidelines). The median time to achieve approval was 2 months for proposals and 1-2 months for final guidelines. The median number of submissions was 2 for proposals and 2-2.5 for final guidelines. The GRC implements a rigorous quality assurance process and identifies problems with a significant percentage of initial submissions. WHO needs to continuously evaluate its guideline development processes to inform effective quality improvement measures and optimise the

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

Science.gov (United States)

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

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

Demographic drivers of a refugee species: Large‐scale experiments guide strategies for reintroductions of hirola

Science.gov (United States)

Ali, Abdullahi H.; Kauffman, Matthew J.; Amin, Rajan; Kibara, Amos; King, Juliet; Mallon, David P.; Musyoki, Charles; Goheen, Jacob R.

2018-01-01

Effective reintroduction strategies require accurate estimates of vital rates and the factors that influence them. The hirola (Beatragus hunteri) is the rarest antelope on Earth, with a global population size of <500 individuals restricted to the Kenya–Somali border. We estimated vital rates of hirola populations exposed to varying levels of predation and rangeland quality from 2012 to 2015, and then built population matrices to estimate the finite rate of population change (λ) and demographic sensitivities. Mean survival for all age classes and population growth was highest in the low‐predation–high‐rangeland‐quality setting (λ = 1.08 ± 0.03 [mean ± SE]), and lowest in the high‐predation–low‐rangeland‐quality setting (λ = 0.70 ± 0.22). Retrospective demographic analyses revealed that increased fecundity (the number of female calves born to adult females annually) and female calf survival were responsible for higher population growth where large carnivores were absent. In contrast, variation in adult female survival was the primary contributor to differences in population growth attributable to rangeland quality. Our analyses suggest that hirola demography is driven by a combination of top‐down (predation) and bottom‐up (rangeland quality) forces, with populations in the contemporary geographic range impacted both by declining rangeland quality and predation. To enhance the chances of successful reintroductions, conservationists can consider rangeland restoration to boost both the survival and fecundity of adult females within the hirola's historical range.

[The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika

2007-01-15

In Germany, the first national consensus on evidence-based recommendations for COPD prevention and disease management was reached in spring 2006. After a development period of 9 months, the National Disease Management Guideline COPD was finalized by nominal group process under the authorship of the scientific societies for pneumology (DGP and Atemwegsliga), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the NICE COPD Guideline 2004, the GOLD Recommendations as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline COPD 2006 (www.copd.versorgungsleitlinien.de).

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

International Nuclear Information System (INIS)

1996-06-01

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

Guidelines for Guidelines: Are They Up to the Task? A Comparative Assessment of Clinical Practice Guideline Development Handbooks

Science.gov (United States)

Ansari, Shabnam; Rashidian, Arash

2012-01-01

Objectives We conducted a comparative review of clinical practice guideline development handbooks. We aimed to identify the main guideline development tasks, assign weights to the importance of each task using expert opinions and identify the handbooks that provided a comprehensive coverage of the tasks. Methods We systematically searched and included handbooks published (in English language) by national, international or professional bodies responsible for evidenced-based guideline development. We reviewed the handbooks to identify the main guideline development tasks and scored each handbook for each task from 0 (the handbook did not mention the task) to 2 (the task suitably addressed and explained), and calculated a weighted score for each handbook. The tasks included in over 75% of the handbooks were considered as ‘necessary’ tasks. Result Nineteen guideline development handbooks and twenty seven main tasks were identified. The guideline handbooks’ weighted scores ranged from 100 to 220. Four handbooks scored over 80% of the maximum possible score, developed by the National Institute for Health and Clinical Excellence, Swiss Centre for International Health, Scottish Intercollegiate Guidelines Network and World Health Organization. Necessary tasks were: selecting the guideline topic, determining the guideline scope, identifying relevant existing guidelines, involving the consumers, forming guideline development group,, developing clinical questions, systematic search for evidence, selecting relevant evidence, appraising identifies research evidence, making group decision, grading available evidence, creating recommendations, final stakeholder consultation, guideline implementation strategies, updating recommendations and correcting potential errors. Discussion Adequate details for evidence based development of guidelines were still lacking from many handbooks. The tasks relevant to ethical issues and piloting were missing in most handbooks. The findings

Decision analysis for conservation breeding: Maximizing production for reintroduction of whooping cranes

Science.gov (United States)

Smith, Des H.V.; Converse, Sarah J.; Gibson, Keith; Moehrenschlager, Axel; Link, William A.; Olsen, Glenn H.; Maguire, Kelly

2011-01-01

Captive breeding is key to management of severely endangered species, but maximizing captive production can be challenging because of poor knowledge of species breeding biology and the complexity of evaluating different management options. In the face of uncertainty and complexity, decision-analytic approaches can be used to identify optimal management options for maximizing captive production. Building decision-analytic models requires iterations of model conception, data analysis, model building and evaluation, identification of remaining uncertainty, further research and monitoring to reduce uncertainty, and integration of new data into the model. We initiated such a process to maximize captive production of the whooping crane (Grus americana), the world's most endangered crane, which is managed through captive breeding and reintroduction. We collected 15 years of captive breeding data from 3 institutions and used Bayesian analysis and model selection to identify predictors of whooping crane hatching success. The strongest predictor, and that with clear management relevance, was incubation environment. The incubation period of whooping crane eggs is split across two environments: crane nests and artificial incubators. Although artificial incubators are useful for allowing breeding pairs to produce multiple clutches, our results indicate that crane incubation is most effective at promoting hatching success. Hatching probability increased the longer an egg spent in a crane nest, from 40% hatching probability for eggs receiving 1 day of crane incubation to 95% for those receiving 30 days (time incubated in each environment varied independently of total incubation period). Because birds will lay fewer eggs when they are incubating longer, a tradeoff exists between the number of clutches produced and egg hatching probability. We developed a decision-analytic model that estimated 16 to be the optimal number of days of crane incubation needed to maximize the number of

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

Energy Technology Data Exchange (ETDEWEB)

None

1996-06-01

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

Clonal Re-Introduction of Endangered Plant Species: The Case of German False Tamarisk in Pre-Alpine Rivers

Science.gov (United States)

Koch, Christiane; Kollmann, Johannes

2012-08-01

The scope of re-introduction as a measure for plant species protection is increasing, but as long as no standardized methods are available, species-specific assessments are necessary to determine whether seeds, adult plants or plant fragments should be used. The endangered German False Tamarisk ( Myricaria germanica), which occurs on gravel bars along pre-alpine rivers, is difficult to grow from seeds. Thus, propagation of stem cuttings was investigated as an alternative method. Experiments were conducted in a greenhouse and a field site with three treatments: cutting length 5 or 10 cm, vertical burial 5 or 10 cm, and water level low or high. Plants grown in the greenhouse were transplanted to the River Isar to test establishment of rooted cuttings on gravel bars. The cuttings in the greenhouse showed high survival (34-96 %). Survival and biomass production were greatest for 10-cm cuttings buried at 10-cm depth, while only one of the 5-cm cuttings survived at this depth, and no significant effect of variation in water level was observed. None of the cuttings transplanted to field sites survived, most likely because of drought stress and competition. We conclude that for re-introduction of Myricaria germanica rooted cuttings can be easily produced in large quantities, while transplantation to near-natural environments has to be improved to reduce mortality.

Information and Communication Technology (ICT) Standards and Guidelines. Final rule.

Science.gov (United States)

2017-01-18

We, the Architectural and Transportation Barriers Compliance Board (Access Board or Board), are revising and updating, in a single rulemaking, our standards for electronic and information technology developed, procured, maintained, or used by Federal agencies covered by section 508 of the Rehabilitation Act of 1973, as well as our guidelines for telecommunications equipment and customer premises equipment covered by Section 255 of the Communications Act of 1934. The revisions and updates to the section 508-based standards and section 255-based guidelines are intended to ensure that information and communication technology covered by the respective statutes is accessible to and usable by individuals with disabilities.

[The German Program for Disease Management Guidelines: CHD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2006-12-15

In Germany, the first national consensus on evidence-based recommendations for disease management in patients with chronic coronary heart disease was reached in summer 2006. After a development period of 4 years, the National Disease Management Guideline Chronic Coronary Heart Disease was finalized by nominal group process under the authorship of the scientific associations for cardiac rehabilitation (DGPR), cardiac surgery (DGTHG), cardiology (DGK), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the ACC/AHA guidelines 2002 updates as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Chronic Coronary Heart Disease 2006 (www.khk.versorgungsleitlinie.de).

Singapore Paediatric Resuscitation Guidelines 2016.

Science.gov (United States)

Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong

2017-07-01

We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.

A review of the proposed reintroduction program for the Far Eastern leopard (Panthera pardus orientalis) and the role of conservation organizations, veterinarians, and zoos.

Science.gov (United States)

Kelly, Paul; Stack, David; Harley, Jessica

2013-11-01

The Amur leopard is at the point of extinction. At present there are fewer than 35 in the wild. Their natural habitat ranges from China to the North Korean peninsula to Primorsky Krai in Russia. A reintroduction plan has been proposed to increase the population in the wild; however, this proposed plan still has many questions to be answered as to how effective it will be. The main objective is to reintroduce animals from a select group within the Far Eastern leopard programme or the Species Survival programme, which consist of leopards from select populations in the Northern Hemisphere. Zoos are central to the success of this plan, providing suitable breeding pairs to breed animals for reintroduction and also raising much needed funds to finance the project. Zoos are also central in educating the public about the critical status of the Amur leopard and other endangered animals of the world. Veterinary surgeons, by the very nature of their professional skills, are at the forefront of this seemingly endless battle against extinction of thousands of species that are critical to maintaining the balance of our fragile ecosystem. Veterinarians can analyze the health risks and health implications of reintroduction on the animals to be reintroduced and also on the native population. A world without large cats is a world hard to imagine. If we look closer at the implications of extinction, we see the domino effect of their loss and an ecosystem out of control. © 2013 Published by Elsevier Inc.

Guidelines for Preparing Final Technical Reports

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

fdieudonne

Prior to submitting the Final Technical Report, any outstanding issues related to dissemination in accordance with ... The report should be an opportunity to reflect on the management of the project from various perspectives: .... of poor quality.

Reintroducing resurrected species: selecting DeExtinction candidates.

Science.gov (United States)

Seddon, Philip J; Moehrenschlager, Axel; Ewen, John

2014-03-01

Technological advances have raised the controversial prospect of resurrecting extinct species. Species DeExtinction should involve more than the production of biological orphans to be scrutinized in the laboratory or zoo. If DeExtinction is to realize its stated goals of deep ecological enrichment, then resurrected animals must be translocated (i.e., released within suitable habitat). Therefore, DeExtinction is a conservation translocation issue and the selection of potential DeExtinction candidates must consider the feasibility and risks associated with reintroduction. The International Union for the Conservation of Nature (IUCN) Guidelines on Reintroductions and Other Conservation Translocations provide a framework for DeExtinction candidate selection. We translate these Guidelines into ten questions to be addressed early on in the selection process to eliminate unsuitable reintroduction candidates. We apply these questions to the thylacine, Yangtze River Dolphin, and Xerces blue butterfly. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2014-01-01

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

Philometra rubra (Nematoda: Philometridae) first description of the male from striped bass (Morone saxatilis) and implications for re-introduction of an extirpated population

Czech Academy of Sciences Publication Activity Database

Measures, L.; Moravec, František; Douglas, S.; Lair, S.

2017-01-01

Roč. 95, č. 5 (2017), s. 345-352 ISSN 0008-4301 R&D Projects: GA ČR(CZ) GBP505/12/G112 Institutional support: RVO:60077344 Keywords : Philometra rubra * striped bass * Morone saxatilis * re-introduction * conservation Subject RIV: EG - Zoology OBOR OECD: Zoology Impact factor: 1.347, year: 2016

The CARE guidelines: consensus-based clinical case report guideline development.

Science.gov (United States)

Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

2014-01-01

A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.

Demographic outcomes and ecosystem implications of giant tortoise reintroduction to Española Island, Galapagos.

Science.gov (United States)

Gibbs, James P; Hunter, Elizabeth A; Shoemaker, Kevin T; Tapia, Washington H; Cayot, Linda J

2014-01-01

Restoration of extirpated species via captive breeding has typically relied on population viability as the primary criterion for evaluating success. This criterion is inadequate when species reintroduction is undertaken to restore ecological functions and interactions. Herein we report on the demographic and ecological outcomes of a five-decade-long population restoration program for a critically endangered species of "ecosystem engineer": the endemic Española giant Galapagos tortoise (Chelonoidis hoodensis). Our analysis of complementary datasets on tortoise demography and movement, tortoise-plant interactions and Española Island's vegetation history indicated that the repatriated tortoise population is secure from a strictly demographic perspective: about half of tortoises released on the island since 1975 were still alive in 2007, in situ reproduction is now significant, and future extinction risk is low with or without continued repatriation. Declining survival rates, somatic growth rates, and body condition of repatriates suggests, however, that resources for continued population growth are increasingly limited. Soil stable carbon isotope analyses indicated a pronounced shift toward woody plants in the recent history of the island's plant community, likely a legacy of changes in competitive relations between woody and herbaceous plants induced by now-eradicated feral goats and prolonged absence of tortoises. Woody plants are of concern because they block tortoise movement and hinder recruitment of cactus--a critical resource for tortoises. Tortoises restrict themselves to remnant cactus patches and areas of low woody plant density in the center of the island despite an apparent capacity to colonize a far greater range, likely because of a lack of cactus elsewhere on the island. We conclude that ecosystem-level criteria for success of species reintroduction efforts take much longer to achieve than population-level criteria; moreover, reinstatement of

Demographic outcomes and ecosystem implications of giant tortoise reintroduction to Española Island, Galapagos.

Directory of Open Access Journals (Sweden)

James P Gibbs

Full Text Available Restoration of extirpated species via captive breeding has typically relied on population viability as the primary criterion for evaluating success. This criterion is inadequate when species reintroduction is undertaken to restore ecological functions and interactions. Herein we report on the demographic and ecological outcomes of a five-decade-long population restoration program for a critically endangered species of "ecosystem engineer": the endemic Española giant Galapagos tortoise (Chelonoidis hoodensis. Our analysis of complementary datasets on tortoise demography and movement, tortoise-plant interactions and Española Island's vegetation history indicated that the repatriated tortoise population is secure from a strictly demographic perspective: about half of tortoises released on the island since 1975 were still alive in 2007, in situ reproduction is now significant, and future extinction risk is low with or without continued repatriation. Declining survival rates, somatic growth rates, and body condition of repatriates suggests, however, that resources for continued population growth are increasingly limited. Soil stable carbon isotope analyses indicated a pronounced shift toward woody plants in the recent history of the island's plant community, likely a legacy of changes in competitive relations between woody and herbaceous plants induced by now-eradicated feral goats and prolonged absence of tortoises. Woody plants are of concern because they block tortoise movement and hinder recruitment of cactus--a critical resource for tortoises. Tortoises restrict themselves to remnant cactus patches and areas of low woody plant density in the center of the island despite an apparent capacity to colonize a far greater range, likely because of a lack of cactus elsewhere on the island. We conclude that ecosystem-level criteria for success of species reintroduction efforts take much longer to achieve than population-level criteria; moreover

Population sex ratios: another consideration in the reintroduction - reinforcement debate?

Directory of Open Access Journals (Sweden)

Sergio A Lambertucci

Full Text Available Reintroduction or reinforcement (RorR of wild populations is a common conservation strategy. Many conservation projects involve the release of individuals of poorly studied species. This may lead to inefficient results or negative impacts on the conservation efforts. Here, we provide new insights into the conservation implications and potential consequences of a skew in the sex ratio of released birds and of the number of birds supplemented for the demography of a long-lived dimorphic bird species, the Andean condor (Vulturgryphus. We demonstrate that a RorR conservation program may be less effective in conserving a species if the sex ratios of the releases and the recipient populations are not considered. We also show that releases can reduce population declines but only if carried out over long periods (i.e., several decades. This can mean high costs for release programs and the added challenge of maintaining programs over time. If RorR programs are to be implemented, bearing in mind the importance of properly assessing their effectiveness, we urge conservation researchers and managers to consider the implications of sex ratio biases for wild populations, and particularly for dimorphic species with sexually despotic behaviour.

Reintroduction of Orangutans: A New Approach. A Study on the Behaviour and Ecology of Reintroduced Orangutans in the Sungai Wain Nature Reserve, East Kalimantan Indonesia

NARCIS (Netherlands)

Fredriksson, Gabriella

1995-01-01

The reintroduction of ex-captive orangutans Pongo pygmaeus) is part of a comprehensive conservation program to preserve this species and it’s habitat. During the last decades the orangutan has been under severe threat throughout it’s range- Northern Sumatra, Kalimantan and East Malaysia- due to

BSACI guideline for the diagnosis and management of cow's milk allergy.

Science.gov (United States)

Luyt, D; Ball, H; Makwana, N; Green, M R; Bravin, K; Nasser, S M; Clark, A T

2014-01-01

This guideline advises on the management of patients with cow's milk allergy. Cow's milk allergy presents in the first year of life with estimated population prevalence between 2% and 3%. The clinical manifestations of cow's milk allergy are very variable in type and severity making it the most difficult food allergy to diagnose. A careful age- and disease-specific history with relevant allergy tests including detection of milk-specific IgE (by skin prick test or serum assay), diagnostic elimination diet, and oral challenge will aid in diagnosis in most cases. Treatment is advice on cow's milk avoidance and suitable substitute milks. Cow's milk allergy often resolves. Reintroduction can be achieved by the graded exposure, either at home or supervised in hospital depending on severity, using a milk ladder. Where cow's milk allergy persists, novel treatment options may include oral tolerance induction, although most authors do not currently recommend it for routine clinical practice. Cow's milk allergy must be distinguished from primary lactose intolerance. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for clinicians in secondary and tertiary care. The recommendations are evidence based, but where evidence is lacking the panel of experts in the committee reached consensus. Grades of recommendation are shown throughout. The document encompasses epidemiology, natural history, clinical presentations, diagnosis, and treatment. © 2014 John Wiley & Sons Ltd.

Reintroduction of rare arable plants by seed transfer. What are the optimal sowing rates?

Science.gov (United States)

Lang, Marion; Prestele, Julia; Fischer, Christina; Kollmann, Johannes; Albrecht, Harald

2016-08-01

During the past decades, agro-biodiversity has markedly declined and some species are close to extinction in large parts of Europe. Reintroduction of rare arable plant species in suitable habitats could counteract this negative trend. The study investigates optimal sowing rates of three endangered species (Legousia speculum-veneris (L.) Chaix, Consolida regalis Gray, and Lithospermum arvense L.), in terms of establishment success, seed production, and crop yield losses.A field experiment with partial additive design was performed in an organically managed winter rye stand with study species added in ten sowing rates of 5-10,000 seeds m(-2). They were sown as a single species or as a three-species mixture (pure vs. mixed sowing) and with vs. without removal of spontaneous weeds. Winter rye was sown at a fixed rate of 350 grains m(-2). Performance of the study species was assessed as plant establishment and seed production. Crop response was determined as grain yield.Plant numbers and seed production were significantly affected by the sowing rate, but not by sowing type (pure vs. mixed sowing of the three study species), and weed removal. All rare arable plant species established and reproduced at sowing rates >25 seeds m(-2), with best performance of L. speculum-veneris. Negative density effects occurred to some extent for plant establishment and more markedly for seed production.The impact of the three study species on crop yield followed sigmoidal functions. Depending on the species, a yield loss of 10% occurred at >100 seeds m(-2). Synthesis and applications: The study shows that reintroduction of rare arable plants by seed transfer is a suitable method to establish them on extensively managed fields, for example, in organic farms with low nutrient level and without mechanical weed control. Sowing rates of 100 seeds m(-2) for C. regalis and L. arvense, and 50 seeds m(-2) for L. speculum-veneris are recommended, to achieve successful establishment

A social network analysis of social cohesion in a constructed pride: implications for ex situ reintroduction of the African lion (Panthera leo.

Directory of Open Access Journals (Sweden)

Jackie Abell

Full Text Available Animal conservation practices include the grouping of captive related and unrelated individuals to form a social structure which is characteristic of that species in the wild. In response to the rapid decline of wild African lion (Panthera leo populations, an array of conservational strategies have been adopted. Ex situ reintroduction of the African lion requires the construction of socially cohesive pride structures prior to wild release. This pilot study adopted a social network theory approach to quantitatively assess a captive pride's social structure and the relationships between individuals within them. Group composition (who is present in a group and social interaction data (social licking, greeting, play was observed and recorded to assess social cohesion within a released semi-wild pride. UCINET and SOCPROG software was utilised to represent and analyse these social networks. Results indicate that the pride is socially cohesive, does not exhibit random associations, and the role of socially influential keystone individuals is important for maintaining social bondedness within a lion pride. These results are potentially informative for the structure of lion prides, in captivity and in the wild, and could have implications for captive and wild-founder reintroductions.

A social network analysis of social cohesion in a constructed pride: implications for ex situ reintroduction of the African lion (Panthera leo).

Science.gov (United States)

Abell, Jackie; Kirzinger, Morgan W B; Gordon, Yvonne; Kirk, Jacqui; Kokeŝ, Rae; Lynas, Kirsty; Mandinyenya, Bob; Youldon, David

2013-01-01

Animal conservation practices include the grouping of captive related and unrelated individuals to form a social structure which is characteristic of that species in the wild. In response to the rapid decline of wild African lion (Panthera leo) populations, an array of conservational strategies have been adopted. Ex situ reintroduction of the African lion requires the construction of socially cohesive pride structures prior to wild release. This pilot study adopted a social network theory approach to quantitatively assess a captive pride's social structure and the relationships between individuals within them. Group composition (who is present in a group) and social interaction data (social licking, greeting, play) was observed and recorded to assess social cohesion within a released semi-wild pride. UCINET and SOCPROG software was utilised to represent and analyse these social networks. Results indicate that the pride is socially cohesive, does not exhibit random associations, and the role of socially influential keystone individuals is important for maintaining social bondedness within a lion pride. These results are potentially informative for the structure of lion prides, in captivity and in the wild, and could have implications for captive and wild-founder reintroductions.

Ecological Effects of Re-introduction of Salmonid Spawning Gravel in Lowland Danish Streams

DEFF Research Database (Denmark)

Pedersen, Morten Lauge; Kristensen, Esben Astrup; Kronvang, Brian

2009-01-01

recently been conducted in many streams and rivers. However, systematic monitoring of these spawning gravel restoration projects is limited. The overall aim of this paper was to evaluate gravel reintroduction as a long-term salmonid rehabilitation method in 32 lowland streams. Displacement of gravel......, including both restored reaches and upstream control reaches. Downstream displacement of gravel was most common at sites where gravel was reintroduced without further improvement, although these sites exhibited the highest density of YOY brown trout (Salmo trutta), evidencing that the remaining gravel...... is still functional. The intensive study of three streams showed that spawning was enhanced by the introduction of spawning gravel at the restored sites compared to control sites and that habitat quality generally were improved. Our results also suggest complex interactions exist between spawning activity...

Re-Introduction of Lower Columbia River Chum Salmon into Duncan Creek, 2001-2002 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Hillson, Todd D. (Washington Department of Wildlife, Olympia, WA)

2002-10-01

The National Marine Fisheries Service (NMFS) listed Lower Columbia River chum as threatened under the auspices of the Endangered Species Act (ESA) in March of 1999 (64 FR 14508, March 25, 1999). The listing was in response to reduction in abundance from historical levels of more than half a million returning adults to fewer than 10,000 spawners present day (Johnson et al. 1997). Harvest, loss of habitat, changes in flow regimes, riverbed movement and heavy siltation have been largely responsible for the decline in this species in the Columbia River. The timing of seasonal changes in river flow and water temperatures is perhaps the most critical factor in structuring the freshwater life history of chum salmon (Johnson et al. 1997). This is especially true of the population located directly below Bonneville Dam where hydropower operations can block access to spawning sites, dewater redds, strand fry, cause scour or fill of redds and increase sedimentation of spawning gravels. The recovery strategy for Lower Columbia River chum as outlined in the Hatchery Genetic Management Plan (HGMP) for the Grays River project has four main tasks. First, determine if remnant populations of Lower Columbia River chum salmon exist in Lower Columbia River tributaries. Second, if such populations exist, develop stock-specific recovery plans that would involve habitat restoration including the creation of spawning refugias, supplementation if necessary and a habitat and fish monitoring and evaluation plan. If chum have been extirpated from previously utilized streams, develop re-introduction plans that utilize appropriate genetic donor stock(s) of Lower Columbia River chum salmon and integrate habitat improvement and fry-to-adult survival evaluations. Third, reduce the extinction risk to Grays River chum salmon population by randomly capturing adults in the basin for use in a supplementation program and reintroduction of Lower Columbia River chum salmon into the Chinook River basin. The

Review guidelines on software languages for use in nuclear power plant safety systems. Final report

International Nuclear Information System (INIS)

Hecht, H.; Hecht, M.; Graff, S.; Green, W.; Lin, D.; Koch, S.; Tai, A.; Wendelboe, D.

1996-06-01

Guidelines for the programming and auditing of software written in high level languages for safety systems are presented. The guidelines are derived from a framework of issues significant to software safety which was gathered from relevant standards and research literature. Language-specific adaptations of these guidelines are provided for the following high level languages: Ada, C/C++, Programmable Logic Controller (PLC) Ladder Logic, International Electrotechnical Commission (IEC) Standard 1131-3 Sequential Function Charts, Pascal, and PL/M. Appendices to the report include a tabular summary of the guidelines and additional information on selected languages.s

Captive breeding and reintroduction of the oriental pied hornbill (Anthracoceros albirostris) in Khao Kheow Open Zoo, Thailand.

Science.gov (United States)

Chaiyarat, Rattanawat; Kongprom, Urarikha; Manathamkamon, Darika; Wanpradab, Sunan; Sangarang, Satean

2012-01-01

This article discusses two related issues of the captive breeding and reintroduction of the Oriental pied hornbill (Anthracoceros albirostris) in order to increase its population in the natural habitats. Oriental pied hornbills were bred in Khao Kheow Open Zoo. Three pairs were separated and kept in breeding cages. Females occupied artificial nests between February and April 2005-2007. Eggs were laid and incubated between February and March each year from 2005 to 2007. Nestlings hatched in late March and left the nest in late April 2005-2007. Each breeding pair was fed with approximately 400 g of food each day. All three pairs reproduced resulting in mature offspring of seven in 2005, six in 2006, and five in 2007. Four of sixteen 3-year-old birds were randomly selected and equipped with a GPS receiver on their backs. Activities of the birds attached and unattached with GPS were not significantly different. The first two birds (one female, one male with GPS) were reintroduced on August 5, 2006, and another nine birds (four birds with GPS) were reintroduced on December 26, 2006. The average home range of these reintroduced birds was 0.13 km(2) . Their foods consisted of wild plants and animals in the home range. The first reintroduced pair was able to breed naturally by laying and hatching eggs in an artificial nest. Two juveniles left the nest in April 2008. These results indicate that both captive breeding and reintroduction are potentially important ways to increase the population of the Oriental pied hornbill in natural habitats. © 2011 Wiley Periodicals, Inc.

Climate-driven introduction of the Black Death and successive plague reintroductions into Europe.

Science.gov (United States)

Schmid, Boris V; Büntgen, Ulf; Easterday, W Ryan; Ginzler, Christian; Walløe, Lars; Bramanti, Barbara; Stenseth, Nils Chr

2015-03-10

The Black Death, originating in Asia, arrived in the Mediterranean harbors of Europe in 1347 CE, via the land and sea trade routes of the ancient Silk Road system. This epidemic marked the start of the second plague pandemic, which lasted in Europe until the early 19th century. This pandemic is generally understood as the consequence of a singular introduction of Yersinia pestis, after which the disease established itself in European rodents over four centuries. To locate these putative plague reservoirs, we studied the climate fluctuations that preceded regional plague epidemics, based on a dataset of 7,711 georeferenced historical plague outbreaks and 15 annually resolved tree-ring records from Europe and Asia. We provide evidence for repeated climate-driven reintroductions of the bacterium into European harbors from reservoirs in Asia, with a delay of 15 ± 1 y. Our analysis finds no support for the existence of permanent plague reservoirs in medieval Europe.

Climate-driven introduction of the Black Death and successive plague reintroductions into Europe

Science.gov (United States)

Büntgen, Ulf; Easterday, W. Ryan; Ginzler, Christian; Walløe, Lars; Bramanti, Barbara; Stenseth, Nils Chr.

2015-01-01

The Black Death, originating in Asia, arrived in the Mediterranean harbors of Europe in 1347 CE, via the land and sea trade routes of the ancient Silk Road system. This epidemic marked the start of the second plague pandemic, which lasted in Europe until the early 19th century. This pandemic is generally understood as the consequence of a singular introduction of Yersinia pestis, after which the disease established itself in European rodents over four centuries. To locate these putative plague reservoirs, we studied the climate fluctuations that preceded regional plague epidemics, based on a dataset of 7,711 georeferenced historical plague outbreaks and 15 annually resolved tree-ring records from Europe and Asia. We provide evidence for repeated climate-driven reintroductions of the bacterium into European harbors from reservoirs in Asia, with a delay of 15 ± 1 y. Our analysis finds no support for the existence of permanent plague reservoirs in medieval Europe. PMID:25713390

Experimental reintroduction reveals novel life-history variation in Laysan Ducks (Anas laysanensis)

Science.gov (United States)

Walters, Jeffrey R.; Reynolds, Michelle H.

2013-01-01

Subfossil remains indicate that the Laysan Duck (Anas laysanensis) formerly occurred throughout the Hawaiian archipelago, but for more than 150 years it has been confined to a single, small atoll in the northwestern chain, Laysan Island. In 2004–2005, 42 ducks were reintroduced from Laysan to Midway Atoll, where they exhibited variation in life history never observed on Laysan. On Laysan, females have never been observed to breed successfully at age 1 year and few attempt it, whereas on Midway, females routinely raised young at study; n = 21 and 19, respectively) and triple brooding has never been observed. Other novel life history on Midway included early cessation of parental care to renest. Altered life history on Midway is likely related to better feeding conditions and low population density compared with Laysan. An especially intriguing possibility is that the phenotypic plasticity observed represents exposure of hidden reaction norms evolved when the species inhabited a range of environments, but several alternative explanations exist. Future reintroductions of this species may provide opportunities to test hypotheses about mechanisms underlying phenotypic plasticity.

Guidelines for the content of records to support nuclear power plant operation, maintenance, and modification (NCIG-08): Volume 1, Guidelines: Final report

International Nuclear Information System (INIS)

Reedy, R.F.; Hegglin, D.P.

1988-11-01

The record systems at many nuclear power plant sites are becoming overloaded with unnecessary and superfluous records. The reason for this overload is that although the Codes and Standards list the record types to be retained, there is no definition for the contents of the records. This encourages varied interpretations which often lead to the approach of ''save everything''. This document provides guidelines for the content of records to support nuclear power plant operation, maintenance and modification. These Guidelines are based on an engineering approach to identify which data in the records are of ''significant value'' in (1) demonstrating capability for safe operation; (2) maintaining, reworking, repairing, replacing, or modifying an item; (3) determining the cause of an accident or malfunction of an item; and (4) providing required baseline data for in-service inspection. Particular topical issues affecting record retention needs, such as plant life extension activities, may require additional evaluation of data or records. By identifying the data to be retained in the records, it is possible to modify the record management system to substantially reduce the amount of unnecessary information being retained in the records. These Guidelines will provide for more uniform interpretation of requirements. The Guidelines are meant as an interpretation of current Codes, Standards and Regulatory Guides, and not as new requirements. Should any conflict exist between these Guidelines and the specified requirements of the NRC Regulations, the regulations govern. 4 tabs

Canadian sedentary behaviour guidelines for children and youth.

Science.gov (United States)

Tremblay, Mark S; Leblanc, Allana G; Janssen, Ian; Kho, Michelle E; Hicks, Audrey; Murumets, Kelly; Colley, Rachel C; Duggan, Mary

2011-02-01

The Canadian Society for Exercise Physiology (CSEP), in partnership with the Healthy Active Living and Obesity Research Group (HALO) at the Children's Hospital of Eastern Ontario Research Institute, and in collaboration with ParticipACTION, and others, has developed the Canadian Sedentary Behaviour Guidelines for Children (aged 5-11 years) and Youth (aged 12-17 years). The guidelines include a preamble to provide context, followed by the specific recommendations for sedentary behaviour. The entire development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process and the recommendations are based on evidence from a systematic review and interpretation of the research evidence. The final guidelines benefitted from an extensive online consultation process with 230 domestic and international stakeholders and key informants. The final guideline recommendations state that for health benefits, children (aged 5-11 years) and youth (aged 12-17 years) should minimize the time that they spend being sedentary each day. This may be achieved by (i) limiting recreational screen time to no more than 2 h per day - lower levels are associated with additional health benefits; and (ii) limiting sedentary (motorized) transport, extended sitting time, and time spent indoors throughout the day. These are the first evidence-based Canadian Sedentary Behaviour Guidelines for Children and Youth and provide important and timely recommendations for the advancement of public health based on a systematic synthesis, interpretation, and application of the current scientific evidence.

Osteoarthritis guidelines: Barriers to implementation and solutions.

Science.gov (United States)

Ferreira de Meneses, Sarah; Rannou, Francois; Hunter, David J

2016-06-01

Osteoarthritis (OA) is a leading cause of disability worldwide. Clinical practice guidelines (CPGs) have been developed to facilitate improved OA management. Scientific communities worldwide have proposed CPGs for OA treatment. Despite the number of highly prominent guidelines available and their remarkable consistency, their uptake has been suboptimal. Possibly because of the multitude of barriers related to the implementation of CPGs. For example, different guidelines show contradictions, some lack evidence, and they lack a hierarchy or tools to facilitate their translation and application. Also, the guidelines do not acknowledge the effect of comorbidities on choosing the treatments. Finally, poor integration of multidisciplinary services within and across healthcare settings is a major barrier to the effective implementation of management guidelines. Here we describe the main problems related to the OA guidelines and some solutions so as to offer some guidance on the elaboration of future CPGs and their implementation in primary care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Final versions of the initial package of classroom materials and guidelines

NARCIS (Netherlands)

Doorman, Michiel; Jonker, Vincent

2014-01-01

The main aim of the mascil Work Package 3 ‘classroom materials’ is to present guidelines and an online collection of teaching materials that encourage and support teachers to design their own classroom materials that connect IBL and the WoW in mathematics and science education.The collection

Dental students′ compliance with antibiotic prescribing guidelines for dental infections in children

Directory of Open Access Journals (Sweden)

Yee Chen Wong

2016-01-01

Full Text Available Context: To investigate the antibiotic prescribing training received by dental students, clinical experience in treating child patients, awareness of antibiotic prescribing guidelines, preparedness in antibiotic prescribing, and compliance with antibiotic prescribing guidelines for the management of dental infections in children. Methods: This was a cross-sectional study involving final year dentals students from Malaysian and Asian dental schools. A self-administered questionnaire consisting of five clinical case scenarios was e-mailed to all final year students at selected dental schools. Students′ responses were compared for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association. Compliance in each scenario was tested for association with their preparedness in antibiotic prescribing, previous training on antibiotic prescribing and awareness of antibiotic prescribing guidelines using Chi-square test. Data collected were analyzed using SPSS statistics version 20. Results: A total of 108 completed responses were received. About 74 (69% students were from Malaysian dental schools. The compliance rate with prescribing guidelines ranged from 15.7% to 43.5%. Those attending Malaysian dental schools (47.3% and those who had treated child patient more often (46.3% were more likely (P < 0.05 to be aware of the guidelines. Those who had received antibiotic prescribing training (21.3% were more likely to think they were well prepared in antibiotic prescribing (P < 0.05. Conclusions: Final year dental students had low awareness and compliance with antibiotic prescribing guidelines. Further research is needed to investigate how compliance with the guidelines may be enhanced.

Genetic consequences of trumpeter swan (Cygnus buccinator) reintroductions

Science.gov (United States)

Ransler, F.A.; Quinn, T.W.; Oyler-McCance, S.J.

2011-01-01

Relocation programs are often initiated to restore threatened species to previously occupied portions of their range. A primary challenge of restoration efforts is to translocate individuals in a way that prevents loss of genetic diversity and decreases differentiation relative to source populations-a challenge that becomes increasingly difficult when remnant populations of the species are already genetically depauperate. Trumpeter swans were previously extirpated in the entire eastern half of their range. Physical translocations of birds over the last 70 years have restored the species to portions of its historical range. Despite the long history of management, there has been little monitoring of the genetic outcomes of these restoration attempts. We assessed the consequences of this reintroduction program by comparing patterns of genetic variation at 17 microsatellite loci across four restoration flocks (three wild-released, one captive) and their source populations. We found that a wild-released population established from a single source displayed a trend toward reduced genetic diversity relative to and significant genetic differentiation from its source population, though small founder population effects may also explain this pattern. Wild-released flocks restored from multiple populations maintained source levels of genetic variation and lacked significant differentiation from at least one of their sources. Further, the flock originating from a single source revealed significantly lower levels of genetic variation than those established from multiple sources. The distribution of genetic variation in the captive flock was similar to its source. While the case of trumpeter swans provides evidence that restorations from multiple versus single source populations may better preserve natural levels of genetic diversity, more studies are needed to understand the general applicability of this management strategy. ?? 2010 Springer Science+Business Media B.V. (outside

Interim radon-resistant construction guidelines for use in Florida-1989. Final report, August 1987-June 1988

International Nuclear Information System (INIS)

Pugh, T.D.

1990-08-01

The report gives results of a project to investigate, analyze, and develop radon-resistant construction guidelines that are consistent with other building codes and that could be applied to Florida. A literature search resulted in information on radon remediation techniques, new construction methods, and existing radon-resistant building codes such as those in Sweden and Canada. The identified techniques were amended, modified, or supplemented for incorporation into draft model guidelines for new construction in format consistent with the Southern Building Code Congress International, Inc.'s Standard Building Code. A technical review advisory committee formed during development of the guidelines, provided input and recommended changes to the draft guidelines. Although the project has resulted in guidelines for recommended construction practices, they should be coupled with a carefully planned and implemented program of experimentation. Eventually, this approach will lead to building code provisions that are scientifically defensible, cost effective, reliable, and easily incorporated into standard construction practice

High genetic diversity and demographic history of captive Siamese and Saltwater crocodiles suggest the first step toward the establishment of a breeding and reintroduction program in Thailand.

Directory of Open Access Journals (Sweden)

Sorravis Lapbenjakul

Full Text Available The Siamese crocodile (Crocodylus siamensis and Saltwater crocodile (C. porosus are two of the most endangered animals in Thailand. Their numbers have been reduced severely by hunting and habitat fragmentation. A reintroduction plan involving captive-bred populations that are used commercially is important and necessary as a conservation strategy to aid in the recovery of wild populations. Here, the genetic diversity and population structure of 69 individual crocodiles, mostly members of captive populations, were analyzed using both mitochondrial D-loop DNA and microsatellite markers. The overall haplotype diversity was 0.924-0.971 and the mean expected heterozygosity across 22 microsatellite loci was 0.578-0.701 for the two species. This agreed with the star-like shaped topology of the haplotype network, which suggests a high level of genetic diversity. The mean ratio of the number of alleles to the allelic range (M ratio for the populations of both species was considerably lower than the threshold of 0.68, which was interpreted as indicative of a historical genetic bottleneck. Microsatellite markers provided evidence of introgression for three individual crocodiles, which suggest that hybridization might have occurred between C. siamensis and C. porosus. D-loop sequence analysis detected bi-directional hybridization between male and female individuals of the parent species. Therefore, identification of genetically non-hybrid and hybrid individuals is important for long-term conservation management. Relatedness values were low within the captive populations, which supported their genetic integrity and the viability of a breeding and reintroduction management plan. This work constitutes the first step in establishing an appropriate source population from a scientifically managed perspective for an in situ/ex situ conservation program and reintroduction of crocodile individuals to the wild in Thailand.

Mexican Asthma Guidelines: GUIMA 2017

Directory of Open Access Journals (Sweden)

Désirée Larenas-Linnemann

2017-04-01

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

Population growth, movements, and status of the Nushagak Peninsula Caribou Herd following reintroduction, 1988 - 2000

Directory of Open Access Journals (Sweden)

Gail H. Collins

2003-04-01

Full Text Available Barren ground caribou (Rangifer tarandus were reintroduced to the Nushagak Peninsula, Alaska in February of 1988 after an absence of more than 100 years. Since reintroduction, herd growth and population dynamics have been monitored closely. At this time, there has been no significant dispersal from the herds' core range. The Nushagak Peninsula Caribou Herd (NPCH grew rapidly from 146 reintroduced individuals to over 1000 in 13 years. Dramatic mean annual growth during the first 6 years (1988-1994 of 38% (r = 0.32 can be attributed to the high percentage of females in the initial reintroduction, high calf production and survival, exceptional range conditions, few predators, and no hunting. However, the populations' exceptional growth (peak counts of 1400 slowed and stabilized between 1996¬1998 and then decreased between 1998 and 2000. Size, body condition and weights of calves captured in 2000 were significantly lower than those captured in 1995 and 1997. Although calf production also decreased from close to 100% (1990-1995 to about 91% (1996-2000, overall calf survival continued to be high. Legal harvest began in 1995, and harvest reports have accounted for approximately 3% of population mortality annually. Although brown bears (Ursus arctos and wolves (Canis lupus are present, the extent of predation is unknown. Mean home range of the NPCH was 674 km2 and group sizes were greatest during post-calving aggregation in July (mean = 127. Caribou population density on the Nushagak Peninsula reached approximately 1.2 caribou/km2 in 1997 before declining to about 1.0 caribou/km2. A range survey in 1994 noted only trace utilization of lichens on the Nushagak Peninsula by caribou. A subsequent survey in 1999 found moderate to severe utilization in 46% of plots, suggesting the reintroduced herd was beginning to alter range condition. Between 1997 and 2000, both calf production and condition of 10-month-old calves declined. Calving has also been delayed

Human-system interface design review guideline -- Reviewer`s checklist: Final report. Revision 1, Volume 2

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-06-01

NUREG-0700, Revision 1, provides human factors engineering (HFE) guidance to the US Nuclear Regulatory Commission staff for its: (1) review of the human system interface (HSI) design submittals prepared by licensees or applications for a license or design certification of commercial nuclear power plants, and (2) performance of HSI reviews that could be undertaken as part of an inspection or other type of regulatory review involving HSI design or incidents involving human performance. The guidance consists of a review process and HFE guidelines. The document describes those aspects of the HSI design review process that are important to the identification and resolution of human engineering discrepancies that could adversely affect plant safety. Guidance is provided that could be used by the staff to review an applicant`s HSI design review process or to guide the development of an HSI design review plan, e.g., as part of an inspection activity. The document also provides detailed HFE guidelines for the assessment of HSI design implementations. NUREG-0700, Revision 1, consists of three stand-alone volumes. Volume 2 is a complete set of the guidelines contained in Volume 1, Part 2, but in a checklist format that can be used by reviewers to assemble sets of individual guidelines for use in specific design reviews. The checklist provides space for reviewers to enter guidelines evaluations and comments.

Medicare and Medicaid programs; salary equivalency guidelines for physical therapy, respiratory therapy, speech language pathology, and occupational therapy services; revised effective date and technical correction--HCFA. Final rule; delay of effective date and correction.

Science.gov (United States)

1998-03-31

This document delays the effective date of the final rule on salary equivalency guidelines, published in the Federal Register (63 FR 5106) on January 30, 1998, from April 1, 1998 to April 10, 1998. In addition, we are making a technical correction in the preamble to the January 30, 1998 final rule.

Integrated Guidelines for Management of Alloy 600 Locations

Energy Technology Data Exchange (ETDEWEB)

Na, Kyung-Hwan; Chung, Hansub; Yang, Jun-Seog; Lee, Kyoung-Soo [KHNP-Central Research Institute, Daejeon (Korea, Republic of)

2015-05-15

The locations experiencing PWSCC include steam generator tubes, pressurizer instrumental nozzles, control rod driving mechanism(CRDM) penetration nozzles, reactor outlet nozzles, and bottom mounted instrumental(BMI) nozzles. Korea Hydro and Nuclear Power Co.(KHNP) has developed integrated guidelines for management of alloy 600 locations and the guidelines are under review by the regulator. The guidelines consist of alloy 600 location database, inspection program, maintenance/preventive maintenance method, and finally water chemistry management for PWSCC mitigation. In this paper, the detailed contents are presented. The integrated guidelines collected all relevant information on the management of alloy 600 locations. This information may be useful for establishing the most effective preventive maintenance strategies by prioritization in addition to maintenance strategies. Table II summarize maintenance strategies for alloy 600 locations.

Review guidelines for software languages for use in nuclear power plant safety systems: Final report. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Hecht, M.; Decker, D.; Graff, S.; Green, W.; Lin, D.; Dinsmore, G.; Koch, S. [SoHaR, Inc., Beverly Hills, CA (United States)

1997-10-01

Guidelines for the programming and auditing of software written in high level languages for safety systems are presented. The guidelines are derived from a framework of issues significant to software safety which was gathered from relevant standards and research literature. Language-specific adaptations of these guidelines are provided for the following high level languages: Ada83 and Ada95; C and C++; International Electrochemical Commission (IEC) Standard 1131-3 Ladder Logic, Sequential Function Charts, Structured Text, and Function Block Diagrams; Pascal; and PL/M. Appendices to the report include a tabular summary of the guidelines and additional information on selected languages.

Review guidelines for software languages for use in nuclear power plant safety systems: Final report. Revision 1

International Nuclear Information System (INIS)

Hecht, M.; Decker, D.; Graff, S.; Green, W.; Lin, D.; Dinsmore, G.; Koch, S.

1997-10-01

Guidelines for the programming and auditing of software written in high level languages for safety systems are presented. The guidelines are derived from a framework of issues significant to software safety which was gathered from relevant standards and research literature. Language-specific adaptations of these guidelines are provided for the following high level languages: Ada83 and Ada95; C and C++; International Electrochemical Commission (IEC) Standard 1131-3 Ladder Logic, Sequential Function Charts, Structured Text, and Function Block Diagrams; Pascal; and PL/M. Appendices to the report include a tabular summary of the guidelines and additional information on selected languages

Principles of the developmental process and implementation of guidelines. An update

International Nuclear Information System (INIS)

Kopp, I.

2008-01-01

Guidelines are important tools to improve knowledge management, processes and outcomes in health care. Their function is to assist professionals and patients decisions about appropriate and effective practice, especially in those areas of health care where considerable variation or potential for improvement exists. The achievement of a favourable impact necessitates both a systematic and methodically sound approach in the development of guidelines. The German Instrument for Methodological Guideline Appraisal, an adopted and supplemented version of the AGREE (Appraisal of Guidelines Research and Evaluation) instrument, provides 34 quality criteria guideline developers should take into account. However, the impact of guidelines is not only determined by methodological soundness but also by the choice of the guideline topic (need for a guideline), by its dissemination (accessibility) and implementation (acceptance and use). Finally, this impact must be monitored by means of guideline-based quality indicators. (orig.) [de

77 FR 38282 - Final Test Guidelines; OCSPP 850 Series; Notice of Availability

Science.gov (United States)

2012-06-27

... Plants, Cyanobacteria, and Terrestrial Soil Core Microcosm. Group F--Field Test Data Reporting Guidelines...'' to ``Terrestrial and Aquatic Plants, Cyanobacteria, and Terrestrial Soil Core Microcosm Test... 850.5400) and OCSPP 850.4900 ``Terrestrial Soil-Core Microcosm Test'' (Public Draft OPPTS 850.2450...

Final report of advisory subcommittee on development of JENDL. Guideline for developing next JENDL

International Nuclear Information System (INIS)

Chiba, Go; Iwamoto, Osamu

2015-01-01

Advisory Subcommittee on Development of JENDL was established under JENDL Committee on fiscal year 2013 to discuss the subject concerning on development of next JENDL. Members of the subcommittee were selected from developers and users of JENDL and researchers on nuclear data measurements. They discussed guidelines on next JENDL with exchanging ideas on problems of JENDL and its solution from each view point. This report describes the results of the discussions on the problems and guideline with the present status on the JENDL development. (author)

Consensus statement: Management of drug-induced liver injury in HIV-positive patients treated for TB

Directory of Open Access Journals (Sweden)

E Jong

2013-09-01

Full Text Available Drug-induced liver injury (DILI in HIV/tuberculosis (TB co-infected patients is a common problem in the South African setting, and re-introduction of anti-TB drugs can be challenging for the healthcare worker. Although international guidelines on the re-introduction of TB treatment are available, the definition of DILI is not uniform, management of antiretroviral therapy (ART in HIV co-infection is not mentioned, and the guidance on management is not uniform and lacks a practical approach. In this consensus statement, we summarise important aspects of DILI and provide practical guidance for healthcare workers for different patient groups and healthcare settings on the re-introduction of anti-TB drugs and ART in HIV/TB co-infected individuals presenting with DILI.

Belgian guidelines for economic evaluations: second edition.

Science.gov (United States)

Thiry, Nancy; Neyt, Mattias; Van De Sande, Stefaan; Cleemput, Irina

2014-12-01

The aim of this study was to present the updated methodological guidelines for economic evaluations of healthcare interventions (drugs, medical devices, and other interventions) in Belgium. The update of the guidelines was performed by three Belgian health economists following feedback from users of the former guidelines and personal experience. The updated guidelines were discussed with a multidisciplinary team consisting of other health economists, assessors of reimbursement request files, representatives of Belgian databases and representatives of the drugs and medical devices industry. The final document was validated by three external validators that were not involved in the previous discussions. The guidelines give methodological guidance for the following components of an economic evaluation: literature review, perspective of the evaluation, definition of the target population, choice of the comparator, analytic technique and study design, calculation of costs, valuation of outcomes, definition of the time horizon, modeling, handling uncertainty and discounting. We present a reference case that can be considered as the minimal requirement for Belgian economic evaluations of health interventions. These guidelines will improve the methodological quality, transparency and uniformity of the economic evaluations performed in Belgium. The guidelines will also provide support to the researchers and assessors performing or evaluating economic evaluations.

Rapid extirpation of a North American frog coincides with an increase in fungal pathogen prevalence: Historical analysis and implications for reintroduction.

Science.gov (United States)

Adams, Andrea J; Pessier, Allan P; Briggs, Cheryl J

2017-12-01

As extinctions continue across the globe, conservation biologists are turning to species reintroduction programs as one optimistic tool for addressing the biodiversity crisis. For repatriation to become a viable strategy, fundamental prerequisites include determining the causes of declines and assessing whether the causes persist in the environment. Invasive species-especially pathogens-are an increasingly significant factor contributing to biodiversity loss. We hypothesized that Batrachochytrium dendrobatidis (Bd), the causative agent of the deadly amphibian disease chytridiomycosis, was important in the rapid (herpetological experts, analysis of archived field notes and museum specimen collections, and field sampling of the extant amphibian assemblage to examine (1) historical relative abundance of R. boylii ; (2) potential causes of R. boylii declines; and (3) historical and contemporary prevalence of Bd. We found that R. boylii were relatively abundant prior to their rapid extirpation, and an increase in Bd prevalence coincided with R. boylii declines during a time of rapid change in the region, wherein backcountry recreation, urban development, and the amphibian pet trade were all on the rise. In addition, extreme flooding during the winter of 1969 coincided with localized extirpations in R. boylii populations observed by interview respondents. We conclude that Bd likely played an important role in the rapid extirpation of R. boylii from southern California and that multiple natural and anthropogenic factors may have worked in concert to make this possible in a relatively short period of time. This study emphasizes the importance of recognizing historical ecological contexts in making future management and reintroduction decisions.

Demarcating Mobile Phone Interface Design Guidelines to Expedite Selection

Directory of Open Access Journals (Sweden)

Karen Vera Renaud

2017-12-01

Full Text Available Guidelines are recommended as a tool for informing user interface design. Despite a proliferation of guidelines in the research literature, there is little evidence of their use in industry, nor their influence in academic literature. In this paper, we explore the research literature related to mobile phone design guidelines to find out why this should be so. We commenced by carrying out a scoping literature review of the mobile phone design guideline literature to gain insight into the maturity of the field. The question we wanted to explore was: “Are researchers building on each others’ guidelines, or is the research field still in the foundational stage?” We discovered a poorly structured field, with many researchers proposing new guidelines, but little incremental refinement of extant guidelines. It also became clear that the current reporting of guidelines did not explicitly communicate their multi-dimensionality or deployment context. This leaves designers without a clear way of discriminating between guidelines, and could contribute to the lack of deployment we observed. We conducted a thematic analysis of papers identified by means of a systematic literature review to identify a set of dimensions of mobile phone interface design guidelines. The final dimensions provide a mechanism for differentiating guidelines and expediting choice.

Re-introduction of tule elk to Point Reyes National Seashore, California, USA

Science.gov (United States)

Gogan, Peter J.; McCrea A. Cobb,; Gates, Natalie B.; Barrett, Reginald H.; Soorae, Pritpal S.

2013-01-01

Tule elk (Cervus elaphus nannodes), a subspecies endemic to California, was historically found in large herds throughout much of central and coastal California. Market hunting during the California Gold Rush decimated these herds, and by 1895, only two to 10 elk remained. This remnant group was protected and served as the source for early relocation efforts (McCullough, 1971). Early efforts were generally unsuccessful but did establish a herd in California’s Owens Valley, outside their historical range, in 1933. The herd grew rapidly and supported six controversial hunts between 1943 and 1969. In an effort to limit hunting, concerned preservationists formed the Committee for the Preservation of Tule Elk in 1960. Public pressure resulted in the California State Legislature passing a law in 1971 that halted hunting until either state-wide numbers reached 2,000, or no further unoccupied elk habitat existed. This law prompted the California Department of Fish and Game to begin reintroducing tule elk throughout their former range. In 1976, the U.S. Congress passed a resolution that concurred with state law and directed federal agencies to make lands available for reintroductions within the subspecies’ historical range. Point Reyes National Seashore was identified as a potential translocation site.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

Science.gov (United States)

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

Gradual reintroduction of oxygen reduces reperfusion injury in cat stomach

International Nuclear Information System (INIS)

Perry, M.A.; Wadhwa, S.S.

1988-01-01

Recent studies have shown that oxygen-derived free radicals are responsible for a major portion of ischemia-reperfusion injury in the stomach. The oxygen radicals are produced during perfusion when oxygen delivery to the tissue increases. In the present study the authors investigate the effect on mucosal injury of regulating the rate of reintroduction of oxygen to the stomach after ischemia. Local gastric ischemia was achieved by reducing celiac artery pressure to 30 mmHg for 1 h. Ischemic injury was assessed by measuring the loss of 51 Cr-labeled red blood cells across the gastric mucosa. Mucosal blood loss was negligible before and during the ischemia period but increased during reperfusion. When blood flow to the stomach was gradually returned to normal after ischemia, the mucosal blood loss was reduced. If the stomach was vascularly perfused with low Po 2 blood for 1 h after ischemia before being returned to normal arterial perfusion, the mucosal blood loss was also reduced. When the stomach was made hypoxemic for 1 h rather than ischemic by perfusing the vasculature with low Po 2 blood then reperfused with normoxic blood, there was very little mucosal bleeding. The data indicate that gastric mucosal bleeding after ischemia is reduced if the tissue is returned slowly to a normal Po 2 . These findings support the concept that reperfusion injury is due largely to the production of oxygen radicals. The low level of injury produced by hypoxemia indicates that hypoxia per se makes only a minor contribution to reperfusion injury in the stomach

Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

DEFF Research Database (Denmark)

Dunscombe, Peter; Grau, Cai; Defourny, Noémie

2014-01-01

of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. RESULTS: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major...... guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. CONCLUSION: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon...

REINTRODUCTION OF ASTACUS ASTACUS L. IN EAST TYROL, AUSTRIA

Directory of Open Access Journals (Sweden)

SINT D.

2004-01-01

Full Text Available In Tyrolean like in other European freshwaters, crayfish populations decreased in numbers and qualities. They are today regarded as endangered animals. The Astacus astacus (Linnaeus, 1758 population of historical evidence in Tristacher See and its out flowing stream Tristacher Seebach (mentioned already by Emperor Maximilian I in 1504 became extinct in the late 1990s. After the restoration of the stream we started a species conservation programme with various specific protection measures, including breeding and restocking of young-of-the-year and adult A. astacus. Females, after having released their young in the hatchery, were stocked together with males in a 200-m-section of Tristacher Seebach, previously populated by A. astacus. In October, the young-of-theyear crayfish were released in another area of the same stream. To show the importance of habitat diversity and shelter, four sites for introduction were selected describing a gradient of habitat diversity. We monitored general characteristics of the population (sex, size, densities and compared them to habitat conditions. Individual crayfish were tagged with gloss-paint pens to allow an observation of their movements between the different sections over the summer months. We found significant results when migration behaviour, population assemblage and habitat conditions were compared. Males frequently moved longer distances than females. Migration length corresponded to the gradient of available structures and shelter. Heterogeneous riprap was somewhat preferred to artificial shelter like bricks or plastic tubes. Sections without additional shelter showed almost no presence of crayfish. Sex and size distribution within assemblages appeared also to be affected by habitat conditions. Our results indicate the importance of monitoring in species reintroduction projects, as this research demonstrated the immediate effect and importance of habitat structure and affirmed the success of the

Microsites Matter: Improving the Success of Rare Species Reintroductions.

Directory of Open Access Journals (Sweden)

Peter W Dunwiddie

Full Text Available Our study was undertaken to better understand how to increase the success rates of recovery plantings of a rare hemiparasite, golden paintbrush (Castilleja levisecta-Orobanchaceae. This species is endemic to western Washington and Oregon, USA, and southwestern British Columbia, Canada. Over 5000 golden paintbrush plants were outplanted as plugs in 2007 at six different native prairie sites that were considered to be suitable habitat, based on general evaluations of vegetation and soil conditions. Outplantings were installed at regular intervals along transects up to 1 km long to include a range of conditions occurring at each site. All plantings were re-examined five years later. The patchy distribution of surviving plugs and new recruits within each reintroduction site suggested success is strongly influenced by microsite characteristics. Indicator species analysis of taxa growing in microsites around outplanted golden paintbrush identified species that were positively or negatively associated with paintbrush survival. Species such as Festuca roemeri, Eriophyllum lanatum, and Viola adunca were strong indicators at some sites; non-natives such as Hypochaeris radicata and Teesdalia nudicaulis tended to be frequent negative indicators. Overall, higher richness of native perennial forbs was strongly correlated with both survival and flowering of golden paintbrush, a pattern that may reflect interactions of this hemiparasite with the immediately surrounding plant community. Topographic position also influenced outcomes, with greater survival occurring on mounds and in swales, where soils generally were deeper. Our findings suggest that assessments of site suitability based on vegetation alone, and coarser, site-level assessments that do not characterize heterogeneity at the microsite scale, may not be strong predictors of restoration success over the longer term and in sites with variability in vegetation and soils. By identifying suitable

Time to detoxify medical literature from guideline overdose

Institute of Scientific and Technical Information of China (English)

Dinesh Vyas; Arpita K Vyas

2012-01-01

The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product (GDP)in 1965 to 16 percent of the GDP in 2004.Healthcare is driven with a goal to provide best possible care available at that period of time.Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care.To provide the standard of care,physicians follow guidelines,proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network.This has lead to multiple tests for the patient and has not survived the test of time.This independence leads to lacunae in the standardization of guidelines,hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment,inefficiency,and patient inconvenience.There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials,a systematic launch of the Guidelines.There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.

Assessment of children's nutritional attitudes before oral food challenges to identify patients at risk of food reintroduction failure: a prospective study.

Science.gov (United States)

Polloni, L; Ferruzza, E; Ronconi, L; Toniolo, A; Lazzarotto, F; Bonaguro, R; Celegato, N; Muraro, A

2017-05-01

Inappropriate dietary eliminations may impair quality of life, affect children's growth and unnecessarily impact on healthcare costs. Previous retrospective studies reported that around 25% of children continue a food-avoidance diet despite a negative oral food challenge (OFC). A definite pattern has not been found yet for patients not reintroducing the food. This study aimed to examine the role of child's nutritional attitudes and maternal anxiety in reintroducing food after a negative OFC. A prospective study was conducted involving 81 mothers of children with IgE-mediated food allergy. They completed a survey on nutritional behaviour and attitudes and the State-Trait Anxiety Inventory on the day of OFC and 6 months later. In total, 11.1% of children never or rarely ate the food after a negative OFC. Consumption of the reintroduced food is positively correlated to child's interest in tasting new foods before and after OFC and to changes in child's nutritional habits after OFC. It is negatively correlated to monotony of the diet after OFC. No correlations were found with other participants' characteristics or maternal anxiety. State anxiety significantly decreased after the OFC. A correlation was found between trait and state anxiety and the degree of change in nutritional habits after OFC. Evaluating child's approach towards food before the OFC is a promising approach to identify patients at risk of food reintroduction failure. Furthermore, it underlined the importance of reassessing food consumption in all patients after a negative OFC and supporting patients in the reintroduction of food. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Swiss guideline: Protection objectives for the disposal of radioactive waste

International Nuclear Information System (INIS)

Zurkinden, A.

1994-01-01

The Swiss guideline R-21 establishing the protection objectives for the disposal of radioactive waste has been reviewed and amended in order to adapt it to improvements made in the field of radioactive waste disposal. In an introductory part, the new guideline states the overall objective of radioactive waste disposal and the associated principles which have to be observed. The guideline then establishes the safety requirements applied to a geological disposal facility. These safety requirements are formulated as protection goals for the whole disposal system and not as specific criteria applying to the system components. The guideline gives finally a series of explanatory comments and indications concerning the conduct of the safety assessment for a disposal facility

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

Directory of Open Access Journals (Sweden)

Burgers Jako S

2007-11-01

for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

1993 guidelines for the management of mild hypertension: memorandum from a WHO/ISH meeting.

OpenAIRE

1993-01-01

The present guidelines were prepared by the Guidelines Sub-Committee of the WHO/ISH (International Society of Hypertension) Mild Hypertension Liaison Committee. They represent the third revision of the WHO/ISH guidelines and were finalized after discussions at the Sixth WHO/ISH Meeting on Mild Hypertension in Chantilly, France, on 28-31 March 1993. The new guidelines discuss the cardiovascular risk in patients with hypertension, the definition and classification of mild hypertension, drug tre...

Study on Establishing Standard Administrative Report Guidelines for KAERI

International Nuclear Information System (INIS)

Koo, Hwang Duk; Cho, Woo Sung; Lee, Bong Jae

2012-12-01

Ο The main purpose of administrative report of an organization is to deliver a critical mind about surrounding circumstance and rational alternatives to a final decision maker Ο An established report system with unified formality and systematic concept playes critical role to make right decision and efficient review about pending issues Ο By understanding current situation of report system using in KAERI and analysing examples of other organization, we established specific administrative report writing guideline for KAERI Ο We expect efficient communication and increasing productivity from the guideline by establishing and diffusing administrative report common writing guideline reflecting longstanding administrative experience and know-how of a specialized committeeman of KAERI

Study on Establishing Standard Administrative Report Guidelines for KAERI

Energy Technology Data Exchange (ETDEWEB)

Koo, Hwang Duk; Cho, Woo Sung; Lee, Bong Jae

2012-12-15

Ο The main purpose of administrative report of an organization is to deliver a critical mind about surrounding circumstance and rational alternatives to a final decision maker Ο An established report system with unified formality and systematic concept playes critical role to make right decision and efficient review about pending issues Ο By understanding current situation of report system using in KAERI and analysing examples of other organization, we established specific administrative report writing guideline for KAERI Ο We expect efficient communication and increasing productivity from the guideline by establishing and diffusing administrative report common writing guideline reflecting longstanding administrative experience and know-how of a specialized committeeman of KAERI.

Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

International Nuclear Information System (INIS)

Dunscombe, Peter; Grau, Cai; Defourny, Noémie; Malicki, Julian; Borras, Josep M.; Coffey, Mary; Bogusz, Marta; Gasparotto, Chiara; Slotman, Ben; Lievens, Yolande; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; De Hertogh, Olivier; Hadjieva, Tatiana; Petera, Jiri; Eriksen, Jesper Grau; Jaal, Jana; Bly, Ritva; Azria, David

2014-01-01

Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need

Public health response to the silent reintroduction of wild poliovirus to Israel, 2013-2014.

Science.gov (United States)

Moran-Gilad, J; Kaliner, E; Gdalevich, M; Grotto, I

2016-12-01

During 2013/14, Israel witnessed the silent reintroduction and sustained transmission of wild poliovirus type 1 (WPV1) detected through routine environmental surveillance performed on sewage samples. The public health response to silent poliovirus transmission in a population with high inactivated polio vaccine (IPV) coverage poses an emerging challenge towards the 'End Game' of global poliovirus eradication. This paper reviews the risk assessment, risk management and risk communication aspects of this poliovirus incident. Special emphasis is placed on the use of scientific data generated in the risk assessment phase to inform the public health response. Reintroducing a live vaccine in supplemental immunization activities in response to transmission of WPV or vaccine-derived poliovirus should be considered close to the 'End Game' of polio eradication, especially if targeting the population at risk is feasible. Such circumstances require a comprehensive contingency plan that will support the generation of important public health evidence at the risk assessment stage, thereby allowing to tailor the risk management approaches and underpin appropriate risk communication. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Evidence-based guidelines for wise use of electronic games by children.

Science.gov (United States)

Straker, Leon; Abbott, Rebecca; Collins, Rachel; Campbell, Amity

2014-01-01

Electronic games (e-games) are widely used by children, often for substantial durations, yet to date there are no evidence-based guidelines regarding their use. The aim of this paper is to present guidelines for the wise use of e-games by children based on a narrative review of the research. This paper proposes a model of factors that influence child-e-games interaction. It summarises the evidence on positive and negative effects of use of e-games on physical activity and sedentary behaviour, cardio-metabolic health, musculoskeletal health, motor coordination, vision, cognitive development and psychosocial health. Available guidelines and the role of guidelines are discussed. Finally, this information is compiled into a clear set of evidence-based guidelines, about wise use of e-games by children, targeting children, parents, professionals and the e-game industry. These guidelines provide an accessible synthesis of available knowledge and pragmatic guidelines based on e-game specific evidence and related research.

Computerization of guidelines: towards a "guideline markup language".

Science.gov (United States)

Dart, T; Xu, Y; Chatellier, G; Degoulet, P

2001-01-01

Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice. A way to ease the use of guidelines is to implement computerised guidelines (computer reminders). We present in this paper a method of computerising guidelines. Our objectives were: 1) to propose a generic model that can be instantiated for any specific guidelines; 2) to use eXtensible Markup Language (XML) as a guideline representation language to instantiate the generic model for a specific guideline. Our model is an object representation of a clinical algorithm, it has been validated by running two different guidelines issued by a French official Agency. In spite of some limitations, we found that this model is expressive enough to represent complex guidelines devoted to diabetes and hypertension management. We conclude that XML can be used as a description format to structure guidelines and as an interface between paper-based guidelines and computer applications.

Siting guidelines for utility application of wind turbines. Final report

Energy Technology Data Exchange (ETDEWEB)

Pennell, W.T.

1983-01-01

Utility-oriented guidelines are described for identifying viable sites for wind turbines. Topics and procedures are also discussed that are important in carrying out a wind turbine siting program. These topics include: a description of the Department of Energy wind resource atlases; procedures for predicting wind turbine performance at potential sites; methods for analyzing wind turbine economics; procedures for estimating installation and maintenance costs; methods for anlayzing the distribution of wind resources over an area; and instrumentation for documenting wind behavior at potential sites. The procedure described is applicable to small and large utilities. Although the procedure was developed as a site-selection tool, it can also be used by a utility who wishes to estimate the potential for wind turbine penetration into its future generation mix.

Guidelines for rating Global Assessment of Functioning (GAF

Directory of Open Access Journals (Sweden)

Aas IH Monrad

2011-01-01

Full Text Available Abstract Background Global Assessment of Functioning (GAF is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines. Methods A thorough literature search was conducted. Results Few studies of existing guidelines have been conducted; existing guidelines are short; and rating has a subjective element. Seven main categories were identified as being important in relation to further development of guidelines: (1 general points about guidelines for rating GAF; (2 introduction to guidelines, with ground rules; (3 starting scoring at the top, middle or bottom level of the scale; (4 scoring for different time periods and of different values (highest, lowest or average; (5 the finer grading of the scale; (6 different guidelines for different conditions; and (7 different languages and cultures. Little information is available about how rules for rating are understood by different raters: the final score may be affected by whether the rater starts at the top, middle or bottom of the scale; there is little data on which value/combination of GAF values to record; guidelines for scoring within 10-point intervals are limited; there is little empirical information concerning the suitability of existing guidelines for different conditions and patient characteristics; and little is known about the effects of translation into different languages or of different cultural understanding. Conclusions Few studies have dealt specifically with guidelines for rating GAF. Current guidelines for rating GAF are not comprehensive, and relevant points for new guidelines are presented. Theoretical and

Solid low level waste management guidelines: Final report

International Nuclear Information System (INIS)

Castagnacci, A.; Dalton, D.; Genoa, P.

1994-11-01

Since 1989, the nuclear industry has been moving in the direction of greater minimization of low level radioactive waste (LLW). This has been driven in part by increasing regulatory attention, but it also is in response to the desire on the part of nuclear utilities to be more cost efficient and to be environmentally responsive. Over the past half-dozen years, LLW disposal costs have increased dramatically. In addition, improvements in LLW volume reduction technologies have substantially reduced the volume of LLW that is disposed. At the same time, utilities are implementing aggressive source reduction programs and programs to reuse materials so as to extend the useful life of many materials. Thus, there has been a dramatic change in LLW economics and LLW management practices in just the past few years. This report was developed by utility nuclear experts to provide guidance to all utilities on mechanisms for integrating the program economics, advanced volume reduction techniques, and approaches to source reduction. Thus, utilizes will be able to use this report as a guide to optimizing their LLW program economics and minimizing LLW disposal volumes to the smallest reasonable fraction. This report discusses the implementation of these guidelines, management support, waste materials and waste inventory, radioactive tool and equipment management, protective clothing management, processing and volume reduction, solid LLW tracking, outage LLW management, and interim storage of LLW

Guidelines for Management Information Systems in Canadian Health Care Facilities

Science.gov (United States)

Thompson, Larry E.

1987-01-01

The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

Textual analysis of sugar industry influence on the World Health Organization’s 2015 sugars intake guideline

Science.gov (United States)

Reeves, Aaron; Loopstra, Rachel; McKee, Martin

2016-01-01

Abstract Objective To determine whether sugar industry-related organizations influenced textual changes between the draft and final versions of the World Health Organization’s (WHO’s) 2015 guideline Sugars intake for adults and children. Methods Stakeholder consultation submissions on the draft guideline from seven sugar industry-related and 10 public health organizations were assessed using the Wordscores program. Document scores were rescaled using the Martin–Vanberg transformation to improve comparability. Draft and final guidelines were compared to identify changes influenced by the sugar industry and public health organizations. Findings There was a small shift in transformed Wordscores score between the draft and final guidelines, from 0.25 to 0.24, towards the industry position. The change was linked to increased use of the word “low” to describe the quality of the evidence, consistent with industry arguments. There was also a shift from use of the word “consumption” to “intake”, irrespective of policy position. Scores for World Sugar Research Organisation and Sugar Nutrition UK submissions ( 0.11 and 0.18, respectively) represented strong pro-industry positions and scores for European Public Health Alliance and Wemos submissions (1.00 and 0.88, respectively) represented the strongest public health positions. Industry tactics included challenging the quality of the evidence, distinguishing between different types of sugar and advocating harm reduction. Conclusion There was little change between draft and final versions of the WHO sugars intake guideline 2015, following industry consultation. The main change was linked to emphasizing the low quality of the evidence on sugar’s adverse effects. Guideline development appeared relatively resistant to industry influence at the stakeholder consultation stage. PMID:27516634

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

Science.gov (United States)

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

2012-12-01

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

2006 Guidelines for Advancement and Promotion

CERN Multimedia

HR Department

2006-01-01

1. General The Director-General has now fixed the guidelines and schedule for the 2006 annual advancement review in the framework of the Merit Advancement and Promotion Scheme (MAPS). Procedures are set out in Administrative Circular 26 (Rev. 6). All decisions will be made by 1 July 2006. These now include career path changes for staff in Career Paths A to D. Departments are invited to comply strictly with the target date for the completion of the annual interviews which this year has been fixed at 15 March 2006. Group Leader evaluations are expected to be finalized by 13 April 2006. Exceptions due to particular circumstances (e.g. long-term absences) must be documented. The annual appraisal report should be completed using the electronic version in the EDH system. 2. Budget guidelines Within the annual advancement budget, the guideline allocations have been defined by the Director-General on a departmental basis for staff in Career Paths A to E and on a CERN-wide basis for staff in Career Paths F and ...

2006 Guidelines for Advancement and Promotion

CERN Multimedia

HR Department

2006-01-01

1. General The Director-General has now fixed the guidelines and schedule for the 2006 annual advancement review in the framework of the Merit Advancement and Promotion Scheme (MAPS). Procedures are set out in Administrative Circular 26 (Rev. 6). All decisions will be made by 1 July 2006. These now include career path changes for staff in Career Paths A to D. Departments are invited to comply strictly with the target date for the completion of the annual interviews which this year has been fixed at 15 March 2006. Group Leader evaluations are expected to be finalized by 13 April 2006. Exceptions due to particular circumstances (e.g. long-term absences) must be documented. The annual appraisal report should be completed using the electronic version in the EDH system. 2. Budget guidelines Within the annual advancement budget, the guideline allocations have been defined by the Director-General on a departmental basis for staff in Career Paths A to E and on a CERN-wide basis for staff in Career Paths F and G...

Predation by Northern Pikeminnow and tiger muskellunge on juvenile salmonids in a high–head reservoir: Implications for anadromous fish reintroductions

Science.gov (United States)

Sorel, Mark H.; Hansen, Adam G.; Connelly, Kristin A.; Wilson, Andrew C.; Lowery, Erin D.; Beauchamp, David A.

2016-01-01

The feasibility of reintroducing anadromous salmonids into reservoirs above high-head dams is affected by the suitability of the reservoir habitat for rearing and the interactions of the resident fish with introduced fish. We evaluated the predation risk to anadromous salmonids considered for reintroduction in Merwin Reservoir on the North Fork Lewis River in Washington State for two reservoir use-scenarios: year-round rearing and smolt migration. We characterized the role of the primary predators, Northern Pikeminnow Ptychocheilus oregonensis and tiger muskellunge (Northern Pike Esox lucius × Muskellunge E. masquinongy), by using stable isotopes and stomach content analysis, quantified seasonal, per capita predation using bioenergetics modeling, and evaluated the size and age structures of the populations. We then combined these inputs to estimate predation rates of size-structured population units. Northern Pikeminnow of FL ≥ 300 mm were highly cannibalistic and exhibited modest, seasonal, per capita predation on salmonids, but they were disproportionately much less abundant than smaller, less piscivorous, conspecifics. The annual predation on kokanee Oncorhynchus nerka (in biomass) by a size-structured unit of 1,000 Northern Pikeminnow having a FL ≥ 300 mm was analogous to 16,000–40,000 age-0 spring Chinook Salmon O. tshawytscha rearing year-round, or 400–1,000 age-1 smolts migrating April–June. The per capita consumption of salmonids by Northern Pikeminnow having a FL ≥ 200 mm was relatively low, due in large part to spatial segregation during the summer and the skewed size distribution of the predator population. Tiger muskellunge fed heavily on Northern Pikeminnow, other nonsalmonids, and minimally on salmonids. In addition to cannibalism within the Northern Pikeminnow population, predation by tiger muskellunge likely contributed to the low recruitment of larger (more piscivorous) Northern Pikeminnow, thereby decreasing the risk of predation to

Guidelines for applying criteria to designate routes for transporting hazardous materials. Final report

International Nuclear Information System (INIS)

1989-07-01

These guidelines were prepared to assist State and local officials in the analysis of alternate routes to be used by highway vehicles transportating hazardous materials. A methodology for assessing comparative risks of routing alternatives is discussed and demonstrated through a hypothetical example. Mathematical models are provided for situations in which measured local data may not be easily obtained or adequate

Specified radioactive waste final disposal act

International Nuclear Information System (INIS)

Yasui, Masaya

2001-01-01

Radioactive wastes must be finally and safely disposed far from human activities. Disposal act is a long-range task and needs to be understood and accepted by public for site selection. This paper explains basic policy of Japanese Government for final disposal act of specified radioactive wastes, examination for site selection guidelines to promote residential understanding, general concept of multi-barrier system for isolating the specific radioactive wastes, and research and technical development for radioactive waste management. (S. Ohno)

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

International Nuclear Information System (INIS)

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

1995-05-01

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

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

Science.gov (United States)

Prybil, L; Golden, P; Ballance, X

1995-04-01

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

Using Qualitative Research to Inform Development of Professional Guidelines: A Case Study of the Society of Critical Care Medicine Family-Centered Care Guidelines.

Science.gov (United States)

Coombs, Maureen A; Davidson, Judy E; Nunnally, Mark E; Wickline, Mary A; Curtis, J Randall

2017-08-01

To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research. Using Grading of Recommendations, Assessments, Development and Evaluations and the Council of Medical Specialty Societies principles, we conducted a systematic review of qualitative research to establish family-centered domains and outcomes. Thematic analyses were undertaken on study findings and used to support Population, Intervention, Comparison, Outcome question development. We identified and employed three approaches using qualitative research in these guidelines. First, previously published qualitative research was used to identify important domains for the Population, Intervention, Comparison, Outcome questions. Second, this qualitative research was used to identify and prioritize key outcomes to be evaluated. Finally, we used qualitative methods, member checking with patients and families, to validate the process and outcome of the guideline development. In this, a novel report, we provide direction for standardizing the use of qualitative evidence in future guidelines. Recommendations are made to incorporate qualitative literature review and appraisal, include qualitative methodologists in guideline taskforce teams, and develop training for evaluation of qualitative research into guideline development procedures. Effective methods of involving patients and families as members of guideline development represent opportunities for future work.

Exploring the Behavioral and Metabolic Phenotype Generated by Re-Introduction of the Ghrelin Receptor in the Ventral Tegmental Area

DEFF Research Database (Denmark)

Skov, Louise J; Jensen, Morten; Christiansen, Søren H

2017-01-01

Ghrelin receptor (Ghr-R) signaling in neurons of the ventral tegmental area (VTA) can modulate dopaminergic function and the reward-related effects of both palatable foods and drugs of abuse. In this study, we re-introduced the Ghr-R in VTA neurons in Ghr-R knockout mice (Ghr-R(VTA) mice) to spec...... for the reward-related effects of activation of VTA neurons. Overall, our data suggest that re-introduction of the Ghr-R in the mesolimbic reward system of Ghr-R knockout mice increases the level of activation induced by both cocaine and novelty stress.......Ghrelin receptor (Ghr-R) signaling in neurons of the ventral tegmental area (VTA) can modulate dopaminergic function and the reward-related effects of both palatable foods and drugs of abuse. In this study, we re-introduced the Ghr-R in VTA neurons in Ghr-R knockout mice (Ghr-R(VTA) mice...

Passive solar design strategies: Remodeling guidelines for conserving energy at home. [Final report

Energy Technology Data Exchange (ETDEWEB)

1991-12-31

The idea of passive solar is simple, but applying it effectively does require information and attention to the details of design and construction. Some passive solar techniques are modest and low-cost, and require only small changes in remodeler`s typical practice. At the other end of the spectrum, some passive solar systems can almost eliminate a house`s need for purchased heating (and in some cases, cooling) energy -- but probably at a relatively high first cost. In between are a broad range of energy-conserving passive solar techniques. Whether or not they are cost-effective, practical and attractive enough to offer a market advantage to any individual remodeler depends on very specific factors such as local costs, climate, and market characteristics. Passive solar design strategies: Remodeling Guidelines For Conserving Energy At Homes is written to help give remodelers the information they need to make these decisions. Passive Solar Design Strategies is a package in three basic parts: The Guidelines contain information about passive solar techniques and how they work, and provides specific examples of systems which will save various percentages of energy; The Worksheets offer a simple, fill-in-the-blank method to pre-evaluate the performance of a specific design; The Worked Example demonstrates how to complete the worksheets for a typical residence.

Guidelines for the responsible management of plutonium

International Nuclear Information System (INIS)

Agrell, P.H.

1997-01-01

Since 1994 an informal group of representatives of States party to the NPT has been trying to develop agreed international guidelines for the responsible management of non-military plutonium. This paper gives a brief description of the outcome. Since the results are still subject to decision by Governments, the description must be in general terms only. The paper describes the background to, and genesis of, the discussions and the general approach taken, which was based on commitment to the NPT, national responsibility for the management of nuclear materials and the fuel cycle, upholding of the IAEA's safeguards system, and a focus on civil material. An indication is given of the development of the Group's thinking, especially the decisions that any guidelines must be capable of accommodating surplus military plutonium, as well as civil, and that the main focus should be on measures to increase transparency. The resulting guidelines are described. Their main features are a re-statement of commitments and standards for the management of non-military plutonium with regard to non-proliferation, safety, and other fields, a commitment to the management of such plutonium according to a consistent national strategy, and a commitment to the publication of information on that strategy, and of annual statistics for holdings of plutonium in a consistent format. Other aspects of the guidelines are also explained. Finally, an attempt is made to assess the possible practical effects of the guidelines if adopted by governments. (author)

MDT Commissioning Procedures Guidelines for Certifying RFI Chambers

CERN Document Server

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

2004-01-01

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

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

Directory of Open Access Journals (Sweden)

Lemieux-Charles Louise

2011-03-01

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

Radiotherapy fractionation for the palliation of uncomplicated painful bone metastases – an evidence-based practice guideline

International Nuclear Information System (INIS)

Wu, Jackson Sai-Yiu; Wong, Rebecca KS; Lloyd, Nancy S; Johnston, Mary; Bezjak, Andrea; Whelan, Timothy

2004-01-01

This practice guideline was developed to provide recommendations to clinicians in Ontario on the preferred standard radiotherapy fractionation schedule for the treatment of painful bone metastases. A systematic review and meta-analysis was performed and published elsewhere. The Supportive Care Guidelines Group, a multidisciplinary guideline development panel, formulated clinical recommendations based on their interpretation of the evidence. In addition to evidence from clinical trials, the panel also considered patient convenience and ease of administration of palliative radiotherapy. External review of the draft report by Ontario practitioners was obtained through a mailed survey, and final approval was obtained from the Practice Guidelines Coordinating Committee. Meta-analysis did not detect a significant difference in complete or overall pain relief between single treatment and multifraction palliative radiotherapy for bone metastases. Fifty-nine Ontario practitioners responded to the mailed survey (return rate 62%). Forty-two percent also returned written comments. Eighty-three percent of respondents agreed with the interpretation of the evidence and 75% agreed that the report should be approved as a practice guideline. Minor revisions were made based on feedback from the external reviewers and the Practice Guidelines Coordinating Committee. The Practice Guidelines Coordinating Committee approved the final practice guideline report. For adult patients with single or multiple radiographically confirmed bone metastases of any histology corresponding to painful areas in previously non-irradiated areas without pathologic fractures or spinal cord/cauda equine compression, we conclude that: • Where the treatment objective is pain relief, a single 8 Gy treatment, prescribed to the appropriate target volume, is recommended as the standard dose-fractionation schedule for the treatment of symptomatic and uncomplicated bone metastases. Several factors frequently

Korean clinical practice guidelines: otitis media in children.

Science.gov (United States)

Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae; Kim, Hyung-Jong; Korean Otologic Society

2012-08-01

Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.

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

Science.gov (United States)

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

2012-07-04

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

Guideline of guidelines: asymptomatic microscopic haematuria.

Science.gov (United States)

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

2018-02-01

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

Addition of residues and reintroduction of microorganisms in Jatropha curcas cultivated in degraded soil

Directory of Open Access Journals (Sweden)

Adriana A. Santos

2016-04-01

Full Text Available ABSTRACT The aim of this study was to evaluate, through mycorrhization (root colonization and number of spores of arbuscular mycorrhizal fungi - AMF, leaf acid phosphatase and soil chemical characteristics, the effects of the addition of residues (macrophytes and ash, hydrogel and the reintroduction of microorganisms in a degraded area cultivated with jatropha. Degradation occurred when the surface soil was removed during the construction of a hydroelectric power plant. The experiment was set in a randomized block design, using a 2 x 2 x 4 factorial scheme, i.e., two inoculation treatments (with and without soil-inoculum, two hydrogel treatments (with and without and four with the addition of residues (macrophytes - MAC, ash, MAC + ash and control, without residues applied in the planting hole, with 4 replicates and 5 plants in each replicate. Soil from preserved Cerrado area was used as a source of microorganisms, including AMF. The conclusion is that, after 12 months of planting, the hydrogel increased root colonization, while the chemical characteristics of the degraded soil responded positively to the addition of MAC and MAC + ash, with increase in pH and SB and reduction of Al and H + Al. The addition of the soil-inoculum, along with MAC and MAC + ash, promoted higher mycorrhizal colonization and number of spores and reduced amounts of leaf acid phosphatase, indicating increased absorption of P by the host.

Consensus on the guidelines for the dietary management of classical galactosemia.

Science.gov (United States)

Kerckhove, Kristel Vande; Diels, Marianne; Vanhaesebrouck, Sigrid; Luyten, Karin; Pyck, Nancy; De Meyer, An; Van Driessche, Marleen; Robert, Martine; Corthouts, Karen; Caris, Ariane; Duchateau, Emilie; Dassy, Martine; Bihet, Genevieve

2015-02-01

Worldwide there is scientific discussion about the dietary management of galactosemia. The dietary management is very different in several countries among Europe, the US and Canada. The main points of discussion are related to the fact that i) despite a strict diet some patients still have poor outcomes; ii) there is lack of scientific knowledge about the role of endogenous production of galactose on disease evolution, with or without diet. The aim of the current work was the creation of a Belgian consensus on dietary guidelines for the management of galactosemia. A step-wise approach was used to achieve a consensus, including: a workshop, a Delphi round, discussion groups and a round table of different Belgian experts. The consensus is an agreement between strict guidelines (strict limitation of fruits, vegetables and soybean products/French guidelines) and the more liberal guidelines (comparable with a diet free of lactose/guidelines of UK and the Netherlands). The consensus document consists of different modules, including the medical context, the theoretical background of dietary guidelines and the age-specific practical dietary guidelines. A Belgian consensus on the guidelines for the dietary management of classical galactosemia was developed despite the uncertainties of the efficacy and practical application of these guidelines. The final consensus is based on scientific knowledge and practical agreement among experts. In the future, regular revision of the guidelines is recommended and a uniform European guideline is desirable. Copyright © 2014 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

A comprehensive literature review of guidelines facilitating transition of newly graduated nurses to professional nurses.

Science.gov (United States)

van Rooyen, Dalena R M; Jordan, Portia J; Ten Ham-Baloyi, Wilma; Caka, Ernestina M

2018-05-01

Literature shows that successful transition of newly graduate nurses to professional nurses is imperative but does not always take place, resulting in difficulty in performance, cognizance or behaviour of a role as a nurse, affecting the quality of patient care negatively. No integrative literature review could be found to summarize available guidelines facilitating transition of final year nursing students to professional nurses. An extensive search of the literature by means of an integrative literature review was conducted in 2014 and updated in June 2017, following a five-step process. All relevant studies were subsequently appraised for rigour and quality using the AGREE II tool by two independent reviewers. Eight (n = 8) guidelines on transitions were independently extracted. After thematic analysis was done, three factors to facilitate transition of final year nursing students to professional nurses were found: 1) support for new graduates, 2) the graduate's need for socialization and belonging, and 3) a positive clinical learning environment. The availability and implementation of guidelines on transition of final year nursing students by educational institutions and healthcare facilities could ease the transition from being final year nursing students to becoming professional nurses as well as improve retention of newly qualified professional nurses. Copyright © 2018. Published by Elsevier Ltd.

75 FR 61631 - Marine Mammal Protection Act; Deterrence Guidelines

Science.gov (United States)

2010-10-06

... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service 50 CFR Part 18 [Docket No. FWS-R7-FHC-2010...: Fish and Wildlife Service, Interior. ACTION: Final rule. SUMMARY: These guidelines set forth best... determined that the reasonable use of acoustic devices may startle or dissuade a bear from approaching a...

Preliminary report on operational guidelines developed for use in emergency preparedness and response to a radiological dispersal device incident.

Energy Technology Data Exchange (ETDEWEB)

Yu, C.; Cheng, J.-J.; Kamboj, S.; Domotor, S.; Wallo, A.; Environmental Science Division; DOE

2006-12-15

This report presents preliminary operational guidelines and supporting work products developed through the interagency Operational Guidelines Task Group (OGT). The report consolidates preliminary operational guidelines, all ancillary work products, and a companion software tool that facilitates their implementation into one reference source document. The report is intended for interim use and comment and provides the foundation for fostering future reviews of the operational guidelines and their implementation within emergency preparedness and response initiatives in the event of a radiological dispersal device (RDD) incident. The report principally focuses on the technical derivation and presentation of the operational guidelines. End-user guidance providing more details on how to apply these operational guidelines within planning and response settings is being considered and developed elsewhere. The preliminary operational guidelines are categorized into seven groups on the basis of their intended application within early, intermediate, and long-term recovery phases of emergency response. We anticipate that these operational guidelines will be updated and refined by interested government agencies in response to comments and lessons learned from their review, consideration, and trial application. This review, comment, and trial application process will facilitate the selection of a final set of operational guidelines that may be more or less inclusive of the preliminary operational guidelines presented in this report. These and updated versions of the operational guidelines will be made available through the OGT public Web site (http://ogcms.energy.gov) as they become finalized for public distribution and comment.

Guidelines for Qualitative Research in Organization Studies: Controversy and Possibilities

Directory of Open Access Journals (Sweden)

Maria Fernanda Rios Cavalcanti

2017-09-01

Full Text Available The aim of the present article is to tackle the controversy of establishing guidelines for qualitative research in Organization and Management Theory (OMT and to present a summary of suggestions on how to conduct good qualitative research given by methodologists on top-tier international publications. In order to do so, the article discusses: general guidelines for qualitative research; how to achieve coherence and transparency in a qualitative empirical study; the meaning and importance of the concept of reflexivity; and, finally how to establish a theoretical contribution and transferability of findings in such context. The work presents a valuable contribution because such guidelines, concepts, and approaches can be adopted by students and researchers when conducting a qualitative research proposal, and by periodic reviewers to evaluate the quality of existing empirical studies.

Expert validation of fit-for-purpose guidelines for designing programmes of assessment

Directory of Open Access Journals (Sweden)

Dijkstra Joost

2012-04-01

Full Text Available Abstract Background An assessment programme, a purposeful mix of assessment activities, is necessary to achieve a complete picture of assessee competence. High quality assessment programmes exist, however, design requirements for such programmes are still unclear. We developed guidelines for design based on an earlier developed framework which identified areas to be covered. A fitness-for-purpose approach defining quality was adopted to develop and validate guidelines. Methods First, in a brainstorm, ideas were generated, followed by structured interviews with 9 international assessment experts. Then, guidelines were fine-tuned through analysis of the interviews. Finally, validation was based on expert consensus via member checking. Results In total 72 guidelines were developed and in this paper the most salient guidelines are discussed. The guidelines are related and grouped per layer of the framework. Some guidelines were so generic that these are applicable in any design consideration. These are: the principle of proportionality, rationales should underpin each decisions, and requirement of expertise. Logically, many guidelines focus on practical aspects of assessment. Some guidelines were found to be clear and concrete, others were less straightforward and were phrased more as issues for contemplation. Conclusions The set of guidelines is comprehensive and not bound to a specific context or educational approach. From the fitness-for-purpose principle, guidelines are eclectic, requiring expertise judgement to use them appropriately in different contexts. Further validation studies to test practicality are required.

Terminology Guideline for Classifying Offshore Wind Energy Resources

Energy Technology Data Exchange (ETDEWEB)

Beiter, Philipp [National Renewable Energy Lab. (NREL), Golden, CO (United States); Musial, Walt [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2016-09-01

The purpose of this guideline is to establish a clear and consistent vocabulary for conveying offshore wind resource potential and to interpret this vocabulary in terms that are familiar to the oil and gas (O&G) industry. This involves clarifying and refining existing definitions of offshore wind energy resource classes. The terminology developed in this guideline represents one of several possible sets of vocabulary that may differ with respect to their purpose, data availability, and comprehensiveness. It was customized to correspond with established offshore wind practices and existing renewable energy industry terminology (e.g. DOE 2013, Brown et al. 2015) while conforming to established fossil resource classification as best as possible. The developers of the guideline recognize the fundamental differences that exist between fossil and renewable energy resources with respect to availability, accessibility, lifetime, and quality. Any quantitative comparison between fossil and renewable energy resources, including offshore wind, is therefore limited. For instance, O&G resources are finite and there may be significant uncertainty associated with the amount of the resource. In contrast, aboveground renewable resources, such as offshore wind, do not generally deplete over time but can vary significantly subhourly, daily, seasonally, and annually. The intent of this guideline is to make these differences transparent and develop an offshore wind resource classification that conforms to established fossil resource classifications where possible. This guideline also provides methods to quantitatively compare certain offshore wind energy resources to O&G resource classes for specific applications. Finally, this guideline identifies areas where analogies to established O&G terminology may be inappropriate or subject to misinterpretation.

UOP FIN 571 Final Exam Guide New

OpenAIRE

ADMIN

2018-01-01

UOP FIN 571 Final Exam Guide New Check this A+ tutorial guideline at http://www.fin571assignment.com/fin-571-uop/fin-571-final-exam-guide -latest For more classes visit http://www.fin571assignment.com Question 1 The underlying assumption of the dividend growth model is that a stock is worth: A. An amount computed as the next annual dividend divided by the required rate of return. B. An amount computed as the next annual dividend divided by the ma...

Lessons from Białowieża Forest on the history of protection and the world's first reintroduction of a large carnivore.

Science.gov (United States)

Samojlik, Tomasz; Selva, Nuria; Daszkiewicz, Piotr; Fedotova, Anastasia; Wajrak, Adam; Kuijper, Dries Pieter Jan

2018-02-01

Understanding how the relationships between large carnivores and humans have evolved and have been managed through centuries can provide relevant insights for wildlife conservation. The management history of many large carnivores has followed a similar pattern, from game reserved for nobility, to persecuted pests, to conservation targets. We reconstructed the history of brown bear (Ursus arctos) management in Białowieża Forest (Poland and Belarus) based on a detailed survey of historical literature and Russian archives. From the end of the Middle Ages to the end of 18th century, the brown bear was considered "animalia superiora" (i.e., game exclusively reserved for nobility and protected by law). Bears, also a source of public entertainment, were not regarded as a threat. Effective measures to prevent damages to traditional forest beekeeping were already in practice. In the beginning of 19th century, new game-management approaches allowed most forest officials to hunt bears, which became the primary target of hunters due to their valuable pelt. This, together with an effective anticarnivore policy enhanced by bounties, led to bear extirpation in 1879. Different approaches to scientific game management appeared (planned extermination of predators and hunting levels that would maintain stable populations), as did the first initiatives to protect bears from cruel treatment in captivity. Bear reintroduction in Białowieża Forest began in 1937 and represented the world's first reintroduction of a large carnivore motivated by conservation goals. The outbreak of World War II spoiled what might have been a successful project; reproduction in the wild was documented for 8 years and bear presence for 13. Soft release of cubs born in captivity inside the forest but freely roaming with minimal human contact proved successful. Release of captive human-habituated bears, feeding of these bears, and a lack of involvement of local communities were weaknesses of the project

32 CFR 767.9 - Content of permit holder's final report.

Science.gov (United States)

2010-07-01

... RULES APPLICATION GUIDELINES FOR ARCHEOLOGICAL RESEARCH PERMITS ON SHIP AND AIRCRAFT WRECKS UNDER THE.... The permit holder's final report shall include the following: (a) A site history and a contextual...

Radiotherapy fractionation for the palliation of uncomplicated painful bone metastases – an evidence-based practice guideline

Directory of Open Access Journals (Sweden)

Bezjak Andrea

2004-10-01

Full Text Available Abstract Background This practice guideline was developed to provide recommendations to clinicians in Ontario on the preferred standard radiotherapy fractionation schedule for the treatment of painful bone metastases. Methods A systematic review and meta-analysis was performed and published elsewhere. The Supportive Care Guidelines Group, a multidisciplinary guideline development panel, formulated clinical recommendations based on their interpretation of the evidence. In addition to evidence from clinical trials, the panel also considered patient convenience and ease of administration of palliative radiotherapy. External review of the draft report by Ontario practitioners was obtained through a mailed survey, and final approval was obtained from the Practice Guidelines Coordinating Committee. Results Meta-analysis did not detect a significant difference in complete or overall pain relief between single treatment and multifraction palliative radiotherapy for bone metastases. Fifty-nine Ontario practitioners responded to the mailed survey (return rate 62%. Forty-two percent also returned written comments. Eighty-three percent of respondents agreed with the interpretation of the evidence and 75% agreed that the report should be approved as a practice guideline. Minor revisions were made based on feedback from the external reviewers and the Practice Guidelines Coordinating Committee. The Practice Guidelines Coordinating Committee approved the final practice guideline report. Conclusion For adult patients with single or multiple radiographically confirmed bone metastases of any histology corresponding to painful areas in previously non-irradiated areas without pathologic fractures or spinal cord/cauda equine compression, we conclude that: • Where the treatment objective is pain relief, a single 8 Gy treatment, prescribed to the appropriate target volume, is recommended as the standard dose-fractionation schedule for the treatment of symptomatic and

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

Directory of Open Access Journals (Sweden)

Solà Ivan

2011-09-01

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

EXPLORATORY PLASMA BIOCHEMISTRY REFERENCE INTERVALS FOR URAL OWLS (STRIX URALENSIS, PALLAS 1771) FROM THE AUSTRIAN REINTRODUCTION PROJECT.

Science.gov (United States)

Scope, Alexandra; Schwendenwein, Ilse; Stanclova, Gabriela; Vobornik, Angela; Zink, Richard

2016-06-01

The Ural owl (Strix uralensis) is the biggest forest-living owl in Austria; however, it became extinct in Austria through poaching and habitat loss more than half a century ago. The birds examined in the present study were breeding pairs from the reintroduction project with the aim of determining exploratory plasma biochemistry reference intervals in Ural owls and evaluating the amount of biological variation between seasons, sexes, and ages. A total of 45 birds were sampled, including 13 adult males, 14 adult females, and 18 juvenile birds. Remarkably, almost all of the analytes showed significant differences between the subgroups, primarily between seasons, followed by age and sex. Only creatinkinase, glucose, lactatdehydrogenase, and triglycerides did not show any significant variations. Despite partitioning of reference values into subgroups according to biological variation diminishing the number of reference individuals in the respective groups, the resulting smaller reference intervals will improve medical assessment. The results of the present study once again demonstrate that significant seasonal fluctuations must be expected and considered in the interpretation. It can be assumed that these differences are probably even greater in free-range birds with considerable changes in food quantity and quality during and between years.

Comparing 3 guidelines on the management of surgically removed pancreatic cysts with regard to pathological outcome.

Science.gov (United States)

Lekkerkerker, Selma J; Besselink, Marc G; Busch, Olivier R; Verheij, Joanne; Engelbrecht, Marc R; Rauws, Erik A; Fockens, Paul; van Hooft, Jeanin E

2017-05-01

Currently, 3 guidelines are available for the management of pancreatic cysts. These guidelines vary in their indication for resection of high-risk cysts. We retrospectively compared the final pathologic outcome of surgically removed pancreatic cysts with the indications for resection according to 3 different guidelines. Patients who underwent pancreatic resection were extracted from our prospective pancreatic cyst database (2006-present). The final histopathologic diagnosis was compared with the initial indication for surgery stated by the guidelines of the International Association of Pancreatology (IAP), European Study Group on Cystic tumors of the Pancreas and American Gastroenterological Association (AGA). We considered surgery in retrospect justified for malignancy, high-grade dysplasia, solid pseudopapillary neoplasms, neuroendocrine tumors or symptom improvement. Furthermore, we evaluated the patients with suspected intraductal papillary mucinous neoplasm (IPMN) separately. Overall, 115 patients underwent pancreatic resection. The preoperative diagnosis was correct in 83 of 115 patients (72%) and differentiation between benign and premalignant in 99 of 115 patients (86%). In retrospect, surgery was justified according to the aforementioned criteria in 52 of 115 patients (45%). For patients with suspected IPMN (n = 75) resection was justified in 36 of 67 (54%), 36 of 68 (53%), and 32 of 54 (59%) of patients who would have had surgery based on the IAP, European, or AGA guidelines, respectively. The AGA guideline would have avoided resection in 21 of 75 (28%) patients, versus 8 of 75 (11%) and 7 of 75 (9%) when the IAP or European guideline would have been applied strictly. Nevertheless, 4 of 33 patients (12%) with high-grade dysplasia or malignancy would have been missed with the AGA guidelines, compared with none with the IAP or European guidelines. Although fewer patients undergo unnecessary surgery based on the AGA guidelines, the risk of missing

Evidence for introgressive hybridization of captive markhor (Capra falconeri) with domestic goat: cautions for reintroduction.

Science.gov (United States)

Hammer, Sabine E; Schwammer, Harald M; Suchentrunk, Franz

2008-04-01

Markhors (Capra falconeri) are among the most endangered mammal species, and several conservation measures, including ex situ breeding, are implemented to prevent their extinction. We studied sequence diversity and differentiation of the first hypervariable segment of the mitochondrial DNA control region among C. f. heptneri and C. f. megaceros kept in four zoos in relationship to lineages of other wild and domestic goats, to assess for the first time the level of molecular distinctness and variability among those subspecies, and to check for possible introgression by related Capra taxa, such as domestic goats. Levels of differentiation between some Capra falconeri lineages and modern domestic goats were similar to levels between other wild goat species (i.e., Capra aegagrus, Capra ibex) and domestic goats. Among pure markhor lineages, paraphyly was observed for C. f. heptneri, suggesting occurrence of shared ancestral polymorphism among markhor subspecies and/or ancient or recent gene exchange between subspecies. Interestingly, 35.7% of all studied markhors from three zoos are introgressed by the domestic goat. Furthermore, despite relatively small breeding group sizes, markhors have maintained a relatively high proportion of mtDNA variation within zoo groups. In any case, the existence of markhors introgressed with domestic goat DNA in zoos should be considered when selecting markhors for ex situ breeding programs with the aim of building up a stock for later reintroduction into the wild.

The development of a multidisciplinary, evidence-based guideline for "HIV and employment".

Science.gov (United States)

Wagener, Marlies N; Roelofs, Pepijin; Miedema, Harold S; Brandjes, Dees P M; Dahmen, Rutger; van Gorp, Eric C M

2015-01-01

The objective of this study was to develop a multidisciplinary guideline that supports the care and vocational rehabilitation of HIV-infected people with employment-related problems. The guideline was developed according to the "evidence-based guideline development" method developed by the Dutch Institute for Health Care Improvement. This method consists of the following steps: forming a multidisciplinary core group and an expert panel, formulating key questions, searching and appraising the available literature, formulating considerations and recommendations, peer reviewing the draft guideline, and authorizing the final guideline. All relevant professional associations were represented in the core group that was assembled to develop the guideline, i.e., HIV doctors, HIV nurses, general practitioners, occupational health physicians, psychologists, social workers, occupational health nurses, vocational experts, and insurance physicians. Five key questions for the guideline were formulated with the following themes: determinants of employment, disclosure and stigma, self-management, interventions, and the organization of care. In the literature review on these topics, 45 studies met the inclusion criteria. The methodological quality of the included articles was poor. Factors such as patient preferences and medical/ethical issues were considered. The recommendations in the guideline are a weighting of the scientific evidence and the considerations of the core group. The guideline, as well as its summary for daily practice, clarifies the most important barriers and facilitators to people with HIV either staying at work or returning to work, and it constitutes a clinical, easy-to-use guideline for health-care providers and how they can support people with HIV who want to work.

1989 guidelines for the management of mild hypertension: memorandum from a WHO/ISH meeting.

OpenAIRE

1989-01-01

The present guidelines were prepared by a subcommittee of the WHO/ISH (International Society of Hypertension) Mild Hypertension Liaison Committee, and wee finalized after discussion at the Fifth WHO/ISH Mild Hypertension Conference. They include the definition of mild hypertension, and describe blood pressure measurement, factors influencing the decision to begin treatment, methods of treatment, and follow-up. These guidelines are a revision of those published in 1986; they are based on the b...

Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

Energy Technology Data Exchange (ETDEWEB)

Carter, R.J.

1997-07-01

This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

International Nuclear Information System (INIS)

Carter, R.J.

1997-07-01

This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

Economic benefits of final effluent limitations guidelines and standards for the offshore oil and gas industry. Final report

International Nuclear Information System (INIS)

1993-01-01

The report provides an overview of the benefits analysis of the effluent limitation guidelines for offshore oil and gas facilities. Regulatory options were evaluated for two wastestreams: (1) drilling fluids (muds) and cuttings; and (2) produced water. The analysis focuses on the human health-related benefits of the regulatory options considered. These health risk reduction benefits are associated with reduced human exposure to various carcinogenic and noncarcinogenic contaminants, including lead, by way of consumption of shrimp and recreationally caught finfish from the Gulf of Mexico. Most of the health-risk reduction benefits analysis is based upon a previous report (RCG/Hagler, Bailly, January 1991), developed in support of the proposed rulemaking. Recreational, commercial, and nonuse benefits have not been estimated for these regulations, due to data limitations and the difficulty of estimating these values for effluent controls in the open-water marine environment

A fall prevention guideline for older adults living in long-term care facilities.

Science.gov (United States)

Jung, D; Shin, S; Kim, H

2014-12-01

Falls are among the most frequent critical health problems for older adults over 65 years of age and often result in consequential injuries. This study developed a guideline covering risk factors and interventions for falls in order to prevent them from occurring in long-term care facilities. This study was grounded in the methodological approach of the Scottish Intercollegiate Guideline Network for establishing evidence-based guidelines: (1) establishment of the target population and scope of the guideline, (2) systematic literature review and critical analysis, (3) determination of the recommendation grade, (4) development of a draft nursing intervention guideline and algorithm, (5) expert evaluation of the draft nursing intervention guideline, and (6) confirmation of the final intervention guideline and completion of the algorithm. The resulting evidence-based fall prevention guideline consists of a three-step factor assessment and a three-step intervention approach. The resulting guideline was based on the literature and clinical experts. Further research is required to test the guideline's feasibility in across long term care facilities. This guideline can be used by nurses to screen patients who are at a high risk of falling to provide patient interventions to help prevent falls. Considering the high rate of falls at long-term care facilities and the absence of evidence-based guidelines to prevent them, additional studies on falls at long-term care facilities are necessary. Meanwhile, given prior research that indicates the importance of human resources in the application of such guidelines, continuous investigations are needed as to whether the research outcomes are actually conveyed to nurses. © 2014 International Council of Nurses.

[The development of clinical guidelines for the diagnosis and treatment of chronic periodontitis in Belgium].

Science.gov (United States)

Cosyn, Jan; De Bruyn, Hugo

2008-01-01

In many disciplines of medicine guidelines are developed for the diagnosis and treatment of disease. These are essentially intended to standardize care and to optimize communication between the general practitioner and the specialist. Guidelines have already been described in the literature for chronic periodontitis. However, given the unique conditions in Belgium, these may not be appropriate for the average dental practice. In this manuscript the development of Belgian clinical guidelines for the diagnosis and treatment of chronic periodontitis is described. Basically, ten clinical questions were used as a basis for a thorough literature search. Evidence-based clinical guidelines were developed and adapted during three peer review sessions. In the final session Belgian specialists, who had all been invited, participated. This made sure that the scientific input was sufficiently transformed into clinical guidelines which are actually feasible today in Belgium.

[Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].

Science.gov (United States)

Planjar-Prvan, Miljenka; Granić, Davorka

2005-01-01

The choice of AED (antiepileptic drug), worldwide and in Croatia, is been still based on the physician's subjective decision, personal experience, knowledge and marketing pressure made by big pharmaceutical industries. Therefore, according to some opinions, there is a need of treatment guidelines for epilepsy that would provide relevant information based on scientific evidence on the efficacy, tolerability and safety of AEDs. The guidelines, published by a competent source, should be designed as to allow for easy access to the information on the best practice in specific cases. An extensive background literature review was made to identify such a type of guidelines for the management of epilepsy. The literature review revealed a number of references with the recommendations for treating epilepsy in different groups of patients and from various, specific aspects of epilepsy treatment. However, only one comprehensive set of guidelines for the diagnosis and treatment of epilepsy treatment was found, i.e. the evidence-based guidelines published by the Scottish Intercollegiate Guidelines Network (SIGN). The development of this set of guidelines is quite extensively described in order to illustrate how rigorous and long-lasting the process was, including a great number of health professionals at the national level. Such a type of well designed guidelines facilitates access to highest educational standards for all professionals involved in the primary and secondary care of people with epilepsy. However, it is clear that guidelines can fully replace the standards of clinical practice based on critical evaluation and integration of all clinical data of each individual patient. No guidelines can replace the physician's obligation to keep informed of the novel achievements in the epileptology either.

THE 2015 INTERNATIONAL GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS

Directory of Open Access Journals (Sweden)

T. V. Beketova

2016-01-01

Full Text Available In 2015, guidelines for the diagnosis and treatment of eosinophilic granulomatosis with polyangiitis, formerly known as Churg-Strauss syndrome, were prepared with the participation of experts from 5 countries of Europe, the USA, and Canada, who accumulated scientific achievements and currently gained clinical experience. The proposed guidelines should not be regarded as final standards, but must become a guide for the selection of a personification strategy for managing patients with eosinophilic granulomatosis with polyangiitis and serve as a starting point for further investigations. The purposes of the publication are general characterization of the key points of the guidelines and discussion of some debate problems. 

The development of oncology treatment guidelines: an analysis of the National Guidelines Clearinghouse.

Science.gov (United States)

Palta, Manisha; Lee, W Robert

2011-01-01

In the last 2 decades, guidelines have been developed to improve quality of patient care. A recent editorial of guideline development procedures suggested the process has significant limitations that affect their scientific validity.(1) This prompted us to review oncology treatment guidelines to determine if such limitations are widespread. We performed a review of oncology treatment guidelines registered at the National Guidelines Clearinghouse (www.guideline.gov). Each guideline was independently reviewed by 2 authors and the following criteria were assessed: coordinating organization, guideline panel composition, reporting conflict of interest, peer review, dissent, expiration date, PubMed citation, and evidence-based scoring and grading of recommendations. Disagreements were resolved by consensus in subsequent discussions. Sixty-four guidelines were reviewed (39 [61%] were developed by a medical specialty society and 25 [39%] were developed by government agencies). Fifty (78%) guideline panels were multidisciplinary and 44 (69%) included individuals with epidemiologic and health services research expertise. Potential conflicts of interest were disclosed in 43 (67%) guidelines. Sixty (94%) guidelines underwent peer review, with external review in 31 (48%). Seventeen (27%) guidelines are indexed by PubMed. Fifty-one (80%) guidelines included evidence-based methodologies and 46 (72%) used evidence-based scoring of recommendations. Significant differences were observed according to coordinating organization (eg, disclosure of conflict of interest in 46% of guidelines developed by medical specialty societies versus 100% authored by government agencies [P <.0001]). The majority of oncology-related treatment guidelines registered at the National Guidelines Clearinghouse satisfy most of the criteria for sound guideline development. Significant differences in these criteria were observed according to the coordinating organization that developed the guideline. Copyright

Semi-Semantic Annotation: A guideline for the URDU.KON-TB treebank POS annotation

Directory of Open Access Journals (Sweden)

Qaiser ABBAS

2016-12-01

Full Text Available This work elaborates the semi-semantic part of speech annotation guidelines for the URDU.KON-TB treebank: an annotated corpus. A hierarchical annotation scheme was designed to label the part of speech and then applied on the corpus. This raw corpus was collected from the Urdu Wikipedia and the Jang newspaper and then annotated with the proposed semi-semantic part of speech labels. The corpus contains text of local & international news, social stories, sports, culture, finance, religion, traveling, etc. This exercise finally contributed a part of speech annotation to the URDU.KON-TB treebank. Twenty-two main part of speech categories are divided into subcategories, which conclude the morphological, and semantical information encoded in it. This article reports the annotation guidelines in major; however, it also briefs the development of the URDU.KON-TB treebank, which includes the raw corpus collection, designing & employment of annotation scheme and finally, its statistical evaluation and results. The guidelines presented as follows, will be useful for linguistic community to annotate the sentences not only for the national language Urdu but for the other indigenous languages like Punjab, Sindhi, Pashto, etc., as well.

Comments from the Developmental Neurotoxicology Committee of the Japanese Teratology Society on the OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426, Developmental Neurotoxicity Study, Draft Document (October 2006 version), and on the Draft Document of the Retrospective Performance Assessment of the Draft Test Guideline 426 on Developmental Neurotoxicity.

Science.gov (United States)

Ema, Makoto; Fukui, Yoshihiro; Aoyama, Hiroaki; Fujiwara, Michio; Fuji, Junichiro; Inouye, Minoru; Iwase, Takayuki; Kihara, Takahide; Oi, Akihide; Otani, Hiroki; Shinomiya, Mitsuhiro; Sugioka, Kozo; Yamano, Tsunekazu; Yamashita, Keisuke H; Tanimura, Takashi

2007-06-01

In October 2006, a new revision of the draft guideline (OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426. Developmental Neurotoxicity Study) and Draft Document of the Retrospective Performance Assessment (RPA) of the Draft Test Guideline 426 on Developmental Neurotoxicity were distributed following incorporation of the results of the Expert Consultation Meeting in Tokyo on May 24-26, 2005. The draft guideline consists of 50 paragraphs and an appendix with 102 references; and the draft RPA consists of 37 paragraphs with 109 references. National coordinators were requested to arrange for national expert reviews of these draft documents in their member countries. Members of the Developmental Neurotoxicology (DNT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed, and commented on the draft Test Guideline Proposal. The DNT Committee of the JTS also commented on the draft document of the RPA. These comments were sent to the OECD Secretariat. The DNT Committee of the JTS expects the comments to be useful for the finalization of these draft documents.

Prioritization strategies in clinical practice guidelines development: a pilot study

Directory of Open Access Journals (Sweden)

Torres Marcela

2010-03-01

Full Text Available Abstract Objective Few methodological studies address the prioritization of clinical topics for the development of Clinical Practice Guidelines (CPGs. The aim of this study was to validate a methodology for Priority Determination of Topics (PDT of CPGs. Methods and results Firstly, we developed an instrument for PDT with 41 criteria that were grouped under 10 domains, based on a comprehensive systematic search. Secondly, we performed a survey of stakeholders involved in CPGs development, and end users of guidelines, using the instrument. Thirdly, a pilot testing of the PDT procedure was performed in order to choose 10 guideline topics among 34 proposed projects; using a multi-criteria analysis approach, we validated a mechanism that followed five stages: determination of the composition of groups, item/domain scoring, weights determination, quality of the information used to support judgments, and finally, topic selection. Participants first scored the importance of each domain, after which four different weighting procedures were calculated (including the survey results. The process of weighting was determined by correlating the data between them. We also reported the quality of evidence used for PDT. Finally, we provided a qualitative analysis of the process. The main domains used to support judgement, having higher quality scores and weightings, were feasibility, disease burden, implementation and information needs. Other important domains such as user preferences, adverse events, potential for health promotion, social effects, and economic impact had lower relevance for clinicians. Criteria for prioritization were mainly judged through professional experience, while good quality information was only used in 15% of cases. Conclusion The main advantages of the proposed methodology are supported by the use of a systematic approach to identify, score and weight guideline topics selection, limiting or exposing the influence of personal biases

Physiotherapy in rheumatoid arthritis: development of a practice guideline.

Science.gov (United States)

Hurkmans, E J; van der Giesen, F J; Bloo, H; Boonman, D C; van der Esch, M; Fluit, M; Hilberdink, W K; Peter, W F; van der Stegen, H P; Veerman, E A; Verhoef, J; Vermeulen, H M; Hendriks, H M; Schoones, J W; Vliet Vlieland, T P

2011-01-01

To improve the quality of the physiotherapy management in patients with rheumatoid arthritis (RA) a Dutch practice guideline, based on current scientific evidence and best practice, was developed. This guideline comprised all elements of a structured approach (assessment, treatment and evaluation) and was based on the Internatio-nal Classification of Functioning, disability and Health (ICF) and the ICF core sets for RA. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 10 experts from different professional backgrounds resulting in the final guideline. In total 7 topics were selected. For the initial assessment, three recommendations were made. Based on the ICF core sets for RA a list of health problems relevant for the physiotherapist was made and completed with red flags and points of attention. Concerning treatment, three recommendations were formulated; both exercise therapy and education on physiotherapy were recommended, whereas passive interventions (delivery of heat or cold, mechanical, electric and electromagnetic energy, massage, passive mobilization/manipulation and balneotherapy) were neither recommended nor discouraged. For treatment evaluation at the level of activities and participation, the Health Assessment Questionnaire was recommended. For evaluating specific body structures and functions the handheld dynamometer, 6-minute walk test or Ästrand bicycle test (including Borg-scale for rating the perceived exertion), Escola Paulista de Medicina Range of Motion Scale and a Visual Analog Scale for pain and

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

Directory of Open Access Journals (Sweden)

Afshin Mohammad Alizadeh

2018-04-01

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

Guidelines for Description

NARCIS (Netherlands)

Links, P.; Horsman, Peter; Kühnel, Karsten; Priddy, M.; Reijnhoudt, Linda; Merenmies, Mark

2013-01-01

The Guidelines follow the conceptual metadata model (deliverable 17.2). They include guidelines for description of collection-holding institutions, document collections, organisations, personalities, events, camps and ghettos. As much as possible the guidelines comply with the descriptive standards

Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey.

Science.gov (United States)

Kuunders, Theo J M; Jacobs, Monique A M; Goor, Ien A M van de; Bon-Martens, Marja J H van; Oers, Hans A M van; Paulussen, Theo G W M

2017-08-15

Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study explores the determinants of guideline use by regional Dutch health professionals. A web survey was send to 304 RHS health professionals. The questionnaire was based on a theory- and research-based framework of determinants of public health innovations. Main outcomes were guideline use and completeness of use, defined as the number of health topics and checklists used. Associations between determinants and (completeness of) guideline use were explored by multivariate regression models. The survey was started by 120 professionals (39%). Finally, results from 73 respondents (24%) were eligible for analyses. All 28 Dutch RHS organizations were represented in the final dataset. About half of the respondents (48%) used the guideline. The average score for completeness of use (potential range 1-10) was 2.37 (sd = 1.78; range 1-7). Knowledge, perceived task responsibility and usability were significantly related to guideline use in univariate analyses. Only usability remained significant in the multivariate model on guideline use. Only self-efficacy accounted for significant proportions of variance in completeness of use. The results imply that strategies to improve guideline use by RHSs should primarily target perceived usability. Self-efficacy appeared the primary target for improving completeness of guideline use. Methods for targeting these determinants in RHSs are discussed.

Human-system interface design review guideline -- Review software and user's guide: Final report. Revision 1, Volume 3

International Nuclear Information System (INIS)

1996-06-01

NUREG-0700, Revision 1, provides human factors engineering (HFE) guidance to the US Nuclear Regulatory Commission staff for its: (1) review of the human system interface (HSI) design submittals prepared by licensees or applications for a license or design certification of commercial nuclear power plants, and (2) performance of HSI reviews that could be undertaken as part of an inspection or other type of regulatory review involving HSI design or incidents involving human performance. The guidance consists of a review process and HFE guidelines. The document describes those aspects of the HSI design review process that are important to the identification and resolution of human engineering discrepancies that could adversely affect plant safety. Guidance is provided that could be used by the staff to review an applicant's HSI design review process or to guide the development of an HSI design review plan, e.g., as part of an inspection activity. The document also provides detailed HFE guidelines for the assessment of HSI design implementations. NUREG-0700, Revision 1, consists of three stand-alone volumes. Volume 3 contains an interactive software application of the NUREG-0700, Revision 1 guidance and a user's guide for this software. The software supports reviewers during review preparation, evaluation design using the human factors engineering guidelines, and in report preparation. The user's guide provides system requirements and installation instructions, detailed explanations of the software's functions and features, and a tutorial on using the software

Current and potential cyber attacks on medical journals; guidelines for improving security.

Science.gov (United States)

Dadkhah, Mehdi; Seno, Seyed Amin Hosseini; Borchardt, Glenn

2017-03-01

At the moment, scholarly publishing is faced with much academic misconduct and threats such as predatory journals, hijacked journals, phishing, and other scams. In response, we have been discussing this misconduct and trying to increase the awareness of researchers, but it seems that there is a lack of research that presents guidelines for editors to help them protect themselves against these threats. It seems that information security is missing in some parts of scholarly publishing that particularly involves medical journals. In this paper, we explain different types of cyber-attacks that especially threaten editors and academic journals. We then explain the details involved in each type of attack. Finally, we present general guidelines for detection and prevention of the attacks. In some cases, we use small experiments to show that our claim is true. Finally, we conclude the paper with a prioritization of these attacks. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

UOP HRM 300 Final Exam Guide (New, 2017) NEW

OpenAIRE

ADMIN

2018-01-01

UOP HRM 300 Final Exam Guide (New, 2017) NEW Check this A+ tutorial guideline at http://www.hrm300assignment.com/hrm-300-uop/hrm-300-final-exam-guide-latest For more classes visit http://www.hrm300assignment.com True and False: Please mark either T or F in the appropriate space before the question 1. ____A strategic plan is the company’s plan for how it will match its internal strengths and weaknesses with external opportunities and threats in or...

Clinical practice guidelines for translating pharmacogenomic knowledge to bedside. Focus on anticancer drugs.

Directory of Open Access Journals (Sweden)

José A G Agúndez

2014-08-01

Full Text Available The development of clinical practice recommendations or guidelines for the clinical use of pharmacogenomics data is an essential issue for improving drug therapy, particularly for drugs with high toxicity and/or narrow therapeutic index such as anticancer drugs. Although pharmacogenomic-based recommendations have been formulated for over 40 anticancer drugs, the number of clinical practice guidelines available is very low. The guidelines already published indicate that pharmacogenomic testing is useful for patient selection, but final dosing adjustment should be carried out on the basis of clinical or analytical parameters rather than on pharmacogenomic information.Patient selection may seem a modest objective, but it constitutes a crucial improvement with regard to the pre-pharmacogenomics situation and it saves patients’ lives. However we should not overstate the current power of pharmacogenomics. At present the pharmacogenomics of anticancer drugs is not sufficiently developed for dose adjustments based on pharmacogenomics only, and no current guidelines recommend such adjustments without considering clinical and/or analytical parameters.

Primary care guidelines

DEFF Research Database (Denmark)

Ijäs, Jarja; Alanen, Seija; Kaila, Minna

2009-01-01

OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p ...: Hypertension Guideline recommendations that require joint agreements between professionals are less often adopted than simple, precise recommendations. More emphasis on effective multidisciplinary collaboration is needed....

Radiological risk comparison guidelines

International Nuclear Information System (INIS)

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

1992-01-01

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

Quality Guidelines

Science.gov (United States)

... this page: https://medlineplus.gov/criteria.html MedlinePlus Quality Guidelines To use the sharing features on this ... materials must also meet our existing quality guidelines. Quality, authority and accuracy of health content The organization's ...

Reintroduction of Lake Sturgeon (Acipenser fulvescens) into the St. Regis River, NY: Post-release assessment of habitat use and growth

Science.gov (United States)

Dittman, Dawn E.; Chalupnicki, Marc A.; Johnson, James H.; Snyder, James

2015-01-01

One of the depleted endemic fish species of the Great Lakes, Acipenser fulvescens (Lake Sturgeon), has been the target of extensive conservation efforts. One strategy is reintroduction into historically productive waters. The St. Regis River, NY, represents one such adaptive-management effort, with shared management between New York and the St. Regis Mohawk Tribe. Between 1998 and 2004, a total of 4977 young-of-year Lake Sturgeon were released. Adaptive management requires intermediate progress metrics. During 2004 and 2005, we measured growth, habitat use, and survivorship metrics of the released fish. We captured a total of 95 individuals of all stocked ages. Year-class minimal-survival rates ranged from 0.19–2.1%. The size-at-age and length/biomass relationships were comparable to those reported for juveniles in other Great Lakes waters. These intermediate assessment metrics can provide feedback to resource managers who make restoration-program decisions on a much shorter time-scale than the time-frame in which the ultimate goal of a self-sustaining population can be attained.

In vitro propagation and reintroduction of the endangered Renanthera imschootiana Rolfe.

Science.gov (United States)

Wu, Kunlin; Zeng, Songjun; Lin, Danni; Teixeira da Silva, Jaime A; Bu, Zhaoyang; Zhang, Jianxia; Duan, Jun

2014-01-01

Renanthera imschootiana Rolfe is an endangered tropical epiphytic orchid that is threatened with extinction due to over-collection and the loss of suitable habitats. In vitro propagation is a useful way to mass produce plants for re-establishment in the wild and for commercial propagation. Seeds collected 150 days after pollination (DAP) were the optimum stage for in vitro culture. Seed germination reached 93.1% on quarter-strength MS (i.e., MS containing a quarter of macro- and micronutrients) medium containing 0.5 mg l(-1) α-naphthaleneacetic acid (NAA), 20% coconut water (CW), 1.0 g l(-1) peptone, 10 g l(-1) sucrose and 1.0 g l(-1) activated charcoal (AC). Quarter-strength MS medium supplemented with 1.0 mg l(-1) BA, 0.5 mg l(-1) NAA, 1.0 g l(-1) peptone, 10 g l(-1) sucrose and 20% CW was suitable for the sub-culture of protocorm-like bodies (PLBs) in which the PLB proliferation ratio was 2.88. Quarter-strength MS medium containing 1.0 mg l(-1) NAA, 1.0 g l(-1) peptone, 100 g l(-1) banana homogenate (BH), and 1.0 g l(-1) AC was suitable for plantlet formation and 95.67% of plantlets developed from PLBs within 60 days of culture. Hyponex N016 medium supplemented with 0.5 mg l(-1) NAA, 1.0 g l(-1) peptone, 20 g l(-1) sucrose, 150 g l(-1) BH, and 1.0 g l(-1) AC was suitable for the in vitro growth of plantlets about 2-cm in height. Plantlets 3-cm in height or taller were transplanted to Chilean sphagnum moss, and 95% of plantlets survived after 60 days in a greenhouse. Three hundred transplanted of seedlings 360-days old were reintroduced into three natural habitats. Highest percentage survival (79.67%) was observed in Yuanjiang Nature Reserve two years after reintroduction, followed by Huolu Mountain forest park (71.33%). This protocol is an efficient means for the large-scale propagation and in vitro and in vivo germplasm conservation of R. imschootiana.

Western Pond Turtle Head-starting and Reintroduction; 2004-2005 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Van Leuven, Susan; Allen, Harriet; Slavin, Kate (Washington Department of Fish and Wildlife, Wildlife Management Program, Olympia, WA)

2005-09-01

This report covers the results of the western pond turtle head-starting and reintroduction project for the period of October 2004-September 2005. Wild hatchling western pond turtles from the Columbia River Gorge were reared at the Woodland Park and Oregon Zoos in 2004 and 2005 as part of the recovery effort for this Washington State endangered species. The objective of the program is to reduce losses to introduced predators like bullfrogs and largemouth bass by raising the hatchlings to a size where they are too large to be eaten by most of these predators. Thirty-five turtles were placed at the Woodland Park Zoo and 53 at the Oregon Zoo. Of these, 77 head-started juvenile turtles were released at three sites in the Columbia Gorge in 2005. Four were held back to attain more growth in captivity. Eleven were released at the Klickitat ponds, 22 at the Klickitat lake, 39 at the Skamania site, and 5 at Pierce National Wildlife Refuge (NWR). This brought the total number of head-start turtles released since 1991 to 257 for the Klickitat ponds, 136 for the Klickitat lake, 206 for the Skamania pond complex, and 255 at Pierce NWR. In 2005, 34 females from the two Columbia Gorge populations were equipped with transmitters and monitored for nesting activity. Twenty-four nests were located and protected; these produced 90 hatchlings. The hatchlings were collected in September and transported to the Oregon and Woodland Park zoos for rearing in the head-start program. During the 2005 field season trapping effort, 486 western pond turtles were captured in the Columbia Gorge, including 430 previously head-started turtles. These recaptures, together with confirmed nesting by head-start females and visual resightings, indicate the program is succeeding in boosting juvenile recruitment to increase the populations. Records were also collected on 216 individual painted turtles captured in 2005 during trapping efforts at Pierce NWR, to gather baseline information on this native

Western Pond Turtle Head-starting and Reintroduction, 2005-2006 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Van Leuven, Susan; Allen, Harriet; Slavens, Kate (Washington Department of Fish and Wildlife, Wildlife Management Program, Olympia, WA)

2006-11-01

This report covers the results of the western pond turtle head-starting and reintroduction project for the period of October 2005-September 2006. Wild hatchling western pond turtles from the Columbia River Gorge were reared at the Woodland Park and Oregon zoos in 2005 and 2006 as part of the recovery effort for this Washington State endangered species. The objective of the program is to reduce losses to introduced predators like bullfrogs and largemouth bass by raising the hatchlings to a size where they are too large to be eaten by most of these predators. Twenty-six turtles were placed at the Woodland Park Zoo and 62 at the Oregon Zoo in fall 2005. These turtles joined two that were held back from release in summer 2005 due to their small size. All 90 juvenile turtles were released at three sites in the Columbia Gorge in 2006. Twenty-eight juvenile turtles were released at the Klickitat ponds, 22 at the Klickitat lake, 21 at the Skamania site, and 19 at Pierce National Wildlife Refuge (NWR). This brought the total number of head-start turtles released since 1991 to 944; 285 for the Klickitat ponds, 158 for the Klickitat lake, 227 for the Skamania pond complex, and 274 at Pierce NWR. In 2006, 20 females from the Klickitat population were equipped with transmitters and monitored for nesting activity. Fifteen nests were located and protected; these produced 55 hatchlings. The hatchlings were collected in September and transported to the Oregon and Woodland Park zoos for rearing in the head-start program. One wild hatchling captured in spring 2006 was placed in the head-start program to attain more growth in captivity. During the 2006 field season trapping effort, 414 western pond turtles were captured in the Columbia Gorge, including 374 previously head-started turtles. These recaptures, together with confirmed nesting by head-start females and visual resightings, indicate the program is succeeding in boosting juvenile recruitment to increase the populations

Evaluation of the Low Back Pain Practice Guideline Implementation in the Army Medical Department

National Research Council Canada - National Science Library

Farley, Donna

2004-01-01

... clinical care practices across the Army health system. This report presents the final results of the evaluation that RAND conducted as part of the demonstration for the low back practice guideline, which was conducted in 1999 and 2000...

Impact of stochasticity in immigration and reintroduction on colonizing and extirpating populations.

Science.gov (United States)

Rajakaruna, Harshana; Potapov, Alexei; Lewis, Mark

2013-05-01

given the environmental and demographic uncertainties at introductions. Similarly, the recovery of declining and extirpated populations through stochastic stocking, translocation, and reintroduction, may also be suitable strategies. Copyright © 2013 Elsevier Inc. All rights reserved.

Impact of stochasticity in immigration and reintroduction on colonizing and extirpating populations

KAUST Repository

Rajakaruna, Harshana

2013-05-01

the environmental and demographic uncertainties at introductions. Similarly, the recovery of declining and extirpated populations through stochastic stocking, translocation, and reintroduction, may also be suitable strategies. © 2013 Elsevier Inc.

Report: new guidelines for characterization of municipal solid waste: the Portuguese case.

Science.gov (United States)

da Graça Madeira Martinho, Maria; Silveira, Ana Isabel; Fernandes Duarte Branco, Elsa Maria

2008-10-01

This report proposes a new set of guidelines for the characterization of municipal solid waste. It is based on an analysis of reference methodologies, used internationally, and a case study of Valorsul (a company that handles recovery and treatment of solid waste in the North Lisbon Metropolitan Area). In particular, the suggested guidelines present a new definition of the waste to be analysed, change the sampling unit and establish statistical standards for the results obtained. In these new guidelines, the sampling level is the waste collection vehicle and contamination and moisture are taken into consideration. Finally, focus is on the quality of the resulting data, which is essential for comparability of data between countries. These new guidelines may also be applicable outside Portugal because the methodology includes, besides municipal mixed waste, separately collected fractions of municipal waste. They are a response to the need for information concerning Portugal (e.g. Eurostat or OECD inquiries) and follow European Union municipal solid waste management policies (e.g. packaging waste recovery and recycling targets and the reduction of biodegradable waste going to landfill).

Which points deserve special attention in the new guidelines on X-ray use (testing guidelines for experts and quality assurance guidelines)?

International Nuclear Information System (INIS)

Ewen, K.; Lauber, I.

2004-01-01

Two important guidelines for the application of X-rays in medicine became effective on 1 October 2003 and 1 December 2003. These are testing guidelines for experts and quality assurance guidelines. Both guidelines are very extensive and not always easy to interpret. In the present paper the authors try to explain in detail some chapters important for radiology and to make the necessary technical background transparent. Both authors took an essential part in forming the guidelines. (orig.) [de

Latin-American guidelines for opioid use in chronic nononcologic pain.

Science.gov (United States)

Lara-Solares, Argelia; Aguayo Zamora, Carlos; Amescua García, César; Garcia, João Batista Santos; Berenguel Cook, María Del Rosario; Bonilla Sierra, Patricia; Campos Kraychete, Durval; Flores Cantisani, José Alberto; Guerrero, Carlos; Guillén Núñez, María Del Rocío; Hernández Castro, John Jairo; Hernández Ortíz, Andrés; Jreige Iskandar, Aziza; Lech, Osvandré; Macías Guerra, Jacqueline; Ramírez Samayoa, Gerardo; Rangel Morillo, Edwin; Rico Pazos, María Antonieta; Sempértegui Gallegos, Manuel

2017-05-01

Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents.

Knowledge of Guidelines for Cardiopulmonary Resuscitation among Brazilian Medical Students

Directory of Open Access Journals (Sweden)

Felipe Scipião Moura

Full Text Available ABSTRACT Introduction Sudden death is a substantial public health problem, representing a major cause of mortality worldwide. Suitable initial care is essential for a good prognosis of these patients. Objectives To assess the knowledge of the 2010 guidelines for cardiopulmonary resuscitation (CPR among medical students in their final year of undergraduate training. Methods This was a cross-sectional study with a sample of 217 medical students enrolled in the sixth year of accredited medical schools in Brazil. A structured questionnaire with 27 items was used to record the sociodemographic characteristics of the participants and to assess their knowledge base of the 2010 ILCOR guidelines for CPR. Results Only fifty (23.04% out of 217 students achieved results considered as satisfactory in the written evaluation. The average score obtained was 56.74% correct answers. Seventeen percent of the students had never performed CPR maneuvers and 83.80% had never performed cardioversion or defibrillation. Conclusions The knowledge base of medical students regarding cardiopulmonary resuscitation is low. Considering these medical students are in their final year of medical school, this study reveals a worrisome scenario.

[Implementation of Study Results in Guidelines and Adherence to Guidelines in Clinical Practice].

Science.gov (United States)

Waldfahrer, F

2016-04-01

Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. © Georg Thieme Verlag KG Stuttgart · New York.

IMAGE Programming Guidelines

Energy Technology Data Exchange (ETDEWEB)

Stehfest, E; De Waal, L.

2010-09-15

This document describes the requirements and guidelines for the software of the IMAGE system. The motivation for this report was a substantial restructuring of the source code for IMAGE version 2.5. The requirements and guidelines relate to design considerations as well as to aspects of maintainability and portability. The design considerations determine guidelines about subjects, such as program structure, model hierarchy, the use of data modules, and the error message system. Maintainability and portability aspects determine the guidelines on, for example, the Fortran 90 standard, naming conventions, code lay-out, and internal documentation.

75 FR 33759 - Announcement of the Availability of the Final Report of the Dietary Guidelines Advisory Committee...

Science.gov (United States)

2010-06-15

... Meeting AGENCIES: U.S. Department of Agriculture (USDA), Food, Nutrition and Consumer Services (FNCS) and... Public Health and Science (OPHS). ACTION: Notice. SUMMARY: The Department of Agriculture (USDA) and the... the Dietary Guidelines Advisory Committee, Center for Nutrition Policy and Promotion, U.S. Department...

Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years).

Science.gov (United States)

Tremblay, Mark S; Leblanc, Allana G; Carson, Valerie; Choquette, Louise; Connor Gorber, Sarah; Dillman, Carrie; Duggan, Mary; Gordon, Mary Jane; Hicks, Audrey; Janssen, Ian; Kho, Michelle E; Latimer-Cheung, Amy E; Leblanc, Claire; Murumets, Kelly; Okely, Anthony D; Reilly, John J; Stearns, Jodie A; Timmons, Brian W; Spence, John C

2012-04-01

The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These national guidelines are in response to a call from health and health care professionals, child care providers, and fitness practitioners for guidance on sedentary behaviour in the early years. The guideline development process followed the Appraisal of Guidelines for Research Evaluation (AGREE) II framework. The recommendations are informed by evidence from a systematic review that examined the relationships between sedentary behaviour (predominantly screen time) and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged 900 domestic and international stakeholders, end-users, and key informants. The final guidelines state: for healthy growth and development, caregivers should minimize the time infants (aged spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4 years, screen time should be limited to under 1 h per day; less is better.

Brachytherapy guideline in prostate cancer (high and low dose rate)

Energy Technology Data Exchange (ETDEWEB)

Hanna, Samir Abdallah; Pimentel, Leonardo [Sociedade Brasileira de Radioterapia (SBR), Rio de Janeiro, RJ (Brazil)

2017-04-15

Through the elaboration of seven relevant clinical questions related to the proposed theme, we sought to present the main evidences regarding safety, toxicity and effectiveness of the presented radiotherapy (RT) techniques. The study population consisted of male patients of all ages with early primary prostate cancer and candidates for treatment with curative intent. For this, a systematic review of the literature was carried out in primary scientific databases (MEDLINE - PubMed; Embase - Elsevier; LILACS - BIREME; Cochrane Library -Record of Controlled Trials). All articles available through February 22, 2015 were considered. The search strategy used in MEDLINE searches is described in Appendix 1. The articles were selected based on critical evaluation, seeking the best evidence available. The recommendations were elaborated from discussions held with a drafting group composed of four members of the Brazilian Society of Radiotherapy. The guideline was reviewed by an independent group, which specializes in evidence-based clinical guidelines. After completion, the guideline was released for public consultation for 15 days; the suggestions obtained were forwarded to the authors for evaluation and possible insertion in the final text. (author)

Re-Introduction of Lower Columbia River Chum Salmon into Duncan Creek, 2003-2004 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Hillson, Todd D. (Washington Department of Fish and Wildlife, Olympia, WA)

2004-09-01

Currently, two methods of reintroduction are being simultaneously evaluated at Duncan Creek. Recolonization is occurring by introducing adult chum salmon from the Lower Gorge (LG) population into Duncan Creek and allowing them to naturally reproduce. The supplementation strategy required adults to be collected and artificially spawned, incubated, reared, and released at the mouth of Duncan Creek. All eggs from the artificial crossings at Washougal Hatchery were incubated and the fry reared to release size at the hatchery. The Duncan Creek chum salmon project was very successful in 2003-04, providing knowledge and experience that will improve program execution in future years. The gear used to collect adult brood stock was changed from tangle nets to beach seines. This increased efficiency and the speed at which adults could be processed in the field, and most likely reduced stress on the adults handled. Certain weaknesses exposed in past seasons still exist and new ones were exposed (e.g. inadequate incubation and rearing space at Washougal Hatchery for any large salvage operation and having to move the rearing troughs outside the raceway in 2004). Egg-to-fry survival rates of 64% and 58% showed that the channels are functioning at the upper end of what can be expected from them. Possibly the most important event this season was the ability to strontium mark and release all naturally-produced fry from the spawning channels. Channel and floodplain modifications reduced the likelihood that floods will damage the channels and negatively impact survival rates.

The new hypertension guidelines.

Science.gov (United States)

Stern, Ralph H

2013-10-01

The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

Adapting heart failure guidelines for nursing care in home health settings: challenges and solutions.

Science.gov (United States)

Radhakrishnan, Kavita; Topaz, Maxim; Masterson Creber, Ruth

2014-07-01

Nurses provide most of home health services for patients with heart failure, and yet there are no evidence-based practice guidelines developed for home health nurses. The purpose of this article was to review the challenges and solutions for adapting generally available HF clinical practice guidelines to home health nursing. Appropriate HF guidelines were identified and home health nursing-relevant guidelines were extracted by the research team. In addition, a team of nursing academic and practice experts evaluated the extracted guidelines and reached consensus through Delphi rounds. We identified 172 recommendations relevant to home health nursing from the American Heart Association and Heart Failure Society of America guidelines. The recommendations were divided into 5 groups (generic, minority populations, normal ejection fraction, reduced ejection fraction, and comorbidities) and further subgroups. Experts agreed that 87% of the recommendations selected by the research team were relevant to home health nursing and rejected 6% of the selected recommendations. Experts' opinions were split on 7% of guideline recommendations. Experts mostly disagreed on recommendations related to HF medication and laboratory prescription as well as HF patient assessment. These disagreements were due to lack of patient information available to home health nurses as well as unclear understanding of scope of practice regulations for home health nursing. After 2 Delphi rounds over 8 months, we achieved 100% agreement on the recommendations. The finalized guideline included 153 recommendations. Guideline adaptation projects should include a broad scope of nursing practice recommendations from which home health agencies can customize relevant recommendations in accordance with available information and state and agency regulations.

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

Directory of Open Access Journals (Sweden)

A Hillary Steinhart

2015-01-01

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

Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India

Science.gov (United States)

Sharma, Surendra K.; Ryan, H.; Khaparde, Sunil; Sachdeva, K. S.; Singh, Achintya D.; Mohan, Alladi; Sarin, Rohit; Paramasivan, C N; Kumar, Prahlad; Nischal, Neeraj; Khatiwada, Saurav; Garner, Paul; Tharyan, Prathap

2017-01-01

Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research. PMID:28862176

Measure Guideline: Guide to Attic Air Sealing

Energy Technology Data Exchange (ETDEWEB)

Lstiburek, J.

2014-09-01

The Guide to Attic Air Sealing was completed in 2010 and although not in the standard Measure Guideline format, is intended to be a Measure Guideline on Attic Air Sealing. The guide was reviewed during two industry stakeholders meetings held on December 18th, 2009 and January 15th, 2010, and modified based on the comments received. Please do not make comments on the Building America format of this document. The purpose of the Guide to Attic Air Sealing is to provide information and recommendations for the preparation work necessary prior to adding attic insulation. Even though the purpose of this guide is to save energy - health, safety and durability should not be compromised by energy efficiency. Accordingly, combustion safety and ventilation for indoor air quality are addressed first. Durability and attic ventilation then follow. Finally, to maximize energy savings, air sealing is completed prior to insulating. The guide is intended for home remodelers, builders, insulation contractors, mechanical contractors, general contractors who have previously done remodeling and homeowners as a guide to the work that needs to be done.

Public informations guidelines

International Nuclear Information System (INIS)

1986-06-01

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

Public informations guidelines

Energy Technology Data Exchange (ETDEWEB)

None

1986-06-01

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

CHP plant Legionowo Poland - Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-12-01

In 1997, a new Energy Law was passed in Poland. An important element of the law is that local energy planning is made obligatory. The law describes obligatory tasks and procedures for Polish municipalities related to planning and organisation of the energy sector. With the objective of supporting the Polish municipalities in their obligations according to the energy law of 1997, the project 'Energy Planning in Poland at Municipal Level - Support to Decision Makers' was launched. As part of the project, Municipal Guideline Reports have been elaborated for three model municipalities. These guidelines present the basis for the Energy Supply Plans in these municipalities. For the city of Legionowo, the following was recommended: 1. The planning processes initiated during the project should be continues/followed up, 2. Master Plan for the district heating system should be prepared, 3. The possibilities of establishment of a major natural gas-fired CHP plant of the Combined Cycle type should be investigated. The present report is the final Master Plan based on the following reports: Master Plan for Legionowo - Status Report; Master Plan for Legionowo - Hydraulic Analysis; CHP Plant Legionowo Poland - CHP Feasibility Analysis. The final Master Plan describes the status in the DH Company in Legionowo, possible improvements and an investment plan for the selected scenario. (BA)

Guidelines to implement the license renewal technical requirements of 10CFR54 for integrated plant assessments and time-limited aging analyses. Final report

International Nuclear Information System (INIS)

Lehnert, G.; Philpot, L.

1995-11-01

This report documents the initial results of the Nuclear Energy Institute License Renewal Implementation Guideline Task Force over the period August 1994 to July 1995 to develop guidance for complying with technical requirements of 10CFR54. The report also provided a starting point for the development of NEI 95-10, ''Industry Guideline for Implementing the Requirements of 10CCR54-The License Renewal Rule''. Information in this document can be used by utilities to prepare the technical material needed in an application for license renewal (LR) of a nuclear power unit. This guideline provides methods for identifying systems, structures, and components (SSCs) and their intended functions within the scope of license renewal. It identifies structures and components (SCs) requiring aging management review and methods for performing the aging management review. The guideline provides a process for identifying and evaluating time-limited aging analyses

Summary guidelines

Energy Technology Data Exchange (ETDEWEB)

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

1999-09-01

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

75 FR 47592 - Final Test Guideline; Product Performance of Skin-applied Insect Repellents of Insect and Other...

Science.gov (United States)

2010-08-06

.... Crystal Dr., Arlington, VA. The hours of operation of this Docket Facility are from 8:30 a.m. to 4 p.m... has been working to revise this Product Performance Test Guideline since it was published as a... further strengthening the scientific and ethical conduct of this kind of research; these have been...

APPLICATION OF SEDIMENT QUALITY GUIDELINES IN THE ASSESSMENT OF MANGROVE SURFACE SEDIMENT IN MENGKABONG LAGOON, SABAH, MALAYSIA

Directory of Open Access Journals (Sweden)

S. M. Praveena, M. Radojevic, M. H. Abdullah, A. Z. Aris

2008-01-01

Full Text Available There have been numerous sediment quality guidelines developed to monitor the sediments. Sediment quality guidelines are very useful to screen sediment contamination by comparing sediment contaminant concentration with the corresponding quality guideline, provide useful tools for screening sediment chemical data to identify pollutants of concern and prioritise problem sites and relatively good predictors of contaminations. However, these guidelines are chemical specific and do not include biological parameters. Aquatic ecosystems, including sediments, must be assessed in multiple components (biological data, toxicity, physicochemistry by using intregrated approaches in order to establish a complete and comprehensive set of sediment quality guidelines. Numerous sediment quality guidelines Washington Department of Ecology Sediment Quality Guideline, Australian and New Zealand Environment and Conservation Council, Swedish Environmental Sediment Quality, Screening Quick Reference Table, Portuguese Legislation on the Classification of Dredged Materials in Coastal Zones and Interim Sediment Quality Guideline for Hong Kong have been applied to the Mengkabong lagoon mangrove sediment and discussed. The most appropriate guideline that meets the prioritization criteria consistent with international initiatives and regulations is interim sediment quality values for Hong Kong. The guideline verifies that all the metals are below the Interim Sediment Quality Value-low. However, site-specific, biological testing and ecological analysis of exisiting benthics community structure related to sediment contamination are needed for final decision making in the case of Mengkabong lagoon.

Interim guidelines on performance constraints for nuclear waste disposal in crystalline rock

International Nuclear Information System (INIS)

1984-01-01

Performance constraint guidelines have been developed for geologic disposal of nuclear waste in crystalline rock. The approach taken in defining these guidelines was to consider the thermal, thermomechanical, and thermochemical behavior for three regions (very-near field, near field, and far field) of the repository during three time periods (operational, containment, and isolation) associated with the disposal system. Limits are proposed to ensure compliance with the current repository criteria proposed by the United States Nuclear Regulatory Commission (NRC) concerning repository siting and performance assessment. These criteria are: Substantial containment of all radionuclides within the waste package for a period of time between 300 and 1000 years after emplacement. Release rate after loss of containment of one part in 100,000 annually per radionuclide based on the nuclides inventory when the waste package is breached, and in situ ground-water transit time of 1000 years from the repository horizon to the accessible environment, compliance with the performance constraint guidelines presented herein will be required to ensure that the final repository design is in compliance with NRC criteria. The constraint guidelines have also been developed to satisfy the requirement for technical conservatism. 40 refs., 14 figs., 4 tabs

Experimental Data and Guidelines for Stone Masonry Structures: a Comparative Review

International Nuclear Information System (INIS)

Romano, Alessandra

2008-01-01

Indications about the mechanical properties of masonry structures contained in many Italian guidelines are based on different aspects both concerning the constituents material (units and mortar) and their assemblage. Indeed, the documents define different classes (depending on the type, the arrangement and the unit properties) and suggest the use of amplification coefficients for taking into account the influence of different factors on the mechanical properties of masonry. In this paper, a critical discussion about the indications proposed by some Italian guidelines for stone masonry structures is presented. Particular attention is addressed to the classification criteria of the masonry type and to the choice of the amplification factors. Finally, a detailed analytical comparison among the suggested values and some inherent experimental data recently published is performed

The development of seismic guidelines for the Stanford Linear Accelerator Center

International Nuclear Information System (INIS)

Huggins, R.

1996-08-01

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

The development of seismic guidelines for the Stanford Linear Accelerator Center

Energy Technology Data Exchange (ETDEWEB)

Huggins, R.

1996-08-01

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

Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India

Directory of Open Access Journals (Sweden)

Surendra K Sharma

2017-01-01

Full Text Available Extrapulmonary tuberculosis (EPTB is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i use of Xpert MTB/RIF in diagnosis, (ii use of adjunct corticosteroids in treatment, and (iii duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.

Japanese guidelines for food allergy 2017.

Science.gov (United States)

Ebisawa, Motohiro; Ito, Komei; Fujisawa, Takao

2017-04-01

Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers related to food allergy have been published during the last 5 years, the second major revision of the JPGFA was carried out in 2016. In this guideline, food allergies are generally classified into four clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type of food allergy (urticaria, anaphylaxis, etc.), and (4) special forms of immediate-type of food allergy such as food-dependent exercise-induced anaphylaxis and oral allergy syndrome (OAS). Much of this guideline covers the immediate-type of food allergy that is seen during childhood to adolescence. Infantile atopic dermatitis associated with food allergy type is especially important as the onset of most food allergies occurs during infancy. We have discussed the neonatal and infantile gastrointestinal allergy and special forms of immediate type food allergy types separately. Diagnostic procedures are highlighted, such as probability curves and component-resolved diagnosis, including the recent advancement utilizing antigen-specific IgE. The oral food challenge using a stepwise approach is recommended to avoid complete elimination of causative foods. Although oral immunotherapy (OIT) has not been approved as a routine treatment by nationwide insurance, we included a chapter for OIT, focusing on efficacy and problems. Prevention of food allergy is currently the focus of interest, and many changes were made based on recent evidence. Finally, the contraindication between adrenaline and antipsychotic drugs in Japan was discussed among related medical societies, and we reached an agreement that the use of adrenaline can be allowed based on the physician's discretion. In conclusion, this guideline encourages physicians to follow the principle to let patients

Global Imaging referral guidelines

International Nuclear Information System (INIS)

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

2010-01-01

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

Design Guidelines of a Spring-Damper System for Emergency Diesel Generator Sets

Energy Technology Data Exchange (ETDEWEB)

Kim, Min Kyu; Choun, Young Sun; Seo, Jeong Moon

2007-05-15

This guidelines described about the procedure of isolation system design for Emergency Diesel Generator (EDG) of Nuclear Power Plant (NPP). First of all, a vibration concept including the ground vibration was described and vibration control system and seismic isolation system were considered. The behavior characteristics and design consideration of coil spring-viscose damper system were summarized. The material properties of foundation of EDG system and the ground were considered. A design load and seismic load for isolation system design were described and an analysis method was explained. Finally, a design example for an EDG in Yonggwang Nuclear Unit 5 and 6 was attached of Appendix. First of all, this design guideline can apply to design of a vibration and seismic isolation system for EDG system and the design example present a design procedure practically. Moreover, this design guideline can be used for isolation design of other rotational machines and other isolation system except spring-damper system.

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Energy Technology Data Exchange (ETDEWEB)

Bluemel, Christina; Herrmann, Ken; Lassmann, Michael [Universitaetsklinikum Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Giammarile, Francesco; Dubreuil, Julien [Universite Claude Bernard Lyon 1, Medecine Nucleaire, Hospices Civils de Lyon and EA 3738, Lyon (France); Nieweg, Omgo E.; Chakera, Annette H. [The Poche Centre, Melanoma Institute Australia, North Sydney (Australia); Testori, Alessandro [European Institute of Oncology, Milan (Italy); Audisio, Riccardo A. [University of Liverpool, St Helens Teaching Hospital, St Helens (United Kingdom); Zoras, Odysseas [University Hospital of Heraklion, Department of Surgical Oncology, Heraklion (Greece); Uren, Roger [The University of Sydney, Sydney Medical School, Sydney, NSW (Australia); Alfred Nuclear Medicine and Ultrasound, RPAH Medical Centre, Newtown, NSW (Australia); Chondrogiannis, Sotirios; Rubello, Domenico [' Santa Maria della Misericordia' Hospital, Department of Nuclear Medicine, PET/CT Centre, Radiology, NeuroRadiology, Medical Physics, Rovigo (Italy); Colletti, Patrick M. [University of Southern California, Department of Radiology, Los Angeles, CA (United States)

2015-10-15

Sentinel lymph node biopsy is an essential staging tool in patients with clinically localized melanoma. The harvesting of a sentinel lymph node entails a sequence of procedures with participation of specialists in nuclear medicine, radiology, surgery and pathology. The aim of this document is to provide guidelines for nuclear medicine physicians performing lymphoscintigraphy for sentinel lymph node detection in patients with melanoma. These practice guidelines were written and have been approved by the European Association of Nuclear Medicine (EANM) to promote high-quality lymphoscintigraphy. The final result has been discussed by distinguished experts from the EANM Oncology Committee, national nuclear medicine societies, the European Society of Surgical Oncology (ESSO) and the European Association for Research and Treatment of Cancer (EORTC) melanoma group. The document has been endorsed by the Society of Nuclear Medicine and Molecular Imaging (SNMMI). The present practice guidelines will help nuclear medicine practitioners play their essential role in providing high-quality lymphatic mapping for the care of melanoma patients. (orig.)

Existing reporting guidelines for clinical trials are not completely relevant for implantable medical devices: a systematic review.

Science.gov (United States)

Motte, Anne-France; Diallo, Stéphanie; van den Brink, Hélène; Châteauvieux, Constance; Serrano, Carole; Naud, Carole; Steelandt, Julie; Alsac, Jean-Marc; Aubry, Pierre; Cour, Florence; Pellerin, Olivier; Pineau, Judith; Prognon, Patrice; Borget, Isabelle; Bonan, Brigitte; Martelli, Nicolas

2017-11-01

The aim of this study was to determine relevant items for reporting clinical trials on implantable medical devices (IMDs) and to identify reporting guidelines which include these items. A panel of experts identified the most relevant items for evaluating IMDs from an initial list based on reference papers. We then conducted a systematic review of articles indexed in MEDLINE. We retrieved reporting guidelines from the EQUATOR network's library for health research reporting. Finally, we screened these reporting guidelines to find those using our set of reporting items. Seven relevant reporting items were selected that related to four topics: randomization, learning curve, surgical setting, and device information. A total of 348 reporting guidelines were identified, among which 26 met our inclusion criteria. However, none of the 26 reporting guidelines presented all seven items together. The most frequently reported item was timing of randomization (65%). On the contrary, device information and learning curve effects were poorly specified. To our knowledge, this study is the first to identify specific items related to IMDs in reporting guidelines for clinical trials. We have shown that no existing reporting guideline is totally suitable for these devices. Copyright © 2017 Elsevier Inc. All rights reserved.

Guidelines - A Primer for Communicating Effectively with NABIR Stakeholders; FINAL

International Nuclear Information System (INIS)

Bilyard, G.R.; Word, C.J.; Weber, J.R.; Harding, A.K.

2000-01-01

This primer is a tool to help prepare scientists for meetings with stakeholders. It was prepared for staff involved with the Natural and Accelerated Bioremediation Research (NABIR) program, sponsored by the U.S. Department of Energy. It discusses why some efforts in science communication may succeed while others fail, provides methods of approaching group interactions about science that may better orient expert participants, and summarizes experience drawn from observations of groups interacting about topics in bioremediation or the NABIR program. The primer also provides brief, useful models for interacting with either expert or non-expert groups. Finally, it identifies topical areas that may help scientists prepare for public meetings, based on the developers' ongoing research in science communication in public forums

Psychiatry and online social media: potential, pitfalls and ethical guidelines for psychiatrists and trainees.

Science.gov (United States)

Frankish, Katherine; Ryan, Christopher; Harris, Anthony

2012-06-01

This paper proposes ethical guidelines for psychiatrists and psychiatry trainees when interacting with social media. A three-stage process was followed in the development of these guidelines. A literature review provided situations and possible broad rules as to how social media could be ethically engaged. A roundtable discussion by a panel of invited psychiatrists, psychiatry trainees, psychologists, e-health practitioners, lawyers and consumers was held to discuss the situations and to better formulate the ethical principles upon which psychiatrists could act. These vignettes and principles were then broadly discussed at a seminar held at the 2011 RANZCP Congress. Finally, this paper was circulated to the original invitees for final comment. A set of recommendations for working with social media were developed. The new social media provides important avenues for communication, education and treatment. These avenues pose ethical and practical dilemmas that can be resolved by the application of established ethical principles. Practical recommendations for navigating social media are proposed.

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

Science.gov (United States)

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

2016-04-01

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

Development of an Official Guideline for the Economic Evaluation of Drugs/Medical Devices in Japan.

Science.gov (United States)

Shiroiwa, Takeru; Fukuda, Takashi; Ikeda, Shunya; Takura, Tomoyuki; Moriwaki, Kensuke

2017-03-01

In Japan, cost-effectiveness evaluation was implemented on a trial basis from fiscal year 2016. The results will be applied to the future repricing of drugs and medical devices. On the basis of a request from the Central Social Insurance Medical Council (Chuikyo), our research team drafted the official methodological guideline for trial implementation. Here, we report the process of developing and the contents of the official guideline for cost-effectiveness evaluation. The guideline reflects discussions at the Chuikyo subcommittee (e.g., the role of quality-adjusted life-year) and incorporates our academic perspective. Team members generated research questions for each section of the guideline and discussions on these questions were carried out. A draft guideline was prepared and submitted to the Ministry of Health, Labour and Welfare (MHLW), and then to the subcommittee. The draft guideline was revised on the basis of the discussions at the subcommitte, if appropriate. Although the "public health care payer's perspective" is standard in this guideline, other perspectives can be applied as necessary depending on the objective of analysis. On the basis of the discussions at the subcommittee, quality-adjusted life-year will be used as the basic outcome. A discount rate of 2% per annum for costs and outcomes is recommended. The final guideline was officially approved by the Chuikyo general assembly in February 2016. This is the first officially approved guideline for the economic evaluation of drugs and medical devices in Japan. The guideline is expected to improve the quality and comparability of submitted cost-effectiveness data for decision making. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Design patterns for modelling guidelines

NARCIS (Netherlands)

Serban, Radu; Ten Teije, Annette; Marcos, Mar; Polo-Conde, Cristina; Rosenbrand, Kitty C J G M; Wittenberg, Jolanda; van Croonenborg, Joyce

2005-01-01

It is by now widely accepted that medical guidelines can help to significantly improve the quality of medical care. Unfortunately, constructing the required medical guidelines is a very labour intensive and costly process. The cost of guideline construction would decrease if guidelines could be

7 CFR 622.5 - Guidelines.

Science.gov (United States)

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Guidelines. 622.5 Section 622.5 Agriculture... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... Environmental Principles and Guidelines for Water and Related Land Resources Implementation Studies issued by...

Cardiovascular Update: Risk, Guidelines, and Recommendations.

Science.gov (United States)

Pearson, Tamera

2015-09-01

This article provides an update of the current status of cardiovascular disease (CVD) in the United States, including a brief review of the underlying pathophysiology and epidemiology. This article presents a discussion of the latest American Heart Association guidelines that introduce the concept of promoting ideal cardiovascular health, defined by seven identified metrics. Specific CVD risk factors and utilization of the 10-year CVD event prediction calculator are discussed. In addition, current management recommendations of health-related conditions that increase risk for CVD, such as hypertension and hypercholesterolemia, are provided. Finally, a discussion of detailed evidence-based lifestyle recommendations to promote cardiovascular health and reduce CVD risks concludes the update. © 2015 The Author(s).

Smartphone Application of Primary Care Guidelines used in Education of Medical Students

Science.gov (United States)

Waldmann, Uta-Maria; Weckbecker, Klaus

2013-01-01

Background and Objective: The guidelines of the German College of General Practitioners and Family Physicians (DEGAM) on frequent and important reasons for encounter in Primary Care play a central role in the teaching of Family Medicine. They were edited by the authors into an app for mobile phones, making them available at all times to General Practitioners and medical students. This study examines the issue: how useful do students consider this application within their learning process in Family Medicine? Method: The short versions of the 15 DEGAM guidelines were processed as a web app (for all smartphone software systems) including offline utilisation, and offered to students in the Family Medicine course, during clinical attachments in General Practice, on elective compulsory courses or for their final year rotation in General Practice. The evaluation was made with a structured survey using the feedback function of the Moodle learning management system [http://www.elearning-allgemeinmedizin.de] with Likert scales and free-text comments. Results: Feedback for evaluation came from 14 (25%) of the student testers from the Family Medicine course (9), the clinical attachment in General Practice (1), the final year rotation in General Practice (1) and elective compulsory courses (4). Students rated the app as an additional benefit to the printed/pdf-form. They use it frequently and successfully during waiting periods and before, during, or after lectures. In addition to general interest and a desire to become acquainted with the guidelines and to learn, the app is consulted with regard to general (theoretical) questions, rather than in connection with contact with patients. Interest in and knowledge of the guidelines is stimulated by the app, and on the whole the application can be said to be well suited to the needs of this user group. Discussion: The students evaluated the guidelines app positively: as a modern way of familiarising them with the guidelines and

Development of cancer treatment guidelines

African Journals Online (AJOL)

Krystyna Kiel

2011-05-26

May 26, 2011 ... KEYWORDS. Cancer;. Therapy;. Guidelines. Contents. 1. Why develop guidelines? ... Widely available guideline resources in cancer care. ... The use of guidelines in medicine has a long history. Many .... She has a negative family history. ... The patient has 1 cm grade 3 infiltrating ductal carcinoma.

28 CFR 42.306 - Guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidelines. 42.306 Section 42.306... PROCEDURES Equal Employment Opportunity Program Guidelines § 42.306 Guidelines. (a) Recipient agencies are... guidelines under their equal employment opportunity program which will correct, in a timely manner, any...

28 CFR 42.404 - Guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidelines. 42.404 Section 42.404... Guidelines. (a) Federal agencies shall publish title VI guidelines for each type of program to which they extend financial assistance, where such guidelines would be appropriate to provide detailed information...

Visitor's Computer Guidelines | CTIO

Science.gov (United States)

Visitor's Computer Guidelines Network Connection Request Instruments Instruments by Telescope IR Instruments Guidelines Library Facilities Outreach NOAO-S EPO Program team Art of Darkness Image Gallery EPO/CADIAS ‹› You are here CTIO Home » Astronomers » Visitor's Computer Guidelines Visitor's Computer

Guidelines for the treatment of lung cancer using radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Chen, Michael J.; Novaes, Paulo Eduardo; Gadia, Rafael; Motta, Rodrigo [Sociedade Brasileira de Radioterapia (SBR), Rio de Janeiro, RJ (Brazil)

2017-07-01

The aim of this guideline is to evaluate the most appropriate radiotherapy technique to treat patients with lung cancer. Description of evidence collection method Through the elaboration of four relevant clinical questions related to the proposed theme, we sought to present the main evidences regarding safety, toxicity and effectiveness of the presented radiotherapy techniques. The study population consisted of male and female patients of all ages with lung cancer, regardless of histological type, staging or presence of comorbidities. For this, a systematic review of the literature was carried out in primary scientific databases (Medline – PubMed; Embase – Elsevier; Lilacs – Bireme; Cochrane Library – Record of Controlled Trials). All articles available through April 31, 2015 were considered. The search terms used in the research were: ((lung cancer) OR (lung carcinoma)) and (IMRT OR intensity modulation OR intensity modulated) and (conventional OR 2D OR two dimensional OR bidimensional OR standard OR conformal OR 3D OR tridimensional OR CRT OR three dimensional). The articles were selected based on critical evaluation using the instruments (scores) proposed by Jadad and Oxford. The references with greater degree of evidence were used. The recommendations were elaborated from discussions held with a drafting group composed of four members of the Brazilian Society of Radiotherapy. The guideline was reviewed by an independent group, which specializes in evidence-based clinical guidelines. After completion, the guideline was released for public consultation for 15 days, and the suggestions obtained were forwarded to the authors for evaluation and possible insertion in the final text. (author)

Nurses' experiences of guideline implementation

DEFF Research Database (Denmark)

Alanen, Seija; Välimäki, Marita; Kaila, Minna

2009-01-01

AIMS: The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines? BACKGROUND: The implementation of clinical guidelines seems...... to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning guideline implementation. DESIGN: Qualitative interview. METHODS: Data were generated by four focus group interviews involving nurses working in out-patient services in primary...... to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses' awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines...

76 FR 60017 - Technical Conference on Penalty Guidelines; Notice of Technical Conference on Penalty Guidelines

Science.gov (United States)

2011-09-28

... Conference on Penalty Guidelines; Notice of Technical Conference on Penalty Guidelines The staff of the... the Penalty Guidelines, which the Commission issued on September 17, 2010.\\1\\ The conference will be... impact of the Penalty Guidelines on compliance and enforcement matters. More information on the topics to...

Physical Activity Guidelines

Science.gov (United States)

... use this site. health.gov Physical Activity Guidelines Physical Activity Physical activity is key to improving the health of the Nation. Based on the latest science, the Physical Activity Guidelines for Americans is an essential resource for ...

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

Directory of Open Access Journals (Sweden)

Lemieux-Charles Louise

2009-07-01

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

Evidence-based practice guideline: wheelchair biking for the treatment of depression.

Science.gov (United States)

Fitzsimmons, Suzanne; Schoenfelder, Deborah Perry

2011-07-01

Depression is a problem that will continue to burden older adults and challenge health care providers. Failing to recognize and effectively treat depression in institutionalized older adults is sanctioning these members of society to live their final years in despair and emotional suffering. The wheelchair biking program described in this evidence-based practice guideline provides a refreshing, safe, innovative tool to address depression and improve quality of life in older adults.

Testing post-editing guidelines

DEFF Research Database (Denmark)

Flanagan, Marian; Christensen, Tina Paulsen

2014-01-01

guidelines to use in translator training programmes. Recently, the first set of publicly available industry-focused PE guidelines (for ‘good enough’ and ‘publishable’ quality) were developed by Translation Automation User Society (TAUS) in partnership with the Centre for Global Intelligent Content (CNGL......), which can be used as a basis on which to instruct post-editors in professional environments. This paper reports on a qualitative study that investigates how trainee translators on an MA course, which is aimed at preparing the trainees for the translation industry, interpret these PE guidelines...... for publishable quality. The findings suggest trainees have difficulties interpreting the guidelines, primarily due to trainee competency gaps, but also due to the wording of the guidelines. Based on our findings we propose training measures to address these competency gaps. Furthermore, we provide post...

Appraising and comparing pressure ulcer guidelines.

Science.gov (United States)

Wimpenny, Peter; van Zelm, Ruben

2007-01-01

Whilst considerable activity has been related to guideline development for nurses regarding pressure ulcer prevention and management, no attempt has been made to comparatively evaluate these guidelines against some form of quality indicators. To compare and contrast four national pressure ulcer guidelines, and identify similarities and differences in their quality and content. An international comparative appraisal method, using the AGREE (Appraisal of Guidelines Research and Evaluation) instrument, was undertaken to appraise four published pressure ulcer guidelines. Two further domains were added to the AGREE instrument to assess comparability of the guidelines and their perceived contribution to practice. An international group undertook the comparative appraisal. The domain scores for each guideline show some but not total agreement among reviewers. One particular set of guidelines was identified as scoring highest in a majority of AGREE domains. Overall, evidence of variability exists between pressure ulcer guidelines and common areas of development to consider for all guidelines. The results raise many questions concerning the "best" pressure ulcer guideline to use, particularly related to the AGREE scoring. Some notable shortcomings exist in all the pressure ulcer guidelines reviewed and these shortcomings need to be addressed from a quality perspective. However, other issues such as style of reporting and potential contribution to practice might more fully affect choice by practitioners as opposed to guideline developers. Notable differences exist among the four guidelines that are possibly explained by different approaches to development and also because of different cultural factors and intentions for use. Whilst the AGREE tool identifies the quality of the guideline development process it still requires local engagement with practitioners to determine which guideline should be implemented.

Measure Guideline: Guide to Attic Air Sealing

Energy Technology Data Exchange (ETDEWEB)

Lstiburek, Joseph [Building Science Corporation, Westford, MA (United States)

2014-09-01

The purpose of this measure guideline is to provide information and recommendations for the preparation work necessary prior to adding attic insulation. Even though the purpose of this guide is to save energy, health, safety, and durability should not be compromised by energy efficiency. Accordingly, combustion safety and ventilation for indoor air quality are addressed first. Durability and attic ventilation then follow. Finally, to maximize energy savings, air sealing is completed prior to insulating. The guide is intended for home remodelers, builders, insulation contractors, mechanical contractors, general contractors who have previously done remodeling and homeowners as a guide to the work that needs to be done.

Japanese Guideline for Atopic Dermatitis

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2011-01-01

The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2009 (ADGL2009” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle.

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

Directory of Open Access Journals (Sweden)

Gagliardi Anna R

2012-07-01

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

10 CFR 960.3 - Implementation guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...

Maintenance Trades Guidelines

Science.gov (United States)

Weidner, Theodore J.

2008-01-01

In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…

[Clinical guidelines for the screening and the diagnosis of autism and pervasive developmental disorders].

Science.gov (United States)

Baghdadli, A; Beuzon, S; Bursztejn, C; Constant, J; Desguerre, I; Rogé, B; Squillante, M; Voisin, J; Aussilloux, C

2006-04-01

Autism is the best defined category among PDD. Its high prevalence, its onset in very young children and its persistence in adulthood arise many questions about early screening and early diagnosis. The aim of the study was to identify professional best practices about screening and diagnosis of autism in order to propose clinical guidelines and actions for the future. Scientific experts and parents take part to this procedure. Literature and previous guidelines were analyzed, experts in various fields were interviewed, a national study about the medical practices of the diagnosis of autism was made and questionnaires were send to 1600 psychiatrists and pediatricians. Guidelines built around 2 levels were proposed about screening and diagnosis. Diagnosis needs a multidisciplinary approach, validated instruments and more communication between professionals and parents. Finally one of the more important aims of the diagnosis of autism is to facilitate intervention program.

10 CFR 960.5 - Preclosure guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Preclosure guidelines. 960.5 Section 960.5 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5 Preclosure guidelines. The guidelines in this subpart specify the...

10 CFR 960.4 - Postclosure guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Postclosure guidelines. 960.4 Section 960.4 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4 Postclosure guidelines. The guidelines in this subpart specify the...

Implementation of an evidence-based guideline on fluid resuscitation: lessons learnt for future guidelines

NARCIS (Netherlands)

Tabbers, M.M.; Boluyt, N.; Offringa, M.

2010-01-01

There is little experience with the nationwide implementation of an evidence-based pediatric guideline on first-choice fluid for resuscitation in hypovolemia. We investigated fluid prescribing behavior at (1) guideline development, (2) after guideline development, and (3) after active implementation

Waste control guidelines according to the Amendment of the Radiation Protection Ordinance

International Nuclear Information System (INIS)

Schaefer, B.

2003-01-01

Up to now, the Waste Control Guidelines are considered one of the essential evaluation standards for giving an expert opinion about an application for radioactive material disposal. When the new Radiation Protection Ordinance became effective, some parts of the Waste Control Guidelines have become legal regulation. Nevertheless, the Waste Control Guidelines have not been repealed and both regulations exist simultaneously. Therefore, it is now being under discussion how a new subordinate regulation should look like. 14 years of experience with the Waste Control Guidelines have shown that it is not only desirable but necessary to have nationwide standardized regulations for the disposal of radioactive waste. In the following parts, the results of a search made by the TUeV Nord e.V. have been summed up. This search shows for which aspects legal regulation will be necessary in future as well. Those parts of the Waste Control Guidelines, which have been transferred into the Radiation Protection Ordinance, can be found in 72-75 of the Radiation Protection Ordinance. Besides this, other parts are or will be determined by other regulations (AtAV, GGVSE for transport procedures, planned regulations for intermediate storage and clearance). Furthermore, there are some aspects which have hardly been applied in every day's practice (e.g. qualified procedures). In addition to this, there all still some aspects which have to be determined by the Waste Control Guidelines. This refers to the demand for a waste disposal concept, the obligatory application of the Waste Acceptance Criteria for Final Disposal for conditioning, rules for mixing of waste as well as regulations concerning recycling and reuse of radioactive residues. (orig.)

Multicenter randomized phase II clinical trial of oxaliplatin reintroduction as a third- or later-line therapy for metastatic colorectal cancer-biweekly versus standard triweekly XELOX (The ORION Study).

Science.gov (United States)

Matsuda, Chu; Honda, Michitaka; Tanaka, Chihiro; Fukunaga, Mutsumi; Ishibashi, Keiichiro; Munemoto, Yoshinori; Hata, Taishi; Bando, Hiroyuki; Oshiro, Mitsuru; Kobayashi, Michiya; Tokunaga, Yukihiko; Fujii, Akitomo; Nagata, Naoki; Oba, Koji; Mishima, Hideyuki

2016-06-01

The aim of this multicenter, open-label, randomized phase II trial was to evaluate the efficacy of a dose-dense capecitabine and oxaliplatin (XELOX) regimen in patients with metastatic colorectal cancer (mCRC) for whom reintroduction of oxaliplatin had been planned as a third- or later-line regimen. The patients with mCRC who had received prior chemotherapy including oxaliplatin and were scheduled for reintroduction of oxaliplatin were randomized to capecitabine (1,000 mg/m(2)) twice daily on days 1-14 and oxaliplatin (130 mg/m(2)) on day 1 every 21 days (Q3W group) or capecitabine (2,000 mg/m(2)) twice daily on days 1-7 and oxaliplatin (85 mg/m(2)) on day 1 every 14 days (Q2W group). The primary endpoint was the time-to-treatment failure (TTF). Other endpoints included overall survival (OS), progression-free survival (PFS) and other adverse events (AEs). A total of 46 patients were enrolled in the trial-22 patients were randomly assigned to the Q3W group and 23 to the Q2W group. The median TTF was 3.4 months in both groups (hazard ratio [HR] 1.053; p = 0.880). The median PFS and OS were 3.3 and 9.2 months in the Q2W group and 4.3 and 12.1 months in the Q3W group, respectively (HR 1.15; p = 0.153 and 0.672; p = 0.836). The most common grade 3-4 AEs in the Q3W and Q2W groups were fatigue (27.3 vs 21.7), neuropathy (9.1 vs 0 %) and diarrhea (9.1 vs 0 %), respectively. There was no significant inter-group difference in any of the efficacy and safety endpoints, including TTF, OS, RFS and AEs. The results of this clinical trial were convincingly negative.

SPEAR-FCODE-GAMMA functional specifications. Final report

International Nuclear Information System (INIS)

Fiero, I.B.

1983-03-01

SPEAR FCODE GAMMA (SFG), a conceptual fuel-performance code for use in licensing analyses, has been defined and characterized as a set of functional specifications. The potential licensing-related applications of SFG are established and discussed. General code specifications including regulatory, interface, hardware application, code model and software, and operational specifications are discussed. The code input and output information including data requirements as well as formatting aspects are detailed. Finally, the SFG code-accuracy guidelines are established and the validation process is described

RSK-guidelines for PWR reactors

International Nuclear Information System (INIS)

1979-01-01

The RSK guidelines for PWA reactors of April 24, 1974, have been revised and amended in this edition. The RSK presents a summary of safety requirements to be observed in the design, construction, and operation of PWR reactors in the form of guidelines. From January 1979 onwards these guidelines will be the basis of siting and safety considerations for new PWR reactors, and newly built nuclear power plants will have to form these guidelines. They are not binding for existing nuclear power plants under construction or in operation. It will be a matter of individual discussion whether or not the guidelines will be applied in these plants. The main purpose of the guidelines is to facilitate discussion among RSK members and to give early information on necessary safety requirements. If the guidelines are observed by producers and operators, the RSK will make statements on individual projects at short notice. (orig./HP) [de

A review of clinical guidelines.

LENUS (Irish Health Repository)

Andrews, E J

2012-02-03

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

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

Directory of Open Access Journals (Sweden)

Williamson Paula R

2008-11-01

. Current guidelines need to be updated and include the statement that all primary and secondary outcomes prespecified in the protocol should be fully reported and should not be selected for inclusion in the final report based on their results.

From Clinical Practice Guidelines to Computer-interpretable Guidelines. A Literature Overview

NARCIS (Netherlands)

Latoszek-Berendsen, A.; Tange, H.; van den Herik, H. J.; Hasman, A.

2010-01-01

Background: Guidelines are among us for over 30 years. Initially they were used as algorithmic protocols by nurses and other ancillary personnel. Many physicians regarded the use of guidelines as cookbook medicine. However, quality and patient safety issues have changed the attitude towards

Guidelines for radiological interventions

International Nuclear Information System (INIS)

Kauffmann, G.W.

1998-01-01

The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)

EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision

Energy Technology Data Exchange (ETDEWEB)

Verberne, Hein J.; Eck-Smit, Berthe L.F. van; Wit, Tim C. de [University of Amsterdam, Department of Nuclear Medicine, F2-238, Academic Medical Center, Amsterdam (Netherlands); Acampa, Wanda [National Council of Research, Institute of Biostructures and Bioimaging, Naples (Italy); Anagnostopoulos, Constantinos [Academy of Athens, Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Athens (Greece); Ballinger, Jim [Guy' s Hospital - Guy' s and St Thomas' Trust Foundation, Department of Nuclear Medicine, London (United Kingdom); Bengel, Frank [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Bondt, Pieter De [OLV Hospital, Department of Nuclear Medicine, Aalst (Belgium); Buechel, Ronny R.; Kaufmann, Philip A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Flotats, Albert [Universitat Autonoma de Barcelona, Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Hacker, Marcus [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Vienna (Austria); Hindorf, Cecilia [Skaane University Hospital, Department of Radiation Physics, Lund (Sweden); Lindner, Oliver [University Hospital of the Ruhr-University Bochum, Heart and Diabetes Center North Rhine-Westphalia, Institute for Radiology, Nuclear Medicine and Molecular Imaging, Bad Oeynhausen (Germany); Ljungberg, Michael [Lund University, Department of Medical Radiation Physics, Lund (Sweden); Lonsdale, Markus [Bispebjerg Hospital, Department of Clinical Physiology and Nuclear Medicine, Copenhagen (Denmark); Manrique, Alain [Caen University Hospital, Department of Nuclear Medicine, Service Commun Investigations chez l' Homme, GIP Cyceron, Caen (France); Minarik, David [Skaane University Hospital, Radiation Physics, Malmoe (Sweden); Scholte, Arthur J.H.A. [Leiden University Medical Center, Department of Cardiology, Leiden (Netherlands); Slart, Riemer H.J.A. [University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen (Netherlands); Traegaardh, Elin [Skaane University Hospital and Lund University, Clinical Physiology and Nuclear Medicine, Malmoe (Sweden); Hesse, Birger [University Hospital of Copenhagen, Department of Clinical Physiology and Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark)

2015-11-15

Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/ publications/guidelines/2015{sub 0}7{sub E}ANM{sub F}INAL myocardial{sub p}erfusion{sub g}uideline.pdf. (orig.)

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

Science.gov (United States)

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

2012-10-01

Network Research Conference. Finally, a hand search of key journals and conferences was performed, and references of retrieved articles were reviewed for additional citations. Subsequently, abstracts were categorized according to their primary topic (based on an outline of the guidelines) into table format with the following headings: author, title, study purpose, participants, results and general comments. Finally, experts in the field were consulted for their opinions as to whether any articles were missed. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table) and through use of the Appraisal of Guidelines Research and Evaluation instrument for the development of clinical guidelines. The Society of Obstetricians and Gynecologists of Canada, Women and HIV Research Program, Women's College Research Institute, Women's College Hospital, University of Toronto, Abbott Laboratories Canada, the Ontario HIV Treatment Network, the Canadian Institutes of Health Research, and the Canadian HIV Trials Network.

Japanese Guideline for Atopic Dermatitis 2014

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2014-01-01

The basics of treatment discussed in this guideline are based on the "Guidelines for the Treatment of Atopic Dermatitis 2008" prepared by the Health and Labour Sciences Research and the "Guidelines for the Management of Atopic Dermatitis 2012 (ADGL2012" prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the "Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2013" together with those for other allergic diseases.

Incorporating a gender perspective into the development of clinical guidelines: a training course for guideline developers

Directory of Open Access Journals (Sweden)

Burgers Jako S

2007-11-01

Full Text Available Abstract Background Dutch guideline-developing organizations do not focus systematically on differences between men and women when developing guidelines, even though there is increasing evidence that being male or female may have an effect on health and health outcomes. In collaboration with two prominent Dutch guideline-developing organizations, we designed a training course to encourage systematic attention to sex differences in guideline development procedures. Methods The course is targeted towards guideline developers. Its aims are to improve awareness concerning the relevance of considering sex differences in the guideline development process, as well as the competence and skills necessary for putting this into practice. The design and teaching methods of the course are based on adult learning styles and principles of changing provider behaviour. It was adjusted to the working methods of guideline organizations. The course was taught to, and evaluated by, a group of staff members from two guideline organizations in the Netherlands. Results The course consists of five modules, each of which corresponds to a key step in the guideline development process. The participants rated the training course positively on content, programme, and trainers. Their written comments suggest that the course met its objectives. Conclusion The training course is the first to address sex differences in guideline development. Results from the pilot test suggest that the course achieved its objectives. Because its modules and teaching methods of the course are widely transferable, the course could be useful for many organizations that are involved in developing guidelines. Follow-up studies are needed to assess the long-term effect of the course on the actions of guideline developers and its utility in other settings.

Optimal Pain Assessment in Pediatric Rehabilitation: Implementation of a Nursing Guideline.

Science.gov (United States)

Kingsnorth, Shauna; Joachimides, Nick; Krog, Kim; Davies, Barbara; Higuchi, Kathryn Smith

2015-12-01

In Ontario, Canada, the Registered Nurses' Association promotes a Best Practice Spotlight Organization initiative to enhance evidence-based practice. Qualifying organizations are required to implement strategies, evaluate outcomes, and sustain practices aligned with nursing clinical practice guidelines. This study reports on the development and evaluation of a multifaceted implementation strategy to support adoption of a nursing clinical practice guideline on the assessment and management of acute pain in a pediatric rehabilitation and complex continuing care hospital. Multiple approaches were employed to influence behavior, attitudes, and awareness around optimal pain practice (e.g., instructional resources, electronic reminders, audits, and feedback). Four measures were introduced to assess pain in communicating and noncommunicating children as part of a campaign to treat pain as the fifth vital sign. A prospective repeated measures design examined survey and audit data to assess practice aligned with the guideline. The Knowledge and Attitudes Survey (KNAS) was adapted to ensure relevance to the local practice setting and was assessed before and after nurses' participation in three education modules. Audit data included client demographics and pain scores assessed annually over a 3-year window. A final sample of 69 nurses (78% response rate) provided pre-/post-survey data. A total of 108 pediatric surgical clients (younger than 19 years) contributed audit data across the three collection cycles. Significant improvements in nurses' knowledge, attitudes, and behaviors related to optimal pain care for children with disabilities were noted following adoption of the pain clinical practice guideline. Targeted guideline implementation strategies are central to supporting optimal pain practice. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Japanese guidelines for atopic dermatitis 2017

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2017-04-01

The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2015 (ADGL2015” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the “Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2016” together with those for other allergic diseases.

Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.

Science.gov (United States)

2003-02-01

International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. To develop and validate an international instrument for assessing the quality of the process and reporting of clinical practice guideline development. The instrument was developed through a multi-staged process of item generation, selection and scaling, field testing, and refinement procedures. 100 guidelines selected from 11 participating countries were evaluated independently by 194 appraisers with the instrument. Following refinement the instrument was further field tested on three guidelines per country by a new set of 70 appraisers. The final version of the instrument contained 23 items grouped into six quality domains with a 4 point Likert scale to score each item (scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability, editorial independence). 95% of appraisers found the instrument useful for assessing guidelines. Reliability was acceptable for most domains (Cronbach's alpha 0.64-0.88). Guidelines produced as part of an established guideline programme had significantly higher scores on editorial independence and, after the publication of a national policy, had significantly higher quality scores on rigour of development (pinternationally. The instrument is sensitive to differences in important aspects of guidelines and can be used consistently and easily by a wide range of professionals from different backgrounds. The adoption of common standards should improve the consistency and quality of the reporting of guideline development worldwide and provide a framework to encourage international comparison of clinical practice guidelines.

Influence of space use on fitness and the reintroduction success of the Laysan teal

Science.gov (United States)

Reynolds, M.H.; Hatfield, J.S.; Laniawe, L.P.; Vekasy, M.S.; Klavitter, J.L.; Berkowitz, P.; Crampton, L.H.; Walters, J.R.

2012-01-01

-release movement, a stronger component Allee effect, lower survival and lower reproductive rates because of predation to preclude successful reintroductions of this species to sites without predator management.

OSART guidelines

International Nuclear Information System (INIS)

1988-02-01

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

Fever without source: evaluation of a guideline.

Science.gov (United States)

Machado, Beatriz Marcondes; Cardoso, Débora Morais; de Paulis, Milena; Escobar, Ana Maria de Ulhôa; Gilio, Alfredo Elias

2009-01-01

To evaluate the applicability of a standardized guideline for children up to 36 months of age with fever without source (FWS). Prospective cohort study involving children with FWS treated at the emergency department of Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil, from June 2006 to May 2007. The guideline classifies the risk of serious bacterial infection (SBI) according to the presence or absence of toxemia, age, and temperature. Laboratory screening was based on risk assessment: complete blood count, blood culture, urinalysis, urine culture, and, if necessary, chest radiography, cerebrospinal fluid, and coproculture. We studied 251 children and, of these, 215 were followed up until the final diagnosis. Toxemia was found in 20 children, and 195 were well-appearing (30 up to 3 months old and 165 from 3 to 36 months old). Among those children from 3 to 36 months without toxemia, 95 had axillary temperature > 39 degrees C. In 107 (49.8%) children, there was spontaneous resolution of fever; in 88 (40.9%), benign self-limited disease was identified; and in 20 (9.3%), there was SBI. Among the cases of SBI, we identified 16 urinary tract infections, three cases of pneumonia and one occult bacteremia. Of the 215 children, 129 (60%) received no antibiotics, and 86 received antibiotics at some point (45 empirically). Empirical antibiotic treatment was maintained for an average of 72 hours. The guideline was shown to be appropriate to follow up these children using simple laboratory tests that can be carried out at most health facilities. The most frequent SBI in this sample was urinary tract infection.

36 CFR 1191.1 - Accessibility guidelines.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accessibility guidelines... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR BUILDINGS AND FACILITIES; ARCHITECTURAL BARRIERS ACT (ABA) ACCESSIBILITY GUIDELINES § 1191.1 Accessibility guidelines. (a) The...

EMQN best practice guidelines for the molecular genetic testing and reporting of chromosome 11p15 imprinting disorders

DEFF Research Database (Denmark)

Eggermann, Katja; Bliek, Jet; Brioude, Frédéric

2016-01-01

of these disorders and the demand for molecular testing, it turned out that there is an urgent need for a standardized molecular diagnostic testing and reporting strategy. Based on the results from the first external pilot quality assessment schemes organized by the European Molecular Quality Network (EMQN) in 2014...... and in context with activities of the European Network of Imprinting Disorders (EUCID.net) towards a consensus in diagnostics and management of SRS and BWS, best practice guidelines have now been developed. Members of institutions working in the field of SRS and BWS diagnostics were invited to comment......, and in the light of their feedback amendments were made. The final document was ratified in the course of an EMQN best practice guideline meeting and is in accordance with the general SRS and BWS consensus guidelines, which are in preparation. These guidelines are based on the knowledge acquired from peer...

A critical appraisal of guidelines for the management of knee osteoarthritis using Appraisal of Guidelines Research and Evaluation criteria

Science.gov (United States)

Poitras, Stéphane; Avouac, Jérôme; Rossignol, Michel; Avouac, Bernard; Cedraschi, Christine; Nordin, Margareta; Rousseaux, Chantal; Rozenberg, Sylvie; Savarieau, Bernard; Thoumie, Philippe; Valat, Jean-Pierre; Vignon, Éric; Hilliquin, Pascal

2007-01-01

Clinical practice guidelines have been elaborated to summarize evidence related to the management of knee osteoarthritis and to facilitate uptake of evidence-based knowledge by clinicians. The objectives of the present review were summarizing the recommendations of existing guidelines on knee osteoarthritis, and assessing the quality of the guidelines using a standardized and validated instrument – the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Internet medical literature databases from 2001 to 2006 were searched for guidelines, with six guidelines being identified. Thirteen clinician researchers participated in the review. Each reviewer was trained in the AGREE instrument. The guidelines were distributed to four groups of three or four reviewers, each group reviewing one guideline with the exception of one group that reviewed two guidelines. One independent evaluator reviewed all guidelines. All guidelines effectively addressed only a minority of AGREE domains. Clarity/presentation was effectively addressed in three out of six guidelines, scope/purpose and rigour of development in two guidelines, editorial independence in one guideline, and stakeholder involvement and applicability in none. The clinical management recommendation tended to be similar among guidelines, although interventions addressed varied. Acetaminophen was recommended for initial pain treatment, combined with exercise and education. Nonsteroidal anti-inflammatory drugs were recommended if acetaminophen failed to control pain, but cautiously because of gastrointestinal risks. Surgery was recommended in the presence of persistent pain and disability. Education and activity management interventions were superficially addressed in most guidelines. Guideline creators should use the AGREE criteria when developing guidelines. Innovative and effective methods of knowledge translation to health professionals are needed. PMID:18062805

Guidelines on Building Regulations 2008

DEFF Research Database (Denmark)

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

Managing challenging interactions with family caregivers in the cancer setting: Guidelines for clinicians (TRIO Guidelines-2).

Science.gov (United States)

Laidsaar-Powell, Rebekah; Butow, Phyllis; Boyle, Frances; Juraskova, Ilona

2018-06-01

Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial. Copyright © 2018 Elsevier B.V. All rights reserved.

Evidence-based guidelines

DEFF Research Database (Denmark)

Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar

2015-01-01

diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

Adopting preoperative fasting guidelines.

Science.gov (United States)

Anderson, Megan; Comrie, Rhonda

2009-07-01

In 1999, the American Society of Anesthesiologists adopted preoperative fasting guidelines to enhance the quality and efficiency of patient care. Guidelines suggest that healthy, non-pregnant patients should fast six hours from solids and two hours from liquids. Although these guidelines are in place, studies suggest that providers are still using the blanket statement "NPO after midnight" without regard to patient characteristics, the procedure, or the time of the procedure. Using theory to help change provider's beliefs may help make change more successful. Rogers' Theory of Diffusion of Innovations can assist in changing long-time practice by laying the groundwork for an analysis of the benefits and disadvantages of proposed changes, such as changes to fasting orders, while helping initiate local protocols instead of additional national guidelines.

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

International Nuclear Information System (INIS)

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

2010-01-01

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

32 CFR 231.11 - Guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Guidelines. 231.11 Section 231.11 National... PROCEDURES GOVERNING BANKS, CREDIT UNIONS AND OTHER FINANCIAL INSTITUTIONS ON DOD INSTALLATIONS Guidelines for Application of the Privacy Act to Financial Institution Operations § 231.11 Guidelines. (a) The...

Methodological quality of guidelines in gastroenterology.

Science.gov (United States)

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

2014-06-01

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

Approaches to radiation guidelines for space travel

International Nuclear Information System (INIS)

Fry, R.J.M.

1984-01-01

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

SPSP Phase III Recruiting, Selecting, and Developing Secure Power Systems Professionals. Individual and Team Performance Guidelines

Energy Technology Data Exchange (ETDEWEB)

O' Neil, Lori Ross [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Conway, T. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tobey, D. H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Greitzer, Frank L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dalton, Angela C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pusey, Portia K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2015-03-01

The Secure Power Systems Professional Phase III final report was released last year which an appendix of Individual and Team Performance Guidelines. This new report is that appendix broken out as a standalone document to assist utilities in recruiting and developing Secure Power Systems Professionals at their site.

An evidence-based clinical guideline for the use of antithrombotic therapies in spine surgery.

Science.gov (United States)

Bono, Christopher M; Watters, William C; Heggeness, Michael H; Resnick, Daniel K; Shaffer, William O; Baisden, Jamie; Ben-Galim, Peleg; Easa, John E; Fernand, Robert; Lamer, Tim; Matz, Paul G; Mendel, Richard C; Patel, Rajeev K; Reitman, Charles A; Toton, John F

2009-12-01

The objective of the North American Spine Society (NASS) Evidence-Based Clinical Guideline on antithrombotic therapies in spine surgery was to provide evidence-based recommendations to address key clinical questions surrounding the use of antithrombotic therapies in spine surgery. The guideline is intended to address these questions based on the highest quality clinical literature available on this subject as of February 2008. The goal of the guideline recommendations was to assist in delivering optimum, efficacious treatment with the goal of preventing thromboembolic events. To provide an evidence-based, educational tool to assist spine surgeons in minimizing the risk of deep venous thrombosis (DVT) and pulmonary embolism (PE). Systematic review and evidence-based clinical guideline. This report is from the Antithrombotic Therapies Work Group of the NASS Evidence-Based Guideline Development Committee. The work group was composed of multidisciplinary spine care specialists, all of whom were trained in the principles of evidence-based analysis. Each member of the group was involved in formatting a series of clinical questions to be addressed by the group. The final questions agreed on by the group are the subject of this report. A literature search addressing each question and using a specific search protocol was performed on English language references found in MEDLINE, EMBASE (Drugs and Pharmacology), and four additional, evidence-based databases. The relevant literature was then independently rated by at least three reviewers using the NASS-adopted standardized levels of evidence. An evidentiary table was created for each of the questions. Final grades of recommendation for the answers to each clinical question were arrived at via Web casts among members of the work group using standardized grades of recommendation. When Level I to IV evidence was insufficient to support a recommendation to answer a specific clinical question, expert consensus was arrived at by

BWR emergency procedure guidelines

International Nuclear Information System (INIS)

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

1984-01-01

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

Are BTS guidelines followed?

Science.gov (United States)

2002-03-01

In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax. The study's aim was to determine the level of adherence to these guidelines at a London teaching hospital. A retrospective case note audit of 59 episodes was performed. In patients undergoing intervention, the initial procedure was simple aspiration in 32 (73 per cent) and chest tube insertion in 12 (27 per cent) cases, contrasting with the BTS recommendation that aspiration should be attempted first in all such patients. Simple aspiration was successful on 34 per cent of occasions. Successful aspiration was associated with a significantly shorter hospital stay (median 3, range 1-11 days) than either failed aspiration (7, 3-66 days) or chest tube insertion without aspiration (9, 3-16 days). Other areas where practice differed from the BTS guidelines were clamping of chest tubes and use of a pursestring suture for wound closure. A follow up questionnaire suggested a lack of familiarity with the guidelines. These findings indicate that current management of spontaneous pneumothorax deviates from the BTS guidelines in potentially important respects.

36 CFR 910.67 - Square guidelines.

Science.gov (United States)

2010-07-01

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

28 CFR 2.36 - Rescission guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Rescission guidelines. 2.36 Section 2.36... guidelines. (a) The following guidelines shall apply to the sanctioning of disciplinary infractions or new... such period of confinement has resulted from initial parole to a detainer). These guidelines specify...

Micropropagation of Myriophyllum alterniflorum (Haloragaceae) for stream rehabilitation: first in vitro culture and reintroduction assays of a heavy-metal hyperaccumulator immersed macrophyte.

Science.gov (United States)

Delmail, David; Labrousse, Pascal; Hourdin, Philippe; Larcher, Laure; Moesch, Christian; Botineau, Michel

2013-01-01

Nowadays, submersed aquatic macrophytes play a key role in stream ecology and they are often used as biomonitors of freshwater quality. So, these plants appear as natural candidates to stream rehabilitation experiments. Among them, the stream macrophyte Myriophyllum alterniflorum is used recently as biomonitor and is potentially useful for the restoration of heavy-metal contaminated localities. The best way to obtain a mass production of watermilfoil plants is micropropagation. We developed in vitro culture of M. alterniflorum and the effects of five media on the plant development were assessed. Five morphological and four physiological endpoints were examined leading to the recommendation of the Murashige and Skoog medium for ecotoxicological studies on chlorophyllous parts, and of the Gaudet medium for root cytotoxicity and phytoremediation studies. Micropropagated clones were acclimatized in a synthetic medium and in situ reintroduction was performed efficiently. This is the first report of micropropagated plants transplantation in streams. The successful establishment of watermilfoil beds even in polluted areas strongly suggested that ecological restoration using micropropagated watermilfoil is a promising biotechnology for phytoremediation and rehabilitation of degraded areas. Moreover, high bioconcentration factors evidenced that watermilfoil hyperaccumulates Cd and Cu, and could be potentially used in phytoremediation studies.

23 CFR 650.211 - Guidelines.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Guidelines. 650.211 Section 650.211 Highways FEDERAL..., STRUCTURES, AND HYDRAULICS Erosion and Sediment Control on Highway Construction Projects § 650.211 Guidelines. (a) The FHWA adopts the AASHTO Highway Drainage Guidelines, Volume III, “Erosion and Sediment Control...

15 CFR 1170.4 - Guidelines.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Guidelines. 1170.4 Section 1170.4... ADMINISTRATION, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES § 1170.4 Guidelines. Each... agency actions, activities or programs undertaken in compliance with these guidelines or other laws or...

ESUR prostate MR guidelines 2012

DEFF Research Database (Denmark)

Barentsz, Jelle O; Richenberg, Jonathan; Clements, Richard

2012-01-01

The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated......, but a compromise, reflected by "minimal" and "optimal" requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines...... provides guidelines for magnetic resonance imaging (MRI) in prostate cancer. Clinical indications, and minimal and optimal imaging acquisition protocols are provided. A structured reporting system (PI-RADS) is described....

Guidelines for District Heating Substations

Energy Technology Data Exchange (ETDEWEB)

2009-07-15

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

Atopic dermatitis guideline. Position paper from the Latin American Society of Allergy, Asthma and Immunology.

Science.gov (United States)

Sánchez, Jorge; Páez, Bruno; Macías, A; Olmos, C; de Falco, A

2014-01-01

As in other regions, the incidence of atopic dermatitis in Latin America has been increasing in recent years. Although there are several clinical guidelines, many of their recommendations cannot be universal since they depend on the characteristics of each region. Thus, we decided to create a consensus guideline on atopic dermatitis applicable in Latin America and other tropical regions, taking into account socio-economic, geographical, cultural and health care system characteristics. The Latin American Society of Allergy Asthma and Immunology (SLAAI) conducted a systematic search for articles related to the pathophysiology, diagnosis and treatment of dermatitis using various electronic resources such as Google, Pubmed, EMBASE (Ovid) and Cochrane data base. We have also looked for all published articles in Latin America on the subject using LILACS (Latin American and Caribbean Literature on Health Sciences) database. Each section was reviewed by at least two members of the committee, and the final version was subsequently approved by all of them, using the Delphi methodology for consensus building. Afterward, the final document was shared for external evaluation with physicians, specialists (allergists, dermatologists and pediatricians), patients and academic institutions such as universities and scientific societies related to the topic. All recommendations made by these groups were taken into account for the final drafting of the document. There are few original studies conducted in Latin America about dermatitis; however, we were able to create a practical guideline for Latin America taking into account the particularities of the region. Moreover, the integral management was highlighted including many of the recommendations from different participants in the health care of this disease (patients, families, primary care physicians and specialists). This practical guide presents a concise approach to the diagnosis and management of atopic dermatitis that can be

32 CFR 143.8 - Guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Guidelines. 143.8 Section 143.8 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN DOD POLICY ON... BARGAINING § 143.8 Guidelines. The guidelines for making certain factual determinations are as follows: (a...

Transparent Guideline Methodology Needed

DEFF Research Database (Denmark)

Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

2013-01-01

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

Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

Science.gov (United States)

Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E

2015-01-22

Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study

Guidelines versus reality: is coronary stent application in three-vessel disease standard or the exception?

Science.gov (United States)

Linder, Roland; Zeidler, J; Verheyen, F; von der Schulenburg, J-M Graf; Haverich, A; Schilling, T

2017-08-19

The national guidelines for treatment of chronic coronary heart disease (CHD) recommend surgical coronary aortic bypass grafting (CABG) rather than percutaneous coronary intervention (PCI) for patients with a coronary three-vessel disease. The epidemiology of three-vessel CHD and data about the application of different revascularisation strategies raise suspicion of deviation from the guidelines in the treatment of those patients. Claims data containing records of almost 10 million patients of the largest German statutory health insurance fund (Techniker Krankenkasse) were utilised to measure adherence to the guidelines for treatment of groups of patients with one-, two-, and three-vessel CHD, respectively. The impact of age, sex, and comorbidity on each patient's revascularisation procedure was investigated as well. There was no significant difference in the rate of PCI between the groups. In conclusion, the hypothesis that patients with a coronary three-vessel disease are not always treated according to the recommendations of the national guidelines could not be disproved by this study. Finally, the results of this study suggest that the best revascularisation strategy for each patient with two- and three-vessel disease should be decided upon by an interdisciplinary discussion between both cardiologists and cardiac surgeons.

Re-introduction of globally threatened Arabian Gazelles Gazella Arabica (Pallas, 1766 (Mammalia: Bovidae in fenced protected area in central Saudi Arabia

Directory of Open Access Journals (Sweden)

M.Z. Islam

2014-07-01

Full Text Available The Arabian Gazelle is a globally threatened antelope (Vulnerable in Saudi Arabia. Small relict populations remain in limited areas, while historically Arabian Gazelles occurred in Mahazat as-Sayd protected area in central Saudi Arabia but were exterminated by anthropogenic and other pressures, including habitat loss and hunting. Important habitat has been lost to agricultural developments, fencing of pasture for livestock and the construction of human settlements and roads. The reintroduction of Arabian Gazelles was undertaken in Mahazat during 2011-2014 to bring back this locally extinct species study its ecology and biology in a fenced protected area. We released a total of 49 (12 males, 37 females animals. A year after release animals started breeding and six calves have been recorded so far with more to come. The gazelles prefer to use more rocky areas where shrubs and acacia trees occur in the reserve, and do not move long distances except for one individual that moved more than 50km. Mahazat is fenced, which prevents local people from entering the reserve to poach or otherwise disturb animals. Management lessons include the need for continued monitor-ing of reintroduced populations. Interactions between Arabian and Sand Gazelles (Gazella subgutturosa marica and Arabian Oryx (Oryx leucoryx were also studied.

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

Science.gov (United States)

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

2011-01-01

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

Ecologo guidelines spark disagreement

International Nuclear Information System (INIS)

Anon.

1999-01-01

Defining what renewable means has been a challenge, but the authors of a new set of guidelines for the Ecologo certification of renewable low-impact electrcity expect after some delay to have the new rules on the street by March 2000.. There was contention in developing the guideline, according to Terra Choice Environmental Services, the company that created and applied criteria for Ecologo certification under the federal government's Environmetal Choice Program. Interim guidleines were developed and have been in place for renewable power since 1996, and have since been used to certify wood-waste biomass, landfill gas, small hydro and wind power plants, in addition to three green power marketing programs. The first draft of the revised guidelines was issued in March. It was one of the harder guidelines to have been worked on because Canadian power producers did not readily agree on what should qualify as renewable, particularly around the whole area of hydro. While small run-of-river hydro plants will continue to fit within the Ecologo guidelines, larger projects will not. Wind power producers are relatively happy with the latest version of TerraChoice's draft guidelines, released at the end of November. A significant revision of the original rules is a limit on the amount of older generation green power marketers who want to promote the green power Ecologo electricity can sell. At least 50% of their capacity must originate from plants installed after January 1, 1991

Web Accessibility and Guidelines

Science.gov (United States)

Harper, Simon; Yesilada, Yeliz

Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

10 CFR 960.4-2 - Technical guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.4-2 Section 960.4-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4-2 Technical guidelines. The technical guidelines in this subpart...

International Variation in Asthma and Bronchiolitis Guidelines.

Science.gov (United States)

Bakel, Leigh Anne; Hamid, Jemila; Ewusie, Joycelyne; Liu, Kai; Mussa, Joseph; Straus, Sharon; Parkin, Patricia; Cohen, Eyal

2017-11-01

Guideline recommendations for the same clinical condition may vary. The purpose of this study was to determine the degree of agreement among comparable asthma and bronchiolitis treatment recommendations from guidelines. National and international guidelines were searched by using guideline databases (eg, National Guidelines Clearinghouse: December 16-17, 2014, and January 9, 2015). Guideline recommendations were categorized as (1) recommend, (2) optionally recommend, (3) abstain from recommending, (4) recommend against a treatment, and (5) not addressed by the guideline. The degree of agreement between recommendations was evaluated by using an unweighted and weighted κ score. Pairwise comparisons of the guidelines were evaluated similarly. There were 7 guidelines for asthma and 4 guidelines for bronchiolitis. For asthma, there were 166 recommendation topics, with 69 recommendation topics given in ≥2 guidelines. For bronchiolitis, there were 46 recommendation topics, with 21 recommendation topics provided in ≥2 guidelines. The overall κ for asthma was 0.03, both unweighted (95% confidence interval [CI]: -0.01 to 0.07) and weighted (95% CI: -0.01 to 0.10); for bronchiolitis, it was 0.32 unweighted (95% CI: 0.16 to 0.52) and 0.15 weighted (95% CI: -0.01 to 0.5). Less agreement was found in national and international guidelines for asthma than for bronchiolitis. Additional studies are needed to determine if differences are based on patient preferences and values and economic considerations or if other recommendation-level, guideline-level, and condition-level factors are driving these differences. Copyright © 2017 by the American Academy of Pediatrics.

Surfing the best practice guidelines: national clinical guideline clearinghouse in development.

Science.gov (United States)

1997-08-01

The growth in development and usage of clinical guidelines during the last five years has been remarkable. Not only are health care practitioners reaching for what's deemed to be the best in protocols and practice, consumers, too, are looking toward standards and guidelines as they become more educated about the quality and quantity of health care services they should be receiving.

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

International Nuclear Information System (INIS)

Gilbert, T.L.

1985-01-01

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

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

International Nuclear Information System (INIS)

Gilbert, T.L.

1984-01-01

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

10 CFR 960.5-2 - Technical guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.5-2 Section 960.5-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-2 Technical guidelines. The technical guidelines in this subpart set...

Metric Guidelines Inservice and/or Preservice

Science.gov (United States)

Granito, Dolores

1978-01-01

Guidelines are given for designing teacher training for going metric. The guidelines were developed from existing guidelines, journal articles, a survey of colleges, and the detailed reactions of a panel. (MN)

[Guidelines for diagnosis and treatment of secondary iron overload in patients with congenital anemia].

Science.gov (United States)

Cario, H; Grosse, R; Janssen, G; Jarisch, A; Meerpohl, J; Strauss, G

2010-11-01

In Germany and Central Europe, congenital disorders leading to secondary hemochromatosis are rare. The majority of these patients are treated in peripheral medical institutions. As a consequence, the experience of each institution in the treatment of secondary hemochromatosis in patients with congenital anemia is limited. Recent developments concerning new chelating agents, their combination for intensified chelation and new possibilities to diagnose and monitor iron overload have important consequences for the management of patients with secondary hemochromatosis and increase its complexity enormously. Therefore, the development of a guideline for rational and efficient diagnostics and treatment was necessary. The new guideline was developed within a formal consensus process and finally approved by a consensus conference with participants from both the pediatric and adult German hematology societies (GPOH and DGHO). Apart from general information and recommendations, the guideline contains 9 consensus statements on diagnostics (iron status, siderotic complications, chelator side-effects), the start of chelation, indications for intensified chelation, iron elimination in specific disorders, and iron elimination after stem cell transplantation. Here, these consensus statements are presented and discussed in detail. For the complete text of the guideline, please visit the AWMF homepage at http://www.leitlinien.net . © Georg Thieme Verlag KG Stuttgart · New York.

The appraisal of clinical guidelines in dentistry.

Science.gov (United States)

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

2009-01-01

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

Human factors guidelines and methodology in the design of a user computer interface: a case study

International Nuclear Information System (INIS)

Richards, R.E.; Gilmore, W.E.; Haney, L.N.

1986-01-01

In this case study, human factors personnel were requested to participate in a project team of programmers and operations specialists to design a cathode ray tube (CRT) display system for a complex process control application. This presentation describes the process and benefits obtained by incorporating human factors guidelines and methods in system design. Standard human engineering guidelines and techniques were utilized by the project team. In addition, previously published documents and research findings sponsored by the US Nuclear Regulatory Commission (USNRC) were used. Preliminary tasks involved a review of the draft plant procedures. Then, interviews with operators were conducted to establish the initial information for the displays. These initial requirements were evaluated against existing guidelines and criteria to determine the optimal presentation formats. Detailed steps of the approaches used, design decisions made, and tradeoffs that resulted in the final user acceptable design are discussed. 7 refs., 2 figs

Design guidelines for rapid and simple context-aware mobile application development – an android case study

Directory of Open Access Journals (Sweden)

Hossein Shams

2015-11-01

Full Text Available Presenting a context-aware service and information is a key aspect of ubiquitous computing, but development of such applications is quite complicated. Context-aware applications should be able to obtain raw data fromsensors, create highlevel context information, detect the user’s situation, and adapt the behavior of the application to the recognized situation . These complexities caused to reduce the impact of context -awareness in mobile computing while sensors of smartphones have made huge potential for developing context aware mobile applications. In this paper, we explain some guidelines to overcome the existing obstacles by separating the context -aware application layers and make a loosely coupled connection between them. These guidelines will bring easy and rapid development, reusability of the code and flexibility for developers. Finally, we provide a case study example in the Android platform to demonstrate how the guidelines can be used in a real application.

Glaucoma-service provision in Scotland: introduction and need for Scottish Intercollegiate Guidelines Network guidelines.

Science.gov (United States)

Syrogiannis, Andreas; Rotchford, Alan P; Agarwal, Pankaj Kumar; Kumarasamy, Manjula; Montgomery, Donald; Burr, Jennifer; Sanders, Roshini

2015-01-01

To describe the pattern of glaucoma-service delivery in Scotland and identify areas for improvement, taking into account Scottish General Ophthalmic Services (GOS) arrangements and the Eye Care Integration project, and to design Scottish Intercollegiate Guidelines Network (SIGN) guidelines to refine the primary and secondary interface of glaucoma care. A glaucoma-survey questionnaire was sent to all consultant glaucomatologists in Scotland. The design of SIGN guidelines was based on the results of the questionnaire using SIGN methodology. Over 90% of Scottish glaucoma care is triaged and delivered within hospital services. Despite GOS referral, information is variable. There are no consistent discharge practices to the community. These results led to defined research questions that were answered, thus formulating the content of the SIGN guidelines. The guideline covers the assessment of patients in primary care, referral criteria to hospital, discharge criteria from hospital to community, and monitoring of patients at risk of glaucoma. With increasing age and limitations to hospital resources, refining glaucoma pathways between primary and secondary care has become a necessity. Scotland has unique eye care arrangements with both the GOS and Eye Care Integration project. It is hoped that implementation of SIGN guidelines will identify glaucoma at the earliest opportunity and reduce the rate of false-positive referrals to hospital.

SPSP Phase III Recruiting, Selecting, and Developing Secure Power Systems Professionals: Behavioral Interview Guidelines by Job Roles

Energy Technology Data Exchange (ETDEWEB)

O' Neil, Lori Ross [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Conway, T. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tobey, D. H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Greitzer, Frank L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dalton, Angela C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pusey, Portia K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2015-03-01

The Secure Power Systems Professional Phase III final report was released last year which an appendix of Behavioral Interview Guidelines by Job Roles. This new report is that appendix broken out as a standalone document to assist utilities in recruiting and developing Secure Power Systems Professionals at their site.

Guidelines for Quality Control of Equipment Used in Diagnostic Radiology in the Netherlands

International Nuclear Information System (INIS)

Berg, L. van den; Aarts, C.N.M.; Beentjes, L.B.; Dalen, A. van; Elsakkers, P.; Julius, H.W.; Kicken, P.J.H.; Meer, F. van der; Teeuwisse, W.; Thijssen, M.A.O.; Zoetelief, J.

1998-01-01

The Dutch working group on 'Quality Criteria for Equipment Used in Diagnostic Radiology' has formulated guidelines providing technical criteria for equipment used in conventional diagnostic radiology. These guidelines are applicable to the technical parameters having a major impact on image quality and patient dose and include methods for testing. The following parameters are included: tube voltage, automatic exposure control, film processing, film-screen combination, light tightness and illumination of the dark room, half-value layer and filtration, light field, grid, focal spot size, viewing boxes and geometrical indicators. Each guideline consists of the following chapters: (1) Scope and field of application, (2) Background information, (3) Test procedure, (4) Test frequency, (5) Registration of observations, (6) Evaluation and interpretation, (7) Test report. Chapter 3 includes both the principles of the test method and a step by step description of the procedures. The principles of the test procedure provide a basis for adaptation to local circumstances. The step by step test procedure allows a quality control measurement to be performed with limited physical knowledge of the equipment. Chapter 6 includes limiting values. Draft guidelines were evaluated in practice in 20 hospitals. The final document has been accepted by the professional societies in the Netherlands and the Dutch Minister of Health as a reference set of tools to perform Quality Control of equipment used for conventional diagnostic radiology. (author)

Adherence to cancer treatment guidelines: influence of general and cancer-specific guideline characteristics.

NARCIS (Netherlands)

Heins, M.J.; Jong, J.D. de; Spronk, I.; Ho, V.K.; Brink, M.; Korevaar, J.C.

2017-01-01

Background: Guideline adherence remains a challenge in clinical practice, despite guidelines’ ascribed potential to improve patient outcomes. We studied the level of adherence to recommendations from Dutch national cancer treatment guidelines, and the influence of general and

D 59 Design Guidelines

DEFF Research Database (Denmark)

Burcharth, Hans F.; Lamberti, Alberto

The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...

Public safety around dams guidelines

Energy Technology Data Exchange (ETDEWEB)

Bennett, T [Canadian Dam Association, Edmonton, AB (Canada)

2010-07-01

This presentation discussed Canadian and international initiatives for improving dam safety and described some of the drivers for the development of new Canadian Dam Association (CDA) public safety guidelines for dams. The CDA guidelines were divided into the following 3 principal sections: (1) managed system elements, (2) risk assessment and management, and (3) technical bulletins. Public and media responses to the drownings have called for improved safety guidelines. While the public remains unaware of the hazards of dams, public interaction with dams is increasing as a result of interest in extreme sports and perceived rights of access. Guidelines are needed for dam owners in order to provide due diligence. Various organizations in Canada are preparing technical and public safety dam guidelines. CDA guidelines have also been prepared for signage, booms and buoys, and audible and visual alerts bulletins. Working groups are also discussing recommended practices for spill procedures, spillways and the role of professional engineers in ensuring public safety. Methods of assessing risk were also reviewed. Managed system elements for risk assessment and public interactions were also discussed, and stepped control measures were presented. tabs., figs.

Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting.

Science.gov (United States)

Fernando, Sumadhya Deepika; Dharmawardana, Priyani; Epasinghe, Geethanee; Senanayake, Niroshana; Rodrigo, Chaturaka; Premaratne, Risintha; Wickremasinghe, Rajitha

2016-10-18

Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines

Directory of Open Access Journals (Sweden)

Johnson Lorraine

2010-06-01

Full Text Available Abstract Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA. Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future.

Guidelines for the determination of halogenated dibenzo-p-dioxins and dibenzofurans in commercial products. Final report, March 1985-July 1986

International Nuclear Information System (INIS)

Steele, D.H.; Stanley, J.S.

1987-01-01

The determination of halogenated dibenzo-p-dioxins (HDDs) and dibenzofurans (HDFs) in commercial products require specific and sensitive analytical procedures. The development of methods for the measurement of HDD and HDF in commercial products is complicated by the diverse range of matrices, the potentially large number of halogenated (specifically chloro, bromo, or bromo/chloro) HDD and HDF congeners and potential interference due to major components of the product matrices. This report provides: (1) a review of the literature pertaining to commercial product analyses for HDDs and HDFs; (2) detail on the total number of bromo, chloro, and bromo/chloro HDDs and HDFs; (3) a tentative scheme for the analysis of HDDs and HDFs in diverse matrices; and (4) guidelines for the high-resolution gas chromatography/ mass spectrometry or electron capture detector analysis of commercial products for HDDs and HDFs. The guidelines specify a rigorous OA/QC program for the analysis of the commercial products

Energy indicators for sustainable development: Guidelines and methodologies

International Nuclear Information System (INIS)

2005-04-01

This publication is the product of an international initiative to define a set of Energy Indicators for Sustainable Development (EISD) and corresponding methodologies and guidelines. The successful completion of this work is the result of an intensive effort led by the International Atomic Energy Agency (IAEA) in cooperation with the United Nations Department of Economic and Social Affairs (UNDESA), the International Energy Agency (IEA), Eurostat and the European Environment Agency (EEA). The thematic framework, guidelines, methodology sheets and energy indicators set out in this publication reflect the expertise of these various agencies, recognized worldwide as leaders in energy and environmental statistics and analysis. While each agency has an active indicator programme, one goal of this joint endeavour has been to provide users with a consensus by leading experts on definitions, guidelines and methodologies for the development and worldwide use of a single set of energy indicators. No set of energy indicators can be final and definitive. To be useful, indicators must evolve over time to fit country-specific conditions, priorities and capabilities. The purpose of this publication is to present one set of EISD for consideration and use, particularly at the national level, and to serve as a starting point in the development of a more comprehensive and universally accepted set of energy indicators relevant to sustainable development. It is hoped that countries will use the EISD to assess their energy systems and to track their progress towards nationally defined sustainable development goals and objectives. It is also hoped that users of the information presented in this publication will contribute to refinements of energy indicators for sustainable development by adding their own unique perspectives to what is presented herein

Energy indicators for sustainable development: Guidelines and methodologies

International Nuclear Information System (INIS)

2008-01-01

This publication is the product of an international initiative to define a set of Energy Indicators for Sustainable Development (EISD) and corresponding methodologies and guidelines. The successful completion of this work is the result of an intensive effort led by the International Atomic Energy Agency (IAEA) in cooperation with the United Nations Department of Economic and Social Affairs (UNDESA), the International Energy Agency (IEA), Eurostat and the European Environment Agency (EEA). The thematic framework, guidelines, methodology sheets and energy indicators set out in this publication reflect the expertise of these various agencies, recognized worldwide as leaders in energy and environmental statistics and analysis. While each agency has an active indicator programme, one goal of this joint endeavour has been to provide users with a consensus by leading experts on definitions, guidelines and methodologies for the development and worldwide use of a single set of energy indicators. No set of energy indicators can be final and definitive. To be useful, indicators must evolve over time to fit country-specific conditions, priorities and capabilities. The purpose of this publication is to present one set of EISD for consideration and use, particularly at the national level, and to serve as a starting point in the development of a more comprehensive and universally accepted set of energy indicators relevant to sustainable development. It is hoped that countries will use the EISD to assess their energy systems and to track their progress towards nationally defined sustainable development goals and objectives. It is also hoped that users of the information presented in this publication will contribute to refinements of energy indicators for sustainable development by adding their own unique perspectives to what is presented herein

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

Science.gov (United States)

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

2010-04-01

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

AIDS guidelines.

Science.gov (United States)

Berger, R

1986-04-30

The Sun article, "Employers finding that AIDS in the workplace is a managerial nightmare" (April 3), did not accurately portray the status of AIDS in the workplace. The AIDS virus, HTLV III, is transmitted by body fluids, primarily semen and blood, and there is no known risk of transmitting the virus by casual contact in the workplace. The Center for Disease Control (CDC) released guidelines for child care workers last August. Guidelines on preventing transmission of AIDS in the workplace were issued by CDC in November 1985. These guidelines specifically discussed health care, personal service, and food service workers. The recommendations were against routine screening. Furthermore, employment should not be restricted on the basis of a positive HTLV III antibody test. A person with HTLV III infection should be exempt from the workplace only if there are circumstances interfering with job performance. In Maryland, the Governor's Task Force on AIDS has gone on record as endorsing CDC guidelines related to employment. Furthermore, the task force condemns discrimination based on the disease AIDS, AIDS Related Complex (ARC), or HTLV III infection. Increasingly AIDS patients are being considered legally disabled and therefore are protected by federal and state laws prohibiting discrimination on the basis of a handicap. Marylanders who are subjected to mandatory HTLV III screening in the workplace, or if discriminated against on the basis of HTLV III inefction, should contact the Maryland Commission on Human Relations, the Maryland Department of Health and Mental Hygiene, or the Health Education Resource Organization (HERO). All 3 of these resources guarantee confidentiality. It is only by employees reporting incidents that a nightmare in the workplace can be avoided in Maryland. full text

Guidelines and format for preparation and submission of declarations pursuant to Articles 2 and 3 of the Model Protocol Additional to Safeguards Agreements

International Nuclear Information System (INIS)

2005-01-01

compendium of suggested improvements and problems, article-by-article, based on written comments from States, consultations with States and comments from Agency staff. A draft revision addressing all suggestions and comments, often accompanied by new examples, was produced and extensively reviewed within the Agency. Finally, the Agency sought comment from States on the revised Guidelines, culminating in a meeting with State authorities in London, October 2003. The revisions to the Guidelines were finalized following that meeting. The Agency is indebted to the many States who contributed their experience and comments to the process of improving the Guidelines

Guidelines and format for preparation and submission of declarations pursuant to Articles 2 and 3 of the Model Protocol Additional to Safeguards Agreements

International Nuclear Information System (INIS)

2004-01-01

compendium of suggested improvements and problems, article-by-article, based on written comments from States, consultations with States and comments from Agency staff. A draft revision addressing all suggestions and comments, often accompanied by new examples, was produced and extensively reviewed within the Agency. Finally, the Agency sought comment from States on the revised Guidelines, culminating in a meeting with State authorities in London, October 2003. The revisions to the Guidelines were finalized following that meeting. The Agency is indebted to the many States who contributed their experience and comments to the process of improving the Guidelines

Specificity of a novel TaqMan PCR method for detection of poultry DNA

NARCIS (Netherlands)

Scholtens-Toma, Ingrid; Prins, Theo W.; Raamsdonk, Van Leo W.D.

2017-01-01

After the Bovine Spongiform Encephalopathy (BSE) crisis emerged in 1985/1986, all processed animal proteins (PAPs) were finally banned for use in animal feed in the European Union. To partially lift this feed ban, paths for re-introduction of PAPs from species other than ruminants e.g. pig and

Guidelines for nuclear reactor equipments safety-analysis

International Nuclear Information System (INIS)

1978-01-01

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

Incremental guideline formalization with tool support

NARCIS (Netherlands)

Serban, Radu; Puig-Centelles, Anna; ten Teije, Annette

2006-01-01

Guideline formalization is recognized as an important component in improving computerized guidelines, which in turn leads to better informedness, lower inter-practician variability and, ultimately, to higher quality healthcare. By means of a modeling exercise, we investigate the role of guideline

Quality of evidence-based pediatric guidelines

NARCIS (Netherlands)

Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin

2005-01-01

Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified

Development of Final Running Test System for Digital Systems

Energy Technology Data Exchange (ETDEWEB)

Lee, Kwang-Dae; Lee, Eui-Jong; Lim, Hee-Taek; Kim, Min-Seok [KHNP Central Research Institute, Daejeon (Korea, Republic of)

2016-10-15

In nuclear industry, the newly designed systems to upgrade are qualified to meet IEEE standards and the regulatory guidelines for their functions, performance and reliability requirements. Failure Mode and Effect Analysis, Fault Tree Analysis, and Hazard Analysis have been used to improve the reliability of the control system. To ensure the completeness of the software, the verification and validation processes are carried out during the development process. In spite of the many efforts depending on the analysis and procedures, there are limitations to improve the reliability. The lessons learned from the currently installed system failures show the incompleteness of the final integration test. The current point-to-point and logic-to-logic separate test procedures manually performed by the engineers can cause some procedures missed and have effects on the critical functions. The design processes of the digital systems are met in accordance with the international standards and regulatory guidelines. The lessons learned from the failures of the running digital systems showed the limitations of the current verification and validation efforts. The various improvements and attempts have been considered including the expert review processes and the completeness of the test. In this paper, the Final Running Test Method evaluating the completeness of the digital system using the control patterns and the Test System Architecture are proposed.

Development of Final Running Test System for Digital Systems

International Nuclear Information System (INIS)

Lee, Kwang-Dae; Lee, Eui-Jong; Lim, Hee-Taek; Kim, Min-Seok

2016-01-01

In nuclear industry, the newly designed systems to upgrade are qualified to meet IEEE standards and the regulatory guidelines for their functions, performance and reliability requirements. Failure Mode and Effect Analysis, Fault Tree Analysis, and Hazard Analysis have been used to improve the reliability of the control system. To ensure the completeness of the software, the verification and validation processes are carried out during the development process. In spite of the many efforts depending on the analysis and procedures, there are limitations to improve the reliability. The lessons learned from the currently installed system failures show the incompleteness of the final integration test. The current point-to-point and logic-to-logic separate test procedures manually performed by the engineers can cause some procedures missed and have effects on the critical functions. The design processes of the digital systems are met in accordance with the international standards and regulatory guidelines. The lessons learned from the failures of the running digital systems showed the limitations of the current verification and validation efforts. The various improvements and attempts have been considered including the expert review processes and the completeness of the test. In this paper, the Final Running Test Method evaluating the completeness of the digital system using the control patterns and the Test System Architecture are proposed

Building Chronic Kidney Disease Clinical Practice Guidelines Using the openEHR Guideline Definition Language.

Science.gov (United States)

Lin, Ching-Heng; Lo, Ying-Chih; Hung, Pei-Yuan; Liou, Der-Ming

2016-12-07

As a result of the disease's high prevalence, chronic kidney disease (CKD) has become a global public health problem. A clinical decision support system that integrates with computer-interpretable guidelines (CIGs) should improve clinical outcomes and help to ensure patient safety. The openEHR guideline definition language (GDL) is a formal language used to represent CIGs. This study explores the feasibility of using a GDL approach for CKD; it also attempts to identify any potential gaps between the ideal concept and reality. Using the Kidney Disease Improving Global Outcomes (KDIGO) anemia guideline as material, we designed a development workflow in order to establish a series of GDL guidelines. Focus group discussions were conducted in order to identify important issues related to GDL implementation. Ten GDL guidelines and 37 archetypes were established using the KDIGO guideline document. For the focus group discussions, 16 clinicians and 22 IT experts were recruited and their perceptions, opinions and attitudes towards the GDL approach were explored. Both groups provided positive feedback regarding the GDL approach, but raised various concerns about GDL implementation. Based on the findings of this study, we identified some potential gaps that might exist during implementation between the GDL concept and reality. Three directions remain to be investigated in the future. Two of them are related to the openEHR GDL approach. Firstly, there is a need for the editing tool to be made more sophisticated. Secondly, there needs to be integration of the present approach into non openEHR-based hospital information systems. The last direction focuses on the applicability of guidelines and involves developing a method to resolve any conflicts that occur with insurance payment regulations.

Final report of advisory subcommittee on development of JENDL. Guideline for developing next JENDL

International Nuclear Information System (INIS)

Chiba, Go

2016-01-01

An advisory subcommittee on development of JENDL was established in 2013 to discuss future development of JENDL among experts on nuclear data experiments, evaluations and applications. This paper is a summary of a final report which was submitted to the JENDL committee on March in 2014. (author)

Whitebark pine planting guidelines

Science.gov (United States)

Ward McCaughey; Glenda L. Scott; Kay L. Izlar

2009-01-01

This article incorporates new information into previous whitebark pine guidelines for planting prescriptions. Earlier 2006 guidelines were developed based on review of general literature, research studies, field observations, and standard US Forest Service survival surveys of high-elevation whitebark pine plantations. A recent study of biotic and abiotic factors...

Measure Guideline: Ventilation Cooling

Energy Technology Data Exchange (ETDEWEB)

Springer, D. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), David, CA (United States)

2012-04-01

The purpose of this measure guideline is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

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

International Nuclear Information System (INIS)

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

1995-05-01

Reliable software is required for nuclear power industry applications. Verification and validation techniques applied during the software development process can help eliminate errors that could inhibit the proper operation of digital systems and cause availability and safety problems. Most of the techniques described in this report are valid for conventional software systems as well as for expert systems. The project resulted in a set of 16 V ampersand V guideline packages and 11 sets of procedures based on the class, development phase, and system component being tested. These guideline packages and procedures help a utility define the level of V ampersand V, which involves evaluating the complexity and type of software component along with the consequences of failure. In all, the project identified 153 V ampersand V techniques for conventional software systems and demonstrated their application to all aspects of expert systems except for the knowledge base, which requires specially developed tools. Each of these conventional techniques covers anywhere from 2-52 total types of conventional software defects, and each defect is covered by 21-50 V ampersand V techniques. The project also identified automated tools to Support V ampersand V activities

Standards and Guidelines in Telemedicine and Telehealth

Science.gov (United States)

Krupinski, Elizabeth A.; Bernard, Jordana

2014-01-01

The development of guidelines and standards for telemedicine is an important and valuable process to help insure effective and safe delivery of quality healthcare. Some organizations, such as the American Telemedicine Association (ATA), have made the development of standards and guidelines a priority. The practice guidelines developed so far have been well received by the telemedicine community and are being adopted in numerous practices, as well as being used in research to support the practice and growth of telemedicine. Studies that utilize published guidelines not only help bring them into greater public awareness, but they also provide evidence needed to validate existing guidelines and guide the revision of future versions. Telemedicine will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of forms not just in the traditional clinical environments, and practice guidelines will be a key factor in fostering this growth. Creation of guidelines is important to payers and regulators as well as increasingly they are adopting and integrating them into regulations and policies. This paper will review some of the recent ATA efforts in developing telemedicine practice guidelines, review the role of research in guidelines development, review data regarding their use, and discuss some of areas where guidelines are still needed. PMID:27429261

The Gap in Knowledge of Clinical Practice Guidelines by Mental Health Residents in Buenos Aires (Argentina

Directory of Open Access Journals (Sweden)

Javier Fabrissin

2014-05-01

Full Text Available The aim of this pilot study was to evaluate if the residents of psychiatry and clinical psychology from the city of Buenos Aires knew any of the existing mental health Clinical Practice and Treatment Guidelines (CPTGs. We asked residents their opinion about CPTGs and, also, if they followed their recommendations in clinical practice. We asked 59 mental health residents (28 physicians and 29 psychologists with different years of clinical training to fill a questionnaire to know their opinion about CPTGs and also if they follow the CPTG recommendations in their clinical practice. We found that 79.31% of residents did not know any CPTG. Eighty percent of the residents who did know any CPTG have a positive opinion about CPTGs. Finally, the American Psychiatric Association Guidelines were the most known CPTGs. The authors emphasize the need for a clinical guidelines diffusion policy in Buenos Aires city and particularly as a clinical and training resource for mental health residents.

Insights from Guideline for Performance of Internal Flooding Probabilistic Risk Assessment (IFPRA)

International Nuclear Information System (INIS)

Choi, Sun Yeong; Yang, Joo Eon

2009-01-01

An internal flooding (IF) risk assessment refers to the quantitative probabilistic safety assessment (PSA) treatment of flooding as a result of pipe and tank breaks inside the plants, as well as from other recognized flood sources. The industry consensus standard for Internal Events Probabilistic Risk Assessment (ASME-RA-Sb-2005) includes high-level and supporting technical requirements for developing internal flooding probabilistic risk assessment (IFPRA). This industry standard is endorsed in Regulatory Guide 1.200, Revision 1 as an acceptable approach for addressing the risk contribution from IF events for risk informed applications that require U.S. Nuclear Regulatory commission (NRC) approval. In 2006, EPRI published a draft report for IFPRA that addresses the requirements of the ASME PRA consensus standard and have made efforts to refine and update the final EPRI IFPRA guideline. Westinghouse has performed an IFPRA analysis for several nuclear power plants (NPPs), such as Watts Bar and Fort Calhoun, using the draft EPRI guidelines for development of an IFPRA. Proprietary methodologies have been developed to apply the EPRI guidelines. The objectives of the draft report for IFPRA guideline are to: · Provide guidance for PSA practitioners in the performance of the elements of a PRA associated with internal flooding events consistent with the current state of the art for internal flooding PRA · Provide guidance regarding acceptable approaches that is sufficient to meeting the requirements of the ASME PRA Standard associated with internal flooding · Incorporate lessons learned in the performance of internal flooding PRAs including those identified as pilot applications of earlier drafts of this procedures guide The purpose of this paper is to present a vision for domestic nuclear power plants' IFPRA by comparing the method of the draft EPRI guidelines with the existing IFPRA method for domestic NPPs

Insights from Guideline for Performance of Internal Flooding Probabilistic Risk Assessment (IFPRA)

Energy Technology Data Exchange (ETDEWEB)

Choi, Sun Yeong; Yang, Joo Eon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2009-10-15

An internal flooding (IF) risk assessment refers to the quantitative probabilistic safety assessment (PSA) treatment of flooding as a result of pipe and tank breaks inside the plants, as well as from other recognized flood sources. The industry consensus standard for Internal Events Probabilistic Risk Assessment (ASME-RA-Sb-2005) includes high-level and supporting technical requirements for developing internal flooding probabilistic risk assessment (IFPRA). This industry standard is endorsed in Regulatory Guide 1.200, Revision 1 as an acceptable approach for addressing the risk contribution from IF events for risk informed applications that require U.S. Nuclear Regulatory commission (NRC) approval. In 2006, EPRI published a draft report for IFPRA that addresses the requirements of the ASME PRA consensus standard and have made efforts to refine and update the final EPRI IFPRA guideline. Westinghouse has performed an IFPRA analysis for several nuclear power plants (NPPs), such as Watts Bar and Fort Calhoun, using the draft EPRI guidelines for development of an IFPRA. Proprietary methodologies have been developed to apply the EPRI guidelines. The objectives of the draft report for IFPRA guideline are to: {center_dot} Provide guidance for PSA practitioners in the performance of the elements of a PRA associated with internal flooding events consistent with the current state of the art for internal flooding PRA {center_dot} Provide guidance regarding acceptable approaches that is sufficient to meeting the requirements of the ASME PRA Standard associated with internal flooding {center_dot} Incorporate lessons learned in the performance of internal flooding PRAs including those identified as pilot applications of earlier drafts of this procedures guide The purpose of this paper is to present a vision for domestic nuclear power plants' IFPRA by comparing the method of the draft EPRI guidelines with the existing IFPRA method for domestic NPPs.

Update and revision of WHO air quality guidelines for Europe

Energy Technology Data Exchange (ETDEWEB)

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

1995-12-31

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

Update and revision of WHO air quality guidelines for Europe

Energy Technology Data Exchange (ETDEWEB)

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

1996-12-31

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

Raising the Bar with Trades Staffing Guidelines.

Science.gov (United States)

Weidner, Theodore J.

2000-01-01

Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)

78 FR 38102 - Passenger Vessels Accessibility Guidelines

Science.gov (United States)

2013-06-25

... Costs and Benefits The primary estimates of the costs and benefits of the proposed guidelines are shown... quantify the benefits of the proposed guidelines due to the nature of the benefits. The proposed guidelines..., transportation, public accommodation, and leisure. The proposed guidelines would enable these individuals to...

28 CFR 23.30 - Funding guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Funding guidelines. 23.30 Section 23.30 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL INTELLIGENCE SYSTEMS OPERATING POLICIES § 23.30 Funding guidelines. The following funding guidelines shall apply to all Crime Control Act funded...

5 CFR 724.403 - Advisory guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Advisory guidelines. 724.403 Section 724.403 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... RETALIATION ACT OF 2002 Best Practices § 724.403 Advisory guidelines. OPM will issue advisory guidelines to...

Electrical safety guidelines

Energy Technology Data Exchange (ETDEWEB)

1993-09-01

The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

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

Science.gov (United States)

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

2005-01-01

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

Inspector qualification guidelines

International Nuclear Information System (INIS)

Batty, A.C.; Van Binnebeek, J.J.; Ericsson, P.O.; Fisher, J.C.; Geiger, P.; Grandame, M.; Grimes, B.K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-01

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied

Inspector qualification guidelines

Energy Technology Data Exchange (ETDEWEB)

Batty, A. C.; Van Binnebeek, J. J.; Ericsson, P. O.; Fisher, J. C.; Geiger, P.; Grandame, M.; Grimes, B. K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-15

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied.

Guidelines for Posting Soil Contamination Areas

Energy Technology Data Exchange (ETDEWEB)

Mcnaughton, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Eisele, William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-02-01

All soil guidelines were determined using RESRAD, version 6.1. All offsite guidelines are based on 15 mrem/year. This dose rate is sufficiently low to protect human health and is in accordance with DOE guidance and the proposed EPA 40-CFR-196 regulations for members of the public (never promulgated). For those onsite areas where general employees (non-radiological workers) could have routine access, soil concentrations should be based on a dose rate of 30 mrem/year (approximately one-third of the onsite LANL non-radiological worker dose of 100 mrem/year). In this case, soil concentration guidelines may be obtained by doubling the 15 mrem/year guidelines. Several scenarios were developed to provide maximum flexibility for application of the guidelines. The offsite guidelines were developed using: residential scenarios for both adults and children; a construction worker scenario; a resource user (e.g., a hunter) scenario; a child playing within canyon reaches scenario, a trail using jogger within canyon reaches scenario, and a trail using hiker within canyon reaches scenario. The residential guidelines represent the lowest values from both the adult residential scenario and the child residential scenario.

40 CFR 766.12 - Testing guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Testing guidelines. 766.12 Section 766... DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.12 Testing guidelines. Analytical test methods must be developed using methods equivalent to those described or reviewed in Guidelines for the...

5 CFR 720.206 - Selection guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Selection guidelines. 720.206 Section 720... guidelines. This subpart sets forth requirements for a recruitment program, not a selection program... procedures and criteria must be consistent with the Uniform Guidelines on Employee Selection Procedures (43...

76 FR 63565 - Event Reporting Guidelines

Science.gov (United States)

2011-10-13

...-2011-0237] Event Reporting Guidelines AGENCY: Nuclear Regulatory Commission. ACTION: Draft NUREG... comments on Draft NUREG-1022, Revision 3, ``Event Reporting Guidelines: 10 CFR 50.72 and 50.73''. The NUREG-1022 contains guidelines that the NRC staff considers acceptable for use in meeting the event reporting...

Reporting of financial conflicts of interest in clinical practice guidelines: a case study analysis of guidelines from the Canadian Medical Association Infobase.

Science.gov (United States)

Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin

2016-08-15

Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors' FCOI declarations in guidelines from the Canadian Medical Association (CMA) Infobase. We also assess the financial relationships between guideline-affiliated organizations and drug companies. Using a population approach, we extracted first-line drug recommendations and authors' FCOI disclosures in guidelines from the CMA Infobase. We contacted the corresponding authors on guidelines when FCOI disclosures were missing for some or all authors. We also extracted guideline-affiliated organizations and searched each of their websites to determine if they had financial relationships with drug companies. We analyzed 350 authors from 28 guidelines. Authors were named on one, two, or three guidelines, yielding 400 FCOI statements. In 75.0 % of guidelines at least one author, and in 21.4 % of guidelines all authors, disclosed FCOI with drug companies. In 54.0 % of guidelines at least one author, and in 28.6 % of guidelines over half of the authors, disclosed FCOI with manufacturers of drugs that they recommended. Twenty of 48 authors on multiple guidelines reported different FCOI in their disclosures. Eight guidelines identified affiliated organizations with financial relationships with manufacturers of drugs recommended in those guidelines. This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by

Guidelines for identifying suspect/counterfeit material

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.

Strengthening the Enforcement of CSR Guidelines

DEFF Research Database (Denmark)

Olsen, Birgitte Egelund; Sørensen, Karsten Engsig

2014-01-01

the extensive right to refer complaints to them, the broad scope of the recommendations in the Guidelines and especially the use of naming and shaming in cases of breaches of the Guidelines, has changed the original character of the Guidelines as a purely soft law instrument. Furthermore, it is shown...... that the use of very broad and vague terminology in the Guidelines makes it very difficult for enterprises to comply with them. This is further complicated by the fact that many of the terms, which lay down when the NCPs have jurisdiction, are not clearly defined or explained. The three NCPs examined have...... implemented the Guidelines very differently. In particular the Danish NCP stands out. It has a jurisdiction which in many respects goes far beyond that envisioned in the Guidelines. This may put in question the legitimacy and effectiveness of the Danish NCP, but at the same time it can also be viewed...

10 CFR 960.5-1 - System guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false System guidelines. 960.5-1 Section 960.5-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-1 System guidelines. (a) Qualifying conditions—(1) Preclosure...

32 CFR 310.36 - OMB training guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false OMB training guidelines. 310.36 Section 310.36... PROGRAM DOD PRIVACY PROGRAM Training Requirements § 310.36 OMB training guidelines. The OMB guidelines (OMB Privacy Guidelines, 40 FR 28948 (July 9, 1975) require all agencies additionally to: (a) Instruct...

[Preoperative fasting guidelines: an update].

Science.gov (United States)

López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J

2015-03-01

Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

[Graphic synopsis of implementation of German guideline clearing reports in national disease management guidelines].

Science.gov (United States)

Thole, Henning

2011-01-01

While methods for the production of guidelines (evidence analysis, assessment, adaptation) have been continually refined throughout the past years, there is a lack of instruments for the production of easily understandable synopses. Definition of a methodological approach to encompass synopses by Spidernet diagrams. Tables of synopses can be generated with distinct information to bring down the main results in one Spidernet diagram. This is possible for both the entire synopsis and parts of it. Guideline comparisons require detailed analyses on the one hand and easily understandable presentations of their results on the other. Guideline synopses can be substantially supported by graphic presentation of the results of synopsis. Graphic synopsis is also helpful in other cases; it may be used, for example, to summarise HTA reports, systematic reviews or guidelines. Copyright © 2011. Published by Elsevier GmbH.

Water chemistry guidelines for BWRs

International Nuclear Information System (INIS)

Bilanin, W.J.; Jones, R.L.; Welty, C.S.

1984-01-01

Guidelines for BWR water chemistry control have been prepared by a committee of experienced utility industry personnel sponsored by the BWR Owners Group on IGSCC Research and coordinated by the Electric Power Research Institute. The guidelines are based on extensive plant operational experience and laboratory research data. The purpose of the guidelines is to provide guidance to the electric utility industry on water chemistry control to help reduce corrosion, especially stress corrosion cracking, in boiling water reactors

Olympic emblem guidelines: London 2012

OpenAIRE

2013-01-01

These guidelines issued by the London Organising Committee of the Olympic Games and Paralympic Games Ltd (“LOCOG”) provide standards, requirements and guidelines for use of the London 2012 Olympic Games Emblem (the “Emblem”) by LOCOG and the International Olympic Committee (IOC) creative, marketing and communications personnel, agencies and consultants only who are authorised to use the London 2012 marks. The purpose of these guidelines is to preserve and enhance the value of the Emblem for t...

5 CFR 1310.1 - Policy guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Policy guidelines. 1310.1 Section 1310.1 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES OMB CIRCULARS § 1310.1 Policy guidelines. In carrying out its responsibilities, the Office of Management and Budget issues policy guidelines to...

Design Guidelines for Low Crested Structures

DEFF Research Database (Denmark)

Burcharth, H. F.; Lamberti, Alberto

2004-01-01

1998-2002. The Guidelines comprise engineering aspects related to morphological impact and structure stability, biological aspects related to ecological impact, and socio-economical aspects related to the implementation of LCS-schemes. The guidelines are limited to submerged and regularly overtopped......The paper presents an overview of the design guidelines for low crested structures (LCS's) to be applied in coastal protection schemes. The design guidelines are formulated as a part of the research project: Environmental Design of Low Crested Coastal Defence Structures (DELOS) within the EC 5FP...

Methodological Quality of Consensus Guidelines in Implant Dentistry.

Science.gov (United States)

Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

2017-01-01

Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions.

Clinical practice guidelines in breast cancer

Science.gov (United States)

Tyagi, N. Kumar; Dhesy-Thind, S.

2018-01-01

Background A number of clinical practice guidelines (cpgs) concerning breast cancer (bca) screening and management are available. Here, we review the strengths and weaknesses of cpgs from various professional organizations and consensus groups with respect to their methodologic quality, recommendations, and implementability. Methods Guidelines from four groups were reviewed with respect to two clinical scenarios: adjuvant ovarian function suppression (ofs) in premenopausal women with early-stage estrogen receptor–positive bca, and use of sentinel lymph node biopsy (slnb) after neoadjuvant chemotherapy (nac) for locally advanced bca. Guidelines from the American Society of Clinical Oncology (asco); Cancer Care Ontario’s Program in Evidence Based Care (cco’s pebc); the U.S. National Comprehensive Cancer Network (nccn); and the St. Gallen International Breast Cancer Consensus Conference were reviewed by two independent assessors. Guideline methodology and applicability were evaluated using the agree ii tool. Results The quality of the cpgs was greatest for the guidelines developed by asco and cco’s pebc. The nccn and St. Gallen guidelines were found to have lower scores for methodologic rigour. All guidelines scored poorly for applicability. The recommendations for ofs were similar in three guidelines. Recommendations by the various organizations for the use of slnb after nac were contradictory. Conclusions Our review demonstrated that cpgs can be heterogeneous in methodologic quality. Low-quality cpg implementation strategies contribute to low uptake of, and adherence to, bca cpgs. Further research examining the barriers to recommendations—such as intrinsic guideline characteristics and the needs of end users—is required. The use of bca cpgs can improve the knowledge-to-practice gap and patient outcomes.

Assessing Clinical Microbiology Practice Guidelines: American Society for Microbiology Ad Hoc Committee on Evidence-Based Laboratory Medicine Practice Guidelines Assessment.

Science.gov (United States)

Nachamkin, Irving; Kirn, Thomas J; Westblade, Lars F; Humphries, Romney

2017-11-01

As part of the American Society for Microbiology (ASM) Evidence-Based Laboratory Medicine Practice Guidelines Committee of the Professional Practice Committee, an ad hoc committee was formed in 2014 to assess guidelines published by the committee using an assessment tool, Appraisal of Guidelines for Research Evaluation II (AGREE II). The AGREE II assessment helps reviewers determine whether published guidelines are robust, transparent, and clear in presenting practice recommendations in a standardized manner. Identifying strengths and weaknesses of practice guidelines by ad hoc assessments helps with improving future guidelines through the participation of key stakeholders. This minireview describes the development of the ad hoc committee and results from their review of several ASM best practices guidelines and a non-ASM practice guideline from the Emergency Nurses Association. Copyright © 2017 American Society for Microbiology.

Data Qualification guidelines

International Nuclear Information System (INIS)

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

1992-01-01

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

Guidelines for Learning Stations.

Science.gov (United States)

Fehrle, Carl C.; Schulz, Jolene

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

42 CFR 438.236 - Practice guidelines.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Practice guidelines. 438.236 Section 438.236 Public... Improvement Standards § 438.236 Practice guidelines. (a) Basic rule: The State must ensure, through its...) Adoption of practice guidelines. Each MCO and, when applicable, each PIHP and PAHP adopts practice...

22 CFR 214.42 - Uniform pay guidelines.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Uniform pay guidelines. 214.42 Section 214.42... Advisory Committees § 214.42 Uniform pay guidelines. (a) A.I.D. follows OMB/CSC guidelines in section 11 of... experts, their compensation shall be fixed in accordance with CSC guidelines and regulations, and the...

Methodology for developing evidence-based clinical imaging guidelines: Joint recommendations by Korea society of radiology and national evidence-based healthcare collaborating agency

Energy Technology Data Exchange (ETDEWEB)

Choi, Sol Ji; Jo, Ae Jeong; Choi, Jin A [Div. for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul (Korea, Republic of); and others

2017-01-15

This paper is a summary of the methodology including protocol used to develop evidence-based clinical imaging guidelines (CIGs) in Korea, led by the Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency. This is the first protocol to reflect the process of developing diagnostic guidelines in Korea. The development protocol is largely divided into the following sections: set-up, process of adaptation, and finalization. The working group is composed of clinical imaging experts, and the developmental committee is composed of multidisciplinary experts to validate the methodology. The Korean CIGs will continue to develop based on this protocol, and these guidelines will act for decision supporting tools for clinicians as well as reduce medical radiation exposure.

Methodology for developing evidence-based clinical imaging guidelines: Joint recommendations by Korea society of radiology and national evidence-based healthcare collaborating agency

International Nuclear Information System (INIS)

Choi, Sol Ji; Jo, Ae Jeong; Choi, Jin A

2017-01-01

This paper is a summary of the methodology including protocol used to develop evidence-based clinical imaging guidelines (CIGs) in Korea, led by the Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency. This is the first protocol to reflect the process of developing diagnostic guidelines in Korea. The development protocol is largely divided into the following sections: set-up, process of adaptation, and finalization. The working group is composed of clinical imaging experts, and the developmental committee is composed of multidisciplinary experts to validate the methodology. The Korean CIGs will continue to develop based on this protocol, and these guidelines will act for decision supporting tools for clinicians as well as reduce medical radiation exposure

Clinical practice guidelines in patient management

Directory of Open Access Journals (Sweden)

Santosh Kumar

2001-01-01

Full Text Available Efforts have always been made to evolve certain prin-ciples to reduce the variability in the management of patients and make medical care more appropriate. These efforts have become almost a movement since 1980s as evidenced in the development of clinical practice guide-lines in all medical disciplines. This article describes the need for clinical practice guidelines and their de-velopment methods and qualities. Advantages and limi-tations of clinical practice guidelines are enumerated. The salient features of various available clinical prac-tice guidelines in urology are also described.

The EANM and SNMMI practice guideline for lymphoscintigraphy and sentinel node localization in breast cancer

Energy Technology Data Exchange (ETDEWEB)

Giammarile, Francesco [Universite Claude Bernard Lyon 1, Medecine Nucleaire, Hospices Civils de Lyon and EA 3738, Lyon (France); Alazraki, Naomi; Aarsvold, John N.; Grant, Sandra F. [Emory University, Nuclear Medicine Service Veterans Affairs Medical Center and Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Audisio, Riccardo A. [University of Liverpool, St Helens Teaching Hospital, St Helens (United Kingdom); Glass, Edwin [Medical Imaging Center of Southern California, Nuclear Medicine, Santa Monica, CA (United States); Kunikowska, Jolanta [Medical University of Warsaw, Nuclear Medicine Department, Warsaw (Poland); Leidenius, Marjut [Helsinki University Central Hospital, Breast Surgery Unit, Helsinki (Finland); Moncayo, Valeria M. [Emory University, Nuclear Medicine Service, Atlanta, GA (United States); Uren, Roger F. [University of Sydney, Sydney, NSW (Australia); Nuclear Medicine and Diagnostic Ultrasound, RPAH Medical Centre, Newtown, NSW (Australia); Oyen, Wim J.G. [Radboud University Nijmegen Medical Centre, Department of Nuclear Medicine, Nijmegen (Netherlands); Valdes Olmos, Renato A. [Netherlands Cancer Institute, Department of Nuclear Medicine, Amsterdam (Netherlands); Leiden University Medical Center, Interventional Molecular Imaging, Leiden (Netherlands); Vidal Sicart, Sergi [Hospital Clinic Barcelona, Nuclear Medicine Department, Barcelona (Spain)

2013-12-15

The accurate harvesting of a sentinel node in breast cancer includes a sequence of procedures with components from different medical specialities, including nuclear medicine, radiology, surgical oncology and pathology. The aim of this document is to provide general information about sentinel lymph node detection in breast cancer patients. The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) have written and approved these guidelines to promote the use of nuclear medicine procedures with high quality. The final result has been discussed by distinguished experts from the EANM Oncology Committee, the SNMMI and the European Society of Surgical Oncology (ESSO). The present guidelines for nuclear medicine practitioners offer assistance in optimizing the diagnostic information from the SLN procedure. These guidelines describe protocols currently used routinely, but do not include all existing procedures. They should therefore not be taken as exclusive of other nuclear medicine modalities that can be used to obtain comparable results. It is important to remember that the resources and facilities available for patient care may vary. (orig.)

The EANM and SNMMI practice guideline for lymphoscintigraphy and sentinel node localization in breast cancer

International Nuclear Information System (INIS)

Giammarile, Francesco; Alazraki, Naomi; Aarsvold, John N.; Grant, Sandra F.; Audisio, Riccardo A.; Glass, Edwin; Kunikowska, Jolanta; Leidenius, Marjut; Moncayo, Valeria M.; Uren, Roger F.; Oyen, Wim J.G.; Valdes Olmos, Renato A.; Vidal Sicart, Sergi

2013-01-01

The accurate harvesting of a sentinel node in breast cancer includes a sequence of procedures with components from different medical specialities, including nuclear medicine, radiology, surgical oncology and pathology. The aim of this document is to provide general information about sentinel lymph node detection in breast cancer patients. The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) have written and approved these guidelines to promote the use of nuclear medicine procedures with high quality. The final result has been discussed by distinguished experts from the EANM Oncology Committee, the SNMMI and the European Society of Surgical Oncology (ESSO). The present guidelines for nuclear medicine practitioners offer assistance in optimizing the diagnostic information from the SLN procedure. These guidelines describe protocols currently used routinely, but do not include all existing procedures. They should therefore not be taken as exclusive of other nuclear medicine modalities that can be used to obtain comparable results. It is important to remember that the resources and facilities available for patient care may vary. (orig.)

Guidelines in lower-middle income countries.

Science.gov (United States)

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

2017-06-01

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

BWR water chemistry guidelines and PWR primary water chemistry guidelines in Japan – Purpose and technical background

Energy Technology Data Exchange (ETDEWEB)

Kawamura, Hirotaka, E-mail: kawamuh@criepi.denken.or.jp [Central Research Institute of Electric Power Industry (Japan); Hirano, Hideo [Central Research Institute of Electric Power Industry (Japan); Katsumura, Yousuke [University of Tokyo (Japan); Uchida, Shunsuke [Tohoku University (Japan); Mizuno, Takayuki [Mie University (Japan); Kitajima, Hideaki; Tsuzuki, Yasuo [Japan Nuclear Safety Institute (Japan); Terachi, Takumi [Institute of Nuclear Safety System, Inc. (Japan); Nagase, Makoto; Usui, Naoshi [Hitachi-GE Nuclear Energy, Ltd. (Japan); Takagi, Junichi; Urata, Hidehiro [Toshiba Corporation (Japan); Shoda, Yasuhiko; Nishimura, Takao [Mitsubishi Heavy Industry, Ltd. (Japan)

2016-12-01

Highlights: • Framework of BWR/PWR water chemistry Guidelines in Japan are presented. • Guideline necessity, definitions, philosophy and technical background are mentioned. • Some guideline settings for control parameters and recommendations are explaines. • Chemistry strategy is also mentioned. - Abstract: After 40 years of light water reactor (LWR) operations in Japan, the sustainable development of water chemistry technologies has aimed to ensure the highest coolant system component integrity and fuel reliability performance for maintaining LWRs in the world; additionally, it aimed to achieve an excellent dose rate reduction. Although reasonable control and diagnostic parameters are utilized by each boiling water reactor (BWR) and pressurized water reactor (PWR) owner, it is recognized that specific values are not shared among everyone involved. To ensure the reliability of BWR and PWR operation and maintenance, relevant members of the Atomic Energy Society of Japan (AESJ) decided to establish guidelines for water chemistry. The Japanese BWR and PWR water chemistry guidelines provide strategies to improve material and fuel reliability performance as well as to reduce dosing rates. The guidelines also provide reasonable “control values”, “diagnostic values” and “action levels” for multiple parameters, and they stipulate responses when these levels are exceeded. Specifically, “conditioning parameters” are adopted in the Japanese PWR primary water chemistry guidelines. Good practices for operational conditions are also discussed with reference to long-term experience. This paper presents the purpose, technical background and framework of the preliminary water chemistry guidelines for Japanese BWRs and PWRs. It is expected that the guidelines will be helpful as an introduction to achieve safety and reliability during operations.

Other Solid Waste Incineration (OSWI) Units Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources Fact Sheets

Science.gov (United States)

This page contains a November 2005, and and November 2006 fact sheet with information regarding the final and proposed NSPS and Emission Guidelines for Existing Sources for OSWI. This document provides a summary of the information for this regulation

Guidelines for Better Heart Health

Science.gov (United States)

Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...

2012 Guidelines for Water Reuse

Science.gov (United States)

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

Draft guidelines for an environmental impact assessment small scale hydroelectric plant redevelopment

International Nuclear Information System (INIS)

1992-01-01

A pulp and paper company in St. George, New Brunswick, is proposing to redevelop an existing hydroelectric plant built around 1900. The redevelopment proposal consists of decommissioning the existing powerhouse, constructing a new powerhouse containing a 12-MW Kaplan turbine, excavating a tailrace channel, and installing a new penstock. Other design considerations include improvements to gates in the main dam for improved flood control and modifications to the trash racks to prevent potential fish mortality. The provincial environment ministry has determined that an environmental impact assessment of the potential impacts of the redevelopment was required. Guidelines to be used in the assessment process are presented, including definition of the study boundaries, prediction of environmental effects, description of methods of mitigating and compensating for anticipated impacts, a commitment to monitoring and public consultation, and submittal of terms of reference in response to final assessment guidelines. Requirements for conducting the assessment study and content of the report are also listed. 1 fig

Inside guidelines: comparative analysis of recommendations and evidence in diabetes guidelines from 13 countries

NARCIS (Netherlands)

Burgers, Jako S.; Bailey, Julia V.; Klazinga, Niek S.; van der Bij, Akke K.; Grol, Richard; Feder, Gene

2002-01-01

OBJECTIVE: To compare guidelines on diabetes from different countries in order to examine whether differences in recommendations could be explained by use of different research evidence. RESEARCH DESIGN AND METHODS: We analyzed 15 clinical guidelines on type 2 diabetes from 13 countries using

ASSET guidelines. Revised 1991 Edition

International Nuclear Information System (INIS)

1991-12-01

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

Total quality management implementation guidelines

Energy Technology Data Exchange (ETDEWEB)

1993-12-01

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

A Critical Review of Low Back Pain Guidelines.

Science.gov (United States)

Chetty, Laran

2017-09-01

Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17. Only five guidelines effectively addressed the AGREE scoring. On the basis of the appraisal and domain scores, only four guidelines were strongly recommended. Improved translation of research evidence from guidelines to clinical practice is needed.

Librarian contributions to clinical practice guidelines.

Science.gov (United States)

Cruse, Peggy; Protzko, Shandra

2014-01-01

Librarians have become more involved in developing high quality systematic reviews. Evidence-based practice guidelines are an extension of systematic reviews and offer another significant area for librarian involvement. This column highlights opportunities and challenges for the librarian working on guideline panels and provides practical considerations for meaningful contributions to the guideline creation process.

Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital: A Retrospective Review.

Science.gov (United States)

Erwin, Beth L; Kyle, Jeffrey A; Allen, Leland N

2016-08-01

The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic therapy. This study's purpose was to determine the percentage of patients with HAP, VAP, and HCAP who received guideline-based empiric antibiotic therapy and to determine the average time to receipt of an appropriate empiric regimen. A retrospective chart review of adults with HAP, VAP, or HCAP was conducted at a community hospital in suburban Birmingham, Alabama. The hospital's electronic medical record system utilized International Classification of Diseases, Ninth Revision (ICD-9) codes to identify patients diagnosed with pneumonia. The percentage of patients who received guideline-based empiric antibiotic therapy was calculated. The mean time from suspected diagnosis of pneumonia to initial administration of the final antibiotic within the empiric regimen was calculated for patients who received guideline-based therapy. Ninety-three patients met the inclusion criteria. The overall guideline adherence rate for empiric antibiotic therapy was 31.2%. The mean time to guideline-based therapy in hours:minutes was 7:47 for HAP and 28:16 for HCAP. For HAP and HCAP combined, the mean time to appropriate therapy was 21:55. Guideline adherence rates were lower and time to appropriate empiric therapy was greater for patients with HCAP compared to patients with HAP. © The Author(s) 2015.

Nuclear Waste Policy Act of 1982; proposed general guidelines for recommendation of sites for nuclear waste repositories

International Nuclear Information System (INIS)

Anon.

1983-01-01

In accordance with the requirements of the Nuclear Waste Policy Act of 1982 (Pub. L. 97-425), hereinafter referred to as the Act, the Department of Energy is proposing general guidelines for the recommendation of sites for repositories for disposal of high-level radioactive waste and spent nuclear fuel in geologic formations. These guidelines are based on the criteria that the Department has used in its National Waste Terminal Storage program, the criteria proposed by the Nuclear Regulatory Commission (NRC), and the environmental standards proposed by the Environmental Protection Agency. These guidelines establish the performance requirements for a geologic repository system, specify how the Department will implement its site-selection program, and define the technical qualifications that candidate sites must meet in the various steps of the site-selection process mandated by the Act. After considering comments from the public; consulting with the Council on Environmental Quality, the Administrator of the Environmental Protection Agency, the Director of the Geological Survey, and interested Governors; and obtaining NRC concurrence, the Department will issue these guidelines in final form as a new Part 960 to Title 10 of the Code of Federal Regulations (10 CFR Part 960)

Radioactive waste from non-licensed activities - identification of waste, compilation of principles and guidance, and proposed system for final management

International Nuclear Information System (INIS)

Jones, C.; Pers, K.

2001-07-01

Presently national guidelines for the handling of radioactive waste from non-licensed activities are lacking in Sweden. Results and information presented in this report are intended to form a part of the basis for decisions on further work within the Swedish Radiation Protection Institute on regulations or other guidelines on final management and final disposal of this type of waste. An inventory of radioactive waste from non-licensed activities is presented in the report. In addition, existing rules and principles used in Sweden - and internationally - on the handling of radioactive and toxic waste and non-radioactive material are summarized. Based on these rules and principles a system is suggested for the final management of radioactive material from non-licensed activities. A model is shown for the estimation of dose as a consequence of leaching of radio-nuclides from different deposits. The model is applied on different types of waste, e.g. peat ashes, light concrete and low-level waste from a nuclear installation

TWRS Final Safety Analysis Report (FSAR) integrated control decision team (ICDT) meetings January 22 - 31,1997

International Nuclear Information System (INIS)

Saladin, V.L.

1997-01-01

U.S. Department of Energy (DOE), Richland Operations Office (RL) letter 97-MSD-163 dated January 15, 1997, directed the Project Hanford Management Contractor (Contractor), Fluor Daniel Hanford, inc., to form a joint RL-Contractor Integrated Control Decision Team (ICDT) to evaluate the Tank Waste Remediation System (TWRS) Final Safety Analysis Report (FSAR) accident scenarios that were identified to be above the risk evaluation guidelines (radiological and/or toxicological) defined by the April 8, 1996, letter from J. Kinzer, RL-TWRS (96-MSO-069) to Dr. A. L. Trego, Westinghouse Hanford Company. The ICDT evaluated six postulated accidents from the draft FSAR which had analyzed consequences above the DOE directed risk evaluation guidelines after controls were applied. The accidents were: (1) Organic Solvent Fires; (2) Organic Salt-Nitrate Fire; (3) Spray Leak; (4) Flammable Gas; (5) Steam Intrusion; and (6) Seismic Event. Five of the postulated accidents exceed radiological risk guidelines. Although the postulated steam intrusion accident does not exceed the radiological risk guidelines, it was considered in the ICDT evaluation because its calculated consequences exceed toxicological risk evaluation guidelines. Figure 1 delineates the mitigated and unmitigated risk evaluations performed for the FSAR

Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review.

Science.gov (United States)

Francke, Anneke L; Smit, Marieke C; de Veer, Anke J E; Mistiaen, Patriek

2008-09-12

are followed. Finally, environmental characteristics may influence guideline implementation. For example, a lack of support from peers or superiors, as well as insufficient staff and time, appear to be the main impediments. Existing reviews describe various factors that influence whether guidelines are actually used. However, the evidence base is still thin, and future sound research - for instance comparing combinations of implementation strategies versus single strategies - is needed.

Factors influencing the implementation of clinical guidelines for health care professionals: A systematic meta-review

Directory of Open Access Journals (Sweden)

de Veer Anke JE

2008-09-01

instance, co-morbidity reduces the chance that guidelines are followed. Finally, environmental characteristics may influence guideline implementation. For example, a lack of support from peers or superiors, as well as insufficient staff and time, appear to be the main impediments. Conclusion Existing reviews describe various factors that influence whether guidelines are actually used. However, the evidence base is still thin, and future sound research – for instance comparing combinations of implementation strategies versus single strategies – is needed.

Design principle of TVO's final repository and preliminary adaptation to site specific conditions

International Nuclear Information System (INIS)

Salo, J-P.; Reikkola, R.

1995-01-01

Teollisuuden Voima Oy (TVO) is responsible for the management of spent fuel produced by the Olkiluoto power plant. TVO's current programme of spent fuel management is based on the guidelines and time schedule set by the Finnish Government. TVO has studied a final disposal concept in which the spent fuel bundles are encapsulated in copper canisters and emplaced in Finnish bedrock. According to the plan the final repository for spent fuel will be in operation by 2020. TVO's updated technical plans for the disposal of spent fuel together with a performance analysis (TVO-92) were submitted to the authorities in 1992. The paper describes the design principle of TVO's final repository and preliminary adaptation of the repository to site specific conditions. (author). 10 refs., 5 figs

State Emergency Department Opioid Guidelines: Current Status.

Science.gov (United States)

Broida, Robert I; Gronowski, Tanner; Kalnow, Andrew F; Little, Andrew G; Lloyd, Christopher M

2017-04-01

The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM). We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP. We found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions for opioids with 67 total recommendations; preventing/diverting abuse with 56 total recommendations; addiction-related guidelines with 29 total recommendations; and a community resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion. This study highlights the 17 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this study will provide the basis for similar efforts in other states.

The complete European guidelines on phenylketonuria

DEFF Research Database (Denmark)

van Wegberg, A M J; MacDonald, A; Ahring, K

2017-01-01

severe intellectual disability, epilepsy and behavioural problems. PKU management differs widely across Europe and therefore these guidelines have been developed aiming to optimize and standardize PKU care. Professionals from 10 different European countries developed the guidelines according to the AGREE...... (Appraisal of Guidelines for Research and Evaluation) method. Literature search, critical appraisal and evidence grading were conducted according to the SIGN (Scottish Intercollegiate Guidelines Network) method. The Delphi-method was used when there was no or little evidence available. External consultants....... In addition, knowledge gaps are identified which require further research in order to direct better care for the future....

Misguided guidelines for managing labor.

Science.gov (United States)

Cohen, Wayne R; Friedman, Emanuel A

2015-06-01

In a recent review we expressed concerns about new guidelines for the assessment and management of labor recommended jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). These guidelines are based heavily on a new concept of how cervical dilatation and fetal descent progress, derived from the work of Zhang et al. In their Viewpoint article they have addressed, but not allayed, the concerns we described in our review. We assert that the dilatation curve promulgated by Zhang et al cannot be reconciled with direct clinical observation. Even if they were correct, however, it still does not follow that the ACOG/SMFM guidelines should recommend replacing the coherent system of identifying and managing labor aberrations described by Friedman. That system is grounded in well-established clinical principles based on decades of use and the objectively documented association of some labor abnormalities with poor fetal and maternal outcomes. Recommendations for new clinical management protocols should require the demonstration of superior outcomes through extensive, preferably prospective, assessment. Using untested guidelines for the management of labor may adversely affect women and children. Even if those guidelines were to reduce the currently excessive cesarean delivery rate, the price of that benefit is likely to be a trade-off in harm to parturients and their offspring. The nature and degree of that harm needs to be documented before considering adoption of the guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

Paralympic emblem guidelines: London 2012

OpenAIRE

2015-01-01

The purpose of these guidelines is to preserve and enhance the value of the Emblem for the benefit of all authorised users. These guidelines apply to LOCOG and IPC creative, marketing and communications personnel, agencies and consultants only.

Reporting guidelines and journal quality in otolaryngology.

Science.gov (United States)

Henderson, A H; Upile, T; Pilavakis, Y; Patel, N N

2016-10-01

Journals increasingly use reporting guidelines to standardise research papers, partly to improve quality. Although defining journal quality is difficult, various calculated metrics are used. This study investigates guideline adoption by otolaryngology journals and whether a relationship exists between this and journal quality. Retrospective MEDLINE database review for English language, Index Medicus, journals of interest to otolaryngologists (October 2013). The resulting journals were examined for the number of guidelines endorsed and then tabulated against surrogate measures of journal quality (Impact factor, Eigenfactor, SCImago, Source-Normalised rank). The primary outcome measure was the number of recognised reporting guidelines endorsed per journal. This was then correlated against journal quality scores. For comparison, a further small sample correlation was performed with 6 randomly selected and 6 high-profile clinical non-otolaryngology journals. 37 otolaryngology journals were identified. Number of guidelines used and quality scores were not normally distributed. Mean guideline usage was 1.0 for otolaryngology journals, 1.5 for randomly selected, and 5.5 for the high-profile journals. Only 18/37 (49%) otolaryngology journals endorsed any guidelines, compared with 11/12 non-otolaryngology journals. Within otolaryngology, Eigenfactor positively correlated with guideline use (r = 0.4, n = 44, p otolaryngology journals is low. Although it might be expected that use of reporting guidelines improved quality, this is not reflected in the derived quality scores in otolaryngology. This may reflect low levels of use/enforcement, that quality indicators are inherently flawed, or that generalised guidelines are not always appropriate or valued by editors. © 2015 John Wiley & Sons Ltd.

The 2015 Dutch food-based dietary guidelines.

Science.gov (United States)

Kromhout, D; Spaaij, C J K; de Goede, J; Weggemans, R M

2016-08-01

The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.

How do SAGES members rate its guidelines?

Science.gov (United States)

Hope, William W; Richardson, William; Fanelli, Robert; Stefanidis, Dimitrios

2014-04-01

The development of practice guidelines should take into consideration the opinions of end users. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has implemented several changes in its guideline development and dissemination process based on previous end-user input. An anonymous electronic survey was conducted via e-mail solicitation in September 2011. Respondents were asked to submit their feedback on the 26 guidelines produced by our society using a 32-item questionnaire and to suggest topics for new guideline development and areas of improvement. Responses from the survey were received by 494 people, of whom 474 (96 %) were clinicians; 373 (75 %) were general, laparoscopic, or bariatric surgeons; and 324 (65 %) held leadership roles within their institution. Most respondents were 35-44 years old (36 %), male (83 %), and had been in practice for over 10 years (54 %). A total of 383 (81 %) had used our guidelines, and, of those, 96 % agreed with their content. Guideline quality was rated 4.34; value 4.27; and ease of access 3.97 on a five-point Likert scale. The most commonly referenced guideline in the survey regarded surgical treatment of reflux (67 %), followed by laparoscopy during pregnancy (51 %). The three most common reasons guidelines were accessed were to update knowledge (68 %), to maximize patient care through evidence-based treatment (51 %), and to obtain a critical literature review. The majority of respondents indicated they greatly value and agree with our guidelines. These results indicate that recent efforts to improve our guidelines have succeeded.

Interconnection Guidelines

Science.gov (United States)

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

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

Science.gov (United States)

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

2017-01-01

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

77 FR 17496 - Fisheries and Habitat Conservation and Migratory Birds Programs; Final Land-Based Wind Energy...

Science.gov (United States)

2012-03-26

...] RIN 1018-AX45 Fisheries and Habitat Conservation and Migratory Birds Programs; Final Land-Based Wind...) established the Wind Turbine Guidelines Advisory Committee (Committee) under the Federal Advisory Committee... concern over certain issues such as the effects of wind turbine noise on wildlife, these issues have not...

Approaches to radiation guidelines for space travel

International Nuclear Information System (INIS)

Fry, R.J.M.

1984-01-01

There are obvious risks in space travel that have loomed larger than any risk from radiation. Nevertheless, NASA has maintained a radiation program that has involved maintenance of records of radiation exposure, and planning so that the astronauts' exposures are kept as low as possible, and not just within the current guidelines. These guidelines are being reexamined currently by NCRP Committee 75 because new information is available, for example, risk estimates for radiation-induced cancer and about the effects of HZE particles. The current career limit is 400 rem to the blood forming organs. The appropriateness of this limit and its basis are being examined as well as the limits for specific organs. There is now considerably more information about age-dependency for radiation effects and this will be taken into account. In 1973 a committee of the National Research Council made a separate study of HZE particle effects and it was concluded that the attendant risks did not pose a hazard for low inclination near-earth orbit missions. Since that time work has been carried out on the so-called microlesions caused by HZE particles and on the relative carcinogenic effect of heavy ions, including iron. A remaining question is whether the fluence of HZE particles could reach levels of concern in missions under consideration. Finally, it is the intention of the committee to indicate clearly the areas requiring further research. 26 references, 1 figure, 7 tables

Effluent Guidelines

Science.gov (United States)

Effluent guidelines are national standards for wastewater discharges to surface waters and municipal sewage treatment plants. We issue the regulations for industrial categories based on the performance of treatment and control technologies.

Suggested Guidelines for Transparency and Participation in Nuclear Waste Management Programmes. Deliverable 22

International Nuclear Information System (INIS)

Jonsson, Josefin Paeivioe; Andersson, Kjell; Bolado, Ricardo; Drottz Sjoeberg, Britt-Marie; Elam, Mark; Sundqvist, Goeran; Kojo, Matti; Meskens, Gaston; Pritrsky, Jozef; Richardson, Phil; Soneryd, Linda; Steinerova, Lucie; Szerszynski, Bronislaw; Wene, Clas-Otto; Vojtechova, Hana

2010-02-01

. Annex 2 gives references for the various sections of the guidelines to more background information in ARGONA deliverables and in the ARGONA Final Report. These guidelines concern nuclear waste management, however, this issue represents only one part of society's concerns in complex and controversial matters. The ARGONA participants believe that many of the following suggested guidelines should be of relevance in a much wider context than nuclear waste management only

IT governance guidelines for directors

CERN Document Server

Calder, Alan

2005-01-01

This important new book – 'IT Governance: Guidelines for Directors' provides directors, executives, managers and professional advisers with clear, pragmatic guidelines for ensuring that IT and the business work together for the same strategic objectives. 

Exploiting thesauri knowledge in medical guideline formalization

OpenAIRE

Serban, R.C.; ten Teije, A.C.M.

2009-01-01

Objectives: As in software product lifecycle, the effort spent in maintaining medical knowl edge in guidelines can be reduced, if modularization, formalization and tracking of domain knowledge are employed across the guideline development phases. Methods: We propose to exploit and combine knowledge templates with medical background knowledge from existing thesauri in order to produce reusable building blocks used in guideline development. These tem- plates enable easier guideline formalizatio...

First record of Anopheles stephensi in Sri Lanka: a potential challenge for prevention of malaria reintroduction.

Science.gov (United States)

Gayan Dharmasiri, A G; Perera, A Yashan; Harishchandra, Jeevanie; Herath, Hemantha; Aravindan, Kandasamy; Jayasooriya, H T R; Ranawaka, Gaya R; Hewavitharane, Mihirini

2017-08-10

The major malaria vector in Sri Lanka is reported to be Anopheles culicifacies with Anopheles subpictus, Anopheles annularis, and Anopheles varuna considered as potential vectors. The occurrence of Anopheles stephensi, which is the key vector of urban malaria in India and the Middle East, had never been reported from Sri Lanka. A series of entomological investigations were carried out by the Anti Malaria Campaign, Ministry of Health, Sri Lanka during December 2016 to April 2017 in two localities of the Mannar District in the Northern Province of the country. Adult mosquito collections were done through indoor and outdoor resting collections, animal and human biting collections and emergence traps. Potential mosquito breeding sites were investigated through larval surveys. The larvae and adults of An. stephensi were initially identified using morphological keys, and subsequently confirmed by sequencing the barcode region of the cytochrome c oxidase I (COI) gene. This is the first report of the presence of An. stephensi in the island of Mannar in the Northern Province of Sri Lanka. Anopheles stephensi (36.65%) was the most abundant anopheline species in the larval habitats in Mannar. It was found breeding together with An. culicifacies (20.7%), An. subpictus (13.5%) and An. varuna (28.13%). Anopheles stephensi was found to be abundantly breeding in built wells used for domestic purposes. Adult females of An. stephensi were observed in emergence trap collections (93.9%), human landing catches all night (79.2%), pyrethrum spray sheet collections (38.6%), outdoor collections (8.3%), donkey-baited trap collections (14.3), and cattle-baited net trap collections (0.7%). Sri Lanka was certified as malaria-free by the WHO in September 2016, however, this new finding may pose a serious challenge to the efforts of the Ministry of Health to prevent the re-introduction of malaria transmission in the country, considering the role that An. stephensi could play in urban and high

Manual for implementing residual radioactivity guidelines

International Nuclear Information System (INIS)

Gilbert, T.L.; Eckerman, K.F.; Hansen, W.R.; Healy, J.W.; Kennedy, W.E.; Napier, B.A.; Solday, J.K.

1986-01-01

The US Department of Energy (DOE) has recently issued guidelines for residual radioactivity at Formerly Utilized Sites Remedial Action Program (FUSRAP) and remote Surplus Facilities Management Program (SFMP) sites. A manual for implementing these guidelines has been prepared jointly by four DOE laboratories (ANL, LANL, ORNL, and PNL) and is being issued as a supplement to the guidelines. The manual presents procedures and tables for deriving site-specific guidelines for levels of residual radionuclide concentrations in soil that must not be exceeded if a site is to be released for unrestricted use. Guidance for implementing DOE ALARA policy for remedial actions is also included. The concentration factor method is used in the pathway analysis for deriving soil guidelines. The analysis has been structured in a manner that explicitly identifies all of the factors involved. Tables are provided for dose-conversion factors and pathway factors from which environmental transport factors for each radionuclide and pathway may be calculated. The scenarios used for deriving the environmental transport factors and dose conversion factors, and the manner in which the information provided in the manual is used to derive site-specific soil guidelines will be presented

Guidelines of the French Society of Otorhinolaryngology (SFORL). Epistaxis and high blood pressure.

Science.gov (United States)

Michel, J; Prulière Escabasse, V; Bequignon, E; Vérillaud, B; Robard, L; Crampette, L; Malard, O

2017-02-01

The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) on epistaxis in high blood pressure. A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. It is recommended to measure the blood pressure of patients in acute-phase epistaxis (Grade A); to control high blood pressure medically in the acute phase of bleeding, to reduce its duration; to monitor blood pressure at the waning of nosebleed; and to control high blood pressure medically in the waning phase to reduce the risk of recurrence. In case of persistent high blood pressure on waning of severe epistaxis, it is recommended to prescribe cardiovascular evaluation to screen for underlying hypertensive disease (Grade B). Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The Turkish Guideline for the Diagnosis and Management of Urticaria-2016

Directory of Open Access Journals (Sweden)

Emek Kocatürk Göncü

2016-09-01

Full Text Available Background and Design: Albeit an easily recognized disease, urticaria features many diverse approaches which rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic evaluation and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology and the Turkish Dermatoimmunology and Allergy Association aimed to create an urticaria guideline for the diagnosis, treatment and followup of urticaria. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the description, classification, pathophysiology as well as diagnosis and treatment of urticaria. Urticaria is classified into two main types: acute urticaria and chronic urticaria while chronic urticaria is further subdivided into spontaneous urticaria and inducible urticaria. The first step of treatment includes standard doses of H1-blockers. In patients who do not respond to the first step, antihistamine dose is increased up to four times; if unsuccessful, another second-generation antihistamine is given in the same dose. In antihistamine-resistant cases, introduction of omalizumab is required. Omalizumab dose may be increased in patients failing to respond to the standard dose. In patients unresponsive to omalizumab, cyclosporine-A may be given. Routine diagnostic tests are not recommended in acute urticaria. In chronic urticaria, erythrocyte sedimentation rate, differential blood count and C-reactive protein testing are the only investigations that are needed routinely. Conclusion: Chronic urticaria is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences, this

[Guideline 'Organ donation following euthanasia"

NARCIS (Netherlands)

Mulder, H.; Olthuis, G.J.; Siebelink, M.; Gerritsen, R; Heurn, E. van

2017-01-01

- The multidisciplinary guideline 'Organ donation following euthanasia' was published in March 2017 at request of the Minister of Health, Welfare and Sport.- This guideline provides recommendations for the organisation and implementation of a request to donate organs expressed by a patient who asks

Medical Malpractice Implications of Clinical Practice Guidelines.

Science.gov (United States)

Ruhl, Douglas S; Siegal, Gil

2017-08-01

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

Lupus nephritis management guidelines compared.

Science.gov (United States)

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

2016-06-01

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

Characteristics of effective clinical guidelines for general practice.

NARCIS (Netherlands)

Burgers, J.S.; Grol, R.P.T.M.; Zaat, J.O.M.; Spies, T.H.; Bij, A.K. van der; Mokkink, H.G.A.

2003-01-01

BACKGROUND: The use of clinical guidelines in general practice is often limited. Research on barriers to guideline adherence usually focuses on attitudinal factors. Factors linked to the guideline itself are much less studied. AIM: To identify characteristics of effective clinical guidelines for

[Adult congenital heart disease--between guidelines and clinical practice].

Science.gov (United States)

Chessa, Massimo

2011-01-01

Advances in medical and surgical management of congenital heart disease have changed the prognosis of infants and children with cardiac defects, so that an increasing number of patients reach adolescence and adult life, even those with complex defects. Recent data suggest that the number of adults with congenital heart disease, either repaired or not, approaches the number of children with the disorder. A cure is rarely achieved and ongoing surveillance and management in conjunction with specialists in this highly specialized field is mandatory to provide optimal care for patients. The profile of this patient population is going to change over the next few decades. Ideally specialist units should be established in appropriate geographic locations; patients need to be concentrated for expertise, experience, and optimal management. Less specialized regional centers and outpatient clinics in districts in connection with grown-up congenital heart disease units should be created. Specialist units should accept responsibility for educating the professionals, training the specialists, and sharing particular skills between each other. Guidelines and recommendations should help physicians to make decision in their daily practice. However, the final judgment regarding the care of an individual patient must be made by his/her physician. This article will briefly discuss some aspects of these dedicated guidelines and how they influence the clinical daily practice.

Guidelines for Reporting Medical Research

DEFF Research Database (Denmark)

Johansen, Mathilde; Thomsen, Simon Francis

2016-01-01

As a response to a low quality of reporting of medical research, guidelines for several different types of study design have been developed to secure accurate reporting and transparency for reviewers and readers from the scientific community. Herein, we review and discuss the six most widely...... accepted and used guidelines: PRISMA, CONSORT, STROBE, MOOSE, STARD, and SPIRIT. It is concluded that the implementation of these guidelines has led to only a moderate improvement in the quality of the reporting of medical research. There is still much work to be done to achieve accurate and transparent...... reporting of medical research findings....

Implementation guidelines for seismic PSA

International Nuclear Information System (INIS)

Coman, Ovidiu; Samaddar, Sujit; Hibino, Kenta; )

2014-01-01

The presentation was devoted to development of guidelines for implementation of a seismic PSA. If successful, these guidelines can close an important gap. ASME/ANS PRA standards and the related IAEA Safety Guide (IAEA NS-G-2.13) describe capability requirements for seismic PSA in order to support risk-informed applications. However, practical guidance on how to meet these requirements is limited. Such guidelines could significantly contribute to improving risk-informed safety demonstration, safety management and decision making. Extensions of this effort to further PSA areas, particularly to PSA for other external hazards, can enhance risk-informed applications

International clinical guideline for the management of classical galactosemia: diagnosis, treatment, and follow-up.

Science.gov (United States)

Welling, Lindsey; Bernstein, Laurie E; Berry, Gerard T; Burlina, Alberto B; Eyskens, François; Gautschi, Matthias; Grünewald, Stephanie; Gubbels, Cynthia S; Knerr, Ina; Labrune, Philippe; van der Lee, Johanna H; MacDonald, Anita; Murphy, Elaine; Portnoi, Pat A; Õunap, Katrin; Potter, Nancy L; Rubio-Gozalbo, M Estela; Spencer, Jessica B; Timmers, Inge; Treacy, Eileen P; Van Calcar, Sandra C; Waisbren, Susan E; Bosch, Annet M

2017-03-01

Classical galactosemia (CG) is an inborn error of galactose metabolism. Evidence-based guidelines for the treatment and follow-up of CG are currently lacking, and treatment and follow-up have been demonstrated to vary worldwide. To provide patients around the world the same state-of-the-art in care, members of The Galactosemia Network (GalNet) developed an evidence-based and internationally applicable guideline for the diagnosis, treatment, and follow-up of CG. The guideline was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. A systematic review of the literature was performed, after key questions were formulated during an initial GalNet meeting. The first author and one of the working group experts conducted data-extraction. All experts were involved in data-extraction. Quality of the body of evidence was evaluated and recommendations were formulated. Whenever possible recommendations were evidence-based, if not they were based on expert opinion. Consensus was reached by multiple conference calls, consensus rounds via e-mail and a final consensus meeting. Recommendations addressing diagnosis, dietary treatment, biochemical monitoring, and follow-up of clinical complications were formulated. For all recommendations but one, full consensus was reached. A 93 % consensus was reached on the recommendation addressing age at start of bone density screening. During the development of this guideline, gaps of knowledge were identified in most fields of interest, foremost in the fields of treatment and follow-up.

Guidelines for the Diagnosis and Management of Food Allergy in the United States

Science.gov (United States)

Boyce, Joshua A.; Assa'ad, Amal; Burks, A. Wesley; Jones, Stacie M.; Sampson, Hugh A.; Wood, Robert A.; Plaut, Marshall; Cooper, Susan F.; Fenton, Matthew J.; Arshad, S. Hasan; Bahna, Sami L.; Beck, Lisa A.; Byrd-Bredbenner, Carol; Camargo, Carlos A.; Eichenfield, Lawrence; Furuta, Glenn T.; Hanifin, Jon M.; Jones, Carol; Kraft, Monica; Levy, Bruce D.; Lieberman, Phil; Luccioli, Stefano; McCall, Kathleen M.; Schneider, Lynda C.; Simon, Ronald A.; Simons, F. Estelle R.; Teach, Stephen J.; Yawn, Barbara P.; Schwaninger, Julie M.

2014-01-01

Food allergy is an important public health problem that affects children and adults and may be increasing in prevalence. Despite the risk of severe allergic reactions and even death, there is no current treatment for food allergy: the disease can only be managed by allergen avoidance or treatment of symptoms. The diagnosis and management of food allergy also may vary from one clinical practice setting to another. Finally, because patients frequently confuse nonallergic food reactions, such as food intolerance, with food allergies, there is an unfounded belief among the public that food allergy prevalence is higher than it truly is. In response to these concerns, the National Institute of Allergy and Infectious Diseases, working with 34 professional organizations, federal agencies, and patient advocacy groups, led the development of clinical guidelines for the diagnosis and management of food allergy. These Guidelines are intended for use by a wide variety of health care professionals, including family practice physicians, clinical specialists, and nurse practitioners. The Guidelines include a consensus definition for food allergy, discuss comorbid conditions often associated with food allergy, and focus on both IgE-mediated and non-IgE-mediated reactions to food. Topics addressed include the epidemiology, natural history, diagnosis, and management of food allergy, as well as the management of severe symptoms and anaphylaxis. These Guidelines provide 43 concise clinical recommendations and additional guidance on points of current controversy in patient management. They also identify gaps in the current scientific knowledge to be addressed through future research. PMID:21134576

Maintaining formal models of living guidelines efficiently

NARCIS (Netherlands)

Seyfang, Andreas; Martínez-Salvador, Begoña; Serban, Radu; Wittenberg, Jolanda; Miksch, Silvia; Marcos, Mar; Ten Teije, Annette; Rosenbrand, Kitty C J G M

2007-01-01

Translating clinical guidelines into formal models is beneficial in many ways, but expensive. The progress in medical knowledge requires clinical guidelines to be updated at relatively short intervals, leading to the term living guideline. This causes potentially expensive, frequent updates of the

Compliance with practice guidelines: clinical autonomy revisited

NARCIS (Netherlands)

Klazinga, N.

1994-01-01

The development of practice guidelines is gaining popularity in both North America and Europe. This review article explores the different reasons behind guideline development, the methodologies used and the effects assessed so far. Experience since 1982 with a guideline development programme at CBO

European guidelines for workplace drug testing in urine.

Science.gov (United States)

Taskinen, Sanna; Beck, Olof; Bosch, Tessa; Brcak, Michaela; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Weinmann, Wolfgang

2017-06-01

These European Guidelines for Workplace Drug Testing in Urine have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The first version of these urine guidelines was published in 2002. Since then, the guidelines have been followed by many laboratories in different European countries and their role has been essential particularly in countries lacking legislation for workplace drug testing. In 2014, the EWDTS started a guidelines updating project and published a new version of the urine guidelines in 2015. Here we represent this updated version of the urine guidelines. The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

[Elaboration and critical evaluation of clinical guidelines].

Science.gov (United States)

García Villar, C

2015-11-01

Clinical guidelines are documents to help professionals and patients select the best diagnostic or therapeutic option. Elaborating guidelines requires an efficient literature search and a critical evaluation of the articles found to select the most appropriate ones. After that, the recommendations are formulated and then must be externally evaluated before they can be disseminated. Even when the guidelines are very thorough and rigorous, it is important to know whether they fulfill all the methodological requisites before applying them. With this aim, various scales have been developed to critically appraise guidelines. Of these, the AGREE II instrument is currently the most widely used. This article explains the main steps in elaborating clinical guidelines and the main aspects that should be analyzed to know whether the guidelines are well written. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Closed cooling water chemistry guidelines revision

International Nuclear Information System (INIS)

McElrath, Joel; Breckenridge, Richard

2014-01-01

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

World Health Organization guideline development: an evaluation.

Directory of Open Access Journals (Sweden)

David Sinclair

Full Text Available BACKGROUND: Research in 2007 showed that World Health Organization (WHO recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO established a "Guidelines Review Committee" (GRC to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff's perceptions of the new procedures. METHODS AND FINDINGS: We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for "Rigour of Development" (up 37.6%, from 30.7% to 68.3% and "Editorial Independence" (up 52.7%, from 20.9% to 73.6%. Four main themes emerged from the interviews: (1 high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2 views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3 staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4 the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support. CONCLUSIONS: Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance

PIAAC Technical Standards and Guidelines

Science.gov (United States)

OECD Publishing, 2014

2014-01-01

The Programme for International Assessment of Adult Competencies (PIAAC) will establish technical standards and guidelines to ensure that the survey design and implementation processes of PIAAC yield high-quality and internationally comparable data. This document provides a revised version of the technical standards and guidelines originally…

Specialty Guidelines for Forensic Psychology

Science.gov (United States)

American Psychologist, 2013

2013-01-01

In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

ESUR prostate MR guidelines 2012

Energy Technology Data Exchange (ETDEWEB)

Barentsz, Jelle O.; Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands); Richenberg, Jonathan [Brighton and Sussex University Hospital Trust, Brighton (United Kingdom); Clements, Richard [Royal Gwent Hospital, Department of Clinical Radiology, Newport, South Wales (United Kingdom); Choyke, Peter [National Cancer Institute, Molecular Imaging Program, Bethesda, MD (United States); Verma, Sadhna [University Of Cincinnati Medical Center, Cincinnati, OH (United States); Villeirs, Geert [Ghent University Hospital, Division of Genitourinary Radiology, Ghent (Belgium); Rouviere, Olivier [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Lyon (France); Universite de Lyon, Lyon (France); Universite Lyon 1, Faculte de Medecine Lyon Est, Lyon (France); Logager, Vibeke [Copenhagen University, Hospital Herlev, Herlev (Denmark)

2012-04-15

The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a compromise, reflected by ''minimal'' and ''optimal'' requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines for the optimal technique and three protocols for ''detection'', ''staging'' and ''node and bone'' are presented. The use of endorectal coil vs. pelvic phased array coil and 1.5 vs. 3 T is discussed. Clinical indications and a PI-RADS classification for structured reporting are presented. (orig.)

41 CFR 109-39.301 - Utilization guidelines.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Utilization guidelines... Management System Vehicles § 109-39.301 Utilization guidelines. DOE activities utilizing GSA IFMS motor... meeting DOE utilization guidelines or established local use objectives, as appropriate. Those vehicles not...

28 CFR 2.21 - Reparole consideration guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Reparole consideration guidelines. 2.21....21 Reparole consideration guidelines. (a)(1) If revocation is based upon administrative violation(s... analogy with listed federal offense behaviors. (b) The guidelines for parole consideration specified at 28...

Dutch physiotherapy guidelines for low back pain

NARCIS (Netherlands)

Bekkering, Geertruida E; Hendriks, H.J.M.; Koes, Bart W; Oostendorp, R. A B; Ostelo, R. W J G; Thomassen, J. M C; van Tulder, M. W.

2003-01-01

Many guidelines for the management of low back pain in primary care have been published during recent years, but guidelines for physiotherapy do not yet exist. Therefore, physiotherapy guidelines have been developed, reflecting the consequences of the current state of knowledge of effective and

Do knowledge brokers facilitate implementation of the stroke guideline in clinical practice?

Science.gov (United States)

Willems, Mia; Schröder, Carin; Post, Marcel; van der Weijden, Trudy; Visser-Meily, Anne

2013-10-23

The implementation of clinical practice guidelines in rehabilitation practice is often troublesome and incomplete. An intervention to enhance the implementation of guidelines is the knowledge transfer program built around the activities of a knowledge broker (KB).This study investigates the use of KBs to implement guideline recommendations for intensive therapy and physical activity for patients post-stroke in 22 stroke units in hospitals and rehabilitation centers in The Netherlands. This study includes a quantitative evaluation with a non controlled pre-post intervention design and a mixed methods process evaluation. From each stroke unit, enterprising nurses and therapists will be recruited and trained as KB. The KB will work for one year on the implementation of the guideline recommendations in their team. To evaluate the effectiveness of the KB, a questionnaire will be administered to patients, health professionals and KBs at baseline (T0) and after one year (T1). Furthermore, semi structured interviews with 5 KBs will be performed at T1.The primary outcome of this implementation project will be the support health professionals give patients to exercise and be physically active, as reported by patients and health professionals themselves. The support immediately after the intervention is compared with the support at the start of the intervention.Additionally we will explore the influence of socio-demographic characteristics of health professionals and determinants identified in the Theory of Planned Behavior (intention, attitude, subjective norm and perceived behavioral control) on the change of supportive behavior of health professionals. Finally, KBs will complete a questionnaire on their own psychological and social demographic characteristics and on organizational conditions needed for health-care improvement such as time, workforce, sponsoring and support from management. With this study we will gain insight in when and why knowledge brokers seem to be

40 CFR 799.11 - Availability of test guidelines.

Science.gov (United States)

2010-07-01

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

Management of fibromyalgia syndrome – an interdisciplinary evidence-based guideline

Science.gov (United States)

Häuser, Winfried; Arnold, Bernhard; Eich, Wolfgang; Felde, Eva; Flügge, Christl; Henningsen, Peter; Herrmann, Markus; Köllner, Volker; Kühn, Edeltraud; Nutzinger, Detlev; Offenbächer, Martin; Schiltenwolf, Marcus; Sommer, Claudia; Thieme, Kati; Kopp, Ina

2008-01-01

The prevalence of fibromyalgia syndrome (FMS) of 1–2% in the general population associated with high disease-related costs and the conflicting data on treatment effectiveness had led to the development of evidence-based guidelines designed to provide patients and physicians guidance in selecting among the alternatives. Until now no evidence-based interdisciplinary (including patients) guideline for the management of FMS was available in Europe. Therefore a guideline for the management of fibromyalgia syndrome (FMS) was developed by 13 German medical and psychological associations and two patient self-help organisations. The task was coordinated by two German scientific umbrella organisations, the Association of the Scientific Medical Societies in Germany AWMF and the German Interdisciplinary Association of Pain Therapy DIVS. A systematic search of the literature including all controlled studies, systematic reviews and meta-analyses of pharmacological and non-pharmacological treatments of FMS was performed in the Cochrane Library (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) and Scopus (1980–12/ 2006). Levels of evidence were assigned according to the classification system of the Oxford-Centre for Evidence Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures were used to reach a consensus on recommendations. The guideline was reviewed and finally approved by the boards of the societies involved and published online by the AWMF on april 25, 2008: http://www.uni-duesseldorf.de/AWMF/ll/041-004.htm. A short version of the guideline for patients is available as well: http://www.uni-duesseldorf.de/AWMF/ll/041-004p.htm. The following procedures in the management of FMS were strongly recommended: information on diagnosis and therapeutic options and patient-centered communication, aerobic exercise, cognitive and operant behavioural therapy

Management of fibromyalgia syndrome – an interdisciplinary evidence-based guideline

Directory of Open Access Journals (Sweden)

Sommer, Claudia

2008-12-01

Full Text Available The prevalence of fibromyalgia syndrome (FMS of 1–2% in the general population associated with high disease-related costs and the conflicting data on treatment effectiveness had led to the development of evidence-based guidelines designed to provide patients and physicians guidance in selecting among the alternatives. Until now no evidence-based interdisciplinary (including patients guideline for the management of FMS was available in Europe. Therefore a guideline for the management of fibromyalgia syndrome (FMS was developed by 13 German medical and psychological associations and two patient self-help organisations. The task was coordinated by two German scientific umbrella organisations, the Association of the Scientific Medical Societies in Germany AWMF and the German Interdisciplinary Association of Pain Therapy DIVS. A systematic search of the literature including all controlled studies, systematic reviews and meta-analyses of pharmacological and non-pharmacological treatments of FMS was performed in the Cochrane Library (1993–12/2006, Medline (1980–12/2006, PsychInfo (1966–12/2006 and Scopus (1980–12/ 2006. Levels of evidence were assigned according to the classification system of the Oxford-Centre for Evidence Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures were used to reach a consensus on recommendations. The guideline was reviewed and finally approved by the boards of the societies involved and published online by the AWMF on april 25, 2008: http://www.uni-duesseldorf.de/AWMF/ll/041-004.htm. A short version of the guideline for patients is available as well: http://www.uni-duesseldorf.de/AWMF/ll/041-004p.htm. The following procedures in the management of FMS were strongly recommended: information on diagnosis and therapeutic options and patient-centered communication, aerobic exercise, cognitive and operant

Towards a standardised approach for evaluating guidelines and guidance documents on palliative sedation: study protocol.

Science.gov (United States)

Abarshi, Ebun; Rietjens, Judith; Caraceni, Augusto; Payne, Sheila; Deliens, Luc; Van Den Block, Lieve

2014-01-01

Sedation in palliative care has received growing attention in recent years; and so have guidelines, position statements, and related literature that provide recommendations for its practice. Yet little is known collectively about the content, scope and methodological quality of these materials. According to research, there are large variations in palliative sedation practice, depending on the definition and methodology used. However, a standardised approach to comparing and contrasting related documents, across countries, associations and governmental bodies is lacking. This paper reports on a protocol designed to enable thorough and systematic comparison of guidelines and guidance documents on palliative sedation. A multidisciplinary and international group of palliative care researchers, identified themes and clinical issues on palliative sedation based on expert consultations and evidence drawn from the EAPC (European Association of Palliative Care) framework for palliative sedation and AGREE II (Appraisal Guideline Research and Evaluation) instrument for guideline assessment. The most relevant themes were selected and built into a comprehensive checklist. This was tested on people working closely with practitioners and patients, for user-friendliness and comprehensibility, and modified where necessary. Next, a systematic search was conducted for guidelines in English, Dutch, Flemish, or Italian. The search was performed in multiple databases (PubMed, CancerLit, CNAHL, Cochrane Library, NHS Evidence and Google Scholar), and via other Internet resources. Hereafter, the final version of the checklist will be used to extract data from selected literature, and the same will be compiled, entered into SPSS, cleaned and analysed systematically for publication. We have together developed a comprehensive checklist in a scientifically rigorous manner to allow standardised and systematic comparison. The protocol is applicable to all guidelines on palliative sedation, and

The nuclear codes and guidelines

International Nuclear Information System (INIS)

Sonter, M.

1984-01-01

This paper considers problems faced by the mining industry when implementing the nuclear codes of practice. Errors of interpretation are likely. A major criticism is that the guidelines to the codes must be seen as recommendations only. They are not regulations. Specific clauses in the guidelines are criticised

Bioassay guideline 2: guidelines for tritium bioassay

International Nuclear Information System (INIS)

1983-01-01

This guideline is one of a series under preparation by the Federal-Provincial Working Group on Bioassay and In Vivo Monitoring Criteria. In this report tritium compounds have been grouped into four categories for the purpose of calculating Annual Limits on Intake and Investigation Levels: tritium gas, tritiated water, tritium-labelled compounds and nucleic acid precursors

5 CFR 1312.10 - Systematic review guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Systematic review guidelines. 1312.10... Declassification of National Security Information § 1312.10 Systematic review guidelines. The EOP Security Officer will prepare and keep current such guidelines as are required by Executive Order 12958 for the...

50 CFR 253.18 - Program operating guidelines.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Program operating guidelines. 253.18 Section 253.18 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... Guarantee Program § 253.18 Program operating guidelines. The Division may issue Program operating guidelines...

National guidelines for the use of antibiotics in hospitalised adult patients: the SWAB guidelines revisited

NARCIS (Netherlands)

Prins, J. M.; Kullberg, B. J.; Gyssens, I. C.

2005-01-01

Since 1996, the Dutch Working Party on Antibiotic Policy (Stichting Werkgroep AntibioticaBeleid, SWAB) has been developing national guidelines for the use of antibiotics in hospitalised adult patients. As a result of both an inventory of the wishes of the users of these guidelines and the recently

Methodological guidelines

Energy Technology Data Exchange (ETDEWEB)

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

1999-04-01

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

Methodological guidelines

International Nuclear Information System (INIS)

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

1999-01-01

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

Contemporaneous International Asthma Guidelines Present Differing Recommendations: An Analysis

Directory of Open Access Journals (Sweden)

Samir Gupta

2016-01-01

Full Text Available Background. Several international groups develop asthma guidelines. Conflicting recommendations across guidelines have been described in several disease areas and may contribute to practice variability. Accordingly, we compared the latest Canadian Thoracic Society (CTS asthma guideline with contemporaneous international asthma guidelines to evaluate conflicting recommendations and their causes. Methods. We identified the latest CTS asthma guideline update (2012 and the following societies which also updated their guidelines in 2012: the British Thoracic Society and Scottish Intercollegiate Guidelines Network and the Global Initiative for Asthma. We compared these three guidelines on (1 key methodological factors and (2 adult pharmacotherapy recommendations. Results. Methods used and documentation provided for literature search strategy and dates, evidence synthesis, outcomes considered, evidence appraisal, and recommendation formulation varied between guidelines. Criteria used to define suboptimal asthma control varied widely between guidelines. Inhaled corticosteroid dosing recommendations diverged, as did recommendations surrounding use of budesonide/formoterol as a reliever and controller and recommendations in the subsequent step. Conclusions. There are important differences between recommendations provided in contemporaneous asthma guidelines. Causes include differences in methods used for interpreting evidence and formulating recommendations. Adopting a common set of valid and explicit methods across international societies could harmonize recommendations and facilitate guideline implementation.

40 CFR 60.31d - Emissions guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Emissions guidelines. 60.31d Section 60...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Sulfuric Acid Production Units § 60.31d Emissions guidelines. Sulfuric acid production units. The emission...

40 CFR 60.36e - Inspection guidelines.

Science.gov (United States)

2010-07-01

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

41 CFR 101-39.301 - Utilization guidelines.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Utilization guidelines... § 101-39.301 Utilization guidelines. An agency must be able to justify a full-time vehicle assignment. The following guidelines may be employed by an agency requesting GSA Interagency Fleet Management...

76 FR 22342 - National Standard 10 Guidelines

Science.gov (United States)

2011-04-21

.... 110218147-1199-01] RIN 0648-BA74 National Standard 10 Guidelines AGENCY: National Marine Fisheries Service... comment on potential adjustments to the National Standard 10 Guidelines. DATES: Written comments regarding... advisory guidelines (which shall not have the force and effect of law), based on the national standards to...

41 CFR 101-27.102-2 - Guidelines.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Guidelines. 101-27.102-2 Section 101-27.102-2 Public Contracts and Property Management Federal Property Management Regulations... Replenishment § 101-27.102-2 Guidelines. Guidelines for implementing the EOQ principle of stock replenishment...

Journal of Wildlife Management guidelines

Science.gov (United States)

William M. Block; Frank R. Thompson; Dawn Hanseder; Allison Cox; Anna Knipps

2011-01-01

These Guidelines apply to all Journal of Wildlife Management (JWM, The Journal) submissions. Publishing a professional manuscript proceeds most smoothly if authors understand the policy, procedures, format, and style of the outlet to which they are submitting a manuscript. These instructions supersede all previous guidelines. Manuscripts that clearly deviate from this...