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Sample records for return-to-play guidelines providing

  1. Educating Providers in Return-to-Play Suggested Guidelines Postconcussion.

    Science.gov (United States)

    Bires, Angela Macci; Leonard, Amanda L; Thurber, Brandon

    As the awareness of concussions increases, it is imperative to be able to evaluate, diagnose, and treat concussed individuals properly to prevent further complications or death. The primary purpose of this study was to compare a provider's current awareness and comfort level as it relates to the return-to-play guidelines for concussions. A secondary aim was to evaluate current protocols that are in use and determine whether they coincide with the suggested guidelines. An educational intervention was implemented to assess the knowledge and confidence of health care providers. The study design was a quantitative, convenient sample, pretest/posttest questionnaire. The questionnaire was administered to participants who were nurse practitioners prior to an educational PowerPoint presentation. At 8 weeks, the posttest was administered. Approximately 19% of individuals were not aware of a graded return-to-play protocols. The findings suggest that the educational intervention increased their confidence levels in making a diagnosis of a concussion, in assessing danger signs, and in understanding when to refer to a specialist. Additional supporting evidence from this study indicates that the educational intervention allowed the participants to achieve a greater comfort level in finding appropriate resources for them and their patients.

  2. Return to Play Guidelines Cannot Solve the Football-Related Concussion Problem

    Science.gov (United States)

    Johnson, L. Syd M.

    2012-01-01

    Background: High school football players are the single largest cohort of athletes playing tackle football, and account for the majority of sport-related concussions. Return to play guidelines (RTPs) have emerged as the preferred approach for addressing the problem of sport-related concussion in youth athletes. Methods: This article reviews…

  3. Magnetic Resonance Imaging in Acute Hamstring Injury: Can We Provide a Return to Play Prognosis?

    NARCIS (Netherlands)

    Reurink, Gustaaf; Brilman, Elisabeth G.; de Vos, Robert-Jan; Maas, Mario; Moen, Maarten H.; Weir, Adam; Goudswaard, Gert Jan; Tol, Johannes L.

    2015-01-01

    Background Sports physicians are increasingly requested to perform magnetic resonance imaging (MRI) of acute hamstring muscle injuries and to provide a prognosis of the time to return to play (RTP) on the basis of their findings. Objectives To systematically review the literature on the prognostic

  4. Return to play after infectious mononucleosis.

    Science.gov (United States)

    Becker, Jonathan A; Smith, Julie Anne

    2014-05-01

    Infectious mononucleosis is a disease primarily of adolescence and early adulthood. The risk of splenic injury and chronic fatigue make return-to-play decisions a challenge for the clinician caring for athletes with infectious mononucleosis. Data were obtained from the PubMed and MEDLINE databases through December 2012 by searching for epidemiology, diagnosis, clinical manifestations, management, and the role of the spleen in infectious mononucleosis. Clinical review. Level 4. Infectious mononucleosis is commonly encountered in young athletes. Its disease pattern is variable and can affect multiple organ systems. Supportive care is the cornerstone, with little role for medications such as corticosteroids. Physical examination is unreliable for the spleen, and ultrasound imaging has limitations in its ability to guide return-to-play decisions. Exercise does not appear to place the young athlete at risk for chronic fatigue, but determining who is at risk for persistent symptoms is a challenge. Return-to-play decisions for the athlete with infectious mononucleosis need to be individualized because of the variable disease course and lack of evidence-based guidelines.

  5. Making prudent recommendations for return-to-play in adult athletes with cardiac conditions.

    Science.gov (United States)

    Oliveira, Leonardo P J; Lawless, Christine E

    2011-01-01

    Clinicians who treat millions of adult athletes throughout the world may be faced with participation or return-to-play decisions in individuals with known or suspected cardiac conditions. Here we review existing published participation guidelines and analyze emerging data from ongoing registries and population-based studies pertaining to return-to-play decisions for cardiac conditions specifically affecting adult athletes. Considerations related to return-to-play decisions will vary according to age of the athlete, with inherited disorders being the main consideration in younger adult athletes aged 18 to 40 yr, and coronary artery disease being the main consideration in older adult athletes aged 40 yr and older. Although this arbitrary division is based on the epidemiology of underlying heart disease in these populations, the essential return-to-play decision process for both age groups is quite similar. Among the most widely used guidelines to make return-to-play decisions in this group of athletes are the 36th Bethesda Conference Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities. These have long been considered the "gold standard" for determining return-to-play decisions in young athletes in the United States. Other guidelines are available for unique purposes, including The European Society of Cardiology guidelines, and the American Heart Association published recommendations regarding participation of young patients (younger than 40 yr) with genetic cardiovascular diseases in recreational sports. The latter are consistent with the 36th Bethesda guidelines and cover common genetically based diseases such as inherited cardiomyopathies, channelopathy, and connective tissue disorders like Marfan's syndrome. The consensus on masters athletes (older than 40 yr) provides return-to-play decisions for a wide variety of conditioned states, from elite older athletes to walk-up athletes. For any adult athlete with a cardiac condition

  6. Return to Play in Athletes Following Ankle Injuries

    OpenAIRE

    Clanton, Thomas O.; Matheny, Lauren M.; Jarvis, Hannah C.; Jeronimus, Anastasia B.

    2012-01-01

    Background: The decision to return to play following an ankle injury is a multifactorial process involving both physical and psychological parameters. The current body of literature lacks evidence-based guidelines to assist in the decision. Objective: This article reviews the evidence to support such testing: the dorsiflexion lunge test, star excursion balance test, agility T-test, and sargent/vertical jump test. The importance of psychological factors is also highlighted. Evidence Acquisitio...

  7. Return to Play After Forearm and Hand Injuries in the National Basketball Association.

    Science.gov (United States)

    Morse, Kyle W; Hearns, Krystle A; Carlson, Michelle Gerwin

    2017-02-01

    Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Descriptive epidemiology study. The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play ( P basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries.

  8. Return to play after liver and spleen trauma.

    Science.gov (United States)

    Juyia, Rushad F; Kerr, Hamish A

    2014-05-01

    Sport-related spleen and liver injuries pose a challenge for the physician. Although rare, these injuries can have serious and even life-threatening outcomes if not accurately diagnosed and managed in a timely fashion. Currently, there are no evidence-based guidelines on duration and intensity of restricted activity and return to play after spleen and liver injury. In addition, there is controversy on follow-up imaging after injury. PubMed was searched using the terms splenic or spleen and trauma and hepatic or liver and trauma from 1980 to 2013. The citations from sentinel papers were also reviewed. Clinical review. Level 3. Ultrasound is ideal in the unstable athlete. Nonoperative management of blunt splenic and hepatic injuries is recommended for hemodynamically stable patients regardless of injury grade, patient age, or presence of associated injuries. Follow-up imaging is not routinely recommended unless clinically indicated. Athletes may engage in light activity for the first 3 months after injury and then gradual return to unrestricted activity as tolerated. High-level athletes may choose splenectomy or serial imaging for faster return to play. Intravenous contrast-enhanced computed tomography is the diagnostic imaging modality of choice in stable athletes with blunt abdominal trauma. C.

  9. On-field management and return-to-play in sports-related concussion in children: Are children managed appropriately?

    Science.gov (United States)

    Haran, Harini P; Bressan, Silvia; Oakley, Ed; Davis, Gavin A; Anderson, Vicki; Babl, Franz E

    2016-03-01

    On-field management and return-to-play guidelines aim to ensure the identification and appropriate management of the concussed athlete. Compliance with current guidelines in many settings is unknown. We assessed whether key components of current concussion guidelines are being followed in child athletes. Prospective observational study. Data were collected from children (5-18 years) presenting to a paediatric emergency department with sport-related concussion via researcher-administered surveys in the emergency department and during a follow up phone call. On hospital discharge all patients received a return to sports fact sheet based on the International Concussion in Sports Group. Ninety-three had sustained a concussion (mean age 12.7 (±0.27) years, 83% male). Sports played included Australian Football (47%), soccer (12%), rugby (9%) basketball (8%), other (25%). 82% participated in organised sports. Concussive signs or symptoms included loss of consciousness (41%), disorientation (36%), vomiting (23%), amnesia (30%), headache (60%). For concussive injury in organised sports (n=76), overall 42% were not managed according to recommended guidelines: 19% were not immediately removed from play, 29% were allowed to return to play on the same day and 27% were not assessed by qualified personnel. 93% of parents and 96% of patients were unaware of concussion or return-to-play guidelines from their organisations. Overall, 72% were compliant with provided return-to-play guidelines. Many children with sports related-concussion are not formally assessed on-field and continue to play. On-field concussion management and return to play practices are often suboptimal. Awareness and education of coaches, teachers, parents and children need to be improved. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. ENERGY SYSTEM DEVELOPMENT AND LOAD MANAGEMENT THROUGH THE REHABILITATION AND RETURN TO PLAY PROCESS.

    Science.gov (United States)

    Morrison, Scot; Ward, Patrick; duManoir, Gregory R

    2017-08-01

    Return-to-play from injury is a complex process involving many factors including the balancing of tissue healing rates with the development of biomotor abilities. This process requires interprofessional cooperation to ensure success. An often-overlooked aspect of return-to-play is the development and maintenance of sports specific conditioning while monitoring training load to ensure that the athlete's training stimulus over the rehabilitation period is appropriate to facilitate a successful return to play. The purpose of this clinical commentary is to address the role of energy systems training as part of the return-to-play process. Additionally the aim is to provide practitioners with an overview of practical sports conditioning training methods and monitoring strategies to allow them to direct and quantify the return-to-play process. 5.

  11. Return to Play Following Anterior Shoulder Dislocation and Stabilization Surgery.

    Science.gov (United States)

    Donohue, Michael A; Owens, Brett D; Dickens, Jonathan F

    2016-10-01

    Anterior shoulder instability in athletes may lead to time lost from participation and decreases in level of play. Contact, collision, and overhead athletes are at a higher risk than others. Athletes may successfully be returned to play but operative stabilization should be considered for long-term treatment of recurrent instability. Open and arthroscopic stabilization procedures for athletes with less than 20% to 25% bone loss improve return to play rates and decrease recurrent instability, with a slightly lower recurrence with open stabilization. For athletes with greater than 20% to 25% bone loss, an open osseous augmentation procedure should be considered. Published by Elsevier Inc.

  12. Return to Play After Shoulder Surgery in Throwers.

    Science.gov (United States)

    Thorsness, Robert; Alland, Jeremy A; McCulloch, Colin B; Romeo, Anthony

    2016-10-01

    The throwing athlete's shoulder is a unique, complex entity with challenges in diagnosis and management. The shoulders in these athletes possess unique biomechanics and pathologic conditions. Unfortunately, return to play outcomes are often poor when specifically evaluating overhead athletes, especially with regard to SLAP repair. It is imperative for the surgeon to be cautious when indicating these athletes for surgery, because although they may demonstrate improvements in pain and general function, subtle changes in accuracy or velocity as a result of surgery can significantly affect the success of an overhead throwing athlete at the competitive level. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Does posteromedial chondromalacia reduce rate of return to play after ulnar collateral ligament reconstruction?

    Science.gov (United States)

    Osbahr, Daryl C; Dines, Joshua S; Rosenbaum, Andrew J; Nguyen, Joseph T; Altchek, David W

    2012-06-01

    Biomechanical studies suggest ulnohumeral chondral and ligamentous overload (UCLO) explains the development of posteromedial chondromalacia (PMC) in throwing athletes with ulnar collateral ligament (UCL) insufficiency. UCL reconstruction reportedly allows 90% of baseball players to return to prior or a higher level of play; however, players with concomitant posteromedial chondromalacia may experience lower rates of return to play. The purpose of this investigation is to determine: (1) the rates of return to play of baseball players undergoing UCL reconstruction and posteromedial chondromalacia; and (2) the complications occurring after UCL reconstruction in the setting of posteromedial chondromalacia. We retrospectively reviewed 29 of 161 (18%) baseball players who were treated for the combined posteromedial chondromalacia and UCL injury. UCL reconstruction was accomplished with the docking technique, and the PMC was addressed with nothing or débridement if Grade 2 or 3 and with débridement or microfracture if Grade 4. The mean age was 19.6 years (range, 16-23 years). Most players were college athletes (76%) and pitchers (93%). We used a modified four-level scale of Conway et al. to assess return to play with 1 being the highest level (return to preinjury level of competition or performance for at least one season after UCL reconstruction). The minimum followup was 24 months (mean, 37 months; range, 24-52 months). Return to play was Level 1 in 22 patients (76%), Level 2 in four patients (14%), Level 3 in two patients (7%), and Level 4 in one (3%) patient. Our data suggest baseball players with concomitant PMC, may have lower rates of return to the same or a higher level of play compared with historical controls. Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.

  14. Athletic pubalgia: Return to play after targeted surgery.

    Science.gov (United States)

    Kajetanek, C; Benoît, O; Granger, B; Menegaux, F; Chereau, N; Pascal-Mousselard, H; Khiami, F

    2018-03-13

    Surgery for athletic pubalgia usually consists in abdominal wall repair combined with routine bilateral adductor tenotomy. We currently confine the surgical procedure to the injured structure(s) (abdominal wall only, adductor tendon only, or both) to limit morbidity and expedite recovery. Outcomes of this à la carte approach are unclear. The objectives of this retrospective study were to determine the return to play (RTP) time, evaluate the potential influence of injury location, and assess the frequency of recurrence or contralateral involvement. À la carte surgery for athletic pubalgia is associated with similar RTP times as the conventional procedure and is not followed by recurrence. Consecutive adults younger than 40 years of age who underwent surgery for athletic pubalgia with injury to the abdominal wall and/or adductor attachment sites between 2009 and 2015 were included. Patients with intra-articular hip disorders, isolated pubic symphysis involvement, or herniation were not eligible. The diagnosis was established clinically then confirmed by at least one imaging technique (ultrasonography plus either a radiograph of the pelvis or magnetic resonance imaging of the pelvis). The criterion for performing surgery was failure of appropriate conservative therapy followed for at least 3 months. Of the 27 included patients, eight had abdominal wall involvement only, seven adductor tendon involvement only, and 12 both. Overall, 25 (92.6%) patients returned to play at their previous level, after a mean of 112±38 days (range, 53-223 days), and experienced no recurrence during the 1-year follow-up. Mean RTP time was significantly shorter in the group with abdominal wall injury only (91.1±21.0 days) compared to the groups with adductor tendon injury only (101.7±42.0 days) or combined injuries (132.5±39.0) (p=0.02). In patients with athletic pubalgia, à la carte surgery confined to the injured structure(s) produces excellent RTP outcomes. RTP time is shortest in

  15. Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes.

    Science.gov (United States)

    Kerr, Zachary Y; Zuckerman, Scott L; Wasserman, Erin B; Covassin, Tracey; Djoko, Aristarque; Dompier, Thomas P

    2016-07-01

    To our knowledge, little research has examined concussion across the youth/adolescent spectrum and even less has examined concussion-related outcomes (ie, symptoms and return to play). To examine and compare sport-related concussion outcomes (symptoms and return to play) in youth, high school, and collegiate football athletes. Athletic trainers attended each practice and game during the 2012 to 2014 seasons and reported injuries. For this descriptive, epidemiological study, data were collected from youth, high school, and collegiate football teams, and the analysis of the data was conducted between July 2015 and September 2015. The Youth Football Surveillance System included more than 3000 youth football athletes aged 5 to 14 years from 118 teams, providing 310 team seasons (ie, 1 team providing 1 season of data). The National Athletic Treatment, Injury, and Outcomes Network Program included 96 secondary school football programs, providing 184 team seasons. The National Collegiate Athletic Association Injury Surveillance Program included 34 college football programs, providing 71 team seasons. We calculated the mean number of symptoms, prevalence of each symptom, and the proportion of patients with concussions that had long return-to-play time (ie, required participation restriction of at least 30 days). Generalized linear models were used to assess differences among competition levels in the mean number of reported symptoms. Logistic regression models estimated the odds of return to play at less than 24 hours and at least 30 days. Overall, 1429 sports-related concussions were reported among youth, high school, and college-level football athletes with a mean (SD) of 5.48 (3.06) symptoms. Across all levels, 15.3% resulted return to play at least 30 days after the concussion and 3.1% resulted in return to play less than 24 hours after the concussion. Compared with youth, a higher number of concussion symptoms were reported in high school athletes (β = 1.39; 95

  16. Use of the stepwise progression return-to-play protocol following concussion among practicing athletic trainers

    Directory of Open Access Journals (Sweden)

    Jessica Wallace

    2018-04-01

    Full Text Available Purpose: The purpose of this study was to determine whether practicing athletic trainers (ATs were using the stepwise progression to make return-to-play (RTP decisions after concussion and to determine what factors influenced their decision to use the stepwise progression. Methods: A total of 166 ATs (response rate = 16.6% completed a 21-item questionnaire that evaluated participant demographics, methods of concussion management, and RTP decision-making using the stepwise progression. Descriptive statistics and a logistic regression were completed to analyze data. Results: Factors such as education level (p = 0.05 and number of concussions treated (p = 0.05 predicted use of the stepwise progression, whereas sex (p = 0.17, employment setting (p = 0.17, state law (p = 0.86, and years practicing (p = 0.17 did not predict whether ATs were following the stepwise progression. Conclusion: The majority of the ATs from this study are employing the stepwise progression to safely return athletes to play after sustaining a concussion. This demonstrates that ATs are providing a standard of care for concussed athletes across various athletic training settings; however, having a graduate degree and treating more concussions per year are predictors of whether an AT follows all steps of the stepwise progression. Keywords: Athletic trainers, Concussion, Concussion management, Graduate degree, Return to play, Sports medicine, Stepwise progression

  17. Does a Syrinx Matter for Return to Play in Contact Sports? A Case Report and Evidence-Based Review of Return-to-Play Criteria After Transient Quadriplegia.

    Science.gov (United States)

    Milles, Jeffrey L; Gallizzi, Michael A; Sherman, Seth L; Smith, Patrick A; Choma, Theodore J

    2014-09-01

    Transient quadriplegia is a rare injury that can change the course of an athlete's career if misdiagnosed or managed inappropriately. The clinician should be well versed in the return-to-play criteria for this type of injury. Unfortunately, when an unknown preexisting syrinx is present in the athlete, there is less guidance on their ability to return to play. This case report and review of the current literature illustrates a National Collegiate Athletic Association (NCAA) Division I football player who suffered a transient quadriplegic event during a kickoff return that subsequently was found to have an incidental cervical syrinx on magnetic resonance imaging. The player was able to have a full neurologic recovery, but ultimately he was withheld from football.

  18. Return to Play After Hip Arthroscopic Surgery for Femoroacetabular Impingement in Professional Soccer Players.

    Science.gov (United States)

    Locks, Renato; Utsunomiya, Hajime; Briggs, Karen K; McNamara, Shannen; Chahla, Jorge; Philippon, Marc J

    2018-02-01

    Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play. To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play. Case series; Level of evidence, 4. Professional soccer players who underwent hip arthroscopic surgery for FAI by a single surgeon between 2005 and 2015 were evaluated. Data retrieved from www.mlssoccer.com , www.fifa.com , www.transfermarkt.co.uk , and www.wikipedia.org included information on each player's professional career, participation on the national team, length of professional career before surgery, number of appearances (games) before surgery, time between surgery and first appearance in a professional game, and number of appearances after surgery. Other data were obtained from the patient's medical records. Twenty-four professional soccer players (26 hips) were included. The mean age at surgery was 25.0 ± 4.0 years (range, 19-32 years). A total of 96% of patients were able to return to play at the professional level. The mean time between surgery and the first professional game played was 9.2 months (range, 1.9-24.0 months). On average, players played in 70 games after surgery (range, 0-224). National team players were able to return to play significantly earlier than the rest of the players (median, 5.7 months vs 11.6 months, respectively; P = .018). Severe chondral damage and microfracture did not interfere with return to play. The arthroscopic management of FAI in symptomatic professional soccer players allowed 96% of them to return to play. Players with national team experience were able to return to play earlier than those without it. Severe chondral damage

  19. Return to Play After Hamstring Injuries : A Qualitative Systematic Review of Definitions and Criteria

    NARCIS (Netherlands)

    van der Horst, Nick; van de Hoef, Sander; Reurink, Gustaaf; Huisstede, Bionka; Backx, Frank

    BACKGROUND: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when

  20. Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria

    NARCIS (Netherlands)

    N. van der Horst (Nick); S. van de Hoef (Sander); G. Reurink (Gustaaf); B.M.A. Huisstede (Bionka); F.J.G. Backx (Frank)

    2016-01-01

    textabstractBackground: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to

  1. Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria.

    Science.gov (United States)

    van der Horst, Nick; van de Hoef, Sander; Reurink, Gustaaf; Huisstede, Bionka; Backx, Frank

    2016-06-01

    More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when a person can start playing again. These criteria need to be critically evaluated, in an attempt to reduce recurrence rates and optimize RTP. To carry out a systematic review of the literature on (1) definitions of RTP used in hamstring research and (2) criteria for RTP after hamstring injuries. Systematic review. Seven databases (PubMed, EMBASE/MEDLINE, CINAHL, PEDro, Cochrane, SPORTDiscus, Scopus) were searched for articles that provided a definition of, or criteria for, RTP after hamstring injury. There were no limitations on the methodological design or quality of articles. Content analysis was used to record and analyze definitions and criteria for RTP after hamstring injury. Twenty-five papers fulfilled inclusion criteria, of which 13 provided a definition of RTP and 23 described criteria to support the RTP decision. "Reaching the athlete's pre-injury level" and "being able to perform full sport activities" were the primary content categories used to define RTP. "Absence of pain", "similar strength", "similar flexibility", "medical staff clearance", and "functional performance" were core themes to describe criteria to support the RTP decision after hamstring injury. Only half of the included studies provided some definition of RTP after hamstring injury, of which reaching the athlete's pre-injury level and being able to perform full sport activities were the most important. A wide variety of criteria are used to support the RTP decision, none of which have been validated. More research is needed to reach a consensus on the definition of RTP and to provide validated RTP criteria to facilitate hamstring injury management and reduce hamstring injury recurrence. PROSPERO

  2. MRI assessment of calf injuries in Australian Football League players: findings that influence return to play

    International Nuclear Information System (INIS)

    Waterworth, George; Wein, Sara; Rotstein, Andrew H.; Gorelik, Alexandra

    2017-01-01

    Calf muscle strains have become increasingly prevalent in recent seasons of the Australian Football League (AFL) and represent a significant cause of time lost from competition. The purpose of this study was to examine the association between MRI features of calf muscle strains and games missed and to thereby identify parameters that are of prognostic value. A retrospective analysis of MRI scans of AFL players with calf strains referred to a musculoskeletal radiology clinic over a 5-year period (2008-2012) was performed. The muscle(s) and muscle component affected, the site and size of strain, and the presence of an intramuscular tendon tear or intermuscular fluid were recorded. These data were cross-referenced with whether a player missed at least one game. Imaging features of prognostic value were thus identified. Sixty-three athletes had MRI scans for calf muscle strains. Soleus strains were more common than strains of other muscles. Players with soleus strains were more likely to miss at least one game if they had multiple muscle involvement (p = 0.017), musculotendinous junction strains (p = 0.046), and deep strains (p = 0.036). In a combined analysis of gastrocnemius and soleus strains, intramuscular tendon tears were observed in a significantly greater proportion of players who missed games (p = 0.010). Amongst AFL players with calf injuries, there is an association between missing at least one game and multiple muscle involvement, musculotendinous junction strains, deep strain location, and intramuscular tendon tears. In this setting, MRI may therefore provide prognostic information to help guide return-to-play decisions. (orig.)

  3. MRI assessment of calf injuries in Australian Football League players: findings that influence return to play

    Energy Technology Data Exchange (ETDEWEB)

    Waterworth, George; Wein, Sara; Rotstein, Andrew H. [Victoria House Medical Imaging, Prahran, Victoria (Australia); Gorelik, Alexandra [Royal Melbourne Hospital, University of Melbourne, Melbourne Epicentre, Parkville (Australia)

    2017-03-15

    Calf muscle strains have become increasingly prevalent in recent seasons of the Australian Football League (AFL) and represent a significant cause of time lost from competition. The purpose of this study was to examine the association between MRI features of calf muscle strains and games missed and to thereby identify parameters that are of prognostic value. A retrospective analysis of MRI scans of AFL players with calf strains referred to a musculoskeletal radiology clinic over a 5-year period (2008-2012) was performed. The muscle(s) and muscle component affected, the site and size of strain, and the presence of an intramuscular tendon tear or intermuscular fluid were recorded. These data were cross-referenced with whether a player missed at least one game. Imaging features of prognostic value were thus identified. Sixty-three athletes had MRI scans for calf muscle strains. Soleus strains were more common than strains of other muscles. Players with soleus strains were more likely to miss at least one game if they had multiple muscle involvement (p = 0.017), musculotendinous junction strains (p = 0.046), and deep strains (p = 0.036). In a combined analysis of gastrocnemius and soleus strains, intramuscular tendon tears were observed in a significantly greater proportion of players who missed games (p = 0.010). Amongst AFL players with calf injuries, there is an association between missing at least one game and multiple muscle involvement, musculotendinous junction strains, deep strain location, and intramuscular tendon tears. In this setting, MRI may therefore provide prognostic information to help guide return-to-play decisions. (orig.)

  4. MRI assessment of calf injuries in Australian Football League players: findings that influence return to play.

    Science.gov (United States)

    Waterworth, George; Wein, Sara; Gorelik, Alexandra; Rotstein, Andrew H

    2017-03-01

    Calf muscle strains have become increasingly prevalent in recent seasons of the Australian Football League (AFL) and represent a significant cause of time lost from competition. The purpose of this study was to examine the association between MRI features of calf muscle strains and games missed and to thereby identify parameters that are of prognostic value. A retrospective analysis of MRI scans of AFL players with calf strains referred to a musculoskeletal radiology clinic over a 5-year period (2008-2012) was performed. The muscle(s) and muscle component affected, the site and size of strain, and the presence of an intramuscular tendon tear or intermuscular fluid were recorded. These data were cross-referenced with whether a player missed at least one game. Imaging features of prognostic value were thus identified. Sixty-three athletes had MRI scans for calf muscle strains. Soleus strains were more common than strains of other muscles. Players with soleus strains were more likely to miss at least one game if they had multiple muscle involvement (p = 0.017), musculotendinous junction strains (p = 0.046), and deep strains (p = 0.036). In a combined analysis of gastrocnemius and soleus strains, intramuscular tendon tears were observed in a significantly greater proportion of players who missed games (p = 0.010). Amongst AFL players with calf injuries, there is an association between missing at least one game and multiple muscle involvement, musculotendinous junction strains, deep strain location, and intramuscular tendon tears. In this setting, MRI may therefore provide prognostic information to help guide return-to-play decisions.

  5. Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play

    Science.gov (United States)

    Chu, Samuel K.; Rho, Monica E.

    2016-01-01

    Hamstring injuries are very common in athletes. Acute hamstring strains can occur with high-speed running or with excessive hamstring lengthening. Athletes with proximal hamstring tendinopathy often do not report a specific inciting event; instead they develop the pathology from chronic overuse. A thorough history and examination is important to determine the appropriate diagnosis and rule out other causes of posterior thigh pain. Conservative management of hamstring strains involves a rehabilitation protocol that gradually increases intensity, range of motion and progresses to sport-specific and neuromuscular control exercises. Eccentric strengthening exercises are used for management of proximal hamstring tendinopathy. Studies investigating corticosteroid and platelet-rich plasma injections have mixed results. MRI and ultrasound are effective for identification of hamstring strains and tendinopathy, but have not demonstrated correlation with return to play. The article focuses on diagnosis, treatment and return to play considerations for acute hamstring strains and proximal hamstring tendinopathy in the athlete. PMID:27172083

  6. Social support from the athletic trainer and symptoms of depression and anxiety at return to play.

    Science.gov (United States)

    Yang, Jingzhen; Schaefer, Julie T; Zhang, Ni; Covassin, Tracey; Ding, Kele; Heiden, Erin

    2014-01-01

    Few empirical studies have examined social support from athletic trainers (ATs) and its buffering effect during injury recovery. To examine the effect of social support received from ATs during injury recovery on reported symptoms of depression and anxiety at return to play among a cohort of collegiate athletes. Cohort study. Two Big 10 Conference universities. A total of 594 injuries sustained by 387 collegiate athletes (397 injuries by 256 males, 197 injuries by 131 females) on 9 sports teams. Data were collected during the 2007-2011 seasons. Social support was measured using the 6-item Social Support Questionnaire. Symptoms of depression were assessed using the Center for Epidemiological Studies Depression Scale. Anxiety was measured by the State-Trait Anxiety Inventory. We used generalized estimation equation regression models to examine the effect of the social support from ATs on the odds of symptoms of depression and anxiety at return to play. In 84.3% (n = 501) of injury events, injured athletes received social support from ATs during their recovery. Of these, 264 (53.1%) athletes reported being very satisfied with this social support. Whether or not athletes received social support from ATs during recovery did not affect the symptoms of depression or anxiety experienced at return to play. However, compared with athletes who were dissatisfied with the social support received from ATs, athletes who were very satisfied or satisfied with this social support were 87% (95% confidence interval = 0.06, 0.30) and 70% (95% confidence interval = 0.13, 0.70) less likely to report symptoms of depression at return to play, respectively. Similar results were observed for anxiety. Our findings support the buffering effect of social support from ATs and have important implications for successful recovery in both the physical and psychological aspects for injured athletes.

  7. Variable reporting of functional outcomes and return to play in superior labrum anterior and posterior tear.

    Science.gov (United States)

    Steinhaus, Michael E; Makhni, Eric C; Lieber, Adam C; Kahlenberg, Cynthia A; Gulotta, Lawrence V; Romeo, Anthony A; Verma, Nikhil N

    2016-11-01

    Outcomes assessments after superior labrum anterior and posterior (SLAP) tear/repair are highly varied, making it difficult to draw comparisons across the literature. This study examined the inconsistency in outcomes reporting in the SLAP tear literature. We hypothesize that there is significant variability in outcomes reporting and that although most studies may report return to play, time to return reporting will be highly variable. The PubMed, Medline, Scopus, and Embase databases were systematically reviewed for studies from January 2000 to December 2014 reporting outcomes after SLAP tear/repair. Two reviewers assessed each study, and those meeting inclusion criteria were examined for pertinent data. Outcomes included objective (range of motion, strength, clinical examinations, and imaging) and subjective (patient-reported outcomes, satisfaction, activities of daily living, and return to play) measures. Of the 56 included studies, 43% documented range of motion, 14% reported strength, and 16% noted postoperative imaging. There was significant variation in use of patient-reported outcomes measures, with the 3 most commonly noted measures reported in 20% to 55% of studies. Return to play was noted in 75% of studies, and 23% reported time to return, with greater rates in elite athletes. Eleven studies (20%) did not report follow-up or noted data with <12 months of follow-up. The SLAP literature is characterized by substantial variability in outcomes reporting, with time to return to play noted in few studies. Efforts to standardize outcomes reporting would facilitate comparisons across the literature and improve our understanding of the prognosis of this injury. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. Professional Athletes' Return to Play and Performance After Operative Repair of an Achilles Tendon Rupture.

    Science.gov (United States)

    Trofa, David P; Miller, J Chance; Jang, Eugene S; Woode, Denzel R; Greisberg, Justin K; Vosseller, J Turner

    2017-10-01

    Most Achilles tendon ruptures are sports related. However, few studies have examined and compared the effect of surgical repair for complete ruptures on return to play (RTP), play time, and performance across multiple sports. To examine RTP and performance among professional athletes after Achilles tendon repair and compare pre- versus postoperative functional outcomes of professional athletes from different major leagues in the United States. Cohort study; Level of evidence, 3. National Basketball Association (NBA), National Football League (NFL), Major League Baseball (MLB), and National Hockey League (NHL) athletes who sustained a primary complete Achilles tendon rupture treated surgically between 1989 and 2013 were identified via public injury reports and press releases. Demographic information and performance-related statistics were recorded for 2 seasons before and after surgery and compared with matched controls. Statistical analyses were used to assess differences in recorded metrics. Of 86 athletes screened, 62 met inclusion criteria including 25 NBA, 32 NFL, and 5 MLB players. Nineteen (30.6%) professional athletes with an isolated Achilles tendon rupture treated surgically were unable to return to play. Among athletes who successfully returned to play, game participation averaged 75.4% ( P .05). When individual sports were compared, NBA players were most significantly affected, experiencing significant decreases in games played, play time, and performance. An Achilles tendon rupture is a devastating injury that prevents RTP for 30.6% of professional players. Athletes who do return play in fewer games, have less play time, and perform at a lower level than their preinjury status. However, these functional deficits are seen only at 1 year after surgery compared with matched controls, such that players who return to play can expect to perform at a level commensurate with uninjured controls 2 years postoperatively.

  9. Connective tissue injury in calf muscle tears and return to play: MRI correlation.

    Science.gov (United States)

    Prakash, Ashutosh; Entwisle, Tom; Schneider, Michal; Brukner, Peter; Connell, David

    2017-10-26

    The aim of our study was to assess a group of patients with calf muscle tears and evaluate the integrity of the connective tissue boundaries and interfaces. Further, we propose a novel MRI grading system based on integrity of the connective tissue and assess any correlation between the grading score and time to return to play. We have also reviewed the anatomy of the calf muscles. We retrospectively evaluated 100 consecutive patients with clinical suspicion and MRI confirmation of calf muscle injury. We evaluated each calf muscle tear with MRI for the particular muscle injured, location of injury within the muscle and integrity of the connective tissue structure at the interface. The muscle tears were graded 0-3 depending on the degree of muscle and connective tissue injury. The time to return to play for each patient and each injury was found from the injury records and respective sports doctors. In 100 patients, 114 injuries were detected. Connective tissue involvement was observed in 63 out of 100 patients and failure (grade 3 injury) in 18. Mean time to return to play with grade 0 injuries was 8 days, grade 1 tears was 17 days, grade 2 tears was 25 days and grade 3 tears was 48 days (pmuscle tears. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Return to play in elite rugby union: application of global positioning system technology in return-to-running programs.

    Science.gov (United States)

    Reid, Laura C; Cowman, Jason R; Green, Brian S; Coughlan, Garrett F

    2013-05-01

    Global positioning systems (GPS) are widely used in sport settings to evaluate the physical demands on players in training and competition. The use of these systems in the design and implementation of rehabilitation and return-to-running programs has not yet been elucidated. To demonstrate the application of GPS technology in the management of return to play in elite-club Rugby Union. Case series. Professional Rugby Union club team. 8 elite Rugby Union players (age 27.86 ± 4.78 y, height 1.85 ± 0.08 m, weight 99.14 ± 9.96 kg). Players wore GPS devices for the entire duration of a club game. Variables of locomotion speed and distance were measured. Differences in physical demands between playing positions were observed for all variables. An analysis of the position-specific physical demands measured by GPS provides key information regarding the level and volume of loads sustained by a player in a game environment. Using this information, sports-medicine practitioners can develop rehabilitation and return-to-running protocols specific to the player position to optimize safe return to play.

  11. Return to Play and Patient Satisfaction After ACL Reconstruction: Study with Minimum 2-Year Follow-up.

    Science.gov (United States)

    Nwachukwu, Benedict U; Voleti, Pramod B; Berkanish, Patricia; Chang, Brenda; Cohn, Matthew R; Williams, Riley J; Allen, Answorth A

    2017-05-03

    Return to play and patient satisfaction after anterior cruciate ligament reconstruction (ACLR) have been inconsistently studied. The purposes of this study were to (1) investigate rates and predictors of return to play after ACLR, (2) evaluate patient satisfaction after ACLR, and (3) analyze the relationship between return to play and satisfaction with the result of ACLR. Eligible patients were active athletes included in an institutional ACL registry who had undergone ACLR and had been followed for a minimum of 2 years. A questionnaire was administered to elicit information regarding factors associated with return to play, sports performance, reinjury, and overall patient satisfaction. The Wilcoxon-Mann-Whitney U test was used to compare return to play with patient satisfaction. Multivariable logistic regression was used to identify demographic, sports, and clinical factors associated with return to play. Two hundred and thirty-two patients with a mean age of 26.7 years (standard deviation [SD] = 12.5 years) who had been followed for a mean of 3.7 years were enrolled. Of 231 patients who responded to the return-to-play question, 201 (87.0%) had returned to play, at a mean of 10.1 months; of 175 athletes eligible to return to their prior level of competition, 89.1% had done so. Overall satisfaction was high: 85.4% were very satisfied with the outcome and 98.1% stated that they would have surgery again. Patients were more likely to respond "very satisfied" if they had returned to play (p patient satisfaction are high after ACLR in active athletes. The use of patellar tendon autograft increased the likelihood of returning to play whereas preinjury participation in soccer and lacrosse decreased these odds. Additionally, patients who returned to play were more likely to be very satisfied with the result of the ACLR. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  12. Return to play after hamstring injuries in football (soccer) : A worldwide Delphi procedure regarding definition, medical criteria and decision-making

    NARCIS (Netherlands)

    Van Der Horst, Nick; Backx, F. J.G.; Goedhart, Edwin A.; Huisstede, Bionka M.A.

    2017-01-01

    There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify

  13. Strategic Assessment of Risk and Risk Tolerance (StARRT) framework for return-to-play decision-making.

    Science.gov (United States)

    Shrier, Ian

    2015-10-01

    The sport medicine clinician is faced with return-to-play (RTP) decisions for every patient who wants to return to activity. The complex interaction of factors related to history, physical examination, testing, activity and baseline characteristics can make RTP decision-making challenging. Further, when reasoning is not explicit, unnecessary conflict can arise among clinicians themselves, or among clinicians and patients. This conflict can have negative health consequences for the patient. In 2010, a transparent framework for RTP decisions was proposed. However, some have identified limitations to the framework and found difficulties in its implementation. This paper presents a revised framework that addresses the limitations, and provides concrete examples of how to apply it in simple and complex cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Return to Play and Performance After Jones Fracture in National Basketball Association Athletes

    Science.gov (United States)

    Begly, John P.; Guss, Michael; Ramme, Austin J.; Karia, Raj; Meislin, Robert J.

    2015-01-01

    Background: Basketball players are at risk for foot injuries, including Jones fractures. It is unknown how this injury affects the future play and performance of athletes. Hypothesis: National Basketball Association (NBA) players who sustain Jones fractures of the base of the fifth metatarsal have high rates of return to play and do not experience a decrease in performance on return to competition when compared with preinjury and with control-matched peers. Study Design: Retrospective cohort study. Level of Evidence: Level 5. Methods: Data on 26 elite basketball players with Jones fractures over 19 NBA seasons (1994-1995 to 2012-2013) were obtained from injury reports, press releases, player profiles, and online public databases. Variables included age, body mass index (BMI), player position, experience, and surgical treatment. Individual season statistics pre- and postinjury were collected. Twenty-six controls were identified by matched player position, age, and performance statistics. Results: The mean age at the time of injury was 24.8 years, mean BMI was 24.7 kg/m2, and the mean experience prior to injury was 4.1 NBA seasons. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and postinjury performance was compared. When compared with controls, no decline in PER measured performance was identified. Conclusion: The majority of NBA players sustaining a Jones fracture return to their preinjury level of competition. These elite athletes demonstrate no decrease in performance on their return to play. Clinical Relevance: Jones fractures are well-studied injuries in terms of etiology, diagnosis, and management. However, the effect of these injuries on future performance of athletes is unknown. Using the findings of our study, orthopaedic surgeons may be better prepared to counsel and educate elite athletes who sustain a Jones fracture. PMID:26627111

  15. Return to Play and Performance After Jones Fracture in National Basketball Association Athletes.

    Science.gov (United States)

    Begly, John P; Guss, Michael; Ramme, Austin J; Karia, Raj; Meislin, Robert J

    2016-07-01

    Basketball players are at risk for foot injuries, including Jones fractures. It is unknown how this injury affects the future play and performance of athletes. National Basketball Association (NBA) players who sustain Jones fractures of the base of the fifth metatarsal have high rates of return to play and do not experience a decrease in performance on return to competition when compared with preinjury and with control-matched peers. Retrospective cohort study. Level 5. Data on 26 elite basketball players with Jones fractures over 19 NBA seasons (1994-1995 to 2012-2013) were obtained from injury reports, press releases, player profiles, and online public databases. Variables included age, body mass index (BMI), player position, experience, and surgical treatment. Individual season statistics pre- and postinjury were collected. Twenty-six controls were identified by matched player position, age, and performance statistics. The mean age at the time of injury was 24.8 years, mean BMI was 24.7 kg/m(2), and the mean experience prior to injury was 4.1 NBA seasons. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and postinjury performance was compared. When compared with controls, no decline in PER measured performance was identified. The majority of NBA players sustaining a Jones fracture return to their preinjury level of competition. These elite athletes demonstrate no decrease in performance on their return to play. Jones fractures are well-studied injuries in terms of etiology, diagnosis, and management. However, the effect of these injuries on future performance of athletes is unknown. Using the findings of our study, orthopaedic surgeons may be better prepared to counsel and educate elite athletes who sustain a Jones fracture. © 2015 The Author(s).

  16. Arthroscopic Shoulder Surgery in Female Professional Tennis Players: Ability and Timing to Return to Play.

    Science.gov (United States)

    Young, Simon W; Dakic, Jodie; Stroia, Kathleen; Nguyen, Michael L; Safran, Marc R

    2017-07-01

    To assess the outcome and time to return to previous level of competitive play after shoulder surgery in professional tennis players. Retrospective case series. Tertiary academic centre. The records of all female tennis players on the Women's Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Primary outcomes were the ability and time to return to professional play and if they were able to return to their previous level of function as determined by singles ranking. Preoperative and postoperative singles rankings were used to determine rate and completeness of return to preoperative function. During the study period, 8 professional women tennis players from the WTA tour underwent shoulder surgery on their dominant arm. Indications included rotator cuff debridement or repair, labral reconstruction for instability or superior labral anterior posterior lesion, and neurolysis of the suprascapular nerve. Seven players (88%) returned to professional play. The mean time to return to play was 7 months after surgery. However, only 25% (2 of 8) players achieved their preinjury singles rank or better by 18 months postoperatively. In total, 4 players returned to their preinjury singles ranking, with their peak singles ranking being attained at a mean of 2.4 years postoperatively. In professional female tennis players, a high return to play rate after arthroscopic shoulder surgery is associated with a prolonged and often incomplete return to previous level of performance. Thus, counseling the patient to this fact is important to manage expectations. Level IV-Case Series.

  17. Active release technique in hamstrings strain: Rehabilitation and return to play – a case study

    Directory of Open Access Journals (Sweden)

    Hariharasudhan Ravichandran

    2017-01-01

    Full Text Available Hamstring injuries and its rehabilitation in competitive events such as football targets safe and early return to play. This is because hamstring injuries are more related to prolonged recovery time and high rate of re-injury. In this case study, Zakeer Mundampara, 26-year-old footballer of Chennaiyin FC team (Indian super league tournament, who was rehabilitated for Grade 2 hamstring strain was briefed. To describe the importance of conservative rehabilitation in hamstring injuries and report on player's rehabilitation program and clinical outcome. Zakeer Mundampara was conservatively treated with active release technique for 2 weeks duration. Data collected includes passive knee extension test range of motion and verbal rating score. After 2 weeks of rehabilitation, Zakeer Mundampara had nearly full range of pain-free movement, normal gait and trained to run safely. By the 3rd week, he started to perform all sports specific drills. He was rehabilitated and set fit to play after 4 weeks from the date of injury. Active release technique is effective in hamstring injuries. In this case study, rehabilitation program with an emphasis on active release technique is found to be effective in returning the footballer back to play.

  18. Return to play criteria after hamstring muscle injury in professional football: a Delphi consensus study.

    Science.gov (United States)

    Zambaldi, Mattia; Beasley, Ian; Rushton, Alison

    2017-08-01

    Hamstring muscle injury (HMI) is the most common injury in professional football and has a high re-injury rate. Despite this, there are no validated criteria to support return to play (RTP) decisions. To use the Delphi method to reach expert consensus on RTP criteria after HMI in professional football. All professional football clubs in England (n=92) were invited to participate in a 3-round Delphi study. Round 1 requested a list of criteria used for RTP decisions after HMI. Responses were independently collated by 2 researchers under univocal definitions of RTP criteria. In round 2 participants rated their agreement for each RTP criterion on a 1-5 Likert Scale. In round 3 participants re-rated the criteria that had reached consensus in round 2. Descriptive statistics and Kendall's coefficient of concordance enabled interpretation of consensus. Participation rate was limited at 21.7% (n=20), while retention rate was high throughout the 3 rounds (90.0%, 85.0%, 90.0%). Round 1 identified 108 entries with varying definitions that were collated into a list of 14 RTP criteria. Rounds 2 and 3 identified 13 and 12 criteria reaching consensus, respectively. Five domains of RTP assessment were identified: functional performance, strength, flexibility, pain and player's confidence. The highest-rated criteria were in the functional performance domain, with particular importance given to sprint ability. This study defined a list of consensually agreed RTP criteria for HMI in professional football. Further work is now required to determine the validity of the identified criteria. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion.

    Science.gov (United States)

    Stone, Sarah; Lee, Bobby; Garrison, J Craig; Blueitt, Damond; Creed, Kalyssa

    2016-10-03

    Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Retrospective cohort study. Level 3. A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non-sport-related activity were excluded. Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, ages 11 to 20 years, with regard to initiation of an RTP progression after SRC. Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population. © 2016 The Author(s).

  20. Recurrent stingers in an adolescent American football player: dilemmas of return to play. A case report and review of the literature.

    Science.gov (United States)

    Zaremski, Jason L; Horodyski, MaryBeth; Herman, Daniel C

    2017-01-01

    We present the case of a 16-year-old football linebacker with a history of recurrent stingers. Initial physical examination was normal as were cervical spine radiographs. MRI of the cervical spine revealed relative stenosis. Electrodiagnostic testing revealed chronic bilateral neurogenic changes of the superior trunk of the brachial plexus. A Kerr Collar was obtained to minimize head acceleration and force transmission through the neck. While there are return-to-play guidelines for recurrent stingers, there are inconsistencies with those recommendations. Our case highlights the challenges in contact sport athletes with recurrent stingers.

  1. Complete avulsion of the adductor longus in a semi-professional football player: Rapid return to play with nonoperative treatment

    Directory of Open Access Journals (Sweden)

    Vince W Lands

    2016-01-01

    Full Text Available The adductor longus has become recognized as one of the more commonly injured muscles in the medial compartment. Acute complete rupture injuries occurring at the proximal aspect of the muscle are less common. Limited data exist regarding management of the injuries in athletes required for return to play and functioning. The current data favors operative management; however, nonoperative treatment may be a viable option. Nonoperative management of avulsion injuries of the proximal adductor longus tendon may prove equal results to surgical repair in return to play and functioning. A semi-professional football player sustained a left groin injury while participating in the play. Due to continued pain, swelling, and suspicion of injury, a magnetic resonance imaging was performed diagnosing a complete tear of proximal adductor longus tendon. Physical examination, strength, and range of motion were recorded until the patient was able to function normally without strength deficit, the range of motion loss, and the return of speed. The player was treated nonoperatively and was eventually allowed to return to play. The time of return to play was 6 weeks. Strength deficit was not appreciated or loss of motion and player was able to return to baseline function. Nonoperative management of complete avulsion injuries of the proximal adductor longus tendon result in faster return to play than operative management even if significant retraction is present.

  2. Femoroacetabular Impingement in Professional Football Players: Return to Play and Predictors of Career Length After Hip Arthroscopy.

    Science.gov (United States)

    Menge, Travis J; Bhatia, Sanjeev; McNamara, Shannen C; Briggs, Karen K; Philippon, Marc J

    2017-07-01

    Previous studies have shown hip arthroscopy to be a highly effective treatment for symptomatic femoroacetabular impingement (FAI) in a wide range of athletes; however, the rate of return to play and length of career after hip arthroscopy in professional football players are unknown. To determine how many athletes returned to professional football and the number of seasons they played after surgery. Case series; Level of evidence, 4. Fifty-one professional football players (60 hips) underwent hip arthroscopy for FAI between 2000 and 2014 by a single surgeon. Return to play was defined as competing in a preseason or regular season professional football game after surgery. Data were retrospectively obtained for each player from NFL.com , ESPN.com , individual team websites, and/or CFL.ca . We found that 87% (52/60) of the arthroscopic procedures allowed professional football players to return to play in a preseason or regular season game. Athletes who returned played an average of 38 games during 3.2 seasons after arthroscopy, with an average total career length of 7.4 seasons. Ninety-two percent (48/52) of players who returned had a minimum total career length of 3 years. When participants were analyzed by position, linemen were less likely to return after hip arthroscopy compared with other players (odds ratio 5.6; 95% CI, 1.1-35; P = .04). All quarterbacks and tight ends returned to play after surgery. No significant difference in return to play rate was found between athletes who underwent microfracture and those who did not (25% vs 38%, P = .698). Hip arthroscopy for treatment of FAI and associated pathologic abnormalities in professional football players resulted in a high rate of return to play. The study's findings demonstrate that 87% of the arthroscopic procedures allowed professional football players to return to play, linemen were less likely to return compared with other positions, and the presence of microfracture did not significantly affect the return

  3. Intramuscular tendon involvement on MRI has limited value for predicting time to return to play following acute hamstring injury

    NARCIS (Netherlands)

    van der Made, Anne D.; Almusa, Emad; Whiteley, Rod; Hamilton, Bruce; Eirale, Cristiano; van Hellemondt, Frank; Tol, Johannes L.

    2018-01-01

    Background Hamstring injury with intramuscular tendon involvement is regarded as a serious injury with a delay in return to play (RTP) of more than 50 days and reinjury rates up to 63%. However, this reputation is based on retrospective case series with high risk of bias. Objective Determine whether

  4. Concussion Assessment in California Community College Football: Athletic Trainers' Strides toward a Safer Return to Play

    Science.gov (United States)

    Chinn, Nancy Resendes

    2010-01-01

    The purpose of this mixed method study was to compare current practices of athletic trainers in the management of concussion in football at California Community Colleges (CCC) with the concussion management guidelines set forth by the National Athletic Trainers Association (NATA). The study also set out to gain understanding of why some athletic…

  5. Return to play after an initial or recurrent concussion in a prospective study of physician-observed junior ice hockey concussions: implications for return to play after a concussion.

    Science.gov (United States)

    Echlin, Paul Sean; Tator, Charles H; Cusimano, Michael D; Cantu, Robert C; Taunton, Jack E; Upshur, Ross E G; Czarnota, Michael; Hall, Craig R; Johnson, Andrew M; Forwell, Lorie A; Driediger, Molly; Skopelja, Elaine N

    2010-11-01

    The authors investigated return-to-play duration for initial and recurrent concussion in the same season in 2 teams of junior (16-21-year-old) ice hockey players during a regular season. The authors conducted a prospective cohort study during 1 junior regular season (2009-2010) of 67 male fourth-tier ice hockey players (mean age 18.2 ± 1.2 years [SD], range 16-21 years) from 2 teams. Prior to the start of the season, every player underwent baseline assessments that were determined using the Sideline Concussion Assessment Tool 2 (SCAT2) and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). The study protocol also required players who entered the study during the season to complete a baseline SCAT2 and ImPACT. If the protocol was not followed, the postinjury test results of a player without true baseline test results were compared with previously established age- and sex-matched group normative levels. Each game was directly observed by a physician and at least 1 neutral nonphysician observer. Players suspected of suffering a concussion were evaluated by the physician during the game. If a concussion was diagnosed, the player underwent clinical evaluation at the physician's office within 24 hours. The return-to-play decision was based on clinical evaluation guided by the Zurich return-to-play protocol (contained in the consensus statement of international expert opinion at the 3rd International Conference on Concussion in Sport held in Zurich, November 2008). This clinical evaluation and return-to-play protocol was augmented by the 2 tests (SCAT2 and ImPACT) also recommended by the Zurich consensus statement, for which baseline values had been obtained. Seventeen players sustained a physician-observed or self-reported, physician-diagnosed concussion during a physician-observed ice hockey game. The mean clinical return-to-play duration (in 15 cases) was 12.8 ± 7.02 days (median 10 days, range 7-29 days); the mean number of physician office visits

  6. A Functional Return-to-Play Progression After Exertional Heat Stroke in a High School Football Player.

    Science.gov (United States)

    Lopez, Rebecca M; Tanner, Patrick; Irani, Sarah; Mularoni, P Patrick

    2018-03-01

      To present a functional return-to-play (RTP) progression after exertional heat stroke (EHS) in a 17-year-old high school football defensive end (height = 185 cm, mass = 145.5 kg).   The patient had no pertinent medical history but moved to a warm climate several days before the EHS occurred. After completing an off-season conditioning test (14- × 110-yd [12.6- × 99.0-m] sprints) on a warm afternoon (temperature = approximately 34°C [93°F], relative humidity = 53%), the patient collapsed. An athletic trainer (AT) was called to the field, where he found the patient conscious but exhibiting central nervous system dysfunction. Emergency medical services were summoned and immediately transported the patient to the hospital.   Exertional heat stroke, heat exhaustion, exertional sickling, rhabdomyolysis, and cardiac arrhythmia.   The patient was immediately transported to a hospital, where his oral temperature was 39.6°C (103.3°F). He was transferred to a children's hospital and treated for rhabdomyolysis, transaminitis, and renal failure. He was hospitalized for 11 days. After a physician's clearance once the laboratory results normalized, an RTP progression was completed. The protocol began with light activity and progressed over 3 weeks to full football practice. During activity, an AT monitored the patient's gastrointestinal temperature, heart rate, rating of perceived exertion, fluid consumption, and sweat losses.   Documentation of RTP guidelines for young athletes is lacking. We used a protocol intended for the football setting to ensure the athlete was heat tolerant, had adequate physical fitness, and could safely RTP. Despite his EHS, he recovered fully, with no lasting effects, and successfully returned to compete in the final 5 games of the season.   Using a gradual RTP progression and close monitoring, a high school defensive end successfully returned to football practice and games after EHS. This case demonstrates the feasibility of

  7. Concussion Incidence and Return-to-Play Time in National Basketball Association Players: Results From 2006 to 2014.

    Science.gov (United States)

    Padaki, Ajay S; Cole, Brian J; Ahmad, Christopher S

    2016-09-01

    Various research efforts have studied concussions in the National Football League, Major League Baseball, and the National Hockey League. However, no study has investigated the incidence and return-to-play trends in the National Basketball Association (NBA), which this study aims to do. Increased media scrutiny and public awareness, in addition to the institution of a league-wide concussion protocol, may have resulted in more conservative return-to-play practices. Descriptive epidemiology study. All concussions to NBA players that were publicly reported in the media from the beginning of the 2006 NBA season to the end of the 2014 season were included. The incidence and return-to-play statistics were generated by synthesizing information from publicly available records. There were 134 publicly reported concussions to NBA players from the beginning of the 2006 season to the conclusion of the 2014 season, resulting in an average of 14.9 concussions per season. The incidence has not changed significantly during this time span. The average games missed after a concussion from 2006 to 2010 was 1.6, significantly less than the 5.0 games missed from 2011 to 2014, following the institution of the NBA concussion protocol (P = .023). Although the incidence of publicly reported concussions in the NBA has not changed appreciably over the past 9 seasons, the time missed after a concussion has. While players often returned in the same game in the 2006 season, the combination of implemented policy, national coverage, medical staff awareness, and player education may have contributed to players now missing an average of 4 to 6 games after a concussion. A multitude of factors has resulted in more conservative return-to-play practices for NBA players after concussions. © 2016 The Author(s).

  8. Return to Play and Decreased Performance After Anterior Cruciate Ligament Reconstruction in National Football League Defensive Players.

    Science.gov (United States)

    Read, Connor R; Aune, Kyle T; Cain, E Lyle; Fleisig, Glenn S

    2017-07-01

    Anterior cruciate ligament (ACL) injuries occur commonly in football. Recent work has reported ACL reconstruction (ACLR) as one of several orthopaedic procedures with unfavorable outcomes for professional athletes. The performance impact to defensive players after surgery has not been quantified. To quantify the effect of ACLR on the performance of defensive players by comparing them to a cohort of matched controls as well as to measure the effect of ACLR on athletes' career length in the National Football League (NFL). Case-control and cohort study; Level of evidence, 3. Thirty-eight NFL defensive players with a history of ACLR from 2006 to 2012 were identified. For each injured player, a matched control player was identified. Demographic and performance statistics were collected from the online NFL player database. Players who returned after ACLR (n = 23) were compared with players who did not return (n = 15) using t tests and chi-squared analyses. Similarly, players who returned after ACLR (n = 23) were compared with their matched controls with t tests and chi-squared analyses. Two-way repeated-measures analysis of variance was utilized to test for significant differences between performance before and after the season of the injury for the players in the ACLR group who returned (n = 23) and for their matched controls. Kaplan-Meier analysis was performed to test for differences in the rate of retirement between the groups. For all analyses, P values <.05 were considered significant. Approximately 74% (28/38) of athletes who underwent ACLR returned to play at least 1 NFL game, and 61% (23/38) successfully returned to play at least half a season (ie, 8 games). Athletes in the ACLR group who returned retired from the NFL significantly sooner and more often after surgery than their matched controls. In the seasons leading up to their injury, athletes who successfully returned to play started a greater percentage of their games (81%) and made more solo tackles per

  9. Determinants of Return to Play After the Nonoperative Management of Hamstring Injuries in Athletes: A Systematic Review.

    Science.gov (United States)

    Fournier-Farley, Camille; Lamontagne, Martin; Gendron, Patrick; Gagnon, Dany H

    2016-08-01

    It is important for clinicians to rely on suitable prognosis factors after hamstring injuries because of the high incidence of these injuries and time away from athletic activities. To summarize the current literature on factors that influence return to play after a hamstring injury in athletes. Systematic review. A computer-assisted literature search of CINAHL, MEDLINE, Embase, and EBM Reviews databases (and a manual search of the reference lists of all selected articles) was conducted using keywords related to hamstring injuries and return to play. The literature review criteria included (1) patients with an acute hamstring or posterior thigh injury; (2) a randomized controlled trial, cohort study, case-control study, case series, or prospective or retrospective design; (3) information on rehabilitation, physical therapy, clinical assessment, imaging techniques, and return to play; and (4) studies written in English or French. The search strategy identified 914 potential articles, of which 24 met the inclusion criteria. In terms of the clinical assessment, the following factors were associated with a longer recovery time: stretching-type injuries, recreational-level sports, structural versus functional injuries, greater range of motion deficit with the hip flexed at 90°, time to first consultation >1 week, increased pain on the visual analog scale, and >1 day to be able to walk pain free after the injury. As for magnetic resonance imaging studies, the following factors correlated with a longer recovery time: positive findings; higher grade of injury; muscle involvement >75%; complete transection; retraction; central tendon disruption of the biceps femoris; proximal tendon involvement; shorter distance to the ischial tuberosity; length of the hamstring injury; and depth, volume, and large cross-sectional area. With respect to ultrasound studies, the following factors were associated with a poor prognosis: large cross-sectional area, injury outside the

  10. Return to Play After Shoulder Instability Surgery in National Collegiate Athletic Association Division I Intercollegiate Football Athletes.

    Science.gov (United States)

    Robins, R Judd; Daruwalla, Jimmy H; Gamradt, Seth C; McCarty, Eric C; Dragoo, Jason L; Hancock, Robert E; Guy, Jeffrey A; Cotsonis, George A; Xerogeanes, John W; Tuman, Jeffrey M; Tibone, James E; Javernick, Matthew A; Yochem, Eric M; Boden, Stephanie A; Pilato, Alexis; Miley, Jennifer H; Greis, Patrick E

    2017-08-01

    Recent attention has focused on the optimal surgical treatment for recurrent shoulder instability in young athletes. Collision athletes are at a higher risk for recurrent instability after surgery. To evaluate variables affecting return-to-play (RTP) rates in Division I intercollegiate football athletes after shoulder instability surgery. Case series; Level of evidence, 4. Invitations to participate were made to select sports medicine programs that care for athletes in Division I football conferences (Pac-12 Conference, Southeastern Conference [SEC], Atlantic Coast Conference [ACC]). After gaining institutional review board approval, 7 programs qualified and participated. Data on direction of instability, type of surgery, time to resume participation, and quality and level of play before and after surgery were collected. There were 168 of 177 procedures that were arthroscopic surgery, with a mean 3.3-year follow-up. Overall, 85.4% of players who underwent arthroscopic surgery without concomitant procedures returned to play. Moreover, 15.6% of athletes who returned to play sustained subsequent shoulder injuries, and 10.3% sustained recurrent instability, resulting in reduction/revision surgery. No differences were noted in RTP rates in athletes who underwent anterior labral repair (82.4%), posterior labral repair (92.9%), combined anterior-posterior repair (84.8%; P = .2945), or open repair (88.9%; P = .9362). Also, 93.3% of starters, 95.4% of utilized players, and 75.7% of rarely used players returned to play. The percentage of games played before the injury was 49.9% and rose to 71.5% after surgery ( P surgery. Scholarship status significantly correlated with RTP after surgery ( P = .0003). The majority of surgical interventions were isolated arthroscopic stabilization procedures, with no statistically significant difference in RTP rates when concomitant arthroscopic procedures or open stabilization procedures were performed. Athletes who returned to play often

  11. Systematic review of prognosis and return to play after sport concussion: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.

    Science.gov (United States)

    Cancelliere, Carol; Hincapié, Cesar A; Keightley, Michelle; Godbolt, Alison K; Côté, Pierre; Kristman, Vicki L; Stålnacke, Britt-Marie; Carroll, Linda J; Hung, Ryan; Borg, Jörgen; Nygren-de Boussard, Catharina; Coronado, Victor G; Donovan, James; Cassidy, J David

    2014-03-01

    To synthesize the best available evidence on prognosis after sport concussion. MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "sports." Reference lists of eligible articles were also searched. Randomized controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 concussion cases. Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. Evidence was synthesized qualitatively according to modified SIGN criteria, and studies were categorized as exploratory or confirmatory based on the strength of their design and evidence. After 77,914 records were screened, 52 articles were eligible for this review, and 24 articles (representing 19 studies) with a low risk of bias were accepted. Our findings are based on exploratory studies of predominantly male football players at the high school, collegiate, and professional levels. Most athletes recover within days to a few weeks, and American and Australian professional football players return to play quickly after mild traumatic brain injury. Delayed recovery appears more likely in high school athletes, in those with a history of previous concussion, and in those with a higher number and duration of postconcussion symptoms. The evidence concerning sports concussion course and prognosis is very preliminary, and there is no evidence on the effect of return-to-play guidelines on prognosis. Our findings have implications for further research. Well-designed, confirmatory studies are urgently needed to understand the consequences of sport concussion, including recurrent concussion, across different athletic populations and sports. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights

  12. Return to Play and Future ACL Injury Risk Following ACL Reconstruction In Soccer Athletes From the MOON Group

    Science.gov (United States)

    Brophy, Robert H.; Schmitz, Leah; Wright, Rick W.; Dunn, Warren R.; Parker, Richard D.; Andrish, Jack T.; McCarty, Eric C.; Spindler, Kurt P.

    2013-01-01

    Background There is limited information on outcomes and return to play (RTP) after ACL reconstruction (ACLR) in soccer athletes. Hypothesis The purpose of this study was to (i) test the hypotheses that player sex, side of injury and graft choice do not influence RTP, and (ii) define the risk for future ACL injury in soccer players after ACLR. Study design Retrospective cohort study, Level II. Methods Soccer players in a prospective cohort were contacted to determine RTP following ACLR. Information regarding if and when they returned to play, their current playing status, the primary reason they stopped playing soccer (if relevant) and incidence of subsequent ACL surgery was recorded. Results Initially, 72% of 100 soccer athletes (55 male, 45 female) with a mean age of 24.2 years at the time of ACL reconstruction returned to soccer. At average follow up of 7.0 years, 36% were still playing, a significant decrease compared to initial RTP (psoccer athletes had undergone further ACL surgery, including 9 on the contralateral knee and 3 on the ipsilateral knee. In a univariate analysis, females were more likely to have future ACL surgery (20% v. 5.5%, p=0.03). Soccer athletes who underwent ACLR on their non-dominant limb had a higher future rate of contra-lateral ACLR (16%) than soccer athletes who underwent ACLR on their dominant limb (3.5%) (p=0.03). Conclusion Younger and male soccer players are more likely to return to play after ACL reconstruction. Return to soccer following ACLR declines over time. PMID:23002201

  13. Return to Play

    Science.gov (United States)

    Mangan, Marianne

    2013-01-01

    Call it physical activity, call it games, or call it play. Whatever its name, it's a place we all need to return to. In the physical education, recreation, and dance professions, we need to redesign programs to address the need for and want of play that is inherent in all of us.

  14. Negative psychological responses of injury and rehabilitation adherence effects on return to play in competitive athletes: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ivarsson A

    2017-03-01

    Full Text Available Andreas Ivarsson,1 Ulrika Tranaeus,2,3 Urban Johnson,1 Andreas Stenling 4 1Center of Research on Welfare, Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, 2Performance and Training Unit, The Swedish School of Sport and Health Sciences (GIH, 3Musculoskeletal & Sports Injury Epidemiology Center, IMM, Karolinska Institutet, Stockholm, 4Department of Psychology, Umeå University, Umeå, Sweden Abstract: Previous research offers evidence that psychological factors influence an injured athlete during the rehabilitation process. Our first objective was to conduct a systematic review and meta-analysis of the results from all published studies that examined the relationships among negative affective responses after sport injuries, rehabilitation adherence, and return to play (RTP. The second objective was to use a meta-analytic path analysis to investigate whether an indirect effect existed between negative affective responses and RTP through rehabilitation adherence. This literature review resulted in seven studies providing 14 effect sizes. The results from the meta-analysis showed that negative affective responses had a negative effect on successful RTP, whereas rehabilitation adherence had a positive effect on RTP. The results from the meta-analytic path analysis showed a weak and nonsignificant indirect effect of negative affective responses on RTP via rehabilitation adherence. These results underline the importance of providing supportive environments for injured athletes to increase the chances of successful RTP via a decrease in negative affective responses and increase in rehabilitation adherence. Keywords: affective responses, rehabilitation behaviors, return to play, sport injuries

  15. Hamstring Injuries in Professional Soccer Players: Extent of MRI-Detected Edema and the Time to Return to Play.

    Science.gov (United States)

    Crema, Michel D; Godoy, Ivan R B; Abdalla, Rene J; de Aquino, Jose Sanchez; Ingham, Sheila J McNeill; Skaf, Abdalla Y

    Discrepancies exist in the literature regarding the association of the extent of injuries assessed on magnetic resonance imaging (MRI) with recovery times. MRI-detected edema in grade 1 hamstring injuries does not affect the return to play (RTP). Retrospective cohort study. Level 4. Grade 1 hamstring injuries from 22 professional soccer players were retrospectively reviewed. The extent of edema-like changes on fluid-sensitive sequences from 1.5-T MRI were evaluated using craniocaudal length, percentage of cross-sectional area, and volume. The time needed to RTP was the outcome. Negative binomial regression analysis tested the measurements of MRI-detected edema-like changes as prognostic factors. The mean craniocaudal length was 7.6 cm (SD, 4.9 cm; range, 0.9-19.1 cm), the mean percentage of cross-sectional area was 23.6% (SD, 20%; range, 4.4%-89.6%), and the mean volume was 33.1 cm 3 (SD, 42.6 cm 3 ; range, 1.1-161.3 cm 3 ). The mean time needed to RTP was 13.6 days (SD, 8.9 days; range, 3-32 days). None of the parameters of extent was associated with RTP. The extent of MRI edema in hamstring injuries does not have prognostic value. Measuring the extent of edema in hamstring injuries using MRI does not add prognostic value in clinical practice.

  16. Significance of T2 Hyperintensity on Magnetic Resonance Imaging After Cervical Cord Injury and Return to Play in Professional Athletes.

    Science.gov (United States)

    Tempel, Zachary J; Bost, Jeffrey W; Norwig, John A; Maroon, Joseph C

    2015-07-01

    Cervical cord magnetic resonance imaging (MRI) T2 hyperintensity is used as evidence of cord trauma in the evaluation and management of athletes in contact sports. The long-term pathophysiologic and prognostic value of this finding is poorly understood, especially in return to play (RTP). To examine the significance of T2 hyperintensity in the cervical spinal cord of professional athletes. Retrospective review of MRI T2 hyperintensity findings between 2007 and 2014 in 5 professional athletes. Pertinent examination and demographics, including mechanism of injury, surgical intervention, radiographs, MRI studies, long-term outcomes, and RTP recommendations were collected. Four National Football League players and 1 professional wrestler had prior traumatic neurapraxia that at the time of initial consultation had resolved. MRIs showed congenitally small cervical canal (1) and multilevel spondylosis/stenosis/disc herniation (4) along with focal cord T2 hyperintensity (5). The signal abnormalities were at C3/C4 (3), C4 mid-vertebral body (1), and C5/C6 (1). Four athletes had single-level anterior cervical discectomy and fusion, and 1 was nonoperative. Serial MRI imaging at 3 months after surgery showed hyperintensity partially resolved (4) and unchanged (1), and at 9-months 3 of the 5 completely resolved. Based on the author's RTP criteria, 4 of 5 were released to return to their sport. Clearance for RTP preceded complete resolution of MRI T2 hyperintensity in 3 of 4 athletes. The 2 athletes that have returned to profession sport have not had any additional episodes of neurapraxia or any cervical spine-related complications. MRI T2 hyperintensity in contact sport athletes who are symptom-free with normal examination and no evidence of spinal instability may not be a contraindication to RTP. Additional observations are needed to confirm this observation.

  17. Intramuscular tendon involvement on MRI has limited value for predicting time to return to play following acute hamstring injury.

    Science.gov (United States)

    van der Made, Anne D; Almusa, Emad; Whiteley, Rod; Hamilton, Bruce; Eirale, Cristiano; van Hellemondt, Frank; Tol, Johannes L

    2018-01-01

    Hamstring injury with intramuscular tendon involvement is regarded as a serious injury with a delay in return to play (RTP) of more than 50 days and reinjury rates up to 63%. However, this reputation is based on retrospective case series with high risk of bias. Determine whether intramuscular tendon involvement is associated with delayed RTP and elevated rates of reinjury. MRI of male athletes with an acute hamstring injury was obtained within 5 days of injury. Evaluation included standardised MRI scoring and scoring of intramuscular tendon involvement. Time to RTP and reinjury rate were prospectively recorded. Out of 70 included participants, intramuscular tendon disruption was present in 29 (41.4%) injuries. Injuries without intramuscular tendon disruption had a mean time to RTP of 22.2±7.4 days. Injuries with Injuries with full-thickness disruption took longer to RTP compared with injuries without disruption (p=0.025). Longitudinal intramuscular tendon disruption was not significantly associated with time to RTP. Waviness was present in 17 (24.3%) injuries. Mean time to RTP for injuries without and with waviness was 22.6±7.5 and 30.2±10.8 days (p=0.014). There were 11 (15.7%) reinjuries within 12 months, five (17.2%) in the group with intramuscular tendon disruption and six (14.6%) in the group without intramuscular tendon disruption. Time to RTP for injuries with full-thickness disruption of the intramuscular tendon and waviness is significantly longer (by slightly more than 1 week) compared with injuries without intramuscular tendon involvement. However, due to the considerable overlap in time to RTP between groups with and without intramuscular tendon involvement, its clinical significance for the individual athlete is limited. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Return-to-Play and Performance Outcomes of Professional Athletes in North America After Hip Arthroscopy From 1999 to 2016.

    Science.gov (United States)

    Schallmo, Michael S; Fitzpatrick, Thomas H; Yancey, Hunter B; Marquez-Lara, Alejandro; Luo, T David; Stubbs, Allston J

    2018-05-01

    The effect of hip arthroscopy on athletic performance compared with preinjury levels for professional athletes in different sports remains unknown. In addition, while return rates have been reported for professional baseball, football, and hockey players, return rates have not been reported for professional basketball players. Professional athletes in 4 major North American sports would be able to return to their sport and preoperative level of performance at a high rate after arthroscopic hip surgery. Descriptive epidemiology study. Major League Baseball (MLB), National Basketball Association (NBA), National Football League (NFL), and National Hockey League (NHL) athletes who underwent hip arthroscopy were identified through a previously reported protocol based on public sources. Successful return to play (RTP) was defined as returning for at least 1 professional regular season game after surgery. Performance scores were calculated by use of previously established scoring systems. Each player served as his own control, with the season prior to surgery defined as baseline. To make comparisons across sports, the authors adjusted for expected season and career length differences between sports and calculated percentage changes in performance. The authors identified 227 procedures performed on 180 professional athletes between 1999 and 2016. Successful RTP was achieved in 84.6% (192/227) of the procedures. Compared with all other athletes, NBA athletes returned at a similar rate (85.7%, P ≥ .999). NFL offensive linemen returned at a significantly lower rate than all other athletes (61.1%, P = .010). NHL athletes returned at a significantly higher rate than all other athletes (91.8%, P = .048) and demonstrated significantly decreased performance during postoperative season 1 compared with baseline (-35.1%, P = .002). Lead leg surgery for MLB athletes (batting stance for hitters, pitching stance for pitchers) resulted in a 12.7% reduction in hitter performance score

  19. Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making.

    Science.gov (United States)

    van der Horst, Nick; Backx, Fjg; Goedhart, Edwin A; Huisstede, Bionka Ma

    2017-11-01

    There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify RTP consultation and responsibilities after hamstring injury. The study used the Delphi procedure. The results of a systematic review were used as a starting point for the Delphi procedure. Fifty-eight experts in the field of hamstring injury management selected by 28 FIFA Medical Centres of Excellence worldwide participated. Each Delphi round consisted of a questionnaire, an analysis and an anonymised feedback report. After four Delphi rounds, with more than 83% response for each round, consensus was achieved that RTP should be defined as 'the moment a player has received criteria-based medical clearance and is mentally ready for full availability for match selection and/or full training'. The experts reached consensus on the following criteria to support the RTP decision: medical staff clearance, absence of pain on palpation, absence of pain during strength and flexibility testing, absence of pain during/after functional testing, similar hamstring flexibility, performance on field testing, and psychological readiness. It was also agreed that RTP decisions should be based on shared decision-making, primarily via consultation with the athlete, sports physician, physiotherapist, fitness trainer and team coach. The consensus regarding aspects of RTP should provide clarity and facilitate the assessment of when RTP is appropriate after hamstring injury, so as to avoid or reduce the risk of injury recurrence because of a premature RTP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player's risk of subsequent injury.

    Science.gov (United States)

    Blanch, Peter; Gabbett, Tim J

    2016-04-01

    The return to sport from injury is a difficult multifactorial decision, and risk of reinjury is an important component. Most protocols for ascertaining the return to play status involve assessment of the healing status of the original injury and functional tests which have little proven predictive ability. Little attention has been paid to ascertaining whether an athlete has completed sufficient training to be prepared for competition. Recently, we have completed a series of studies in cricket, rugby league and Australian rules football that have shown that when an athlete's training and playing load for a given week (acute load) spikes above what they have been doing on average over the past 4 weeks (chronic load), they are more likely to be injured. This spike in the acute:chronic workload ratio may be from an unusual week or an ebbing of the athlete's training load over a period of time as in recuperation from injury. Our findings demonstrate a strong predictive (R(2)=0.53) polynomial relationship between acute:chronic workload ratio and injury likelihood. In the elite team setting, it is possible to quantify the loads we are expecting athletes to endure when returning to sport, so assessment of the acute:chronic workload ratio should be included in the return to play decision-making process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football player with return to play in less than 8 weeks: applying common sense in the absence of evidence

    Science.gov (United States)

    Weiler, Richard; Monte-Colombo, Mathew; Mitchell, Adam; Haddad, Fares

    2015-01-01

    This case report illustrates and discusses the non-operative management of a complete anterior cruciate ligament (ACL) injury in an English Premier League football player, his return to play within 8 weeks and problem-free follow-up at 18 months post injury. When non-operative verses surgical ACL reconstruction is considered there are many fundamental gaps in our knowledge and currently, at elite level, there are no cases in cutting sports within the literature to guide these decisions. When the norm is for all professional footballers to be recommended surgery, it will be very challenging when circumstances and patient autonomy dictate a conservative approach, where prognosis, end points and risk are unclear and assumed to be high. This case challenges current dogma and provides a starting point for much needed debate about best practice, treatment options, research direction and not just at the elite level of sport. PMID:25917066

  2. Return to play and performance after anterior cruciate ligament reconstruction in the National Basketball Association: surgeon case series and literature review.

    Science.gov (United States)

    Nwachukwu, Benedict U; Anthony, Shawn G; Lin, Kenneth M; Wang, Tim; Altchek, David W; Allen, Answorth A

    2017-09-01

    To investigate return to play (RTP) and functional performance after anterior cruciate ligament reconstruction (ACLR) in National Basketball Association (NBA) players and to perform a systematic review of the literature to understand RTP after ACLR in professional basketball. NBA players undergoing ACLR between 2008 and 2014 by two surgeons were identified. RTP and performance were assessed based on a review of publically available statistics. A systematic review of the literature was performed using the MEDLINE database. Inclusion criteria were: English language, ACL surgery outcome, professional basketball and RTP outcome. We reviewed studies for RTP rates and RTP performance. Our study included 12 professional basketball players with NBA level experience. Eleven of the 12 players returned to their prior level of play. Eight of the 9 (88.9%) players actively playing in the NBA returned to play in the NBA at a mean 9.8 months. Among players returning to NBA play, during RTP season 1, mean per game statistics decreased for the following: minutes, points, rebounds, assists, steals, blocks, turnovers and personal fouls - none of these changes reached statistical significance. Player efficiency ratings significantly declined from pre-injury (12.5) to the first RTP season (7.6) (p = 0.05). By RTP season 2, player performance metrics approximated pre-injury levels and were not significantly different. Six studies met inclusion criteria; reported RTP rates ranged from 78-86%. Identified studies similarly found a decline in functional performance after RTP. There is a high rate (89%) of return to NBA play for NBA players undergoing ACLR. After RTP, however, there is a quantitative decline in initial season 1 RTP statistics with a significant decrease in player efficiency rating. By RTP season 2, performance metrics demonstrated an improvement compared to RTP season 1 but did not reach pre-injury functional performance, though performance metrics are not significantly

  3. Does well maintained graft provide consistent return to play after medial ulnar collateral ligament reconstruction of the elbow joint in elite baseball players?

    Science.gov (United States)

    Park, Jin-Young; Oh, Kyung-Soo; Bahng, Seung-Chul; Chung, Seok-Won; Choi, Jin-Ho

    2014-06-01

    Several studies have reported the clinical outcomes of medial ulnar collateral ligament (MUCL) reconstruction of the elbow joint in throwing athletes, including the rate of return to sports. However, little has been known about the imaging outcomes after MUCL reconstruction. The aim of this study is to report the clinical and imaging outcomes after MUCL reconstruction using figure of eight fashion in the elite and professional baseball players. This study included 17 baseball players, who underwent MUCL reconstruction between July 2007 and May 2010. The average follow-up period was 48.6 months. Imaging assessment consisted of preoperative plain and stress radiographs, magnetic resonance imaging, and postoperative serial ultrasonography. The clinical assessments were composed of visual analogue scale (VAS) for pain, range of motion, and the Conway scale. The mean VAS score was 6.4 (range, 3 to 8) preoperatively and 2.2 (range, 0 to 4) postoperatively (p returned to sports at the same or higher level compared to preinjury. Serial ultrasonography revealed well-maintained grafts at 3 and 12 months in all of the players. Five out of 17 players showed decreased echogenecity in the common flexor tendon at 3 months, which was considered as remaining tissue swelling and resolved completely at 12 months. All grafts are well-maintained until 12-months based on the ultrasonographic findings, although only 53% of the players returned to preinjury level.

  4. Brain network activation as a novel biomarker for the return-to-play pathway following sport-related brain injury: A prospective case study

    Directory of Open Access Journals (Sweden)

    Adam W Kiefer

    2015-11-01

    Full Text Available Children and adolescent athletes are at a higher risk for concussion than adults, and also experience longer recovery times and increased associated symptoms. It has also recently been demonstrated that multiple, seemingly mild concussions may result in exacerbated and prolonged neurologic deficits. Objective assessments and return to play criteria are needed to reduce risk and morbidity associated with concussive events in these populations. Recent research has pushed to study the use of electroencephalography as an objective measure of brain injury. In the present case study, we present a novel approach that examines event related potentials via a brain network activation (BNA analysis as a biomarker of concussion and recovery. Specifically, changes in BNA scores as indexed through this approach, offer a potential indicator of neurological health as the BNA assessment qualitatively and quantitatively indexes the network dynamics associated with brain injury. Objective tools such as these support accurate and efficient assessment of brain injury and may offer a useful step in categorizing the temporal and spatial changes in brain activity following concussive blows, as well as the functional connectivity of brain networks, associated with concussion.

  5. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

    Science.gov (United States)

    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  6. MRI findings and return to play in football: a prospective analysis of 255 hamstring injuries in the UEFA Elite Club Injury Study.

    Science.gov (United States)

    Ekstrand, Jan; Lee, Justin C; Healy, Jeremiah C

    2016-06-01

    The present study evaluated whether the MRI parameters of hamstring injuries in male professional football players correlate with time to return to play (RTP). 46 elite European football teams were followed prospectively for hamstring injuries between 2007 and 2014. Club medical staff recorded individual player exposure and time-loss after hamstring injury. MRI parameters were evaluated by two independent radiologists and correlated with the RTP data. A total of 255 grade 1 and 2 injuries were evaluated in this study. RTP was longer for grade 2 than grade 1 injuries (24±13, 95% CI 21 to 26 days vs 18±15, 95% CI 16 to 20 days; mean difference: 6, 95% CI 2 to 9 days, p=0.004, d=0.39). 84% of injuries affected the biceps femoris (BF) muscle, whereas 12% and 4% affected the semimembranosus (SM) and semitendinosus (ST), respectively. No difference in lay-off time was found for injuries to the three different muscles (BF 20±15 days, SM 18±11 days, ST 23±14 days; p=0.83). The recurrence rate was higher for BF injuries than for SM and ST injuries combined (18% vs 2%, p=0.009). The size of the oedema weakly correlated with time to RTP (r(2)=6-12%). No correlation was found between location of injury and time to RTP. The majority of the intramuscular injuries affected the MT junction (56% in grade 1 and 2 injuries), but no difference in lay-off time was found between the different types of injuries. The radiological grade and size of the oedema correlate with time to RTP for both, grade 1 and 2 injuries. No correlations were found between time to RTP and the location and type of injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Epidemiology of Sports-Related Concussions in National Collegiate Athletic Association Athletes From 2009-2010 to 2013-2014: Symptom Prevalence, Symptom Resolution Time, and Return-to-Play Time.

    Science.gov (United States)

    Wasserman, Erin B; Kerr, Zachary Y; Zuckerman, Scott L; Covassin, Tracey

    2016-01-01

    Limited data exist among collegiate student-athletes on the epidemiology of sports-related concussion (SRC) outcomes, such as symptoms, symptom resolution time, and return-to-play time. This study used the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) to describe the epidemiology of SRC outcomes in 25 collegiate sports. Descriptive epidemiology study. SRC data from the NCAA ISP during the 2009-2010 to 2013-2014 academic years were analyzed regarding symptoms, time to resolution of symptoms, and time to return to play. Findings were also stratified by sex in sex-comparable sports (ie, ice hockey, soccer, basketball, lacrosse, baseball/softball) and whether SRCs were reported as recurrent. Of the 1670 concussions reported during the 2009-2010 to 2013-2014 academic years, an average (±SD) of 5.29 ± 2.94 concussion symptoms were reported, with the most common being headache (92.2%) and dizziness (68.9%). Most concussions had symptoms resolve within 1 week (60.1%); however, 6.2% had a symptom resolution time of over 4 weeks. Additionally, 8.9% of concussions required over 4 weeks before return to play. The proportion of SRCs that required at least 1 week before return to play increased from 42.7% in 2009-2010 to 70.2% in 2013-2014 (linear trend, P sports analyses, the average number of symptoms and symptom resolution time did not differ by sex. However, a larger proportion of concussions in male athletes included amnesia and disorientation; a larger proportion of concussions in female athletes included headache, excess drowsiness, and nausea/vomiting. A total of 151 SRCs (9.0%) were reported as recurrent. The average number of symptoms reported with recurrent SRCs (5.99 ± 3.43) was greater than that of nonrecurrent SRCs (5.22 ± 2.88; P = .01). A greater proportion of recurrent SRCs also resulted in a long symptom resolution time (14.6% vs 5.4%, respectively; P time (21.2% vs 7.7%, respectively; P time may indicate changing

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

    Science.gov (United States)

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

    2016-01-01

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

  9. Guidelines for the Detection and Management of Lead Poisoning for Physicians and Health Care Providers.

    Science.gov (United States)

    Illinois State Dept. of Public Health, Springfield.

    These Illinois guidelines provide information on the medical management and treatment of children with lead poisoning, based on Federal guidelines (revised in 1991) for determining lead poisoning at lower levels. The guidelines outline the effects of lead poisoning, sources of lead, estimated incidence of lead poisoning in Illinois, screening…

  10. Adherence to best practice guidelines in dyspepsia: a survey comparing dyspepsia experts, community gastroenterologists and primary-care providers

    NARCIS (Netherlands)

    Spiegel, B. M. R.; Farid, M.; van Oijen, M. G. H.; Laine, L.; Howden, C. W.; Esrailian, E.

    2009-01-01

    Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). We

  11. Adherence to best practice guidelines in dyspepsia: a survey comparing dyspepsia experts, community gastroenterologists and primary-care providers.

    NARCIS (Netherlands)

    Spiegel, B.M.; Farid, M.; Oijen, M.G.H. van; Laine, L.; Howden, C.W.; Esrailian, E.

    2009-01-01

    BACKGROUND: Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. AIM: To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers

  12. Preoperative Short Form Health Survey Score Is Predictive of Return to Play and Minimal Clinically Important Difference at a Minimum 2-Year Follow-up After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Nwachukwu, Benedict U; Chang, Brenda; Voleti, Pramod B; Berkanish, Patricia; Cohn, Matthew R; Altchek, David W; Allen, Answorth A; Williams, Riley J

    2017-10-01

    There is increased interest in understanding the preoperative determinants of postoperative outcomes. Return to play (RTP) and the patient-reported minimal clinically important difference (MCID) are useful measures of postoperative outcomes after anterior cruciate ligament reconstruction (ACLR). To define the MCID after ACLR and to investigate the role of preoperative outcome scores for predicting the MCID and RTP after ACLR. Case-control study; Level of evidence, 3. There were 294 active athletes enrolled as part of an institutional ACL registry with a minimum 2-year follow-up who were eligible for inclusion. A questionnaire was administered to elicit factors associated with RTP. Patient demographic and clinical data as well as patient-reported outcome measures were captured as part of the registry. Outcome measures included the International Knee Documentation Committee (IKDC) subjective knee evaluation form, Lysholm scale, and 12-Item Short Form Health Survey (SF-12) physical component summary (PCS) and mental component summary (MCS). Preoperative outcome score thresholds predictive of RTP were determined using a receiver operating characteristic (ROC) with area under the curve (AUC) analysis. The MCID was calculated using a distribution-based method. Multivariable logistic models were fitted to identify predictors for achieving the MCID and RTP. At a mean (±SD) follow-up of 3.7 ± 0.7 years, 231 patients were included from a total 294 eligible patients. The mean age and body mass index were 26.7 ± 12.5 years and 23.7 ± 3.2 kg/m 2 , respectively. Of the 231 patients, 201 (87.0%) returned to play at a mean time of 10.1 months. Two-year postoperative scores on all measures were significantly increased from preoperative scores (IKDC: 50.1 ± 15.6 to 87.4 ± 10.7; Lysholm: 61.2 ± 18.1 to 89.5 ± 10.4; SF-12 PCS: 41.5 ± 9.0 to 54.7 ± 4.6; SF-12 MCS: 53.6 ± 8.1 to 55.7 ± 5.7; P predictive of RTP were the following: IKDC, 60.9; Lysholm, 57.0; SF-12 PCS, 42

  13. Screening for non-alcoholic fatty liver disease in children: do guidelines provide enough guidance?

    Science.gov (United States)

    Koot, B G P; Nobili, V

    2017-09-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the industrialized world in children. Its high prevalence and important health risks make NAFLD highly suitable for screening. In practice, screening is widely, albeit not consistently, performed. To review the recommendations on screening for NAFLD in children. Recommendations on screening were reviewed from major paediatric obesity guidelines and NAFLD guidelines. A literature overview is provided on open questions and controversies. Screening for NAFLD is advocated in all obesity and most NAFLD guidelines. Guidelines are not uniform in whom to screen, and most guidelines do not specify how screening should be performed in practice. Screening for NAFLD remains controversial, due to lack of a highly accurate screening tool, limited knowledge to predict the natural course of NAFLD and limited data on its cost effectiveness. Guidelines provide little guidance on how screening should be performed. Screening for NAFLD remains controversial because not all conditions for screening are fully met. Consensus is needed on the optimal use of currently available screening tools. Research should focus on new accurate screening tool, the natural history of NAFLD and the cost effectiveness of different screening strategies in children. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

  14. Online advertising and marketing claims by providers of proton beam therapy: are they guideline-based?

    Science.gov (United States)

    Corkum, Mark T; Liu, Wei; Palma, David A; Bauman, Glenn S; Dinniwell, Robert E; Warner, Andrew; Mishra, Mark V; Louie, Alexander V

    2018-03-15

    Cancer patients frequently search the Internet for treatment options, and hospital websites are seen as reliable sources of knowledge. Guidelines support the use of proton radiotherapy in specific disease sites or on clinical trials. This study aims to evaluate direct-to-consumer advertising content and claims made by proton therapy centre (PTC) websites worldwide. Operational PTC websites in English were identified through the Particle Therapy Co-Operative Group website. Data abstraction of website content was performed independently by two investigators. Eight international guidelines were consulted to determine guideline-based indications for proton radiotherapy. Univariate and multivariate logistic regression models were used to determine the characteristics of PTC websites that indicated proton radiotherapy offered greater disease control or cure rates. Forty-eight PTCs with 46 English websites were identified. 60·9% of PTC websites claimed proton therapy provided improved disease control or cure. U.S. websites listed more indications than international websites (15·5 ± 5·4 vs. 10·4 ± 5·8, p = 0·004). The most common disease sites advertised were prostate (87·0%), head and neck (87·0%) and pediatrics (82·6%), all of which were indicated in least one international guideline. Several disease sites advertised were not present in any consensus guidelines, including pancreatobiliary (52·2%), breast (50·0%), and esophageal (43·5%) cancers. Multivariate analysis found increasing number of disease sites and claiming their centre was a local or regional leader in proton radiotherapy was associated with indicating proton radiotherapy offers greater disease control or cure. Information from PTC websites often differs from recommendations found in international consensus guidelines. As online marketing information may have significant influence on patient decision-making, alignment of such information with accepted guidelines and consensus

  15. Moderation in the Certificates of General Education for Adults. Guidelines for Providers.

    Science.gov (United States)

    Council of Adult Education, Melbourne (Australia).

    This document provides guidelines for the process of moderation and verification of assessments for educators involved in adult education. As used in the education establishment in Australia, "moderation" is the process of ensuring the standardization of assessment. Through the moderation process, assessment procedures conducted in a…

  16. An observational analysis of provider adherence to AUA guidelines on the management of benign prostatic hyperplasia.

    Science.gov (United States)

    Auffenberg, Gregory B; Gonzalez, Chris M; Wolf, J Stuart; Clemens, J Quentin; Meeks, William; McVary, Kevin T

    2014-11-01

    We retrospectively evaluated urologist adherence to the AUA guidelines on the management of new patients with benign prostatic hyperplasia related lower urinary tract symptoms in a large university urology group. All first time benign prostatic hyperplasia/lower urinary tract symptom visits to the urology clinic at the Northwestern Medical Faculty Foundation between January 1, 2008 and December 31, 2012 were evaluated using an institutionally managed electronic medical record data repository. Clinical documentation and orders from each encounter were assessed to determine the rate of performance of guideline measures. Approximately 1% of all results were manually reviewed in a validation process designed to determine the reliability of the electronic medical record based system. A total of 3,494 eligible encounters were evaluated in the final analysis. Provider adherence rates with the 9 measures recommended in the guidelines varied by measure from 53.0% to 92.8%. The rate of performance of 5 not routinely recommended measures was 10.2% or less. Post-void residual and urinary flow measurement were optional measures, and were performed on 68.1% and 4.6% of new encounters respectively. Manual validation revealed the electronic medical record data extraction was concordant with manual review in 96.7% of cases (95% CI 94.8-98.5). Using electronic medical record based data extraction techniques, we reliably document a baseline adherence rate with AUA guidelines on the management of benign prostatic hyperplasia. Establishing this benchmark will be important for future investigation into patient outcomes related to guideline adherence and into methods for improving provider adherence. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Perceptions of the characteristics of the Alberta Nutrition Guidelines for Children and Youth by child care providers may influence early adoption of nutrition guidelines in child care centres.

    Science.gov (United States)

    Nikolopoulos, Hara; Farmer, Anna; Berry, Tanya R; McCargar, Linda J; Mager, Diana R

    2015-04-01

    In 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth (ANGCY) as a resource for child care facilities to translate nutrition recommendations into practical food choices. Using a multiple case study method, early adoption of the guidelines was examined in two child care centres in Alberta, Canada. Key constructs from the Diffusion of Innovations framework were used to develop an interview protocol based on the perceived characteristics of the guidelines (relative advantage, compatibility, complexity, trialability and observability) by child care providers. Analysis of the ANGCY was conducted by a trained qualitative researcher and validated by an external qualitative researcher. This entailed reviewing guideline content, layout, organisation, presentation, format, comprehensiveness and dissemination to understand whether characteristics of the guidelines affect the adoption process. Data were collected through direct observation, key informant interviews and documentation of field notes. Qualitative data were analysed using content analysis. Overall, the guidelines were perceived positively by child care providers. Child care providers found the guidelines to have a high relative advantage, be compatible with current practice, have a low level of complexity, easy to try and easy to observe changes. It is valuable to understand how child care providers perceive characteristics of guidelines as this is the first step in identifying the needs of child care providers with respect to early adoption and identifying potential educational strategies important for dissemination. © 2012 Blackwell Publishing Ltd.

  18. Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial.

    Science.gov (United States)

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

    2011-02-14

    Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on

  19. Implementation of concussion guidelines in community Australian Football and Rugby League-The experiences and challenges faced by coaches and sports trainers.

    Science.gov (United States)

    Kemp, Joanne L; Newton, Joshua D; White, Peta E; Finch, Caroline F

    2016-04-01

    While guidelines outlining the appropriate management of sport-related concussion have been developed and adapted for use within community sport, it remains unknown how they are experienced by those responsible for implementing them. Longitudinal study. 111 coaches and sports trainers from community-level Australian Football and Rugby League teams completed pre- and post-season surveys assessing their attitudes towards using concussion guidelines. Participants also provided post-season feedback regarding their experiences in using the guidelines. 71% of participants reported using the guidelines in the preceding season. Post-season attitude was related to pre-season attitude (p=0.002), football code (p=0.015), and team role (p=0.045). An interaction between team role and guideline use (p=0.012) was also found, with coaches who had used the guidelines, and sports trainers who had not, reporting more positive post-season attitudes towards using the concussion guidelines. Implementation challenges included disputing of decisions about return-to-play by players, parents, and coaches, and a perceived lack of time. Recommendations for improved guideline materials included using larger fonts and providing for witnessing of advice given to players. This is the first study to examine the implementation of concussion guidelines in community sport. Training of coaches/sports trainers needs enhancement. In addition, new education should be developed for parents/players about the importance of the return-to-play advice given to them by those who follow these guidelines. Information provided by those who attempted to use the guidelines will assist the refinement of implementation and dissemination processes around concussion guidelines across sports. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Adherence to best practice guidelines in dyspepsia: a survey comparing dyspepsia experts, community gastroenterologists and primary-care providers.

    Science.gov (United States)

    Spiegel, B M R; Farid, M; van Oijen, M G H; Laine, L; Howden, C W; Esrailian, E

    2009-04-15

    Although 'best practice' guidelines for dyspepsia management have been disseminated, it remains unclear whether providers adhere to these guidelines. To compare adherence to 'best practice' guidelines among dyspepsia experts, community gastroenterologists and primary-care providers (PCPs). We administered a vignette survey to elicit knowledge and beliefs about dyspepsia including a set of 16 best practices, to three groups: (i) dyspepsia experts; (ii) community gastroenterologists and (iii) PCPs. The expert, community gastroenterologist and PCP groups endorsed 75%, 73% and 57% of best practices respectively. Gastroenterologists were more likely to adhere with guidelines than PCPs (P guideline adherence (P = 0.04). Gastroenterologists are more likely than PCPs to comply with best practices in dyspepsia, although compliance remains incomplete in both groups. PCPs harbour more concerns regarding long-term PPI use and these concerns may affect therapeutic decision making. This suggests that best practices have not been uniformly adopted and persistent guideline-practice disconnects should be addressed.

  1. What's in a setting?: Influence of organizational culture on provider adherence to clinical guidelines for treating tobacco use.

    Science.gov (United States)

    Hung, Dorothy Y; Leidig, Robynn; Shelley, Donna R

    2014-01-01

    Organizational culture is an important but underinvestigated feature of the work environment that can impact provider behavior, including adherence to clinical practice guidelines. There is substantial evidence that physician assistance to smokers can produce significant reductions in tobacco use. However, this evidence has not been well translated into practice, as only a small proportion of smokers receive recommended treatment during medical visits. This study examines organizational culture as a contextual feature of primary care clinics and its impact on adherence to evidence-based guidelines for treating tobacco use. Cross-sectional survey data were collected from 500 primary care providers in 60 community clinics located in New York City. Relationships between provider adherence to "5A" clinical guidelines, as recommended by the U.S. Public Health Service, and both provider and organizational covariates were described. We used hierarchical linear modeling to examine the associations between clinic culture and provider treatment patterns. Providers in clinics with stronger "group/clan," "hierarchical," and "rational" culture types, as compared with a "developmental" culture, reported greater adherence to 5A guidelines (p organizational culture can influence provider adherence to cessation treatment guidelines, even when controlling for other factors known to affect practice patterns. Specifically, cultures that emphasize human resources and performance standards are conducive to integrating 5A guidelines into routine practice. Understanding the role of organizational culture enables healthcare managers and practitioners to be strategic when implementing, and also sustaining, use of evidence-based guidelines.

  2. Provider Adherence to National Guidelines for Managing Hypertension in African Americans

    Directory of Open Access Journals (Sweden)

    Jeanette Sessoms

    2015-01-01

    Full Text Available Purpose. To evaluate provider adherence to national guidelines for the treatment of hypertension in African Americans. Design. A descriptive, preexperimental, quantitative method. Methods. Electronic medical records were reviewed and data were obtained from 62 charts. Clinical data collected included blood pressure readings, medications prescribed, laboratory studies, lifestyle modification, referral to hypertension specialist, and follow-up care. Findings. Overall provider adherence was 75%. Weight loss, sodium restriction, and physical activity recommendations were documented on 82.3% of patients. DASH diet and alcohol consumption were documented in 6.5% of participants. Follow-up was documented in 96.6% of the patients with controlled blood pressure and 9.1% in patients with uncontrolled blood pressure. Adherence in prescribing ACEIs in patients with a comorbidity of DM was documented in 70% of participants. Microalbumin levels were ordered in 15.2% of participants. Laboratory adherence prior to prescribing medications was documented in 0% of the patients and biannual routine labs were documented in 65% of participants. Conclusion. Provider adherence overall was moderate. Despite moderate provider adherence, BP outcomes and provider adherence were not related. Contributing factors that may explain this lack of correlation include patient barriers such as nonadherence to medication and lifestyle modification recommendations and lack of adequate follow-up. Further research is warranted.

  3. Translating sickle cell guidelines into practice for primary care providers with Project ECHO

    Directory of Open Access Journals (Sweden)

    Lisa M. Shook

    2016-11-01

    Full Text Available Background: Approximately 100,000 persons with sickle cell disease (SCD live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin. Methods: STORM investigators hypothesized that Project ECHO® methodology could be replicated to create a low-cost, high-impact intervention to train PCPs in evidence-based care for pediatric and young adult patients with SCD in the Midwest, called STORM TeleECHO. This approach utilizes video technology for monthly telementoring clinics consisting of didactic and case-based presentations focused on the National Heart, Lung and Blood Institute (NHLBI evidence-based guidelines for SCD. Results: Network leads in each of the STORM states assisted with developing the curriculum and are recruiting providers for monthly clinics. To assess STORM TeleECHO feasibility and acceptability, monthly attendance and satisfaction data are collected. Changes in self-reported knowledge, comfort, and practice patterns will be compared with pre-participation, and 6 and 12 months after participation. Conclusions: STORM TeleECHO has the potential to increase implementation of the NHLBI evidence-based guidelines, especially increased use of hydroxyurea, resulting in improvements in the quality of care and outcomes for children and young adults with SCD. This model could be replicated in other pediatric chronic illness conditions to improve PCP knowledge and confidence in delivering evidence-based care.

  4. A Qualitative Study of Provider Perceptions of Influences on Uptake of Pediatric Hospital Guidelines in Lao PDR.

    Science.gov (United States)

    Gray, Amy Z; Soukaloun, Douangdao; Soumphonphakdy, Bandith

    2017-08-01

    Strategies to improve the quality of hospital care are needed if ongoing gains in child health and survival are to be made. We previously reported on improvements in the quality of case management in hospitals following a guideline-based intervention in Lao PDR, with variation in the degree of change achieved between clinical conditions. This study aims to understand the factors that influenced the uptake of the guideline-based intervention, and its impact on care. This qualitative study was embedded in a mixed-methods evaluation of guideline implementation in nine hospitals in Lao PDR. Focus groups and individual interviews were conducted with 70 health staff from central, provincial, and district hospitals. The interview guide was based on the Theoretical Domains Framework. Inductive content analysis was performed on interview transcripts to identify themes, supported by field notes from the intervention. Findings were triangulated against previously reported quantitative outcomes using driver diagrams. Key influences on guidelines uptake related to the guideline and intervention (filling a void, physical accessibility, comprehensibility, training in guideline use), health staff (behavior regulation, trust in guidelines, and beliefs about consequences), and the environment (social influences particularly consensus and incorporation into clinical norms). The major barrier was family preference for treatments in conflict with guideline recommendations. This study identifies contextual factors that explain, as well as validate previously identified improvements in care following guideline implementation in Lao PDR. It provides novel understanding of why the same intervention may have a differential impact on different clinical conditions.

  5. Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Michie Susan

    2011-02-01

    Full Text Available Abstract Background Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Methods Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. Discussion To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster

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

    Science.gov (United States)

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

    2015-04-01

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

  7. Spondylolysis in Active Adolescents: Expediting Return to Play.

    Science.gov (United States)

    Moeller, James L.; Rifat, Sami F.

    2001-01-01

    Spondylolysis is a common cause of back pain in active adolescents. For prolonged pain, an aggressive workup and specific diagnosis are needed. History and physical exam findings are not diagnostic. Tests beyond radiographs (computed tomography, bone scans, and magnetic resonance imaging) are necessary to determine metabolic activity and full…

  8. Groin Injuries (Athletic Pubalgia) and Return to Play.

    Science.gov (United States)

    Elattar, Osama; Choi, Ho-Rim; Dills, Vickie D; Busconi, Brian

    2016-07-01

    Groin pain is a common entity in athletes involved in sports that require acute cutting, pivoting, or kicking such as soccer and ice hockey. Athletic pubalgia is increasingly recognized as a common cause of chronic groin and adductor pain in athletes. It is considered an overuse injury predisposing to disruption of the rectus tendon insertion to the pubis and weakness of the posterior inguinal wall without a clinically detectable hernia. These patients often require surgical therapy after failure of nonoperative measures. A variety of surgical options have been used, and most patients improve and return to high-level competition. PubMed databases were searched to identify relevant scientific and review articles from January 1920 to January 2015 using the search terms groin pain, sports hernia, athletic pubalgia, adductor strain, osteitis pubis, stress fractures, femoroacetabular impingement, and labral tears. Clinical review. Level 4. Athletic pubalgia is an overuse injury involving a weakness in the rectus abdominis insertion or posterior inguinal wall of the lower abdomen caused by acute or repetitive injury of the structure. A variety of surgical options have been reported with successful outcomes, with high rates of return to the sport in the majority of cases. © 2016 The Author(s).

  9. Current thinking: return to play and transient quadriplegia.

    Science.gov (United States)

    Cantu, Robert V; Cantu, Robert C

    2005-02-01

    Athletes that participate in contact and collision sports assume risk of serious injury each time they take the field. For those athletes that have sustained an episode of transient quadriplegia, the decision of whether to return to competition can be a difficult one. Some athletes, realizing how close they may have come to permanent injury, may decide that further participation is not in their best interest. Others may be somewhat undecided, and some may want to return at all costs. As the treating physician, the goal is to identify those athletes who after a single episode of transient quadriplegia are at increased risk for further injury and consequently should discontinue participation in contact sports. Factors that may contribute to that determination include mechanism of injury, prior history of neurologic symptoms or injury, and anatomic features that may predispose to further injury such as disc herniation, fracture, or cervical stenosis.

  10. Concussion knowledge and return-to-play attitudes among subelite ...

    African Journals Online (AJOL)

    Methods. Subelite rugby union players (n=127; mean age 24.1 years) completed a measure of concussion knowledge and a ... that the current research literature might significantly underestimate ..... Statistical Methods for Psychology. 8th ed.

  11. Return to play after health complications associated with infectious mononucleosis guided on autonomic nervous system activity in elite athlete: A case study [Rekonvalescence po infekční mononukleóze řízená na základě aktivity autonomního nervového systému u vrcholového sportovce: Kazuistika

    Directory of Open Access Journals (Sweden)

    Jaroslav Větvička

    2012-06-01

    Full Text Available BACKGROUND: Infectious mononucleosis (IM is an acute serious illness which requires among other things an interruption of training. The return to play for athletes after IM is complicated and a long-term process which could result in the relapse of health complications linked fundamentally with the illness. OBJECTIVE: The aim of this study was to design a convalescence program which leads to an improvement in physical fitness and provides a safe return to play without relapse of health complications for an elite athlete who suffered from IM. METHODS: The convalescence program lasted almost 3 months. Training load was optimized based on autonomic nervous system (ANS activity which was assessed by spectral analysis (SA of heart rate variability (HRV. There were evaluated an individual spectral variables: very low frequency power (PVLF (0.02-0.05 Hz; low frequency power (PLF (0.05-0.15 Hz, high frequency power (PHF (0.15-0.50 Hz, total power (PT (0.02-0.50 Hz, ratio PVLF/PHF and PLF/PHF; heart rate (HR, and age-dependent complex index of SA HRV: index of vagal activity, sympathovagal balance, and total score. Further, perceived exertion during exercise and morning fatigue was assessed. Repeated biochemical analysis was focused on the selected transaminase level. RESULTS: Among recovery periods, an increase in mean of PT was accompanied by elevation of PVLF/PHF and PLF/PHF. No significant differences in mean values of any complex index of SA HRV among periods were found. A decline in HR was identified during measurements in lying, but mostly in supine. A significant elevation of perceived exertion during exercise occurred between periods. The morning fatigue culminated during the last period. No relationship between subjective feeling of fatigue and complex index of SA HRV was found. CONCLUSIONS: A convalescence strategy based on assessment of ANS activity brought an improvement in physical fitness, in spite of borderline or mild elevated

  12. Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana.

    Science.gov (United States)

    Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K

    2016-09-21

    Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. A cross-sectional analysis of the baseline data of a prospective cohort study on adherence to first antenatal care visit guidelines was carried out in 11 facilities in the Greater Accra Region of Ghana. Provider adherence was studied in relation to health facility resource availability such as antenatal workload for clinical staffs, routine antenatal drugs, laboratory testing, protocols, ambulance and equipment. Eleven facilities comprising 6 hospitals (54.5 %), 4 polyclinics (36.4 %) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1 % (95 % CI: 41.8-54.2 %), varying significantly amongst the types of facilities, with highest rate in the polyclinics. Average antenatal workload per month per clinical staff member was higher in polyclinics compared to the hospitals. All facility laboratories were able to conduct routine antenatal tests. Most routine antenatal drugs were available in all facilities except magnesium sulphate and sulphadoxine-pyrimethamine which were lacking in some. Antenatal service protocols and equipment were also available in all facilities. Although antenatal workload varies across different facility types in the Greater Accra region, other health facility resources that support implementation of first antenatal care guidelines are equally available in all the facilities. These factors therefore do not adequately account for the low and varying proportions of complete adherence to guidelines across facility types. Providers should be continually engaged for a better understanding of the barriers to their adherence to these guidelines.

  13. Guidelines for Providing Accommodations Using CASAS Assessment for Learners with Disabilities

    Science.gov (United States)

    CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2005

    2005-01-01

    These guidelines address methods for administering Comprehensive Adult Student Assessment System (CASAS) assessments using accommodations for learners with documented disabilities. The suggested accommodations for disability categories include provisions for: (1) Accommodations in test administration procedures; and (2) Use of appropriate CASAS…

  14. Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

    Science.gov (United States)

    Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

    2012-01-01

    Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

  15. Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers' antibiotic prescribing knowledge.

    Science.gov (United States)

    Blumenthal, Kimberly G; Shenoy, Erica S; Hurwitz, Shelley; Varughese, Christy A; Hooper, David C; Banerji, Aleena

    2014-01-01

    Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P allergy over time (54% vs 80%; P allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Antivenom Therapy for Crotaline Snakebites: Has the Poison Control Center Provided Effective Guidelines?

    Directory of Open Access Journals (Sweden)

    Yen-Chia Chen

    2007-12-01

    Full Text Available Crotaline snakebites (Protobothrops mucrosquamatus and Trimeresurus stejnegeri are a common medical emergency in Taiwan that can be effectively treated by a bivalent F(ab'2 antivenom. We investigated the differences in the clinical outcomes of patients who received different therapeutic regimens of antivenom in a medical center where clinical toxicologists followed the poison control center (PCC guidelines (medical group and surgeons did not (surgical group. The medical records of inpatients with crotaline snakebites between 1991 and 2005 were reviewed and information on demographics, treatments, adverse effects of antivenom, and complications was abstracted and analyzed. A total of 179 patients (90 medical, 89 surgical were eligible for study. There was no significant intergroup difference in baseline characteristics except that the dose of antivenom and the probability of antibiotic use were both higher in the surgical group (5.9 ± 4.2 vials vs. 2.7 ± 1.6 vials; 93% vs. 60%. Multiple logistic regression adjusting for age, gender, calendar year of envenomation, severity of envenomation, and antibiotic use did not disclose evidence of any difference in various clinical outcomes between medical and surgical patients. The lower dose of antivenom recommended by the PCC may be as effective and safe as the higher dose used in the surgical group for the treatment of crotaline snakebites.

  17. Remote maintenance systems requirements are being developed to provide design guidelines for machine components, to define maintenance interfaces, and to quantify maintenance equipment and procedures needed

    International Nuclear Information System (INIS)

    Spampinato, P.T.; Tabor, M.A.

    1988-01-01

    Remote maintenance systems requirements are being developed to provide design guidelines for machine components, to define maintenance interfaces, and to quantify maintenance equipment and procedures needed

  18. Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines.

    Science.gov (United States)

    Kennedy, C E; Yeh, P T; Johnson, C; Baggaley, R

    2017-12-01

    New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. We also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomized trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%, percent difference: 30, 95% confidence interval: 27-32, p lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally.

  19. Techniques and Tools Providing Strategic Decision Support: A Framework, Review, and Guidelines

    Science.gov (United States)

    1990-07-01

    associations in a dream (Lacan, 1977). But the cognitive operations at level 5 are in themselves beyond the language or the person carrying them out (Jameson...formalizing techniques. A major problem for the design of systems able to provide support at this level is that, as in dream interpretation, what needs to...the development of object relations and affects. International Journal of Psychoanalysis , 59, 285-296. Savage, L.J., 1954. The foundations of

  20. Competencies and Training Guidelines for Behavioral Health Providers in Pediatric Primary Care.

    Science.gov (United States)

    Njoroge, Wanjiku F M; Williamson, Ariel A; Mautone, Jennifer A; Robins, Paul M; Benton, Tami D

    2017-10-01

    This article focuses on the cross-discipline training competencies needed for preparing behavioral health providers to implement integrated primary care services. After a review of current competencies in the disciplines of child and adolescent psychiatry, psychology, and social work, cross-cutting competencies for integrated training purposes are identified. These competencies are comprehensive and broad and can be modified for use in varied settings and training programs. An existing and successful integrated care training model, currently implemented at Children's Hospital of Philadelphia, is described. This model and the training competencies are discussed in the context of recommendations for future work and training. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

    Science.gov (United States)

    2014-01-01

    Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who

  2. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines.

    Science.gov (United States)

    Chalmers, Kathryn J; Bond, Kathy S; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Williams-Tchen, Aj

    2014-01-28

    It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey. From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a

  3. Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

    Science.gov (United States)

    2012-01-01

    The adoption of new technology or procedures into a clinician's surgical armamentarium is driven by multiple factors. Patient safety and anticipated long-term improvement in outcomes should be the primary objective that guides a surgeon's decision to deliver care involving new procedures. Surgically complex procedures require a balance of knowledge, surgical skill, and experience, with appropriate ongoing surgical volume and monitoring of outcomes and adverse events. Transvaginal placement of surgical mesh for pelvic organ prolapse has the potential to improve quality of life and anatomic outcomes (especially in the anterior compartment), but also has potential serious adverse events as outlined by the FDA's July 2011 Safety Communication. This document provides Guidelines for privileging and credentialing of physicians planning to implement or continue using this new technology in clinical practice.

  4. Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines

    Directory of Open Access Journals (Sweden)

    Jones Christopher M

    2012-08-01

    Full Text Available Abstract Introduction Effective delivery of cardiopulmonary resuscitation (CPR and prompt defibrillation following sudden cardiac arrest (SCA is vital. Updated guidelines for adult basic life support (BLS were published in 2010 by the European Resuscitation Council (ERC in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p  Conclusions The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

  5. Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines.

    Science.gov (United States)

    Jones, Christopher M; Owen, Andrew; Thorne, Christopher J; Hulme, Jonathan

    2012-08-09

    Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital. Updated guidelines for adult basic life support (BLS) were published in 2010 by the European Resuscitation Council (ERC) in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p < 0.05), reflecting a significantly greater proportion of lay-rescuers performing chest compressions at too fast a rate when trained and assessed with the 2010 rather than 2005 guidelines (6.04% vs. 2.67%; p < 0.05). Error rates for other skills did not differ between guideline groups. The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

  6. Radiology Online Patient Education Materials Provided by Major University Hospitals: Do They Conform to NIH and AMA Guidelines?

    Science.gov (United States)

    Prabhu, Arpan V; Donovan, Ashley L; Crihalmeanu, Tudor; Hansberry, David R; Agarwal, Nitin; Beriwal, Sushil; Kale, Hrishikesh; Heller, Matthew

    The internet creates opportunities for Americans to access medical information about imaging tests and modalities to guide them in their medical decision-making. Owing to health literacy variations in the general population, the American Medical Association and National Institutes of Health recommend patient education resources to be written between the third and seventh grade levels. Our purpose is to quantitatively assess the readability levels of online radiology educational materials, written for the public, in 20 major university hospitals. In September and October 2016, we identified 20 major university hospitals with radiology residency-affiliated hospital systems. On each hospital׳s website, we downloaded all radiology-related articles written for patient use. A total of 375 articles were analyzed for readability level using 9 quantitative readability scales that are well validated in the medical literature. The 375 articles from 20 hospital systems were collectively written at an 11.4 ± 3.0 grade level (range: 8.4-17.1). Only 11 (2.9%) articles were written at the recommended third to seventh grade levels. Overall, 126 (33.6%) were written above a full high-school reading level. University of Washington Medical Center׳s articles were the most readable with a reading level corresponding to 7.9 ± 0.9. The vast majority of websites at major academic hospitals with radiology residencies designed to provide patients with information about imaging were written above the nationally recommended health literacy guidelines to meet the needs of the average American. This may limit the benefit that patients can derive from these educational materials. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Using data mining techniques to explore physicians' therapeutic decisions when clinical guidelines do not provide recommendations: methods and example for type 2 diabetes.

    Science.gov (United States)

    Toussi, Massoud; Lamy, Jean-Baptiste; Le Toumelin, Philippe; Venot, Alain

    2009-06-10

    Clinical guidelines carry medical evidence to the point of practice. As evidence is not always available, many guidelines do not provide recommendations for all clinical situations encountered in practice. We propose an approach for identifying knowledge gaps in guidelines and for exploring physicians' therapeutic decisions with data mining techniques to fill these knowledge gaps. We demonstrate our method by an example in the domain of type 2 diabetes. We analyzed the French national guidelines for the management of type 2 diabetes to identify clinical conditions that are not covered or those for which the guidelines do not provide recommendations. We extracted patient records corresponding to each clinical condition from a database of type 2 diabetic patients treated at Avicenne University Hospital of Bobigny, France. We explored physicians' prescriptions for each of these profiles using C5.0 decision-tree learning algorithm. We developed decision-trees for different levels of detail of the therapeutic decision, namely the type of treatment, the pharmaco-therapeutic class, the international non proprietary name, and the dose of each medication. We compared the rules generated with those added to the guidelines in a newer version, to examine their similarity. We extracted 27 rules from the analysis of a database of 463 patient records. Eleven rules were about the choice of the type of treatment and thirteen rules about the choice of the pharmaco-therapeutic class of each drug. For the choice of the international non proprietary name and the dose, we could extract only a few rules because the number of patient records was too low for these factors. The extracted rules showed similarities with those added to the newer version of the guidelines. Our method showed its usefulness for completing guidelines recommendations with rules learnt automatically from physicians' prescriptions. It could be used during the development of guidelines as a complementary source from

  8. Using data mining techniques to explore physicians' therapeutic decisions when clinical guidelines do not provide recommendations: methods and example for type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Toussi Massoud

    2009-06-01

    Full Text Available Abstract Background Clinical guidelines carry medical evidence to the point of practice. As evidence is not always available, many guidelines do not provide recommendations for all clinical situations encountered in practice. We propose an approach for identifying knowledge gaps in guidelines and for exploring physicians' therapeutic decisions with data mining techniques to fill these knowledge gaps. We demonstrate our method by an example in the domain of type 2 diabetes. Methods We analyzed the French national guidelines for the management of type 2 diabetes to identify clinical conditions that are not covered or those for which the guidelines do not provide recommendations. We extracted patient records corresponding to each clinical condition from a database of type 2 diabetic patients treated at Avicenne University Hospital of Bobigny, France. We explored physicians' prescriptions for each of these profiles using C5.0 decision-tree learning algorithm. We developed decision-trees for different levels of detail of the therapeutic decision, namely the type of treatment, the pharmaco-therapeutic class, the international non proprietary name, and the dose of each medication. We compared the rules generated with those added to the guidelines in a newer version, to examine their similarity. Results We extracted 27 rules from the analysis of a database of 463 patient records. Eleven rules were about the choice of the type of treatment and thirteen rules about the choice of the pharmaco-therapeutic class of each drug. For the choice of the international non proprietary name and the dose, we could extract only a few rules because the number of patient records was too low for these factors. The extracted rules showed similarities with those added to the newer version of the guidelines. Conclusion Our method showed its usefulness for completing guidelines recommendations with rules learnt automatically from physicians' prescriptions. It could be used

  9. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Oyun Chimeddamba

    2016-04-01

    Full Text Available (1 Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2 Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3 Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4 Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines.

  10. Guidelines To Provide Uniform Wiring Service for Telecommunications in North Carolina Public Schools. Version 1.1.0.

    Science.gov (United States)

    North Carolina State Dept. of Public Instruction, Raleigh.

    The purpose of these guidelines, intended for the North Carolina public school administrator, the building architect, and the builder, is to facilitate the planning and installation of uniform wiring in a building regardless of the type of equipment that will ultimately be installed. This approach will allow for flexibility in curriculum…

  11. When human immunodeficiency virus (HIV) treatment goals conflict with guideline-based opioid prescribing: A qualitative study of HIV treatment providers.

    Science.gov (United States)

    Starrels, Joanna L; Peyser, Deena; Haughton, Lorlette; Fox, Aaron; Merlin, Jessica S; Arnsten, Julia H; Cunningham, Chinazo O

    2016-01-01

    Human immunodeficiency virus (HIV)-infected patients have a high prevalence of chronic pain and opioid use, making HIV care a critical setting for improving the safety of opioid prescribing. Little is known about HIV treatment providers' perspectives about opioid prescribing to patients with chronic pain. The authors administered a questionnaire and conducted semistructured telephone interviews with 18 HIV treatment providers (infectious disease specialists, general internists, family medicine physicians, nurse practitioners, and physician assistants) in Bronx, NY. Open-ended interview questions focused on providers' experiences, beliefs, and attitudes about opioid prescribing and about the use of guideline-based opioid prescribing practices (conservative prescribing, and monitoring for and responding to misuse). Transcripts were thematically analyzed using a modified grounded theory approach. Eighteen HIV treatment providers included 13 physicians, four nurse practitioners, and one physician assistant. They were 62% female, 56% white, and practiced as HIV treatment providers for a mean of 14.6 years. Most reported always or almost always using opioid treatment agreements (56%) and urine drug testing (61%) with their patients on long-term opioid therapy. HIV treatment providers tended to view opioid prescribing for chronic pain within the "HIV paradigm," a set of priorities and principles defined by three key themes: (1) primacy of HIV goals, (2) familiarity with substance use, and (3) the clinician as ally. The HIV paradigm sometimes supported, and sometimes conflicted with, guideline-based opioid prescribing practices. For HIV treatment providers, perceived alignment with the HIV paradigm determined whether and how guideline-based opioid prescribing practices were adopted. For example, the primacy of HIV goals superseded conservative opioid prescribing when providers prescribed opioids with the goal of retaining patients in HIV care. These findings highlight

  12. Using Early Learning Standards to Provide High-Quality Education for All Children: The Early Learning Guidelines Toolkit

    Science.gov (United States)

    Flores, Roseanne L.; Curby, Timothy W.; Coleman, Hardin; Melo, Kristan

    2016-01-01

    Today with the rise in the number of 3- to 6-year-old children enrolled in center-based early childhood programs, and a focus on program quality, it becomes imperative for educators to have a better understanding of the role research plays in establishing high-quality programs as these programs provide much of the foundation that supports early…

  13. 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

  14. Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update

    Directory of Open Access Journals (Sweden)

    Nyl

    2016-02-01

    Full Text Available John Nyland,1,2 Alma Mattocks,1 Shane Kibbe,2 Alaa Kalloub,2,3 Joe W Greene,4 David N M Caborn2,3 1Athletic Training Program, Kosair Charities College of Health and Natural Sciences, Spalding University, Louisville, KY, USA; 2Department of Orthopedic Surgery, University of Louisville, Louisville, KY, USA; 3Shea Orthopedic Group, Louisville, KY, USA; 4Norton Orthopedic and Sports, Louisville, KY, USA Abstract: Anatomical discoveries and a growing appreciation of the knee as a complex organ are driving innovations in patient care decision-making following anterior cruciate ligament (ACL injury. Surgeons are increasing their efforts to restore combined mechanical-neurosensory ACL function and placing more consideration on when to reconstruct versus repair native anatomical structures. Surgical options now include primary repair with or without reinforcing the injured ACL with suture-based internal bracing, and growing evidence supports biological augmentation using platelet-rich plasma and mesenchymal stem cells to enhance tissue healing. Physical therapists and athletic trainers are increasing their efforts to facilitate greater athlete cognitive engagement during therapeutic exercise performance to better restore nonimpaired neuromuscular control activation amplitude and timing. Knee brace design and use needs to evolve to better match these innovations and their influence on the rehabilitation plan timetable. There is a growing appreciation for the multifaceted characteristics of the rehabilitation process and how they influence neuromuscular, educational, and psychobehavioral treatment goal achievement. Multiple sources may influence the athlete during the return to sports process and clinical outcome measures need to be refined to better evaluate these influences. This update summarizes contemporary ACL surgical, medical, and rehabilitation interventions and future trends. Keywords: arthroscopy, knee, function, outcomes, decision-making 

  15. Prevention of hamstring injuries in male soccer : Exercise programs and return to play

    NARCIS (Netherlands)

    van der Horst, N

    2017-01-01

    The aim of the studies reported in this thesis was to investigate strategies for the prevention of hamstring injuries. Hamstring injuries are the most prevalent muscle injury in soccer. In spite of efforts to reduce the occurrence of hamstring injuries in soccer, injury rates have not decreased over

  16. Prevention of hamstring injuries in male soccer : Exercise programs and return to play

    OpenAIRE

    van der Horst, N

    2017-01-01

    The aim of the studies reported in this thesis was to investigate strategies for the prevention of hamstring injuries. Hamstring injuries are the most prevalent muscle injury in soccer. In spite of efforts to reduce the occurrence of hamstring injuries in soccer, injury rates have not decreased over the last three decades. Therefore, research on hamstring injury prevention is necessary to reduce hamstring injury rates. Exercise programs to reduce soccer injuries are easy to implement during r...

  17. Does Pay-For-Performance Program Increase Providers Adherence to Guidelines for Managing Hepatitis B and Hepatitis C Virus Infection in Taiwan?

    Science.gov (United States)

    Chen, Huei-Ju; Huang, Nicole; Chen, Long-Sheng; Chou, Yiing-Jenq; Li, Chung-Pin; Wu, Chen-Yi; Chang, Yu-Chia

    2016-01-01

    Many people are concerned about that the quality of preventive care for patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is suboptimal. Taiwan, a hyperendemic area of chronic HBV and HCV infection, implemented a nationwide pay-for-performance (P4P) program in 2010, which aimed to improve the preventive care provided to HBV and HCV patients by increasing physicians' adherence to guidelines through financial incentives. The objective of this study was to evaluate the early effects of the P4P program on utilization of preventive services by HBV and HCV patients. Using a quasi-experimental design with propensity score matching method, we matched the HBV and HCV patients enrolled in the P4P program with non-enrollees in 2010, resulting in 21,643 patients in each group. Generalized estimating equations was applied to examine the difference-in-difference effects of P4P program enrollment on the utilization of three guideline-recommended preventive services (regular outpatient follow-up visits, abdominal ultrasonography (US) examinations, and aspartate aminotransferase and alanine aminotransferase (AST/ALT) tests by HBV and HCV patients. The P4P program enrollees were significantly more likely to attend twice-annual follow-up visits, to receive recommended US examinations and AST/ALT tests, than non-enrollees. The results of our preliminary assessment indicate that financial incentives offered by the P4P program was associated with a modest improvement in adherence to guidelines for better chronic HBV and HBC management.

  18. Robotics Algorithms Provide Nutritional Guidelines

    Science.gov (United States)

    2009-01-01

    On July 5, 1997, a small robot emerged from its lander like an insect from an egg, crawling out onto the rocky surface of Mars. About the size of a child s wagon, NASA s Sojourner robot was the first successful rover mission to the Red Planet. For 83 sols (Martian days, typically about 40 minutes longer than Earth days), Sojourner - largely remote controlled by NASA operators on Earth - transmitted photos and data unlike any previously collected. Sojourner was perhaps the crowning achievement of the NASA Space Telerobotics Program, an Agency initiative designed to push the limits of robotics in space. Telerobotics - devices that merge the autonomy of robotics with the direct human control of teleoperators - was already a part of NASA s efforts; probes like the Viking landers that preceded Sojourner on Mars, for example, were telerobotic applications. The Space Telerobotics Program, a collaboration between Ames Research Center, Johnson Space Center, Jet Propulsion Laboratory (JPL), and multiple universities, focused on developing remote-controlled robotics for three main purposes: on-orbit assembly and servicing, science payload tending, and planetary surface robotics. The overarching goal was to create robots that could be guided to build structures in space, monitor scientific experiments, and, like Sojourner, scout distant planets in advance of human explorers. While telerobotics remains a significant aspect of NASA s efforts, as evidenced by the currently operating Spirit and Opportunity Mars rovers, the Hubble Space Telescope, and many others - the Space Telerobotics Program was dissolved and redistributed within the Agency the same year as Sojourner s success. The program produced a host of remarkable technologies and surprising inspirations, including one that is changing the way people eat

  19. 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.

  20. A critical evaluation of two point-of-use water treatment technologies: can they provide water that meets WHO drinking water guidelines?

    Science.gov (United States)

    Murphy, Heather M; McBean, Edward A; Farahbakhsh, Khosrow

    2010-12-01

    Point-of-use (POU) technologies have been proposed as solutions for meeting the Millennium Development Goal (MDG) for safe water. They reduce the risk of contamination between the water source and the home, by providing treatment at the household level. This study examined two POU technologies commonly used around the world: BioSand and ceramic filters. While the health benefits in terms of diarrhoeal disease reduction have been fairly well documented for both technologies, little research has focused on the ability of these technologies to treat other contaminants that pose health concerns, including the potential for formation of contaminants as a result of POU treatment. These technologies have not been rigorously tested to see if they meet World Health Organization (WHO) drinking water guidelines. A study was developed to evaluate POU BioSand and ceramic filters in terms of microbiological and chemical quality of the treated water. The following parameters were monitored on filters in rural Cambodia over a six-month period: iron, manganese, fluoride, nitrate, nitrite and Escherichia coli. The results revealed that these technologies are not capable of consistently meeting all of the WHO drinking water guidelines for these parameters.

  1. [From guidelines to practice: evaluation of the pediatric care provided by a service of secondary reference in the north of the State of Minas Gerais].

    Science.gov (United States)

    Moreira, Laura Monteiro de Castro; Alves, Cláudia Regina Lindgren; Belisário, Soraya Almeida; Bueno, Mariana de Caux; de Moraes, Erica Furtado

    2013-06-01

    In the State of Minas Gerais, the Secondary Reference Viva Vida Centers (CVVRS) are one of the strategies deployed to tackle the problems in child health. This study sought to evaluate pediatric care provided in a CVVRS, using the guidelines defined when it was set up as a benchmark. A quantitative-qualitative approach was adopted, which included a cross-sectional study with stratified random sampling of 385 medical records of children registered with the program between 2007 and 2009, and analysis of focus groups with strategic actors of the initiative. There were divergences between the user profiles and the target audience in terms of age, hometown and clinical characteristics. Access and use of the service differed depending on the town, due to problems of misinformation concerning the proposal, difficulty of transportation and the fragility of the health network. The centers are considered an innovative and important initiative for the expansion and organization of the health network, though the intended logic is not effectively seen in practice. Interventions for articulation between the network services and adaptation of the agreed guidelines to the regional specificities are necessary.

  2. Clinical practice guidelines for the utilization of positron emission tomography/computed tomography imaging in selected oncologic applications: suggestions from a provider group.

    Science.gov (United States)

    Manning, Ken; Tepfer, Beth; Goldklang, Gerald; Loyd, Richard; Garimella, Prasad; Halkar, Raghuveer

    2007-01-01

    Positron emission tomography, combined with computed tomography (PET/CT) has provided clinicians with useful information regarding the diagnosis, initial staging, restaging, and therapy monitoring of malignancies since the beginning of the current century. Our intent here is to identify the critical steps in clinical workups and follow-up, in the true outpatient clinical setting of a freestanding imaging center, for utilization of PET/CT in four different cancer types. The four most common reasons for referrals to our facility were identified by reviewing two years of referral data. They were lung cancer (including solitary pulmonary nodule), lymphomas, breast cancer, and colorectal cancer. A review of published literature from 1996 and later was accepted as evidence of appropriateness for utilizing PET/CT in various clinical scenarios. In addition, a medical advisory board consisting of 15 referring physicians representing various specialties was established to provide practical advice regarding the appropriate use of PET/CT in clinical situations. National Comprehensive Cancer Network (NCCN) guidelines were also referenced to establish a baseline for clinical workups at various stages of disease. Several inconsistencies were identified among the three primary sources of information leading to the establishment of a standardized algorithm for each cancer type. NCCN data did not always agree with published literature, which was also often different from actual clinical practices of referring physicians. The most common inconsistencies included differing opinions from the referrers vs what was published in the NCCN guidelines, especially with regard to the utilization of PET/CT for applications not yet covered by insurance companies. After a reconciliation of the medical advisory board's clinical practices and several published articles, a consensus was established by the medical advisory board for the use of PET/CT imaging for the four cancer types, enabling us to

  3. THE UNIFICATION OF THE CODE LISTS PROVIDED WITHIN THE DATA MODEL ORIGINATING FROM THE INSPIRE TECHNICAL GUIDELINES AND THE ONES PROVIDED FOR GESUT DATABASES IN THE CONTEXT OF POTENTIAL EXPLOITATION IN THE MINING INDUSTRY

    Directory of Open Access Journals (Sweden)

    Andrzej ZYGMUNIAK

    2016-07-01

    Full Text Available This study is aimed at exposing differences between two data models in case of code lists values provided there. The first of them is an obligatory one for managing Geodesic Register of Utility Networks databases in Poland [9] and the second is the model originating from the Technical Guidelines issued to the INSPIRE Directive. Since the second one mentioned is the basis for managing spatial databases among European parties, correlating these two data models has an effect in easing the way of harmonizing and, in consequence, exchanging spatial data. Therefore, the study presents the possibilities of increasing compatibility between the values of the code lists concerning attributes for objects provid-ed in both models. In practice, it could lead to an increase of the competitiveness of entities managing or processing such databases and to greater involvement in scientific or research projects when it comes to the mining industry. More-over, since utility networks located on mining areas are under particular protection, the ability of making them more fitted to their own needs will make it possible for mining plants to exchange spatial data in a more efficient way.

  4. Factors affecting compliance with clinical practice guidelines for pap smear screening among healthcare providers in africa: systematic review and meta-summary of 2045 individuals.

    Directory of Open Access Journals (Sweden)

    Etienne Asonganyi

    Full Text Available Although the importance of the Pap smear in reducing cancer incidence and mortality is known, many countries in Africa have not initiated yet widespread national cervical cancer screening programs. The World Health Organization (WHO has published Clinical Practice Guidelines (CPGs on cervical cancer screening in developing countries; however, there is a gap between expectations and clinical performance. Thus, the aim of this study was to conduct a systematic review and meta-summary to identify factors affecting compliance with CPGs for Pap screening among healthcare providers in Africa.And Findings: MEDLINE, Scirus, Opengate and EMBASE databases were searched in January 2012. Studies involving medical personnel practicing in Africa, whose outcome measured any factors that affect medical personnel from using a Pap smear to screen for cervical cancer, were included. Two reviewers independently evaluated titles and abstracts, then full-texts, extracted data and assessed quality of the included studies. A descriptive analysis of the included studies was conducted. We calculated Frequency effect sizes (FES for each finding and Intensity effect sizes (IES for each article to represent their magnitudes in the analyses. Of 1011 studies retrieved, 11 studies were included (2045 individuals. Six different themes related to the factors affecting compliance with CPGs were identified: Insufficient Knowledge/Lack of awareness (FES = 82%, Negligence/Misbeliefs (FES = 82%, Psychological Reasons (FES = 73%, Time/Cost Constraint (FES = 36%, Insufficient infrastructure/training (FES = 45% and also no reason given (FES = 36%. IES for articles ranged between 33 and 83%.These results suggest that prevention initiatives should be comprehensive to include education and resources needs assessments and improvement, Pap smear test training, strategies on costing, and practitioner time studies.

  5. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers.

    Science.gov (United States)

    Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

    2017-01-01

    Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH) and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) by using the competing values framework (CVF) and examining its influence on the adherence to the Clinical Practice Guideline (CPG) for DM. A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323) who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p culture was the most predominant (mean =41.13; standard deviation [SD] =8.92), followed by hierarchical (mean =33.14; SD=5.96), while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51), followed by clan/group (mean =29.73; SD =8.37). Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research should preferably mix quantitative and qualitative approaches and explore the use of more sensitive instruments to measure such a complex construct and its effects on guideline adherence in small-sized clinics.

  6. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers

    Directory of Open Access Journals (Sweden)

    Radwan M

    2017-08-01

    Full Text Available Mahmoud Radwan,1 Ali Akbari Sari,1 Arash Rashidian,1 Amirhossein Takian,1 Sanaa Abou-Dagga,2 Aymen Elsous1 1Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine Background: Diabetes mellitus (DM is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA by using the competing values framework (CVF and examining its influence on the adherence to the Clinical Practice Guideline (CPG for DM.Methods: A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323 who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. Results: The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p<0.001; 47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA. In the PHC-MoH, the clan/group culture was the most predominant (mean =41.13; standard deviation [SD] =8.92, followed by hierarchical (mean =33.14; SD=5.96, while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51, followed by clan/group (mean =29.73; SD =8.37. Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Conclusion: Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research

  7. 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

  8. 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.

  9. GRADE guidelines

    DEFF Research Database (Denmark)

    Guyatt, Gordon H; Thorlund, Kristian; Oxman, Andrew D

    2013-01-01

    Presenting continuous outcomes in Summary of Findings tables presents particular challenges to interpretation. When each study uses the same outcome measure, and the units of that measure are intuitively interpretable (e.g., duration of hospitalization, duration of symptoms), presenting differences...... and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers....

  10. ASCOT guidelines

    International Nuclear Information System (INIS)

    1994-05-01

    These guidelines describe an approach used in conducting an Assessment of Safety Culture in Organizations Team (ASCOT) review. They are intended to assist the team members in conducting their reviews and at the same time provide guidance to hosts preparing to receive an ASCOT review. They may also be used by any organization wishing to conduct their own self-assessment of safety culture, independent of an ASCOT review

  11. Field assessment of semi-aerobic condition and the methane correction factor for the semi-aerobic landfills provided by IPCC guidelines

    International Nuclear Information System (INIS)

    Jeong, Sangjae; Nam, Anwoo; Yi, Seung-Muk; Kim, Jae Young

    2015-01-01

    Highlights: • CH 4 /CO 2 and CH 4 + CO 2 % are proposed as indices to evaluate semi-aerobic landfills. • A landfill which CH 4 /CO 2 > 1.0 is difficult to be categorized as semi-aerobic landfill. • Field conditions should be carefully investigated to determine landfill types. • The MCF default value for semi-aerobic landfills underestimates the methane emissions. - Abstract: According to IPCC guidelines, a semi-aerobic landfill site produces one-half of the amount of CH 4 produced by an equally-sized anaerobic landfill site. Therefore categorizing the landfill type is important on greenhouse gas inventories. In order to assess semi-aerobic condition in the sites and the MCF value for semi-aerobic landfill, landfill gas has been measured from vent pipes in five semi-aerobically designed landfills in South Korea. All of the five sites satisfied requirements of semi-aerobic landfills in 2006 IPCC guidelines. However, the ends of leachate collection pipes which are main entrance of air in the semi-aerobic landfill were closed in all five sites. The CH 4 /CO 2 ratio in landfill gas, indicator of aerobic and anaerobic decomposition, ranged from 1.08 to 1.46 which is higher than the values (0.3–1.0) reported for semi-aerobic landfill sites and is rather close to those (1.0–2.0) for anaerobic landfill sites. The low CH 4 + CO 2 % in landfill gas implied air intrusion into the landfill. However, there was no evidence that air intrusion has caused by semi-aerobic design and operation. Therefore, the landfills investigated in this study are difficult to be classified as semi-aerobic landfills. Also MCF of 0.5 may significantly underestimate methane emissions compared to other researches. According to the carbon mass balance analyses, the higher MCF needs to be proposed for semi-aerobic landfills. Consequently, methane emission estimate should be based on field evaluation for the semi-aerobically designed landfills

  12. Field assessment of semi-aerobic condition and the methane correction factor for the semi-aerobic landfills provided by IPCC guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sangjae [Department of Civil and Environmental Engineering, College of Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742 (Korea, Republic of); Nam, Anwoo [Korea Environment Corporation, 42 Hwangyeong-ro, Seo-gu, Incheon 404-170 (Korea, Republic of); Yi, Seung-Muk [Department of Environmental Health, School of Public Health, Seoul National University, Seoul 151-742 (Korea, Republic of); Kim, Jae Young, E-mail: jaeykim@snu.ac.kr [Department of Civil and Environmental Engineering, College of Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742 (Korea, Republic of)

    2015-02-15

    Highlights: • CH{sub 4}/CO{sub 2} and CH{sub 4} + CO{sub 2}% are proposed as indices to evaluate semi-aerobic landfills. • A landfill which CH{sub 4}/CO{sub 2} > 1.0 is difficult to be categorized as semi-aerobic landfill. • Field conditions should be carefully investigated to determine landfill types. • The MCF default value for semi-aerobic landfills underestimates the methane emissions. - Abstract: According to IPCC guidelines, a semi-aerobic landfill site produces one-half of the amount of CH{sub 4} produced by an equally-sized anaerobic landfill site. Therefore categorizing the landfill type is important on greenhouse gas inventories. In order to assess semi-aerobic condition in the sites and the MCF value for semi-aerobic landfill, landfill gas has been measured from vent pipes in five semi-aerobically designed landfills in South Korea. All of the five sites satisfied requirements of semi-aerobic landfills in 2006 IPCC guidelines. However, the ends of leachate collection pipes which are main entrance of air in the semi-aerobic landfill were closed in all five sites. The CH{sub 4}/CO{sub 2} ratio in landfill gas, indicator of aerobic and anaerobic decomposition, ranged from 1.08 to 1.46 which is higher than the values (0.3–1.0) reported for semi-aerobic landfill sites and is rather close to those (1.0–2.0) for anaerobic landfill sites. The low CH{sub 4} + CO{sub 2}% in landfill gas implied air intrusion into the landfill. However, there was no evidence that air intrusion has caused by semi-aerobic design and operation. Therefore, the landfills investigated in this study are difficult to be classified as semi-aerobic landfills. Also MCF of 0.5 may significantly underestimate methane emissions compared to other researches. According to the carbon mass balance analyses, the higher MCF needs to be proposed for semi-aerobic landfills. Consequently, methane emission estimate should be based on field evaluation for the semi-aerobically designed landfills.

  13. 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.

  14. 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...

  15. 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.

  16. Autistic Spectrum Disorder: Intervention Guidance for Service Providers and Families of Young Children with Autistic Spectrum Disorder. Service Guideline 1. Revised.

    Science.gov (United States)

    Connecticut Birth to Three System, Hartford.

    This guide for parents and service providers contains information on autistic spectrum disorder (ASD) in young children and is the product of a review of research-based programs and models and requirements of the Individuals with Disabilities Education Act. The document begins with discussion of the definition of ASD, possible causes of ASD, and…

  17. Standard Compliance: Guidelines to Help State and Alternative Fuel Provider Fleets Meet Their Energy Policy Act Requirements, 10 CFR Part 490 (Book)

    Energy Technology Data Exchange (ETDEWEB)

    2014-03-01

    This guidebook addresses the primary requirements of the Alternative Fuel Transportation Program to help state and alternative fuel provider fleets comply with the Energy Policy Act via the Standard Compliance option. It also addresses the topics that covered fleets ask about most frequently.

  18. Clinical findings just after return to play predict hamstring re-injury, but baseline MRI findings do not

    NARCIS (Netherlands)

    de Vos, Robert-Jan; Reurink, Gustaaf; Goudswaard, Gert-Jan; Moen, Maarten H.; Weir, Adam; Tol, Johannes L.

    2014-01-01

    Acute hamstring re-injuries are common and hard to predict. The aim of this study was to investigate the association between clinical and imaging findings and the occurrence of hamstring re-injuries. We obtained baseline data (clinical and MRI findings) of athletes who sustained an acute hamstring

  19. Clinical findings just after return to play predict hamstring re-injury, but baseline MRI findings do not

    NARCIS (Netherlands)

    R.J. de Vos (Robert-Jan); G. Reurink (Gustaaf); G.J. Goudswaard (Gert Jan); M.H. Moen (Maaike); A. Weir (Adam); J.L. Tol (Johannes)

    2014-01-01

    markdownabstract__Abstract__ Background Acute hamstring re-injuries are common and hard to predict. The aim of this study was to investigate the association between clinical and imaging findings and the occurrence of hamstring re-injuries. Methods We obtained baseline data (clinical and MRI

  20. At return to play following hamstring injury the majority of professional football players have residual isokinetic deficits

    NARCIS (Netherlands)

    Tol, Johannes L.; Hamilton, Bruce; Eirale, Cristiano; Muxart, Patrice; Jacobsen, Philipp; Whiteley, Rod

    2014-01-01

    There is an ongoing debate regarding the optimal criteria for return to sport after an acute hamstring injury. Less than 10% isokinetic strength deficit is generally recommended but this has never been documented in professional football players after rehabilitation. Our aim was to evaluate

  1. 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 ...

  2. Public informations guidelines

    International Nuclear Information System (INIS)

    1986-06-01

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

  3. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

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

  4. 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

  5. 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.)

  6. [Digital electroencephalography in brain death diagnostics : Technical requirements and results of a survey on the compatibility with medical guidelines of digital EEG systems from providers in Germany].

    Science.gov (United States)

    Walter, U; Noachtar, S; Hinrichs, H

    2018-02-01

    The guidelines of the German Medical Association and the German Society for Clinical Neurophysiology and Functional Imaging (DGKN) require a high procedural and technical standard for electroencephalography (EEG) as an ancillary method for diagnosing the irreversible cessation of brain function (brain death). Nowadays, digital EEG systems are increasingly being applied in hospitals. So far it is unclear to what extent the digital EEG systems currently marketed in Germany meet the guidelines for diagnosing brain death. In the present article, the technical und safety-related requirements for digital EEG systems and the EEG documentation for diagnosing brain death are described in detail. On behalf of the DGKN, the authors sent out a questionnaire to all identified distributors of digital EEG systems in Germany with respect to the following technical demands: repeated recording of the calibration signals during an ongoing EEG recording, repeated recording of all electrode impedances during an ongoing EEG recording, assessability of intrasystem noise and galvanic isolation of measurement earthing from earthing conductor (floating input). For 15 of the identified 20 different digital EEG systems the specifications were provided by the distributors (among them all distributors based in Germany). All of these EEG systems are provided with a galvanic isolation (floating input). The internal noise can be tested with all systems; however, some systems do not allow repeated recording of the calibration signals and/or the electrode impedances during an ongoing EEG recording. The majority but not all of the currently available digital EEG systems offered for clinical use are eligible for use in brain death diagnostics as per German guidelines.

  7. 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...

  8. ASSET guidelines

    International Nuclear Information System (INIS)

    1990-11-01

    The IAEA Assessment of Safety Significant Events Team (ASSET) Service provides advice and assistance to Member States to enhance the overall level of plant safety while dealing with the policy of prevention of incidents at nuclear power plants. The ASSET programme, initiated in 1986, is not restricted to any particular group of Member States, whether developing or industrialized, but is available to all countries with nuclear power plants in operation or approaching commercial operation. The IAEA Safety Series publications form common basis for the ASSET reviews, including the Nuclear Safety Standards (NUSS) and the Basic Safety Principles (Recommendations of Safety Series No. 75-INSAG-3). The ASSET Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of their review of incident investigations. Additional guidance and reference material is provided by the IAEA to complement the expertise of the ASSET members. ASSET reviews accept different approaches that contribute to ensuring an effective prevention of incidents at plants. Suggestions are offered to enhance plant safety performance. Commendable good practices are identified and generic lessons are communicated to other plants, where relevant, for long term improvement

  9. EMI Messaging Guidelines

    CERN Document Server

    Cons, L.

    2011-01-01

    Guidelines for potential users of messaging within EMI. The goal is to provide enough practical information so that EMI product teams can start investigating whether using messaging in their products can be beneficial or not.

  10. London 2012 packaging guidelines

    OpenAIRE

    2013-01-01

    These guidelines are intended to provide supplemental advice to suppliers and licensees regarding the provisions of the LOCOG Sustainable Sourcing Code that relate to packaging design and materials selection.

  11. OSART guidelines. 1992 edition

    International Nuclear Information System (INIS)

    1992-01-01

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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second p age and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the Content 1.1.1 Subheading of the Content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www.teachingenglish.org

  18. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the content 1.1.1 Subheading of the content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Back Matter| 79 80 | STUDIES IN ENGLISH LANGUAGE AND EDUCATION, Volume 1, Number 1, March 2014 Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v

  19. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the Content  1.1.1   Subheading of the Content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  20. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  1. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

    Full Text Available Guidelines for Article Submission   SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION 1.1      Subheading of the content  1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from

  2. 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...

  3. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    they help authors describe the study in enough detail for it to be evaluated by editors, reviewers, readers, and other researchers evaluating the medical literature. Authors of review manuscripts are encouraged to describe the methods used for locating, select¬ing, extracting, and synthesizing data; this is mandatory for systematic reviews. Good sources for reporting guidelines are the EQUATOR Network and the NLM's Research Reporting Guidelines and Initiatives.3. Manuscript SectionsThe following are general requirements for reporting within sections of all study designs and manuscript formats.a. Title PageGeneral information about an article and its authors is presented on a manuscript title page and usually includes the article title, author information, any disclaimers, sources of support, word count, and sometimes the number of tables and figures.Article title. The title provides a distilled description of the complete article and should include information that, along with the Abstract, will make electronic retrieval of the article sensitive and specific. Reporting guidelines recommend and some journals require that information about the study design be a part of the title (particularly important for randomized trials and systematic reviews and meta-analyses. Some journals require a short title, usually no more than 40 characters (including letters and spaces on the title page or as a separate entry in an electronic submission system. Electronic submission systems may restrict the number of characters in the title. Author information: Each author's highest academic degrees should be listed, although some journals do not publish these. The name of the department(s and institution(s or organizations where the work should be attributed should be specified. Most electronic submission systems require that authors provide full contact information, including land mail and e-mail addresses, but the title page should list the corresponding authors' telephone and fax

  4. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    -only material should be submitted and sent for peer review simultaneously with the primary manuscript. 2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because they help authors describe the study in enough detail for it to be evaluated by editors, reviewers, readers, and other researchers evaluating the medical literature. Authors of review manuscripts are encouraged to describe the methods used for locating, selecting, extracting, and synthesizing data; this is mandatory for systematic reviews. Good sources for reporting guidelines are the EQUATOR Network and the NLM's Research Reporting Guidelines and Initiatives. 3. Manuscript SectionsThe following are general requirements for reporting within sections of all study designs and manuscript formats. a. Title Page General information about an article and its authors is presented on a manuscript title page and usually includes the article title, author information, any disclaimers, sources of support, word count, and sometimes the number of tables and figures. Article title. The title provides a distilled description of the complete article and should include information that, along with the Abstract, will make electronic retrieval of the article sensitive and specific. Reporting guidelines recommend and some journals require that information about the study design be a part of the title (particularly important for randomized trials and systematic reviews and meta-analyses. Some journals require a short title, usually no more than 40 characters (including letters and spaces on the title page or as a separate entry in an electronic submission system. Electronic submission systems may restrict the number of characters in the title

  5. OSART guidelines. 1994 edition

    International Nuclear Information System (INIS)

    1994-05-01

    These guidelines have been prepared to provide a basic structure and common reference both across the various areas covered by an OSART mission and across all the missions in the programme. As such, they are addressed, principally, to the team members of OSART missions but they will also provide guidance to a host nuclear plant preparing to receive a mission. The guidelines are intended to help each expert to formulate his review in the light of this own experience. They are not all inclusive and should not limit the expert's investigations, but are better considered as illustrating the adequate requirements for his review

  6. 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

  7. 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...

  8. 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

  9. Curricular Guidelines for Endodontics.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Guidelines developed by the Section on Endodontics of the American Association of Dental Schools for use by educational institutions as curriculum development aids are provided. Endodontics is that branch of dentistry dealing with diagnosis and treatment of oral conditions that arise as a result of pathoses of dental pulp. (MLW)

  10. Guidelines for Authors

    Indian Academy of Sciences (India)

    IAS Admin

    Please follow the instructions given below while preparing the manuscript. Articles which do not conform to the guidelines will not be considered. Authors are encouraged to submit their article in ASCII/MS Word/Latex version in a CD or by email to resonanc@ias.ernet.in. Title: Authors are requested to provide a) first title ...

  11. Record Keeping Guidelines

    Science.gov (United States)

    American Psychologist, 2007

    2007-01-01

    These guidelines are designed to educate psychologists and provide a framework for making decisions regarding professional record keeping. State and federal laws, as well as the American Psychological Association's "Ethical Principles of Psychologists and Code of Conduct," generally require maintenance of appropriate records of psychological…

  12. 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

  13. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

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

  14. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

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

  15. 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

  16. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    to food and eating and the emergence of proposals for integrated guidelines. It explores the conflicts and controversies that have arisen in the wake of the various proposals and identifies a number of different types of conflicts. These relate to conflicts of interests between the various actors involved...... and political resistance against initiatives that are perceived as being in conflict with the values of a market economy and free trade. Furthermore, there are controversies that can be broadly characterised as relating to the politics of knowledge and have to do with the differentiation of expertise...

  17. 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. 

  18. [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

  19. 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…

  20. [Revised practice guideline 'Anaemia in midwifery practice'

    NARCIS (Netherlands)

    Beentjes, M.; Jans, S.M.P.J.

    2012-01-01

    The practice guideline of the Royal Dutch Organization of Midwives 'Anaemia in primary care midwifery practice' published in 2000, has recently been revised. The revised guideline takes physiological haemodilution during pregnancy into consideration and provides gestation specific reference values

  1. 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

  2. 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.

  3. 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....

  4. FDH radiological design review guidelines

    International Nuclear Information System (INIS)

    Millsap, W.J.

    1998-01-01

    These guidelines discuss in more detail the radiological design review process used by the Project Hanford Management Contractors as described in HNF-PRO-1622, Radiological Design Review Process. They are intended to supplement the procedure by providing background information on the design review process and providing a ready source of information to design reviewers. The guidelines are not intended to contain all the information in the procedure, but at points, in order to maintain continuity, they contain some of the same information

  5. FDH radiological design review guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Millsap, W.J.

    1998-09-29

    These guidelines discuss in more detail the radiological design review process used by the Project Hanford Management Contractors as described in HNF-PRO-1622, Radiological Design Review Process. They are intended to supplement the procedure by providing background information on the design review process and providing a ready source of information to design reviewers. The guidelines are not intended to contain all the information in the procedure, but at points, in order to maintain continuity, they contain some of the same information.

  6. 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...

  7. 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....

  8. 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.

  9. 12 CFR 708a.13 - Voting guidelines.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Voting guidelines. 708a.13 Section 708a.13... INSURED CREDIT UNIONS TO MUTUAL SAVINGS BANKS § 708a.13 Voting guidelines. A converting credit union must conduct its member vote on conversion in a fair and legal manner. NCUA provides the following guidelines...

  10. Oak Regeneration Guidelines for the Central Appalachians

    Science.gov (United States)

    Kim C. Steiner; James C. Finley; Peter J. Gould; Songlin Fei; Marc McDill

    2008-01-01

    This article presents the first explicit guidelines for regenerating oaks in the central Appalachians. The objectives of this paper are (1) to describe the research foundation on which the guidelines are based and (2) to provide users with the instructions, data collection forms, supplementary tables, and decision charts needed to apply the guidelines in the field. The...

  11. Guidelines for emergency laparoscopy

    Directory of Open Access Journals (Sweden)

    Sauerland Stefan

    2006-10-01

    Full Text Available Abstract Acute abdominal pain is a leading symptom in many surgical emergency patients. Laparoscopy allows for accurate diagnosis and immediate therapy of many intraabdominal pathologies. The guidelines of the EAES (European Association for Endoscopic Surgery provides scientifically founded recommendations about the role of laparoscopy in the different situations. Generally, laparoscopy is well suited for the therapy of the majority of diseases that cause acute abdominal pain.

  12. 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

  13. 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

  14. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

    Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

  15. Multiple muscle tear after fall on buttock-role of conservative management and exercise for early recovery and return to play.

    Science.gov (United States)

    Adhau, Rajesh; Angrish, Piyush; Ahuja, Ashok; Sandhu, Avtar Singh

    2014-04-01

    to describe role of alternative management as an approach to management and rehabilitation of multiple hip muscles tears by the use of 1 RM (Repetition Maximum) testing and hip muscle strengthening program along with the use of sports specific drills for rehabilitation and recovery. There is very limited literature describing multiple hip muscle tears and the conservative management of the same. 1RM testing and strengthening of hip muscles is an approach that is able to help in the return to sports of an athlete without surgical intervention. the patient, is a 21-year-old male hockey player who presented with pain right buttock, right lower leg and a limp on the right side while walking. Physical examination revealed a positive Trendelenburg sign both in stance and gait phase. Hip rotational movements showed a normal range of motion, there was a severe pain in the right buttock on movements which he described at 8/10 on VAS (Visual Analogue Scale). Strength assessment revealed weakness of the right hip flexors and extensors and also of the abductor and external hip rotator muscles. Treatment protocol followed was based on 1 RM testing of muscles and hip strengthening exercises and sports specific drills. following the intervention, the patient reported pain at 0/10 VAS while doing all activities and also showed good muscle control with no limp. this highlights an alternative protocol for treating multiple hip muscle tears and illustrates the importance of 1 RM testing as a part of examination and sports medicine intervention.

  16. 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

  17. Guideline Implementation: Hand Hygiene.

    Science.gov (United States)

    Goldberg, Judith L

    2017-02-01

    Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  18. ASSET guidelines. Revised 1991 Edition

    International Nuclear Information System (INIS)

    1991-12-01

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

  19. 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.

  20. Backfitting guidelines

    International Nuclear Information System (INIS)

    Allison, D.P.; Conran, J.M.; Trottier, C.A.

    1990-07-01

    The backfitting process is the process by which the US Nuclear Regulatory Commission (NRC) decides whether to issue new or revised requirements or staff positions to licensees of nuclear power reactor facilities. Backfitting is expected to occur and is an inherent part of the regulatory process. However, it is to be done only after formal, systematic review to ensure that changes are properly justified and suitably defined. Requirements for proper justification of backfits and information requests are provided by two NRC rules, Title 10 of the Code of Federal Regulations, Sections 50.109 and 50.54(f). Three types of backfits are recognized. Cost-justified substantial safety improvements require backfit analyses and findings of substantial safety improvement and justified costs. Two types of exceptions, compliance exceptions and adequate protection exceptions, do not require findings of substantial safety improvements and costs are not considered. However, they are still backfits and they require documented evaluations to support use of the exceptions. Information requests (as opposed to backfits) require an analysis of the burden to be imposed to ensure that they are justified in view of the potential safety significance of the information requested. NRC procedures on backfitting include the Charter of the Committee to Review Generic Requirements for generic communications and NRC Manual Chapter 0514 and individual office procedures for plant-specific communications. Considerable guidance has been developed, control mechanisms are in place, and training has been provided to NRC and industry personnel

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

    Science.gov (United States)

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

    2014-01-01

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

  2. 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.

  3. 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.

  4. Develop guidelines for the design of pillar systems for shallow and intermediate depth, tabular, hard rock mines and provide methodology for assessing hangingwall stability and support requirements for the panels between pillars

    CSIR Research Space (South Africa)

    Haile, AT

    1995-12-01

    Full Text Available The overall view of the research being conducted at Impala platinum was to improve pillar design techniques through a rock testing programme, underground instrumentation and back analysis. The laboratory rock testing programme has provided a useful...

  5. 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.

  6. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  7. 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 ...

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. "I don't know if this is right … but this is what I'm offering": healthcare provider knowledge, practice, and attitudes towards safer conception for HIV-affected couples in the context of Southern African guidelines.

    Science.gov (United States)

    West, Nora; Schwartz, Sheree; Phofa, Rebecca; Yende, Nompumelelo; Bassett, Jean; Sanne, Ian; Van Rie, Annelies

    2016-01-01

    The 2011 guidelines for safer conception for HIV-affected individuals and couples were adopted by the South African Department of Health in December 2012. We assessed implementation gaps and facilitators and barriers to delivering safer conception services through examining patient and healthcare provider (HCP) experiences. At Witkoppen Health and Welfare Centre, a primary care clinic in Johannesburg, we conducted in-depth interviews (IDIs) with nine HCPs (doctors, nurses, and counselors) and IDIs and focus group discussions with 42 HIV-affected men and women interested in having a child. Data were analyzed using a grounded theory approach. HCPs were supportive of fertility intentions of HIV-affected couples and demonstrated some knowledge of safer conception methods, especially ART initiation to suppress viral load in infected partners. Unfortunately, HCPs did not follow the key recommendation that HCPs initiate conversations on fertility intentions with HIV-affected men and women. Providers and clients reported that conversations about conception only occur when client-initiated, placing the onus on HIV-affected individuals. Important barriers underlying this were the misconception held by some HCPs that uninfected partners in serodiscordant partnerships are "latently" infected and the desire by most HCPs to protect or control knowledge around fertility and safer conception methods out of concern over what clients will do with this knowledge before they are virally suppressed or ready to conceive. Almost all participants who had conceived or attempted conception did so without safer conception methods knowledge. HCP concern over conception readiness, perception of what clients will do with safer conception knowledge, and gaps in safer conception knowledge prevent HCPs from initiating conversations with HIV-affected patients on the issue of childbearing. Examining these findings in the context of existing South African guidelines illuminates areas that need to be

  13. “I don’t know if this is right…but this is what I’m offering”: Healthcare provider knowledge, practice, and attitudes towards safer conception for HIV-affected couples in the context of Southern African guidelines

    Science.gov (United States)

    Schwartz, Sheree; Phofa, Rebecca; Yende, Nompumelelo; Bassett, Jean; Sanne, Ian; Van Rie, Annelies

    2016-01-01

    The 2011 guidelines for safer conception for HIV-affected individuals and couples were adopted by the South African Department of Health in December 2012. We assessed implementation gaps and facilitators and barriers to delivering safer conception services through examining patient and healthcare provider (HCP) experiences. At Witkoppen Health and Welfare Centre, a primary care clinic in Johannesburg, we conducted in-depth interviews (IDIs) with 9 HCPs (doctors, nurses and counselors) and IDIs and focus group discussions with 42 HIV-affected men and women interested in having a child. Data were analyzed using a grounded theory approach. HCPs were supportive of fertility intentions of HIV-affected couples and demonstrated some knowledge of safer conception methods, especially ART initiation to suppress viral load in infected partners. Unfortunately, HCPs did not follow the key recommendation that HCPs initiate conversations on fertility intentions with HIV-affected men and women. Providers and clients reported that conversations about conception only occur when client-initiated, placing the onus on HIV-affected individuals. Important barriers underlying this were the misconception held by some HCPs that uninfected partners in serodiscordant partnerships are “latently” infected and the desire by most HCPs to protect or control knowledge around fertility and safer conception methods out of concern over what clients will do with this knowledge before they are virally suppressed or ready to conceive. Almost all participants who had conceived or attempted conception did so without safer conception methods knowledge. HCP concern over conception readiness, perception of what clients will do with safer conception knowledge, and gaps in safer conception knowledge prevent HCPs from initiating conversations with HIV-affected patients on the issue of childbearing. Examining these findings in the context of existing South African guidelines illuminates areas that need to be

  14. 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

  15. EAACI Guidelines on allergen immunotherapy

    DEFF Research Database (Denmark)

    Pajno, G B; Fernandez-Rivas, M; Arasi, S

    2018-01-01

    . This Guideline, prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force on Allergen Immunotherapy for IgE-mediated Food Allergy, aims to provide evidence-based recommendations for active treatment of IgE-mediated food allergy with FA-AIT. Immunotherapy relies on the delivery...

  16. Guidelines for Measuring Coastal Acidification

    Science.gov (United States)

    The purpose of this presentation is to provide EPA colleagues in region 1 with background information related to, and a description of, the recently published document entitled "Guidelines for Measuring Changes in seawater pH and associated carbonate chemistry in coastal env...

  17. SARIS Guidelines. 2014 Ed

    International Nuclear Information System (INIS)

    2014-01-01

    The IAEA fundamental safety principles provide the basis for IAEA safety standards and IAEA related programmes. IAEA safety standards reflect an international consensus on what constitutes a high level of safety for protecting people and the environment, and therefore represent what all regulators should achieve. These standards, in particular IAEA Safety Standards Series No. GSR Part 1, Governmental, Legal and Regulatory Framework for Safety, provide the basics for establishing, maintaining and continuously improving the governmental, legal and regulatory framework for safety. Additional IAEA requirements and guidance, such as the IAEA Safety Standards Series No. GSR Part 3 (Interim), Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards, and IAEA Safety Standards Series No. GS-R-3, The Management System for Facilities and Activities, are also used to establish and develop the national infrastructure for safety and for establishing and implementing a management system. Assessment of the regulatory framework for safety with respect to the IAEA safety standards can be made either through an external review or through internal self-assessment. Self-assessment offers a mechanism by which an organization can assess its performance against established standards and models and thereby identify areas for improvement. The IAEA has developed a methodology and tool for Self-assessment of the Regulatory Infrastructure for Safety (SARIS), to assist States in undertaking self-assessment of their national safety framework in accordance with the requirements and recommendations of the IAEA safety standards, and to develop an action plan for improvement. The IAEA self-assessment methodology and the associated tools are fully compatible with the IAEA safety standards and are also used in the preparation for regulatory review missions, such as the Integrated Regulatory Review Service and advisory missions. These guidelines have been developed to

  18. PWR secondary water chemistry guidelines

    International Nuclear Information System (INIS)

    Bell, M.J.; Blomgren, J.C.; Fackelmann, J.M.

    1982-10-01

    Steam generators in pressurized water reactor (PWR) nuclear power plants have experienced tubing degradation by a variety of corrosion-related mechanisms which depend directly on secondary water chemistry. As a result of this experience, the Steam Generator Owners Group and EPRI have sponsored a major program to provide solutions to PWR steam generator problems. This report, PWR Secondary Water Chemistry Guidelines, in addition to presenting justification for water chemistry control parameters, discusses available analytical methods, data management and surveillance, and the management philosophy required to successfully implement the guidelines

  19. 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.

  20. 12 CFR 618.8015 - Policy guidelines.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Policy guidelines. 618.8015 Section 618.8015 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Related Services § 618.8015 Policy guidelines. (a) The board of directors of each System bank or association providing...

  1. Guideline for primary care management of headache in adults

    Science.gov (United States)

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Abstract Objective To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care. Quality of evidence A comprehensive search was conducted for relevant guidelines and systematic reviews published between January 2000 and May 2011. The guidelines were critically appraised using the AGREE (Appraisal of Guidelines for Research and Evaluation) tool, and the 6 highest-quality guidelines were used as seed guidelines for the guideline adaptation process. Main message A multidisciplinary guideline development group of primary care providers and other specialists crafted 91 specific recommendations using a consensus process. The recommendations cover diagnosis, investigation, and management of migraine, tension-type, medication-overuse, and cluster headache. Conclusion A clinical practice guideline for the Canadian health care context was created using a guideline adaptation process to assist multidisciplinary primary care practitioners in providing evidence-informed care for patients with headache. PMID:26273080

  2. Implementing New Reform Guidelines in Teaching Introductory College Statistics Courses

    Science.gov (United States)

    Everson, Michelle; Zieffler, Andrew; Garfield, Joan

    2008-01-01

    This article introduces the recently adopted Guidelines for the Assessment and Instruction in Statistics Education (GAISE) and provides two examples of introductory statistics courses that have been redesigned to better align with these guidelines.

  3. Annotating Evidence Based Clinical Guidelines : A Lightweight Ontology

    NARCIS (Netherlands)

    Hoekstra, R.; de Waard, A.; Vdovjak, R.; Paschke, A.; Burger, A.; Romano, P.; Marshall, M.S.; Splendiani, A.

    2012-01-01

    This paper describes a lightweight ontology for representing annotations of declarative evidence based clinical guidelines. We present the motivation and requirements for this representation, based on an analysis of several guidelines. The ontology provides the means to connect clinical questions

  4. Wireless Emergency Alerts Commercial Mobile Service Provider (CMSP) Cybersecurity Guidelines

    Science.gov (United States)

    2016-06-16

    Switching Centers (MSCs) in CDMA networks . The interface standard be- tween the MC and CDMA networks is the IS-824, IS-637 SMDPP.  Global System for... networks is 3GPP 23.041 CBS-BSC.  Universal Mobile Telecommunications System (UMTS) networks : A CBC function is collocated with a CMSP Gateway for message...agement 16. Does the carrier patch all systems and network devices as appropriate?    CMU/SEI-2016-SR-009 | SOFTWARE ENGINEERING INSTITUTE

  5. Vehicle recovery and towing guideline

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-01-15

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

  6. Long-term pavement performance compliance with Department of Transportation information dissemination quality guidelines

    Science.gov (United States)

    2008-11-01

    This document provides information on the compliance of the LTPP program with the guidelines the Department of Transportation (DOT) issued Information Dissemination Quality Guidelines (IDQG). These guidelines were developed in response to requirement...

  7. 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.

  8. Air quality model guideline

    International Nuclear Information System (INIS)

    Idriss, A.; Spurrell, F.

    2009-06-01

    Alberta Environment has developed a guidelines for operations and proposed operations that require approvals under the province's Environmental Protection and Enhancement Act or that operate under a code of practice for emissions to the atmosphere. In an effort to ensure consistency in the use of dispersion models for regulatory applications in Alberta, this document provided detailed guidance on suitable methods and approaches that should be employed to assess air quality from emission sources, specifically, information required to demonstrate that a source meets the Alberta ambient air quality objectives. The document outlined the statutory authority and provided an overview of the approach. It provided detailed advice on the types and uses of dispersion models with particular reference to the modelling protocol, input data, and output interpretation. Guidance on the application of regulatory models were also presented. Various models were described and their intended uses were explained. Internet addresses for different modelling resources were also offered. Last, some information about regional modelling in the province of Alberta was discussed. 40 refs., 4 tabs., 7 figs., 3 appendices.

  9. 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.

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

    Science.gov (United States)

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

    2018-01-01

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

  11. Guidelines for writing an argumentative essay

    OpenAIRE

    Aleksandra Egurnova

    2014-01-01

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

  12. Fire protection guidelines for nuclear power plants

    International Nuclear Information System (INIS)

    1976-06-01

    Guidelines acceptable to the NRC staff for implementing in the development of a fire protection program for nuclear power plants. The purpose of the fire protection program is to ensure the capability to shut down the reactor and maintain it in a safe shutdown condition and to minimize radioactive releases to the environment in the event of a fire. If designs or methods different from the guidelines presented herein are used, they must provide fire protection comparable to that recommended in the guidelines. Suitable bases and justification should be provided for alternative approaches to establish acceptable implementaion of General Design Criterion 3

  13. 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

  14. 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...

  15. 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…

  16. 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…

  17. 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....

  18. Training Requirements in OSHA Standards and Training Guidelines. Revised.

    Science.gov (United States)

    Occupational Safety and Health Administration, Washington, DC.

    This guide provides an overview of Occupational Safety and Health Act (OSHA) standards and training guidelines for various industries. The first section introduces the concept of voluntary training guidelines, explaining that the guidelines are designed to help employers determine whether a worksite problem can be solved by training, what training…

  19. Systematic review of recent dementia practice guidelines.

    Science.gov (United States)

    Ngo, Jennifer; Holroyd-Leduc, Jayna M

    2015-01-01

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

  20. 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.

  1. Fatores associados ao uso de diretrizes clínicas em operadoras de planos de saúde e prestadores de serviços hospitalares no campo da Saúde Suplementar no Brasil Factors associated with the use of clinical guidelines by health plan operators and their inpatient care providers

    Directory of Open Access Journals (Sweden)

    Margareth Crisóstomo Portela

    2008-10-01

    Full Text Available Este artigo objetiva identificar fatores associados ao uso de diretrizes clínicas, segundo percepção de dirigentes respondentes, em operadoras de planos de saúde e prestadores de serviços hospitalares no campo da saúde suplementar no Brasil. Utiliza dados de dois inquéritos de abrangência nacional: um envolvendo 90 operadoras selecionadas aleatoriamente de um universo de 1.573, voltado para a caracterização da implementação de diretrizes clínicas e outros instrumentos e práticas de gestão da clínica; e outro envolvendo 74 hospitais, selecionados de um universo de 3.817 prestadores de serviços hospitalares a planos de saúde, destinado a apreender os mecanismos de microrregulação das operadoras e suas possíveis repercussões sobre as práticas dos hospitais. Referiram o uso de diretrizes clínicas 32,3% das operadoras e 51,6% dos hospitais. Entre as primeiras, mostraram-se independentemente associados ao uso de diretrizes, localização geográfica, tipo e porte da operadora, enquanto que, entre os hospitais, porte, complexidade e uso de outras ferramentas da gestão da clínica. Os resultados evidenciam o quanto ainda é incipiente e insatisfatória a gestão, por operadoras e hospitais, sobre a qualidade dos cuidados à saúde providos aos pacientes.This paper is aimed at identifying factors related to the use of clinical guidelines by health plan operators and their inpatient care providers in the supplementary care sector in Brazil from the viewpoint of managers. The study is based on two national surveys: one involving 90 health plan operators randomly selected from a universe of 1573, oriented towards characterizing the implementation of clinical guidelines and other tools of clinical governance; and another involving 74 hospitals, selected from a universe of 3817 inpatient care providers, aimed at capturing micro-regulation mechanisms applied by health plan operators and their repercussions on hospital practices. Use of

  2. Introducing guidelines into clinical practice.

    Science.gov (United States)

    Fowkes, F G; Roberts, C J

    1984-04-01

    The impetus for guidelines of practice has been accelerated by a worldwide trend towards insurance based systems of health care. In the past it has been the tradition for the clinician to order all the diagnostic procedures that conceivably might help to clarify what is wrong with a patient, or what course of treatment should be followed. This traditional view ignores the stubborn economic reality that resources are finite and that it is no longer possible to be both endlessly generous and continually fair. Making judgements about the need for, and value of, services now forms an important part of coping with this problem. Clinical practice has to strive to be as safe as possible and to produce a given benefit at a socially acceptable cost. Guidelines are recommendations, preferably developed by clinicians themselves, which describe how and when individual clinical activities should be offered in order to achieve these objectives. Utilisation review of current practice is a valuable source of information for the development of guidelines. In the United Kingdom the Royal College of Radiologists attempted to do this in connection with the use of pre-operative chest X-rays. In 1979 they published the findings of a multicentre review of 10,619 consecutive cases of elective non-cardiopulmonary surgery undertaken in 8 centres throughout the United Kingdom. Substantial variations were found in national practice. Use of pre-operative chest X-rays varied from 11.5% of patients in one centre to 54.2% of patients in another centre. The study also found that the chest X-ray report did not seem to have much influence on the decision to operate nor on the decision to use inhalation anaesthesia. The College study failed to find "any evidence at all for the effectiveness of pre-operative chest X-ray when used routinely" and it was estimated that even if the procedure was 10% effective the costs of avoiding one death would be approximately 1 million pounds. These findings provided

  3. Emergency Response Guideline Development

    International Nuclear Information System (INIS)

    Gary D Storrick

    2007-01-01

    Task 5 of the collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled 'Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor' focuses on operator control and protection system interaction, with particular emphasis on developing emergency response guidelines (ERGs). As in the earlier tasks, we will use the IRIS plant as a specific example of an integrated primary system reactor (IPSR) design. The present state of the IRIS plant design--specifically, the lack of a detailed secondary system design--precludes establishing detailed emergency procedures at this time. However, we can create a structure for their eventual development. This report summarizes our progress to date. Section 1.2 describes the scope of this effort. Section 2 compares IPSR ERG development to the recent AP1000 effort, and identifies three key plant differences that affect the ERGs and control room designs. The next three sections investigate these differences in more detail. Section 3 reviews the IRIS Safety-by-Design philosophy and its impact on the ERGs. Section 4 looks at differences between the IRIS and traditional loop PWR I and C Systems, and considers their implications for both control room design and ERG development. Section 5 examines the implications of having one operating staff control multiple reactor units. Section 6 provides sample IRIS emergency operating procedures (EOPs). Section 7 summarizes our conclusions

  4. [French guidelines on electroencephalogram].

    Science.gov (United States)

    André-Obadia, N; Sauleau, P; Cheliout-Heraut, F; Convers, P; Debs, R; Eisermann, M; Gavaret, M; Isnard, J; Jung, J; Kaminska, A; Kubis, N; Lemesle, M; Maillard, L; Mazzola, L; Michel, V; Montavont, A; N'Guyen, S; Navarro, V; Parain, D; Perin, B; Rosenberg, S D; Sediri, H; Soufflet, C; Szurhaj, W; Taussig, D; Touzery-de Villepin, A; Vercueil, L; Lamblin, M D

    2014-12-01

    Electroencephalography allows the functional analysis of electrical brain cortical activity and is the gold standard for analyzing electrophysiological processes involved in epilepsy but also in several other dysfunctions of the central nervous system. Morphological imaging yields complementary data, yet it cannot replace the essential functional analysis tool that is EEG. Furthermore, EEG has the great advantage of being non-invasive, easy to perform and allows control tests when follow-up is necessary, even at the patient's bedside. Faced with the advances in knowledge, techniques and indications, the Société de Neurophysiologie Clinique de Langue Française (SNCLF) and the Ligue Française Contre l'Épilepsie (LFCE) found it necessary to provide an update on EEG recommendations. This article will review the methodology applied to this work, refine the various topics detailed in the following chapters. It will go over the summary of recommendations for each of these chapters and underline proposals for writing an EEG report. Some questions could not be answered by the review of the literature; in those cases, an expert advice was given by the working and reading groups in addition to the guidelines. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Wind and tornado guidelines

    International Nuclear Information System (INIS)

    McDonald, J.R.

    1989-01-01

    The objective of the Department of Energy Natural Phenomena Hazards Project is to provide guidance and criteria for design of new facilities and for evaluation of existing ones subjected to extreme winds, earthquakes, and floods. This paper describes the treatment of wind and tornado hazards. Four facility-use categories are defined which represent increasing levels of risk to personnel or the environment in the event of a high wind event. Facilities are assigned to a particular category, depending on their mission, value, or toxic material content. The assigned facility-use category determines the design and evaluation criteria. The criteria are based on probabilistic hazard assessment. Performance goals are also specified for each facility-use category. A uniform approach to design wind loads, based on the ANSI A58.1-1982 standard, allows treatment of high winds and hurricane and tornado winds in a similar manner. Based on the wind hazard models, some sites must account for the possibility of tornadoes while others do not. Atmospheric pressure changes and missiles must be taken into account when considering tornadoes. The design and evaluation guidelines are designed to establish consistent levels of risk for different natural phenomena hazards and for facilities at different geographical locations

  6. Guidelines for radioiodinated MIBG scintigraphy in children.

    Science.gov (United States)

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  7. Curriculum Guidelines for Periodontics.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines describe the interrelationships of this and other dental fields, give an overview of the curriculum and its primary educational objectives, and outline the suggested prerequisites, core content, specific behavioral objectives, sequencing, and faculty requirements. (MSE)

  8. 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...

  9. K-Basins design guidelines

    International Nuclear Information System (INIS)

    Roe, N.R.; Mills, W.C.

    1995-06-01

    The purpose of the design guidelines is to enable SNF and K Basin personnel to complete fuel and sludge removal, and basin water mitigation by providing engineering guidance for equipment design for the fuel basin, facility modifications (upgrades), remote tools, and new processes. It is not intended to be a purchase order reference for vendors. The document identifies materials, methods, and components that work at K Basins; it also Provides design input and a technical review process to facilitate project interfaces with operations in K Basins. This document is intended to compliment other engineering documentation used at K Basins and throughout the Spent Nuclear Fuel Project. Significant provisions, which are incorporated, include portions of the following: General Design Criteria (DOE 1989), Standard Engineering Practices (WHC-CM-6-1), Engineering Practices Guidelines (WHC 1994b), Hanford Plant Standards (DOE-RL 1989), Safety Analysis Manual (WHC-CM-4-46), and Radiological Design Guide (WHC 1994f). Documents (requirements) essential to the engineering design projects at K Basins are referenced in the guidelines

  10. Obstetric Thromboprophylaxis: The Swedish Guidelines

    Directory of Open Access Journals (Sweden)

    Pelle G. Lindqvist

    2011-01-01

    Full Text Available Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism. We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. Human Factors Engineering Guidelines for Overhead Cranes

    Science.gov (United States)

    Chandler, Faith; Delgado, H. (Technical Monitor)

    2001-01-01

    This guideline provides standards for overhead crane cabs that can be applied to the design and modification of crane cabs to reduce the potential for human error due to design. This guideline serves as an aid during the development of a specification for purchases of cranes or for an engineering support request for crane design modification. It aids human factors engineers in evaluating existing cranes during accident investigations or safety reviews.

  16. Guidelines for direct radionuclide cystography in children.

    Science.gov (United States)

    Fettich, Jure; Colarinha, Paula; Fischer, Sibylle; Frökier, Jörgen; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Olivier, Pierre; Piepsz, Amy; Porn, Ute; Roca, Isabel; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They contain information on the indications, acquisition, processing and interpretation of direct radioisotope cystography in children. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  17. Adolescent Pregnancy Guidelines.

    Science.gov (United States)

    Fleming, Nathalie; O'Driscoll, Teresa; Becker, Gisela; Spitzer, Rachel F

    2015-08-01

    To describe the needs and evidence-based practice specific to care of the pregnant adolescent in Canada, including special populations. Healthy pregnancies for adolescent women in Canada, with culturally sensitive and age-appropriate care to ensure the best possible outcomes for these young women and their infants and young families, and to reduce repeat pregnancy rates. Published literature was retrieved through searches of PubMed and The Cochrane Library on May 23, 2012 using appropriate controlled vocabulary (e.g., Pregnancy in Adolescence) and key words (e.g., pregnancy, teen, youth). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Results were limited to English or French language materials published in or after 1990. Searches were updated on a regular basis and incorporated in the guideline to July 6, 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, national and international medical specialty societies, and clinical practice guideline collections. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). BENEFITS/HARMS/COSTS: These guidelines are designed to help practitioners caring for adolescent women during pregnancy in Canada and allow them to take the best care of these young women in a manner appropriate for their age, cultural backgrounds, and risk profiles. 1. Health care providers should adapt their prenatal care for adolescents and offer multidisciplinary care that is easily accessible to the adolescent early in the pregnancy, recognizing that adolescents often present to care later than their adult counterparts. A model that provides an opportunity to address all of these needs at one site may be the preferred model of care for pregnant adolescents. (II-1A) 2. Health

  18. 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.

  19. 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.

  20. Colorectal Cancer Screening: A Guide to the Guidelines

    Directory of Open Access Journals (Sweden)

    Douglas K Rex

    1999-01-01

    Full Text Available The two most recent guidelines for colorectal cancer screening are those of the Agency for Healthcare Policy and Research, and the American Cancer Society. The guidelines are similar in many regards and reflect current literature, consensus opinion and compromise between members of multidisciplinary panels. The emphasis of both guidelines is to increase the options available for colorectal cancer screening. Increasing choice should expand the attractiveness of colorectal cancer screening to more patients and physicians, and the development of guidelines should help compel payers to provide reimbursement for colorectal cancer screening. These guidelines are summarized and evaluated as they pertain to colorectal cancer screening.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. EPRI PWR primary water chemistry guidelines revision

    International Nuclear Information System (INIS)

    McElrath, Joel; Fruzzetti, Keith

    2014-01-01

    EPRI periodically updates the PWR Primary Water Chemistry Guidelines as new information becomes available and as required by NEI 97-06 (Steam Generator Program Guidelines) and NEI 03-08 (Guideline for the Management of Materials Issues). The last revision of the PWR water chemistry guidelines identified an optimum primary water chemistry program based on then-current understanding of research and field information. This new revision provides further details with regard to primary water stress corrosion cracking (PWSCC), fuel integrity, and shutdown dose rates. A committee of industry experts, including utility specialists, nuclear steam supply system (NSSS) and fuel vendor representatives, Institute of Nuclear Power Operations (INPO) representatives, consultants, and EPRI staff collaborated in reviewing the available data on primary water chemistry, reactor water coolant system materials issues, fuel integrity and performance issues, and radiation dose rate issues. From the data, the committee updated the water chemistry guidelines that all PWR nuclear plants should adopt. The committee revised guidance with regard to optimization to reflect industry experience gained since the publication of Revision 6. Among the changes, the technical information regarding the impact of zinc injection on PWSCC initiation and dose rate reduction has been updated to reflect the current level of knowledge within the industry. Similarly, industry experience with elevated lithium concentrations with regard to fuel performance and radiation dose rates has been updated to reflect data collected to date. Recognizing that each nuclear plant owner has a unique set of design, operating, and corporate concerns, the guidelines committee has retained a method for plant-specific optimization. Revision 7 of the Pressurized Water Reactor Primary Water Chemistry Guidelines provides guidance for PWR primary systems of all manufacture and design. The guidelines continue to emphasize plant

  7. 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)

  8. 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

    provides examples of how guideline developers perceive and approach the issue of implementation during the development and early launch of prevention guidelines. Models for guideline development could benefit from an initial assessment of how the guideline topic, its target context and stakeholders will affect the upcoming implementation.

  9. Measure Guideline: Window Repair, Rehabilitation, and Replacement

    Energy Technology Data Exchange (ETDEWEB)

    Baker, P.

    2012-12-01

    This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

  10. Guidelines for the environmental protection in peat mining; Turvetuotannon ympaeristoensuojeluohje

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-15

    The objective of these guidelines is to accelerate environmental protection in peat mining and to reduce the harmful effects caused by its related activities. The guidelines promote achievement of environmental objectives set both in legislation and government programmes through uniform practices and interpretations. The guidelines are based on current valid legislation. The guidelines provide up-to-date information on best practices in peat mining, especially in water protection but also in reducing noise and dust. They are intended to ease the work of both peat producers and the licensing and controlling authorities. The guidelines are not legally binding and must be applied on case-by-case basis. The current guidelines replace the 'Guidelines for environmental protection in peat mining' given in 2008. (orig.)

  11. Toward improved guideline quality: using the COGS statement with GEM.

    Science.gov (United States)

    Shiffman, Richard N; Michel, Georges

    2004-01-01

    The Conference on Guideline Standardization (COGS) was convened to create a standardized documentation checklist for clinical practice guidelines in an effort to promote guideline quality and facilitate implementation. The statement was created by a multidisciplinary panel using a rigorous consensus development methodology. The Guideline Elements Model (GEM) provides a standardized approach to representing guideline documents using XML. In this work, we demonstrate the sufficiency of GEM for describing COGS components. Using the mapping between COGS and GEM elements we built an XSLT application to examine a guideline's adherence (or non-adherence) to the COGS checklist. Once a guideline has been marked up according to the GEM hierarchy, its knowledge content can be reused in multiple ways.

  12. Instructional Guidelines. Welding.

    Science.gov (United States)

    Fordyce, H. L.; Doshier, Dale

    Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

  13. pre-art guidelines

    African Journals Online (AJOL)

    Enrique

    2004-11-01

    Nov 1, 2004 ... As these guidelines address pre-ART issues, only conditions that occur at ... All HIV-infected adults who are immunosuppressed, i.e. ... therefore recommended that HIV-infected health care ... vaccine in severely immunosuppressed persons, i.e. those ... with residual insecticides, the use of larvicides, and.

  14. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Wattjes, Mike P; Rovira, Àlex; Miller, David

    2015-01-01

    . This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We...

  15. Formalization of Medical Guidelines

    Czech Academy of Sciences Publication Activity Database

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

    2005-01-01

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

  16. GRADE Equity Guidelines 3

    DEFF Research Database (Denmark)

    Welch, Vivian A; Akl, Elie A; Pottie, Kevin

    2017-01-01

    OBJECTIVE: The aim of this paper is to describe a conceptual framework for how to consider health equity in the GRADE (Grading Recommendations Assessment and Development Evidence) guideline development process. STUDY DESIGN AND SETTING: Consensus-based guidance developed by the GRADE working grou...

  17. Field Campaign Guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-01

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

  18. Curricular Guidelines for Neuroanatomy.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    Presented are the curricular guidelines for Neuroanatomy developed by the Section on Anatomical Sciences of the American Association of Dental Schools for use by individual educational institutions as curriculum development aids. Included are recommendations for primary educational goals, prerequisites, scope, content, behavioral objectives,…

  19. Space Guidelines for Libraries.

    Science.gov (United States)

    Wisconsin Coordinating Committee for Higher Education, Madison.

    The following guidelines are recommended: stack space--for each 10 volumes, one square foot of space; reading room--25 square feet per station x 20% of the total undergraduate population; carrel space--25% of the graduate enrollment x 45 square feet; office and auxilliary space--135 square feet x full time equivalent staff. (NI)

  20. Guidelines on testicular cancer

    NARCIS (Netherlands)

    Albers, Peter; Albrecht, Walter; Algaba, Ferran; Bokemeyer, Carsten; Cohn-Cedermark, Gabriella; Horwich, Alan; Klepp, Olbjoern; Laguna, M. Pilar; Pizzocaro, Giorgio

    2005-01-01

    To up-date the 2001 version of the EAU testicular cancer guidelines. A non-structured literature review until January 2005 using the MEDLINE database has been performed. Literature has been classified according to evidence-based medicine levels. Testicular cancer is a highly curable disease.

  1. Guidelines for Urban Labs

    DEFF Research Database (Denmark)

    Scholl, Christian; Agger Eriksen, Mette; Baerten, Nik

    2017-01-01

    urban lab initiatives from five different European cities: Antwerp (B), Graz and Leoben (A), Maastricht (NL) and Malmö (S). We do not pretend that these guidelines touch upon all possible challenges an urban lab may be confronted with, but we have incorporated all those we encountered in our...

  2. Guidelines for the design and management of artificial raptor ...

    African Journals Online (AJOL)

    The aim of this paper is to provide timber growers with silvicultural guidelines for the establishment of raptor perches and nest stands on forestry estates. Rodents do extensive damage to young saplings and as an ecologically friendly alternative to rodenticides, we provide guidelines on perch height and densities that can ...

  3. Glycogen Storage Disease Type III diagnosis and management guidelines

    NARCIS (Netherlands)

    Kishnani, Priya S.; Austin, Stephanie L.; Arn, Pamela; Bali, Deeksha S.; Med, Anne Boney; Case, Laura E.; Chung, Wendy K.; Desai, Dev M.; El-Gharbawy, Areeg; Haller, Ronald; Smit, G. Peter A.; Smith, Alastair D.; Hobson-Webb, Lisa D.; Wechsler, Stephanie Burns; Weinstein, David A.; Watson, Michael S.

    Disclaimer: ACMG standards and guidelines are designed primarily as an educational resource for medical geneticists and other health care providers to help them provide quality medical genetic services. Adherence to these standards and guidelines does not necessarily ensure a successful medical

  4. Physicians' preferences for asthma guidelines implementation.

    Science.gov (United States)

    Kang, Min-Koo; Kim, Byung-Keun; Kim, Tae-Wan; Kim, Sae-Hoon; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Kim, Sun-Sin; Min, Kyung-Up; Kim, You-Young; Cho, Sang-Heon

    2010-10-01

    Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile. A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4±9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records. This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians' preferences would encourage their implementation in clinical practice.

  5. 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.

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

    Science.gov (United States)

    Planjar-Prvan, Miljenka; Granić, Davorka

    2005-01-01

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

  7. 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

  8. Epilepsy and vaccinations: Italian guidelines.

    Science.gov (United States)

    Pruna, Dario; Balestri, Paolo; Zamponi, Nelia; Grosso, Salvatore; Gobbi, Giuseppe; Romeo, Antonino; Franzoni, Emilio; Osti, Maria; Capovilla, Giuseppe; Longhi, Riccardo; Verrotti, Alberto

    2013-10-01

    Reports of childhood epilepsies in temporal association with vaccination have had a great impact on the acceptance of vaccination programs by health care providers, but little is known about this possible temporal association and about the types of seizures following vaccinations. For these reasons the Italian League Against Epilepsy (LICE), in collaboration with other Italian scientific societies, has decided to generate Guidelines on Vaccinations and Epilepsy. The aim of Guidelines on Vaccinations and Epilepsy is to present recent unequivocal evidence from published reports on the possible relationship between vaccines and epilepsy in order to provide information about contraindications and risks of vaccinations in patients with epilepsy. The following main issues have been addressed: (1) whether contraindications to vaccinations exist in patients with febrile convulsions, epilepsy, and/or epileptic encephalopathies; and (2) whether any vaccinations can cause febrile seizures, epilepsy, and/or epileptic encephalopathies. Diphtheria-tetanus-pertussis (DTP) vaccination and measles, mumps, and rubella vaccination (MMR) increase significantly the risk of febrile seizures. Recent observations and data about the relationships between vaccination and epileptic encephalopathy show that some cases of apparent vaccine-induced encephalopathy could in fact be caused by an inherent genetic defect with no causal relationship with vaccination. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

  9. Guidelines for Building Science Education

    Energy Technology Data Exchange (ETDEWEB)

    Metzger, Cheryn E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rashkin, Samuel [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Huelman, Pat [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-11-01

    The U.S. Department of Energy’s (DOE) residential research and demonstration program, Building America, has triumphed through 20 years of innovation. Partnering with researchers, builders, remodelers, and manufacturers to develop innovative processes like advanced framing and ventilation standards, Building America has proven an energy efficient design can be more cost effective, healthy, and durable than a standard house. As Building America partners continue to achieve their stretch goals, they have found that the barrier to true market transformation for high performance homes is the limited knowledge-base of the professionals working in the building industry. With dozens of professionals taking part in the design and execution of building and selling homes, each person should have basic building science knowledge relevant to their role, and an understanding of how various home components interface with each other. Instead, our industry typically experiences a fragmented approach to home building and design. After obtaining important input from stakeholders at the Building Science Education Kick-Off Meeting, DOE created a building science education strategy addressing education issues preventing the widespread adoption of high performance homes. This strategy targets the next generation and provides valuable guidance for the current workforce. The initiative includes: • Race to Zero Student Design Competition: Engages universities and provides students who will be the next generation of architects, engineers, construction managers and entrepreneurs with the necessary skills and experience they need to begin careers in clean energy and generate creative solutions to real world problems. • Building Science to Sales Translator: Simplifies building science into compelling sales language and tools to sell high performance homes to their customers. • Building Science Education Guidance: Brings together industry and academia to solve problems related to

  10. 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.

  11. Medicare depreciation; useful life guidelines--HCFA. Proposed rule.

    Science.gov (United States)

    1982-09-30

    We are proposing to amend Medicare regulations to clarify which useful life guidelines providers of health care services may use to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize HHS useful life guidelines or, if none have been published by HHS, the American Hospital Association (AHA) useful life guidelines of 1973 or IRS guidelines. We are proposing to eliminate the reference to IRS guidelines because those previously acceptable for Medicare purposes are outdated and have been made obsolete by the IRS or by statutory change. We would also delete the specific reference to the 1973 AHA guidelines. In addition, we intend this amendment to clarify that certain tax legislation on accelerated depreciation, recently passed by Congress, does not apply to the Medicare program.

  12. 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 ...

  13. 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.

  14. 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.

  15. Guidelines for acute ischemic stroke treatment: part II: stroke treatment

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Ouriques Martins

    2012-11-01

    Full Text Available The second part of these Guidelines covers the topics of antiplatelet, anticoagulant, and statin therapy in acute ischemic stroke, reperfusion therapy, and classification of Stroke Centers. Information on the classes and levels of evidence used in this guideline is provided in Part I. A translated version of the Guidelines is available from the Brazilian Stroke Society website (www.sbdcv.com.br.

  16. Industry guidelines for the calibration of maximum anemometers

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, B.H. [AWS Scientific, Inc., Albany, NY (United States)

    1996-12-31

    The purpose of this paper is to report on a framework of guidelines for the calibration of the Maximum Type 40 anemometer. This anemometer model is the wind speed sensor of choice in the majority of wind resource assessment programs in the U.S. These guidelines were established by the Utility Wind Resource Assessment Program. In addition to providing guidelines for anemometers, the appropriate use of non-calibrated anemometers is also discussed. 14 refs., 1 tab.

  17. Severe accident management guidelines

    International Nuclear Information System (INIS)

    Uhle, Jennifer

    2014-01-01

    The events at Fukushima Daiichi have highlighted the importance of Severe Accident Management Guidelines (SAMGs). As the world has learned from the catastrophe and countries are considering changes to their nuclear regulatory programs, the content of SAMGs and their regulatory control are being evaluated. This presentation highlights several factors that are being addressed in the United States as rulemaking is underway pertaining to SAMGs. The question of how to be prepared for the unexpected is discussed with specific insights gleaned from Fukushima. (author)

  18. Guidelines on oncologic imaging

    International Nuclear Information System (INIS)

    1989-01-01

    The present issue of European Journal of Radiology is devoted to guidelines on oncologic imaging. 9 experts on imaging in suspected or evident oncologic disease have compiled a broad survey on strategies as well as techniques on oncologic imaging. The group gives advice for detecting tumours at specific tumour sites and use modern literature to emphasize their recommendations. All recommendations are short, comprehensive and authoritative. (orig./MG)

  19. Guidelines for Urban Labs

    DEFF Research Database (Denmark)

    Scholl, Christian; Agger Eriksen, Mette; Baerten, Nik

    2017-01-01

    These guidelines are intended for team members and managers of urban labs and, more generally, for civil servants and facilitators in cities working with experimental processes to tackle complex challenges. They aim to support the everyday practice of collaboratively experimenting and learning ho...... the result is inspiring and instructive for all those who want to wrap their minds around experimental co-creative approaches to urban governance and city development....

  20. Cancer screening guidelines.

    Science.gov (United States)

    Zoorob, R; Anderson, R; Cefalu, C; Sidani, M

    2001-03-15

    Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.

  1. Measure Guideline. Internal Insulation of Masonry Walls

    Energy Technology Data Exchange (ETDEWEB)

    Straube, J. F. [Building Science Corporation (BSC), Somerville, MA (United States); Ueno, K. [Building Science Corporation (BSC), Somerville, MA (United States); Schumacher, C. J. [Building Science Corporation (BSC), Somerville, MA (United States)

    2012-07-01

    This measure guideline provides recommendations for interior insulation assemblies that control interstitial condensation and durability risks; recommendations for acceptable thermal performance are also provided. An illustrated guide of high-risk exterior details (which concentrate bulk water), and recommended remediation details is provided. This is followed by a recommended methodology for risk assessment of a masonry interior insulation project: a series of steps are suggested to assess the risks associated with this retrofit, with greater certainty with added steps.

  2. Measure Guideline: Internal Insulation of Masonry Walls

    Energy Technology Data Exchange (ETDEWEB)

    Straube, J. F.; Ueno, K.; Schumacher, C. J.

    2012-07-01

    This measure guideline provides recommendations for interior insulation assemblies that control interstitial condensation and durability risks; recommendations for acceptable thermal performance are also provided. An illustrated guide of high-risk exterior details (which concentrate bulk water), and recommended remediation details is provided. This is followed by a recommended methodology for risk assessment of a masonry interior insulation project: a series of steps are suggested to assess the risks associated with this retrofit, with greater certainty with added steps.

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

    Directory of Open Access Journals (Sweden)

    Joslyn S. Kirby

    2015-01-01

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

  4. Guideline for Optical Character Recognition Forms.

    Science.gov (United States)

    National Bureau of Standards (DOC), Washington, DC.

    This publication provides materials relating to the design, preparation, acquisition, inspection, and application of Optical Character Recognition (OCR) forms in data entry systems. Since the materials are advisory and tutorial in nature, this publication has been issued as a guideline rather than as a standard in the Federal Information…

  5. Montana Curriculum Guidelines for Distributive Education. Revised.

    Science.gov (United States)

    Harris, Ron, Ed.

    These distributive education curriculum guidelines are intended to provide Montana teachers with teaching information for 11 units. Units cover introduction to marketing and distributive education, human relations and communications, operations and control, processes involved in buying for resale, merchandise handling, sales promotion, sales and…

  6. Guidelines for upgrading of low volume roads

    CSIR Research Space (South Africa)

    Division of Roads

    1993-03-01

    Full Text Available The purpose of this manual is to provide guidelines on the upgrading of gravel low volume roads to roads and maintenance personnel of road authorities of all sizes. Low volume is, for the purpose of this document, defined to be less than 500...

  7. Sandia software guidelines: Software quality planning

    Energy Technology Data Exchange (ETDEWEB)

    1987-08-01

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

  8. Strategy Guideline: Proper Water Heater Selection

    Energy Technology Data Exchange (ETDEWEB)

    Hoeschele, M. [Alliance for Residential Building Innovation, Davis, CA (United States); Springer, D. [Alliance for Residential Building Innovation, Davis, CA (United States); German, A. [Alliance for Residential Building Innovation, Davis, CA (United States); Staller, J. [Alliance for Residential Building Innovation, Davis, CA (United States); Zhang, Y. [Alliance for Residential Building Innovation, Davis, CA (United States)

    2015-04-01

    This Strategy Guideline on proper water heater selection was developed by the Building America team Alliance for Residential Building Innovation to provide step-by-step procedures for evaluating preferred cost-effective options for energy efficient water heater alternatives based on local utility rates, climate, and anticipated loads.

  9. Strategy Guideline. Proper Water Heater Selection

    Energy Technology Data Exchange (ETDEWEB)

    Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Springer, D. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Staller, J. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Zhang, Y. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

    2015-04-09

    This Strategy Guideline on proper water heater selection was developed by the Building America team Alliance for Residential Building Innovation to provide step-by-step procedures for evaluating preferred cost-effective options for energy efficient water heater alternatives based on local utility rates, climate, and anticipated loads.

  10. Commentary on recent therapeutic guidelines for osteoarthritis.

    Science.gov (United States)

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

    2015-06-01

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

  11. Measure Guideline. High Efficiency Natural Gas Furnaces

    Energy Technology Data Exchange (ETDEWEB)

    Brand, L. [Partnership for Advanced Residential Retrofit (PARR), Des Plaines, IL (United States); Rose, W. [Partnership for Advanced Residential Retrofit (PARR), Des Plaines, IL (United States)

    2012-10-01

    This measure guideline covers installation of high-efficiency gas furnaces, including: when to install a high-efficiency gas furnace as a retrofit measure; how to identify and address risks; and the steps to be used in the selection and installation process. The guideline is written for Building America practitioners and HVAC contractors and installers. It includes a compilation of information provided by manufacturers, researchers, and the Department of Energy as well as recent research results from the Partnership for Advanced Residential Retrofit (PARR) Building America team.

  12. Specific GMP guidelines for radiopharmaceutical products

    International Nuclear Information System (INIS)

    2000-01-01

    These guidelines are intended to complement those provided in ''Good manufacturing practices for pharmaceutical products'', as well as the GMP for sterile pharmaceutical products. The regulatory procedures necessary to control radiopharmaceutical products are in large part determined by the sources of products and methods of manufacture. Manufacturing procedures within the scope of these guidelines include: preparation of radiopharmaceuticals in hospital radiopharmacies, preparation of radiopharmaceuticals in centralized radiopharmacies, production of radiopharmaceuticals in nuclear centres, institutes or industrial manufacturers, preparation and production of radiopharmaceuticals in Positron Emission Tomography (PET) centres

  13. Guidelines for the practice of radiopharmacy

    International Nuclear Information System (INIS)

    1988-05-01

    The main objective of the guidelines is to establish minimum standards for the practice of radiopharmacy in Australia and New Zealand. The guidelines are intended to provide a basis for the safe and efficient practice of radiopharmacy in a hospital or clinical environment. They cover premises in which radiopharmacy is practised; procurement and use of sealed and unsealed radioactive sources; radiopharmaceutical HOT LAB dose preparation; routine quality control procedures; dispensing of radiopharmaceuticals; distribution of radiopharmaceuticals; record keeping; basic radiation protection procedures; consultation and education; research and development; and the preparation of sterile radiopharmaceuticals

  14. Measure Guideline: High Efficiency Natural Gas Furnaces

    Energy Technology Data Exchange (ETDEWEB)

    Brand, L.; Rose, W.

    2012-10-01

    This Measure Guideline covers installation of high-efficiency gas furnaces. Topics covered include when to install a high-efficiency gas furnace as a retrofit measure, how to identify and address risks, and the steps to be used in the selection and installation process. The guideline is written for Building America practitioners and HVAC contractors and installers. It includes a compilation of information provided by manufacturers, researchers, and the Department of Energy as well as recent research results from the Partnership for Advanced Residential Retrofit (PARR) Building America team.

  15. Dietary Guidelines should reflect new understandings about adult protein needs

    Directory of Open Access Journals (Sweden)

    Layman Donald K

    2009-03-01

    Full Text Available Abstract Dietary Guidelines for Americans provide nutrition advice aimed at promoting healthy dietary choices for life-long health and reducing risk of chronic diseases. With the advancing age of the population, the 2010 Dietary Guidelines confront increasing risks for age-related problems of obesity, osteoporosis, type 2 diabetes, Metabolic Syndrome, heart disease, and sarcopenia. New research demonstrates that the meal distribution and amount of protein are important in maintaining body composition, bone health and glucose homeostasis. This editorial reviews the benefits of dietary protein for adult health, addresses omissions in current nutrition guidelines, and offers concepts for improving the Dietary Guidelines.

  16. 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...

  17. 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.

  18. 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

  19. Vitamin D supplementation guidelines.

    Science.gov (United States)

    Pludowski, Pawel; Holick, Michael F; Grant, William B; Konstantynowicz, Jerzy; Mascarenhas, Mario R; Haq, Afrozul; Povoroznyuk, Vladyslav; Balatska, Nataliya; Barbosa, Ana Paula; Karonova, Tatiana; Rudenka, Ema; Misiorowski, Waldemar; Zakharova, Irina; Rudenka, Alena; Łukaszkiewicz, Jacek; Marcinowska-Suchowierska, Ewa; Łaszcz, Natalia; Abramowicz, Pawel; Bhattoa, Harjit P; Wimalawansa, Sunil J

    2018-01-01

    Research carried out during the past two-decades extended the understanding of actions of vitamin D, from regulating calcium and phosphate absorption and bone metabolism to many pleiotropic actions in organs and tissues in the body. Most observational and ecological studies report association of higher serum 25-hydroxyvitamin D [25(OH)D] concentrations with improved outcomes for several chronic, communicable and non-communicable diseases. Consequently, numerous agencies and scientific organizations have developed recommendations for vitamin D supplementation and guidance on optimal serum 25(OH)D concentrations. The bone-centric guidelines recommend a target 25(OH)D concentration of 20ng/mL (50nmol/L), and age-dependent daily vitamin D doses of 400-800IU. The guidelines focused on pleiotropic effects of vitamin D recommend a target 25(OH)D concentration of 30ng/mL (75nmol/L), and age-, body weight-, disease-status, and ethnicity dependent vitamin D doses ranging between 400 and 2000IU/day. The wise and balanced choice of the recommendations to follow depends on one's individual health outcome concerns, age, body weight, latitude of residence, dietary and cultural habits, making the regional or nationwide guidelines more applicable in clinical practice. While natural sources of vitamin D can raise 25(OH)D concentrations, relative to dietary preferences and latitude of residence, in the context of general population, these sources are regarded ineffective to maintain the year-round 25(OH)D concentrations in the range of 30-50ng/mL (75-125nmol/L). Vitamin D self-administration related adverse effects, such as hypercalcemia and hypercalciuria are rare, and usually result from taking extremely high doses of vitamin D for a prolonged time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Guideline implementation strategies for specialist mental healthcare.

    Science.gov (United States)

    Girlanda, Francesca; Fiedler, Ines; Ay, Esra; Barbui, Corrado; Koesters, Markus

    2013-07-01

    Clinical practice guidelines in mental healthcare are viewed as an essential asset if appropriately developed and implemented. The purpose of this article was to review the existing literature on how guidelines should be implemented to optimize their impact on provider performance and patient outcomes in specialist mental healthcare settings. Findings from recent studies suggest a trend toward an improvement in process and patient outcomes following guideline implementation. However, studies are heterogeneous in terms of design, implementation strategies and outcome measures, making it very difficult to draw firm conclusions about which implementation strategy is effective in different healthcare contexts. Current knowledge about how guidelines should be implemented is still sparse and inconclusive in mental healthcare. Future studies should attempt to employ more rigorous designs, including random allocation of patients or clusters of patients, to shed further light on this compelling issue. Research on guideline implementation strategies should additionally take into account potential barriers to knowledge translation, which can heavily influence the implementability of treatment recommendations.

  1. Japanese guidelines for childhood asthma 2017.

    Science.gov (United States)

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

    2017-04-01

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

  2. Design Guidelines for New Generation Network Architecture

    Science.gov (United States)

    Harai, Hiroaki; Fujikawa, Kenji; Kafle, Ved P.; Miyazawa, Takaya; Murata, Masayuki; Ohnishi, Masaaki; Ohta, Masataka; Umezawa, Takeshi

    Limitations are found in the recent Internet because a lot of functions and protocols are patched to the original suite of layered protocols without considering global optimization. This reveals that end-to-end argument in the original Internet was neither sufficient for the current societal network and nor for a sustainable network of the future. In this position paper, we present design guidelines for a future network, which we call the New Generation Network, which provides the inclusion of diverse human requirements, reliable connection between the real-world and virtual network space, and promotion of social potentiality for human emergence. The guidelines consist of the crystal synthesis, the reality connection, and the sustainable & evolutional guidelines.

  3. Corrosion-under-insulation (CUI) guidelines

    CERN Document Server

    Staff, European Federation of Corrosion; Winnik, S

    2014-01-01

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

  4. Guidelines for testing sealed radiation sources

    International Nuclear Information System (INIS)

    1989-01-01

    These guidelines are based on article 16(1) of the Ordinance on the Implementation of Atomic Safety and Radiation Protection dated 11 October 1984 (VOAS), in connection with article 36 of the Executory Provision to the VOAS, of 11 October 1984. They apply to the testing of sealed sources to verify their intactness, tightness and non-contamination as well as observance of their fixed service time. The type, scope and intervals of testing as well as the evaluation of test results are determined. These guidelines also apply to the testing of radiation sources forming part of radiation equipment, unless otherwise provided for in the type license or permit. These guidelines enter into force on 1 January 1990

  5. 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.

  6. Practice guidelines. Cookbook medicine.

    Science.gov (United States)

    Harding, J

    1994-08-01

    A large measure of the confusion and doubt currently being sowed in the ongoing debate over the advisability and effectiveness of practice guidelines is a matter of terminology. In deference to the wishes and fears of physicians, the term "requirements" is not used. But requirements they are. Their quality and the degree to which they are useful will depend on their level of detail and the degree to which they are based on positive outcomes. Regardless, attorneys and others will always view and use them as requirements.

  7. CAD-guidelines

    International Nuclear Information System (INIS)

    Schlechtendahl, E.G.; Lang-Lendorff, G.

    1982-10-01

    The CAD-guidelines (CAD = Computer Aided Design) contain rules for programming, structuring and documentation of programs. The standard deals with the structure of CAD-programs, their components, the programming-methods, the language etc. It describes what documents and references are necessary for a CAD-program. In order to gain a broad application of CAD criteria like portability and completeness of the documentation for an effective maintenance are as important as a transparent way of producing CAD-software. (orig.) [de

  8. American Association of Dental Schools Curricular Guidelines for Oral Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1980

    1980-01-01

    Oral radiology curricular guidelines developed by the American Association of Dental Schools are provided. The guidelines describe minimal conditions under which a satisfactory educational experience can be offered. Principles of x-radiation, radiobiological concepts, radiological health, radiographic technique, radiographic quality, and darkroom…

  9. 42 CFR 422.2264 - Guidelines for CMS review.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Guidelines for CMS review. 422.2264 Section 422... Guidelines for CMS review. In reviewing marketing material or election forms under § 422.2262 of this part, CMS determines that the marketing materials— (a) Provide, in a format (and, where appropriate, print...

  10. The Dietary Guidelines For Americans 2005: Executive Summary

    Science.gov (United States)

    Health Educator, 2005

    2005-01-01

    The Dietary Guidelines for Americans [Dietary Guidelines] provides science-based advice to promote health and to reduce risk for major chronic diseases through diet and physical activity. Major causes of morbidity and mortality in the United States are related to poor diet and a sedentary lifestyle. Some specific diseases linked to poor diet and…

  11. Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis

    DEFF Research Database (Denmark)

    Wyse, Jonathan M; Battat, Robert; Sun, Siyu

    2017-01-01

    OBJECTIVES: The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). METHODS: Six important clinical...

  12. Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis

    NARCIS (Netherlands)

    Wyse, J.M. (Jonathan M.); Battat, R. (Robert); Sun, S. (Siyu); A. Saftoiu (Adrian); Siddiqui, A.A. (Ali A.); Leong, A.T. (Ang Tiing); Arias, B.L.A. (Brenda Lucia Arturo); Fabbri, C. (Carlo); Adler, D.G. (Douglas G.); Santo, E. (Erwin); Kalaitzakis, E. (Evangelos); Artifon, E. (Everson); Mishra, G. (Girish); Okasha, H.H. (Hussein Hassan); J.-W. Poley (Jan-Werner); Guo, J. (Jintao); Vila, J.J. (Juan J.); Lee, L.S. (Linda S.); Sharma, M. (Malay); Bhutani, M.S. (Manoop S.); M. Giovannini (Marcello); Kitano, M. (Masayuki); Eloubeidi, M.A. (Mohamad Ali); Khashab, M.A. (Mouen A.); Nguyen, N.Q. (Nam Q.); Saxena, P. (Payal); Vilmann, P. (Peter); Fusaroli, P. (Pietro); Garg, P.K. (Pramod Kumar); Ho, S. (Sammy); Mukai, S. (Shuntaro); Carrara, S. (Silvia); Sridhar, S. (Subbaramiah); S. Lakhtakia (S.); Rana, S.S. (Surinder S.); Dhir, V. (Vinay); Sahai, A.V. (Anand V.)

    2017-01-01

    textabstractObjectives: The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). Methods: Six important

  13. 49 CFR Appendix F to Part 240 - Medical Standards Guidelines

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Medical Standards Guidelines F Appendix F to Part 240 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD.... F Appendix F to Part 240—Medical Standards Guidelines (1) The purpose of this appendix is to provide...

  14. Strategy Guideline: Quality Management in Existing Homes - Cantilever Floor Example

    Energy Technology Data Exchange (ETDEWEB)

    Taggart, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Sikora, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Wiehagen, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Wood, A. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States)

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented.

  15. Guidelines for gloveboxes. Section 5.14: Electrical

    International Nuclear Information System (INIS)

    Tollner, R.L.

    1995-07-01

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

  16. Safety guidelines for magnetic resonance diagnostic facilities (1991)

    International Nuclear Information System (INIS)

    1992-01-01

    These guidelines provide information on levels and health effects of exposure to magnetic and radiofrequency electromagnetic fields associated with magnetic resonance (MR) devices, and on precautions to minimize effects on patients, staff, and the general public. The guidelines are for use by regulatory authorities, MR users and health professionals. 22 refs., 1 tab

  17. Integrating Practice Guidelines into Professional Training: Implications for Diversity Competence

    Science.gov (United States)

    Miville, Marie L.; Duan, Changming; Nutt, Roberta L.; Waehler, Charles A.; Suzuki, Lisa; Pistole, M. Carole; Arredondo, Patricia; Duffy, Michael; Mejia, Brenda X.; Corpus, Melissa

    2009-01-01

    The authors present the findings of a special task group (STG) organized to explore effective training strategies for the practice guidelines focused on diverse populations. They provide a brief literature review and summarize survey data from academic training directors regarding current use of practice guidelines. The authors then describe the…

  18. Systematic review of guidelines for the physical management of osteoarthritis.

    Science.gov (United States)

    Larmer, Peter J; Reay, Nicholas D; Aubert, Elizabeth R; Kersten, Paula

    2014-02-01

    To undertake a systematic critical appraisal of guidelines to provide a summary of recommendations for the physical management of osteoarthritis (OA). The Cochrane Library, MEDLINE, CINAHL, SPORTDiscus with Full Text, Scopus, ScienceDirect, PEDro, and Google Scholar databases were searched (2000-2013) to identify all guidelines, protocols, and recommendations for the management or treatment of OA. In addition, Internet searches of all relevant arthritis organizations were undertaken. All searches were performed between July 2012 and end of April 2013. Guidelines that included only pharmacological, injection therapy, or surgical interventions were excluded. Guidelines published only in English were retrieved. OA guidelines developed from evidence-based research, consensus, and/or expert opinion were retrieved. There were no restrictions on severity or site of OA, sex, or age. Nineteen guidelines were identified for evaluation. The quality of all guidelines was critically appraised using the Appraisal of Guidelines for REsearch and Evaluation II instrument. Each guideline was independently reviewed. All relevant recommendations for the physical management of OA were synthesized, graded, and ranked according to available evidence. Seventeen guidelines with recommendations on the physical management of OA met the inclusion criteria and underwent a full critical appraisal. There were variations in the interventions, levels of evidence, and strength of recommendations across the guidelines. Forty different interventions were identified. Recommendations were graded from "strongly recommended" to "unsupported." Exercise and education were found to be strongly recommended by most guidelines. Exercise and education were key recommendations supporting the importance of rehabilitation in the physical management of OA. This critical appraisal can assist health care providers who are involved in the management of people with OA. Copyright © 2014 American Congress of

  19. Soil and groundwater remediation guidelines for methanol

    International Nuclear Information System (INIS)

    2010-12-01

    Methanol is used by oil and gas operators to inhibit hydrate formation in the recovery of heavy oils, in natural gas production and transport, as well as in various other production applications. Emissions from methanol primary occur from miscellaneous solvent usage, methanol production, end-product manufacturing, and storage and handling losses. This document provided soil and groundwater remediation guidelines for methanol releases into the environment. The guidelines were consistent with the Alberta Environment tier 1 soil and groundwater framework. The chemical and physical properties of methanol were reviewed. The environmental fate and behavior of methanol releases was discussed, and the behaviour and effects of methanol in terrestrial and aquatic biota were evaluated. The toxicity of methanol and its effects in humans and mammalian species were reviewed. Soil quality and ground water quality guidelines were presented. Surface water and soil guideline calculation methods were provided, and ecological exposure and ground water pathways were discussed. Management limits for methanol concentrations were also provided. 162 refs., 18 tabs., 4 figs.

  20. Current Cervical Carcinoma Screening Guidelines

    Directory of Open Access Journals (Sweden)

    Megan J. Schlichte

    2015-05-01

    Full Text Available A formidable threat to the health of women, cervical carcinoma can be prevented in many cases with adequate screening. The current guidelines for cervical carcinoma screening were created as joint recommendations of the American Cancer Society (ACS, the American Society for Colposcopy and Cervical Pathology (ASCCP and the American Society for Clinical Pathology (ASCP in 2012, and later accepted and promoted by the American Congress of Obstetricians and Gynecologists (ACOG. The 2012 recommendations underscore the utility of molecular testing as an adjunct to cytology screening for certain women and provide guidance to clinicians based on different risk-benefit considerations for different ages. This manuscript will review screening techniques and current recommendations for cervical cancer screening and human papilloma virus (HPV testing, as well as possible future screening strategies.

  1. Environmental audit guidelines for pipelines

    International Nuclear Information System (INIS)

    1991-01-01

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

  2. Guideline-related barriers to optimal prescription of oral anticoagulants in primary care

    NARCIS (Netherlands)

    Beukenhorst, A. L.; Arts, D. L.; Lucassen, W.; Jager, K. J.; van der Veer, S. N.

    2016-01-01

    Guidelines provide recommendations for antithrombotic treatment to prevent stroke in people with atrial fibrillation, but oral anticoagulant prescriptions in Dutch primary care are often discordant with these recommendations. Suboptimal guideline features (i.e. format and content) have been

  3. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... is comprised by fieldwork in three oncology departments and a case study of advanced life support. Although close to all patients within oncology are treated according to a CPG, I found limited application of physical CPGs and web-based CPG portals. However, I found comprehensive application of activity...... of the business strategic aims, and 3) analysis and formalization of CPGs. This will imply orchestration of design teams with competencies from a wide array of disciplines such as health practice, business management, knowledge management and information systems....

  4. [Anemia: guidelines comparison].

    Science.gov (United States)

    Del Vecchio, Lucia

    2009-01-01

    The development of recombinant human erythropoietin and its introduction into the market in the late 1980s has significantly improved the quality of life of patients with chronic kidney disease (CKD) and reduced the need for blood transfusions. Starting from a cautious target, a progressive increase in the recommended hemoglobin levels has been observed over the years, in parallel with an increase in the obtained levels. This trend has gone together with the publication of findings of observational studies showing a relationship between the increase in hemoglobin levels and a reduction in the mortality risk, with the conduction of clinical trials testing the effects of complete anemia correction, and with the compilation of guidelines on anemia control in CKD patients by scientific societies and organizations. In the last two years, evidence of a possible increase in the mortality risk in those patients who were randomized to high hemoglobin levels has resulted in a decrease in the upper limit of the recommended Hb target to be obtained with erythropoietin stimulating agents (ESA), and consequently in a narrowing of the target range. Comparison of guidelines on anemia control in CKD patients is an interesting starting point to discuss single recommendations, strengthen their importance, or suggest new topics of research to fill up important gaps in knowledge.

  5. Postdoctoral program guidelines.

    Energy Technology Data Exchange (ETDEWEB)

    Teich-McGoldrick, Stephanie; Miller, Andrew W.; Sava, Dorina Florentina; Liu, Yanli; Ferreira, Summer Rhodes; Biedermann, Laura Butler; Cruz-Campa, Jose Luis; Hall, Lisa Michelle; Liu, Xiaohua H.; Ekoto, Isaac

    2012-04-01

    We, the Postdoc Professional Development Program (PD2P) leadership team, wrote these postdoc guidelines to be a starting point for communication between new postdocs, their staff mentors, and their managers. These guidelines detail expectations and responsibilities of the three parties, as well as list relevant contacts. The purpose of the Postdoc Program is to bring in talented, creative people who enrich Sandia's environment by performing innovative R&D, as well as by stimulating intellectual curiosity and learning. Postdocs are temporary employees who come to Sandia for career development and advancement reasons. In general, the postdoc term is 1 year, renewable up to five times for a total of six years. However, center practices may vary; check with your manager. At term, a postdoc may apply for a staff position at Sandia or choose to move to university, industry or another lab. It is our vision that those who leave become long-term collaborators and advocates whose relationships with Sandia have a positive effect upon our national constituency.

  6. WHO Environmental Noise Guidelines for the European Region - What is new? 4. Implementation of guidelines and implications for practice

    NARCIS (Netherlands)

    Brink, M.; Babisch, W.; Belojevic, G.; Heroux, M.E.; Janssen, S.; Lercher, P.; Paviotti, M.; Pershagen, G.; Persson Waye, K.; Preis, A.; Stansfeld, S.; Van Den Berg, M.; Verbeek, J.

    2016-01-01

    WHO Environmental Noise Guidelines focus on the WHO European Region and provide guidance to its Member States that is compatible with the noise indicators used in the EU Environmental Noise Directive. The Guidelines aim to serve as a reference for several target audiences, such as decision makers

  7. British Columbia water quality guidelines (criteria): 1998 edition

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, N.K.; Pommen, L.W.; Swain, L.G.

    1998-08-01

    British Columbia has developed water quality guidelines in order that water quality data can be assessed and site-specific water quality objectives can be prepared. The guidelines provide benchmarks for the assessment of water quality and setting water quality objectives. Guidelines are provided to protect the following six major water uses: drinking water, aquatic life, wildlife, recreation/aesthetics, agriculture, and industrial. Water quality encompasses the physical, chemical and biological quality of the water, sediment and biota. Among other quality criteria the guide provides maximum approved concentrations for nitrogen, aluminum, copper, cyanide, lead, mercury, and molybdenum. 30 tabs.

  8. Risk management guidelines for petroleum storage tank sites

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-10-01

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

  9. 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.

  10. 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.

  11. Neck Pain: Clinical Practice Guidelines Help Ensure Quality Care.

    Science.gov (United States)

    2017-07-01

    In 2008, physical therapists published the first neck pain clinical practice guidelines. These guidelines have been updated and are now available in the July 2017 issue of JOSPT. To update these guidelines, physical therapists teamed with the International Collaboration on Neck Pain to identify leading practices. These revised guidelines provide direction to clinicians as they screen, evaluate, diagnose, and make treatment-based classifications of neck pain. They also outline the best nonsurgical treatment options based on the published literature. At the end of the day, the best care is a combination of the leading science, the clinical expertise of your health care provider, and your input as the patient. These guidelines help inform the first step in this process. J Orthop Sports Phys Ther 2017;47(7):513. doi:10.2519/jospt.2017.0508.

  12. The impact of qualitative research on gynaecologic oncology guidelines.

    Science.gov (United States)

    How, Jeffrey Andrew; Abitbol, Jeremie; Lau, Susie; Gotlieb, Walter Henri; Abenhaim, Haim Arie

    2015-02-01

    Inherent in the care provided to patients with cancer is an important psychosocial element which has been explored scientifically through qualitative research. The purpose of our study was to evaluate the availability of qualitative research in gynaecologic oncology and to measure its integration in gynaecologic oncology practice guidelines. We searched Medline, CINHAL, Scopus, and Web of Science databases to identify the availability of qualitative research conducted in the past 20 years on the three most prevalent gynaecologic cancers: endometrial, ovarian, and cervical cancer. National and international practice guidelines on management of gynaecologic cancers were selected using the National Guideline Clearinghouse website, the Society of Obstetricians and Gynaecologists of Canada website, and the Standards and Guidelines Evidence directory of cancer guidelines. Bibliometric analysis was used to determine the frequency of qualitative references cited in these guidelines. One hundred thirteen qualitative research papers on gynaecologic cancers were identified focusing on psychological impacts, social dynamics, and doctor-patient interactions during cancer treatment and recovery. Among the 15 national and international clinical practice guidelines identified on management of gynaecologic cancer, there were a total of 2272 references, and of these only three references citing qualitative research were identified (0.1%) in only one of the 15 practice guidelines. Although qualitative research is being carried out in gynaecologic oncology, its integration into clinical practice guidelines is essentially absent. Efforts to narrow the gap between qualitative research and clinical practice are essential in ensuring a comprehensive approach to the treatment of patients with gynaecologic cancer.

  13. Cost analysis guidelines

    International Nuclear Information System (INIS)

    Strait, R.S.

    1996-01-01

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

  14. Exploration of US men's professional sport organization concussion policies.

    Science.gov (United States)

    Cochrane, Graham Dean; Owen, Matthew; Ackerson, Joseph D; Hale, Matthew H; Gould, Sara

    2017-05-01

    Concussion policies are increasingly being developed and adopted among professional sports organizations. We sought to compare the policies of the National Hockey League (NHL), the National Basketball Association (NBA), the National Football League (NFL), and Major League Baseball (MLB). Our objective was to summarize each policy and evaluate the extent to which each policy is organization-specific and/or consistent with medical guidelines. We visited websites for the NHL, NBA, NFL, and MLB. We searched media articles reporting concussion policy. We utilized only publically available data. We collected information on each league's approach to the definition of concussion, education provided about concussion, baseline testing requirements, minimum return to play time and return to play protocol. We found that concussion policies vary across these organizations. Most organizations utilize the Concussion in Sport Group (CISG) definition (2013) to define concussion. The NFL and NBA mandate preseason education. All organizations require some type of baseline testing. All organizations require sideline evaluation after suspected concussion. The NFL and MLB require Sport Concussion Assessment Tool (SCAT) testing for sideline evaluation of suspected concussion. MLB is the only organization to require minimum time before return to play. There is a return to play protocol in place for each organization. The NFL and MLB require independent neurologic consultation as part of their return to play protocol. There is variability in concussion policy among the professional sports organizations. The most pronounced variation from the CISG consensus statement is the variability in the minimum time to return to play. Further, the rules of the individual sports have a role in how concussion policy can be designed and implemented. Professional sports set an example for thousands of recreational sports enthusiasts so their publically available policies on concussion have a large impact.

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

    Science.gov (United States)

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

    2015-12-01

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

  16. A Blueprint for Telerehabilitation Guidelines

    Directory of Open Access Journals (Sweden)

    David Brennan

    2010-10-01

    Full Text Available Telerehabilitation refers to the delivery of rehabilitation services via information and communication technologies.  Clinically, this term encompasses a range of rehabilitation and habilitation services that include assessment, monitoring, prevention, intervention, supervision, education, consultation, and counseling.  Telerehabilitation has the capacity to provide service across the lifespan and across a continuum of care.  Just as the services and providers of telerehabilitation are broad, so are the points of service, which may include health care settings, clinics, homes, schools, or community-based worksites. This document was developed collaboratively by members of the Telerehabilitation SIG of the American Telemedicine Association, with input and guidance from other practitioners in the field, strategic stakeholders, and ATA staff.   Its purpose is to inform and assist practitioners in providing effective and safe services that are based on client needs, current empirical evidence, and available technologies.   Telerehabilitation professionals, in conjunction with professional associations and other organizations are encouraged to use this document as a template for developing discipline-specific standards, guidelines, and practice requirements.      

  17. A blueprint for telerehabilitation guidelines.

    Science.gov (United States)

    Brennan, David; Tindall, Lyn; Theodoros, Deborah; Brown, Janet; Campbell, Michael; Christiana, Diana; Smith, David; Cason, Jana; Lee, Alan

    2010-01-01

    Telerehabilitation refers to the delivery of rehabilitation services via information and communication technologies. Clinically, this term encompasses a range of rehabilitation and habilitation services that include assessment, monitoring, prevention, intervention, supervision, education, consultation, and counseling. Telerehabilitation has the capacity to provide service across the lifespan and across a continuum of care. Just as the services and providers of telerehabilitation are broad, so are the points of service, which may include health care settings, clinics, homes, schools, or community-based worksites. This document was developed collaboratively by members of the Telerehabilitation SIG of the American Telemedicine Association, with input and guidance from other practitioners in the field, strategic stakeholders, and ATA staff. Its purpose is to inform and assist practitioners in providing effective and safe services that are based on client needs, current empirical evidence, and available technologies. Telerehabilitation professionals, in conjunction with professional associations and other organizations are encouraged to use this document as a template for developing discipline-specific standards, guidelines, and practice requirements.

  18. 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

  19. Technical guidelines for environmental dredging of contaminated sediments

    Science.gov (United States)

    2008-09-01

    This report provides technical guidelines for evaluating : environmental dredging as a sediment remedy component. This document : supports the Contaminated Sediment Remediation Guidance for : Hazardous Waste Sites, released by the U.S. Environmental ...

  20. VALIDATION GUIDELINES FOR LABORATORIES PERFORMING FORENSIC ANALYSIS OF CHEMICAL TERRORISM

    Science.gov (United States)

    The Scientific Working Group on Forensic Analysis of Chemical Terrorism (SWGFACT) has developed the following guidelines for laboratories engaged in the forensic analysis of chemical evidence associated with terrorism. This document provides a baseline framework and guidance for...

  1. Proposed guidelines for the management of nodding syndrome

    African Journals Online (AJOL)

    EB

    , Makerere ... and subsequently, physical and cognitive rehabilitation. ... guidelines were developed and provides an outline of the specific treatments currently ... physiotherapist and a speech and language therapist. .... poor adherence, etc.

  2. Fire protection guidelines for nuclear power plants, June 1976

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    Guidelines acceptable to the NRC staff for implementing in the development of a fire protection program for nuclear power plants. The purpose of the fire protection program is to ensure the capability to shut down the reactor and maintain it in a safe shutdown condition and to minimize radioactive releases to the environment in the event of a fire. If designs or methods different from the guidelines presented herein are used, they must provide fire protection comparable to that recommended in the guidelines. Suitable bases and justification should be provided for alternative approaches to establish acceptable implementation of General Design Criterion 3

  3. Clinical practice guideline: Allergic rhinitis.

    Science.gov (United States)

    Seidman, Michael D; Gurgel, Richard K; Lin, Sandra Y; Schwartz, Seth R; Baroody, Fuad M; Bonner, James R; Dawson, Douglas E; Dykewicz, Mark S; Hackell, Jesse M; Han, Joseph K; Ishman, Stacey L; Krouse, Helene J; Malekzadeh, Sonya; Mims, James Whit W; Omole, Folashade S; Reddy, William D; Wallace, Dana V; Walsh, Sandra A; Warren, Barbara E; Wilson, Meghan N; Nnacheta, Lorraine C

    2015-02-01

    Allergic rhinitis (AR) is one of the most common diseases affecting adults. It is the most common chronic disease in children in the United States today and the fifth most common chronic disease in the United States overall. AR is estimated to affect nearly 1 in every 6 Americans and generates $2 to $5 billion in direct health expenditures annually. It can impair quality of life and, through loss of work and school attendance, is responsible for as much as $2 to $4 billion in lost productivity annually. Not surprisingly, myriad diagnostic tests and treatments are used in managing this disorder, yet there is considerable variation in their use. This clinical practice guideline was undertaken to optimize the care of patients with AR by addressing quality improvement opportunities through an evaluation of the available evidence and an assessment of the harm-benefit balance of various diagnostic and management options. The primary purpose of this guideline is to address quality improvement opportunities for all clinicians, in any setting, who are likely to manage patients with AR as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The guideline is intended to be applicable for both pediatric and adult patients with AR. Children under the age of 2 years were excluded from the clinical practice guideline because rhinitis in this population may be different than in older patients and is not informed by the same evidence base. The guideline is intended to focus on a limited number of quality improvement opportunities deemed most important by the working group and is not intended to be a comprehensive reference for diagnosing and managing AR. The recommendations outlined in the guideline are not intended to represent the standard of care for patient management, nor are the recommendations intended to limit treatment or care provided to individual patients. The development group made a strong

  4. Canadian guidelines for acute bacterial rhinosinusitis

    Science.gov (United States)

    Kaplan, Alan

    2014-01-01

    Objective To provide a clinical summary of the Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) that includes relevant considerations for family physicians. Quality of evidence Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology—Head and Neck Surgery, Canadian Association of Emergency Physicians, and the Family Physicians Airways Group of Canada). Main message Diagnosis of ABRS is based on the presence of specific symptoms and their duration; imaging or culture are not needed in uncomplicated cases. Treatment is dependent on symptom severity, with intranasal corticosteroids (INCSs) recommended as monotherapy for mild and moderate cases, although the benefit might be modest. Use of INCSs plus antibiotics is reserved for patients who fail to respond to INCSs after 72 hours, and for initial treatment of patients with severe symptoms. Antibiotic selection must account for the suspected pathogen, the risk of resistance, comorbid conditions, and local antimicrobial resistance trends. Adjunct therapies such as nasal saline irrigation are recommended. Failure to respond to treatment, recurrent episodes, and signs of complications should prompt referral to an otolaryngologist. The guidelines address situations unique to the Canadian health care environment, including actions to take during prolonged wait periods for specialist referral or imaging. Conclusion The Canadian guidelines provide up-to-date recommendations for diagnosis and treatment of ABRS that reflect an evolving understanding of the disease. In addition, the guidelines offer useful tools to help

  5. 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

  6. 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…

  7. 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...

  8. Sexually Transmitted Diseases Treatment Guidelines, 2015

    Science.gov (United States)

    Workowski, Kimberly A.; Bolan, Gail A.

    2016-01-01

    Summary These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30–May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR–12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs. PMID:26042815

  9. Physical Activity Design Guidelines for School Architecture.

    Science.gov (United States)

    Brittin, Jeri; Sorensen, Dina; Trowbridge, Matthew; Lee, Karen K; Breithecker, Dieter; Frerichs, Leah; Huang, Terry

    2015-01-01

    Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

  10. Physical Activity Design Guidelines for School Architecture.

    Directory of Open Access Journals (Sweden)

    Jeri Brittin

    Full Text Available Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

  11. Guidelines for use of fishes in research

    Science.gov (United States)

    Use of Fishes in Research Committee (joint committee of the American Fisheries Society, the American Institute of Fishery Research Biologists

    2014-01-01

    The 2004 and 2014 Guidelines were developed to provide a structure that advances appropriate attention toward valid experimental designs and procedures with aquatic animals while ensuring humane treatment of the experimental subjects. At a practical level, the Guidelines are intended to provide general recommendations on field and laboratory endeavors, such as sampling, holding, and handling fishes; to offer information on administrative matters, including regulations and permits; and to address typical ethical concerns, such as perceptions of pain or discomfort experienced by experimental subjects. These Guidelines must be recognized as guidelines. They are not intended to provide detailed instructions but rather to alert investigators to a broad array of topics and concerns to consider prior to initiating study. At a comprehensive level, the principles upon which these Guidelines are based are broadly applicable, and many of the described practices and approaches can be adapted to situations involving other aquatic animal species and conditions. Understanding the differences between fishes and other vertebrates, especially mammals, is critically important to conducting scientifically sound research with fishes. Disparities in life histories and mortality rates in fishes versus other vertebrates are critical in designing sustainable sampling levels in fish populations. The UFR Committee points out that (1) compared to mammalian populations, adult populations of many fish species persist despite very high natural mortality rates in juvenile stages by virtue of the fact that most species lay thousands or tens of thousands of eggs; (2) because of these mortality patterns, research on fishes, especially field research or research on early life stages, can involve, and often requires, much larger numbers of research subjects than does research on mammals; and (3) the animal handling and husbandry requirements for fishes are fundamentally different from those for

  12. [Vascular access guidelines for hemodialysis].

    Science.gov (United States)

    Rodríguez Hernández, J A; González Parra, E; Julián Gutiérrez, J M; Segarra Medrano, A; Almirante, B; Martínez, M T; Arrieta, J; Fernández Rivera, C; Galera, A; Gallego Beuter, J; Górriz, J L; Herrero, J A; López Menchero, R; Ochando, A; Pérez Bañasco, V; Polo, J R; Pueyo, J; Ruiz, Camps I; Segura Iglesias, R

    2005-01-01

    Quality of vascular access (VA) has a remarkable influence in hemodialysis patients outcomes. Dysfunction of VA represents a capital cause of morbi-mortality of these patients as well an increase in economical. Spanish Society of Neprhology, aware of the problem, has decided to carry out a revision of the issue with the aim of providing help in comprehensión and treatment related with VA problems, and achieving an homogenization of practices in three mayor aspects: to increase arteriovenous fistula utilization as first vascular access, to increment vascular access monitoring practice and rationalise central catheters use. We present a consensus document elaborated by a multidisciplinar group composed by nephrologists, vascular surgeons, interventional radiologysts, infectious diseases specialists and nephrological nurses. Along six chapters that cover patient education, creation of VA, care, monitoring, complications and central catheters, we present the state of the art and propose guidelines for the best practice, according different evidence based degrees, with the intention to provide help at the professionals in order to make aproppiate decissions. Several quality standars are also included.

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

    Science.gov (United States)

    2016-01-01

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

  14. Guidelines for psychological practice with transgender and gender nonconforming people.

    Science.gov (United States)

    2015-12-01

    In 2015, the American Psychological Association adopted Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients in order to describe affirmative psychological practice with transgender and gender nonconforming (TGNC) clients. There are 16 guidelines in this document that guide TGNC-affirmative psychological practice across the lifespan, from TGNC children to older adults. The Guidelines are organized into five clusters: (a) foundational knowledge and awareness; (b) stigma, discrimination, and barriers to care; (c) lifespan development; (d) assessment, therapy, and intervention; and (e) research, education, and training. In addition, the guidelines provide attention to TGNC people across a range of gender and racial/ethnic identities. The psychological practice guidelines also attend to issues of research and how psychologists may address the many social inequities TGNC people experience. (c) 2015 APA, all rights reserved).

  15. Engineering design guidelines for nuclear criticality safety

    International Nuclear Information System (INIS)

    Waltz, W.R.

    1988-08-01

    This document provides general engineering design guidelines specific to nuclear criticality safety for a facility where the potential for a criticality accident exists. The guide is applicable to the design of new SRP/SRL facilities and to major modifications Of existing facilities. The document is intended an: A guide for persons actively engaged in the design process. A resource document for persons charged with design review for adequacy relative to criticality safety. A resource document for facility operating personnel. The guide defines six basic criticality safety design objectives and provides information to assist in accomplishing each objective. The guide in intended to supplement the design requirements relating to criticality safety contained in applicable Department of Energy (DOE) documents. The scope of the guide is limited to engineering design guidelines associated with criticality safety and does not include other areas of the design process, such as: criticality safety analytical methods and modeling, nor requirements for control of the design process

  16. Dam safety operating guidelines

    International Nuclear Information System (INIS)

    Elsayed, E.; Leung, T.; Kirkham, A.; Lum, D.

    1990-01-01

    As part of Ontario Hydro's dam structure assessment program, the hydraulic design review of several river systems has revealed that many existing dam sites, under current operating procedures, would not have sufficient discharge capacity to pass the Inflow Design Flood (IDF) without compromising the integrity of the associated structures. Typical mitigative measures usually considered in dealing with these dam sites include structural alterations, emergency action plans and/or special operating procedures designed for extreme floods. A pilot study was carried out for the Madawaska River system in eastern Ontario, which has seven Ontario Hydro dam sites in series, to develop and evaluate the effectiveness of the Dam Safety Operating Guidelines (DSOG). The DSOG consist of two components: the flood routing schedules and the minimum discharge schedules, the former of which would apply in the case of severe spring flood conditions when the maximum observed snowpack water content and the forecast rainfall depth exceed threshold values. The flood routing schedules would identify to the operator the optimal timing and/or extent of utilizing the discharge facilities at each dam site to minimize the potential for dam failures cased by overtopping anywhere in the system. It was found that the DSOG reduced the number of structures overtopped during probable maximum flood from thirteen to four, while the number of structures that could fail would be reduced from seven to two. 8 refs., 4 figs., 3 tabs

  17. Guideline level-3 PSA

    International Nuclear Information System (INIS)

    Roelofsen, P.M.; Van der Steen, J.

    1993-09-01

    For several applications of radioactive materials calculations must be executed to determine the radiation risk for the population. A guideline for the risk calculation method of two main sources: nuclear power plants, and other intended and unintended activities with radioactive materials, is given. The standards, recommendations and regulations in this report concern mainly the analysis of the radiological (external) consequences of nuclear power plant accidents, classified as level-3 PSA (Probabilistic Safety Analysis). Level-3 PSA falls within the scales 5-7 of the International Nuclear Event Scale (INES). The standards, etc., focus on the risks for groups of people and the so-called maximum individual risk. In chapter two the standards and regulations are formulated for each part of level-3 PSA: the source term spectrum, atmospheric distribution and deposition, exposure to radiation doses and calculation of radiation doses, dose-response relationships, measures to reduce the effect of radiation doses, design basis accidents, and finally uncertainty analysis. In chapter four, modelled descriptions are given of the standards and regulations, which could or should be used in a calculation program in case of level-3 PSA. In chapter three the practical execution of a probabilistic consequences analysis, the collection of input data and the presentation of the results are dealt with. 2 figs., 14 tabs., 64 refs

  18. 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.

  19. Guidelines for personal exposure monitoring of chemicals: Part III.

    Science.gov (United States)

    Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

    2018-01-25

    This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

  20. Guidelines for personal exposure monitoring of chemicals: Part IV.

    Science.gov (United States)

    Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

    2018-03-27

    This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

  1. Guidelines for personal exposure monitoring of chemicals: Part II.

    Science.gov (United States)

    Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

    2017-11-25

    This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

  2. Guidelines for personal exposure monitoring of chemicals: Part I.

    Science.gov (United States)

    Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

    2017-09-28

    This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided later in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

  3. Guidelines for personal exposure monitoring of chemicals: Part V.

    Science.gov (United States)

    Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

    2018-05-25

    This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

  4. American Clinical Neurophysiology Society Guideline 2: Guidelines for Standard Electrode Position Nomenclature.

    Science.gov (United States)

    Acharya, Jayant N; Hani, Abeer; Cheek, Janna; Thirumala, Partha; Tsuchida, Tammy N

    2016-08-01

    This revision to the EEG Guidelines is an update incorporating current electroencephalography technology and practice and was previously published as Guideline 5. While the 10-10 system of electrode position nomenclature has been accepted internationally for almost two decades, it has not been used universally. The reasons for this and clinical scenarios when the 10-10 system provides additional localizing information are discussed in this revision. In addition, situations in which AF1/2, AF5/6, PO1/2 and PO5/6 electrode positions may be utilized for EEG recording are discussed.

  5. 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...

  6. 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...

  7. 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...

  8. The Practice Guidelines for Primary Care of Acute Abdomen 2015.

    Science.gov (United States)

    Mayumi, Toshihiko; Yoshida, Masahiro; Tazuma, Susumu; Furukawa, Akira; Nishii, Osamu; Shigematsu, Kunihiro; Azuhata, Takeo; Itakura, Atsuo; Kamei, Seiji; Kondo, Hiroshi; Maeda, Shigenobu; Mihara, Hiroshi; Mizooka, Masafumi; Nishidate, Toshihiko; Obara, Hideaki; Sato, Norio; Takayama, Yuichi; Tsujikawa, Tomoyuki; Fujii, Tomoyuki; Miyata, Tetsuro; Maruyama, Izumi; Honda, Hiroshi; Hirata, Koichi

    2016-01-01

    Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine in collaboration with four other medical societies launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines [all clinical questions (CQs) and recommendations are shown in supplementary information]. A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on 9 subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.

  9. Review on Factors Influencing Physician Guideline Adherence in Cardiology.

    Science.gov (United States)

    Hoorn, C J G M; Crijns, H J G M; Dierick-van Daele, A T M; Dekker, L R C

    2018-04-09

    Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applicable guidelines. Female gender and older age had a negative effect on physician guideline adherence. In addition, independent of the type of heart disease, physicians without cardiologic specialization were linked to physician noncompliance. Also, guideline adherence in primary care centers was at a lower level compared to secondary or tertiary care centers. The importance of guideline adherence increases as patients age, and complex diseases and comorbidity arise. Appropriate resources and interventions, taking important factors for nonadherence in account, are necessary to improve guideline adoption and adherence in every level of the chain. This in turn should improve patient outcome.

  10. 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.

  11. 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.

  12. Castration-resistant prostate cancer: AUA Guideline.

    Science.gov (United States)

    Cookson, Michael S; Roth, Bruce J; Dahm, Philipp; Engstrom, Christine; Freedland, Stephen J; Hussain, Maha; Lin, Daniel W; Lowrance, William T; Murad, Mohammad Hassan; Oh, William K; Penson, David F; Kibel, Adam S

    2013-08-01

    This Guideline is intended to provide a rational basis for the management of patients with castration-resistant prostate cancer based on currently available published data. A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with keywords relating to the relevant concepts of prostate cancer and castration resistance. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 303 articles published from 1996 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data. Guideline statements were created to inform clinicians on the appropriate use of observation, androgen-deprivation and antiandrogen therapy, androgen synthesis inhibitors, immunotherapy, radionuclide therapy, systemic chemotherapy, palliative care and bone health. These were based on six index patients developed to represent the most common scenarios encountered in clinical practice. As a direct result of the significant increase in FDA-approved therapeutic agents for use in patients with metastatic CRPC, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. Given the rapidly evolving nature of this field, this guideline should be used in conjunction with recent systematic literature reviews and an understanding of the individual patient's treatment goals. In all cases, patients' preferences and personal goals should be considered when choosing management strategies. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Gilmore, W.E.

    1985-07-01

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

  14. 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.

  15. 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

  16. 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....

  17. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update).

    Science.gov (United States)

    Stachler, Robert J; Francis, David O; Schwartz, Seth R; Damask, Cecelia C; Digoy, German P; Krouse, Helene J; McCoy, Scott J; Ouellette, Daniel R; Patel, Rita R; Reavis, Charles Charlie W; Smith, Libby J; Smith, Marshall; Strode, Steven W; Woo, Peak; Nnacheta, Lorraine C

    2018-03-01

    Objective This guideline provides evidence-based recommendations on treating patients who present with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include, but are not limited to, recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a

  18. 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)

  19. Guideline to Estimate Decommissioning Costs

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Taesik; Kim, Younggook; Oh, Jaeyoung [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    The primary objective of this work is to provide guidelines to estimate the decommissioning cost as well as the stakeholders with plausible information to understand the decommissioning activities in a reasonable manner, which eventually contribute to acquiring the public acceptance for the nuclear power industry. Although several cases of the decommissioning cost estimate have been made for a few commercial nuclear power plants, the different technical, site-specific and economic assumptions used make it difficult to interpret those cost estimates and compare them with that of a relevant plant. Trustworthy cost estimates are crucial to plan a safe and economic decommissioning project. The typical approach is to break down the decommissioning project into a series of discrete and measurable work activities. Although plant specific differences derived from the economic and technical assumptions make a licensee difficult to estimate reliable decommissioning costs, estimating decommissioning costs is the most crucial processes since it encompasses all the spectrum of activities from the planning to the final evaluation on whether a decommissioning project has successfully been preceded from the perspective of safety and economic points. Hence, it is clear that tenacious efforts should be needed to successfully perform the decommissioning project.

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

    Science.gov (United States)

    Polin, Richard A; Lorenz, John M

    2015-12-01

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

  1. The development of evidence-based guidelines in dentistry.

    Science.gov (United States)

    Faggion, C M

    2013-02-01

    Use of guidelines is an important means of reducing the gap between research and clinical practice. Sound and unbiased information should be available to enable dental professionals to provide better clinical treatment for their patients. The development of clinical guidelines in dentistry should follow standard and transparent methodology. The purpose of this article is to propose important steps for developing evidence-based clinical recommendations in dentistry. Initially, dental guidelines should be extensively sought and assessed to answer focused clinical questions. If there is a paucity of guidelines or if existing guidelines are not of good methodological quality, systematic reviews should be searched or conducted to serve as a basis for the development of evidence-based guidelines. When systematic reviews are produced, they should be rigorous in order to provide the best evidence possible. In the last phase of the process, the overall quality of evidence should be scrutinized and assessed, together with other factors (balance between treatment effects and side effects, patients' values, and cost-effectiveness of therapy) to determine the strength of recommendations. It is expected this approach will result in the development of sound clinical guidelines and consequent improvement of dental treatment.

  2. Guidelines for a radiology department

    International Nuclear Information System (INIS)

    1981-05-01

    This manual presents guidelines for hospitals on a radiology quality assurance and dose measurement audit program and a system of planned actions that monitor and record the performance and effectiveness of the radiological service

  3. Measure Guideline: Basement Insulation Basics

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R.; Mantha, P.; Puttagunta, S.

    2012-10-01

    This guideline is intended to describe good practices for insulating basements in new and existing homes, and is intended to be a practical resources for building contractors, designers, and also to homeowners.

  4. Guidelines for direct radionuclide cystography

    International Nuclear Information System (INIS)

    Fettich, J.; Colarinha, P.; Fischer, S.; Hahn, K.; Porn, U.; Froekier, J.; Gordon, I.; Kabasakal, L.; Mann, M.; Mitjavila, M.; Olivier, P.; Piepsz, A.; Roca, I.; Sixt, R.; Velzen, J. van

    2002-01-01

    These ''Empfehlungen'' are the german translation of the Guidelines on MIBG-Scintigraphy in Children, which were published by the Paediatric Committee of the European Association of Nuclear Medicine. (orig.) [de

  5. 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.

  6. [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.

  7. Type 1 diabetes guidelines: Are they enough?

    Directory of Open Access Journals (Sweden)

    Abdul Abdul Zargar

    2015-01-01

    Full Text Available The discovery of insulin by Banting and Best in 1922 changed the landscape of type 1 diabetes mellitus (T1DM. Guidelines on T1DM should be evidence based and should emphasize comprehensive risk management. Guidelines would improve awareness amongst governments, state health care providers and the general public about the serious long-term implications of poorly managed diabetes and of the essential resources needed for optimal care. T1DM requires lifelong daily medication, regular control as well as access to facilities to manage acute and chronic complications. American Diabetes Association 2014 guidelines recommends annual nephropathy screening for albumin levels; random spot urine sample for albumin-to-creatinine ratio at start of puberty or age ≥10 years, whichever is earlier, once the child has had diabetes for 5 years. Hypertension should be screened for in T1DM patients by measuring blood pressure at each routine visit. Dyslipidemia in T1DM patients is important and patients should be screened if there is a family history of hypercholesterolemia or a cardiovascular event before the age of 55 years exists or if family history is unknown. Retinopathy is another important complication of diabetes and patients should be subjected to an initial dilated and comprehensive eye examination. Basic diabetes training should be provided for school staff, and they should be assigned with responsibilities for the care of diabetic children. Self-management should be allowed at all school settings for students.

  8. Guidelines on the use of extracorporeal photopheresis.

    Science.gov (United States)

    Knobler, R; Berlin, G; Calzavara-Pinton, P; Greinix, H; Jaksch, P; Laroche, L; Ludvigsson, J; Quaglino, P; Reinisch, W; Scarisbrick, J; Schwarz, T; Wolf, P; Arenberger, P; Assaf, C; Bagot, M; Barr, M; Bohbot, A; Bruckner-Tuderman, L; Dreno, B; Enk, A; French, L; Gniadecki, R; Gollnick, H; Hertl, M; Jantschitsch, C; Jung, A; Just, U; Klemke, C-D; Lippert, U; Luger, T; Papadavid, E; Pehamberger, H; Ranki, A; Stadler, R; Sterry, W; Wolf, I H; Worm, M; Zic, J; Zouboulis, C C; Hillen, U

    2014-01-01

    After the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma was published in 1983 with its subsequent recognition by the FDA for its refractory forms, the technology has shown significant promise in the treatment of other severe and refractory conditions in a multi-disciplinary setting. Among the major studied conditions are graft versus host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection and inflammatory bowel disease. In order to provide recognized expert practical guidelines for the use of this technology for all indications the European Dermatology Forum (EDF) proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. These guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion. © 2013 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

  9. Comparing guidelines for adjuvant endocrine therapy in postmenopausal women with breast cancer: a coming of age.

    Science.gov (United States)

    Verma, Sunil; Jackisch, Christian

    2011-02-01

    Following surgery for early breast cancer, the standard of care for postmenopausal women is adjuvant therapy with any combination of radiation therapy, endocrine therapy, chemotherapy and/or targeted therapy. Clinicians rely on many tools, including guidelines, to make these treatment decisions. Such guidelines include the St Gallen consensus statement, the American Society of Clinical Oncology guidelines and the National Comprehensive Cancer Network guidelines, as well as various regional and national guidelines. Recommendations may vary, because different methods and criteria were used to assess the strength of supporting data. This article provides an overview of global guidelines for the adjuvant treatment of breast cancer and points out the major differences. Ongoing changes are highlighted, particularly those regarding the adjuvant endocrine treatment of postmenopausal women with breast cancer. While previous guidelines recommended tamoxifen alone, all major guidelines now recommend using third-generation aromatase inhibitors either in sequence with tamoxifen or as upfront treatment.

  10. Healthy eating design guidelines for school architecture.

    Science.gov (United States)

    Huang, Terry T-K; Sorensen, Dina; Davis, Steven; Frerichs, Leah; Brittin, Jeri; Celentano, Joseph; Callahan, Kelly; Trowbridge, Matthew J

    2013-01-01

    We developed a new tool, Healthy Eating Design Guidelines for School Architecture, to provide practitioners in architecture and public health with a practical set of spatially organized and theory-based strategies for making school environments more conducive to learning about and practicing healthy eating by optimizing physical resources and learning spaces. The design guidelines, developed through multidisciplinary collaboration, cover 10 domains of the school food environment (eg, cafeteria, kitchen, garden) and 5 core healthy eating design principles. A school redesign project in Dillwyn, Virginia, used the tool to improve the schools' ability to adopt a healthy nutrition curriculum and promote healthy eating. The new tool, now in a pilot version, is expected to evolve as its components are tested and evaluated through public health and design research.

  11. No. 148-Guidelines for Operative Vaginal Birth.

    Science.gov (United States)

    Cargill, Yvonne M; MacKinnon, Catherine Jane

    2018-02-01

    To provide guidelines for operative vaginal birth in the management of the second stage of labour. Non-operative techniques, episiotomy, and Caesarean section are compared to operative vaginal birth. Reduced fetal and maternal morbidity and mortality. MEDLINE and Cochrane databases were searched using the key words ''vacuum" and "birth" as well as "forceps" and "birth" for literature published in English from january 1970 to June 2004. The level of evidence and quality of rec-ommendations made are described using the Evaluation of Evidence from the Canadian Task Force on the Periodic Health Examination. VALIDATION: The Clinical Practice Obstetrics Committee and Executive and Council of the Society of Obstetricians and Gynaecologists of Canada approved these guidelines. Copyright © 2018. Published by Elsevier Inc.

  12. [Guideline on brain metastases: not a cookbook].

    Science.gov (United States)

    Reijneveld, Jaap C

    2011-01-01

    The guideline 'Brain Metastases', which was revised on behalf of the Dutch Society for Neuro-Oncology (LWNO), provides an excellent overview of levels of scientific evidence on diagnosis and treatment of patients with parenchymal brain metastases of solid tumours. I would like to emphasize, however, that this guideline is not a cookbook for facilitating individual physicians to treat patients on their own. It is important that every patient suffering from brain metastases is discussed by a multidisciplinary tumour board consisting of at least a neurologist, a neurosurgeon, a medical oncologist, a radiation oncologist, a pathologist and a radiologist, and that several crucial questions need to be explicitly asked and answered about every single patient.

  13. Grasses for energy production: hydrological guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Hall, R.L.

    2003-07-01

    This report provides hydrological guidelines for growers, land and water resource managers, environmental groups and other parties interested in utilising grasses for energy production. The aim of the report is to help interested parties decide if a location is suitable for planting energy grasses by considering whether potential hydrological impacts will have an adverse effect on crop productivity and yield. The guidelines consider: the water use of energy grasses compared with other crops; the factors governing water use; the water requirements for a productive crop; and the likely impacts on the availability and quantity of water. The report points out that there are still gaps in our knowledge of the processes controlling the water use and growth of energy grasses and notes that, in some situations, there will be considerable uncertainty in predictions of water use and the magnitude of the associated hydrological impacts.

  14. EAACI Food Allergy and Anaphylaxis Guidelines

    DEFF Research Database (Denmark)

    Muraro, A; Werfel, T; Hoffmann-Sommergruber, K

    2014-01-01

    on previous EAACI position papers on adverse reaction to foods and three recent systematic reviews on the epidemiology, diagnosis, and management of food allergy, and provide evidence-based recommendations for the diagnosis and management of food allergy. While the primary audience is allergists......, this document is relevant for all other healthcare professionals, including primary care physicians, and pediatric and adult specialists, dieticians, pharmacists and paramedics. Our current understanding of the manifestations of food allergy, the role of diagnostic tests, and the effective management...... of patients of all ages with food allergy is presented. The acute management of non-life-threatening reactions is covered in these guidelines, but for guidance on the emergency management of anaphylaxis, readers are referred to the related EAACI Anaphylaxis Guidelines....

  15. Joint IAEA/NEA IRS guidelines

    International Nuclear Information System (INIS)

    1997-01-01

    The Incident Reporting System (IRS) is an international system jointly operated by the International Atomic Energy Agency (IAEA) and the Nuclear Energy Agency of the Organization for Economic Cooperation and Development (OECD/NEA). The fundamental objective of the IRS is to contribute to improving the safety of commercial nuclear power plants (NPPs) which are operated worldwide. This objective can be achieved by providing timely and detailed information on both technical and human factors related to events of safety significance which occur at these plants. The purpose of these guidelines, which supersede the previous IAEA Safety Series No. 93 (Part II) and the NEA IRS guidelines, is to describe the system and to give users the necessary background and guidance to enable them to produce IRS reports meeting a high standard of quality while retaining the high efficiency of the system expected by all Member States operating nuclear power plants

  16. Interim guidelines for protecting fire-fighting personnel from multiple hazards at nuclear plant sites

    International Nuclear Information System (INIS)

    Klein, A.R.; Bloom, C.W.

    1989-07-01

    This report provides interim guidelines for reducing the impact to fire fighting and other supporting emergency response personnel from the multiple hazards of radiation, heat stress, and trauma when fighting a fire in a United States commercial nuclear power plant. Interim guidelines are provided for fire brigade composition, training, equipment, procedures, strategies, heat stress and trauma. In addition, task definitions are provided to evaluate and further enhance the interim guidelines over the long term. 19 refs

  17. Driver fitness medical guidelines.

    Science.gov (United States)

    2009-09-01

    This guide provides guidance to assist licensing agencies in making decisions about an individuals fitness for driving. This is the first attempt to produce a consolidated document covering medical conditions included in the task agreement between...

  18. 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.

  19. 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.

  20. Identifying target audiences: who are the guidelines for? : article 1 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

    Science.gov (United States)

    Yawn, Barbara P; Akl, Elie A; Qaseem, Amir; Black, Peter; Campos-Outcalt, Doug

    2012-12-01

    Professional societies, like many other organizations around the world, have recognized the need to use rigorous processes to ensure that health care recommendations are informed by the best available research evidence. Different clinical practice guidelines addressing the management of the same disease may vary widely in the evidence used and the format of the recommendations, with the result that not all are appropriate for all audiences. This is the first of a series of 14 articles that clinicians, methodologists, and researchers from around the world prepared to advise those developing guidelines in respiratory and other diseases about the potential impact of identifying the target audiences for their clinical practice guidelines. In this review we address the following questions. (1) Which audiences are interested in a chronic obstructive pulmonary disease (COPD) guideline? (2) How many audiences can be addressed in a single COPD guideline? (3) What is the purpose of the guidelines? (4) Who should be included on the guideline panel? We collected information by searching PubMed and reviewing information from groups that are currently making and using respiratory disease guidelines, as well as from workshop discussions. Our conclusions are based on available evidence, consideration of what guideline developers are doing, and the opinions of those who attended the workshop. Clinicians desire COPD and other guidelines that are concise, use evidence from practices similar to theirs, and whose authors have expertise in providing care in similar settings and with similar patients. In the case of COPD, barriers to generalists' use of guidelines include lack of awareness of the guidelines, failure to embrace the diagnostic methods as capable of providing definitive confirmation of COPD, and, most importantly, failure of previous guidelines to address the treatment of COPD in the context of the broad range of multiple morbidities that affect most people with COPD. COPD

  1. Failed fuel action plan guidelines: Special report

    International Nuclear Information System (INIS)

    1987-11-01

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

  2. Guidelines for radiological monitoring of the environment

    International Nuclear Information System (INIS)

    1990-11-01

    This Standard provides criteria to be used in deciding whether an environmental monitoring program is required for a given nuclear facility. It also sets out a systematic approach to monitoring the environment, which is considered to be outside the facility boundary. It provides guidelines for establishing an environmental program covering sampling and analysis protocols, analytical techniques and sensitivity, statistical treatment of monitoring results, quality assurance, methods for expressing results, and record keeping. The standard applies to the environment of a nuclear facility operating mainly under normal conditions; in addition, certain of these requirements may also apply to situations involving abnormal releases

  3. Guidelines for comprehensive quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    Goldson, A.L.; Nibhanupudy, J.R.

    1984-01-01

    Brachytherapy treatment techniques can provide significant improvement in local control and overall survival, but only when quality assurance can be guaranteed. To establish brachytherapy quality assurance, basic requirements for three predetermined subdivisions of clinical institutions will be forwarded. These are: (1) centers having minimum requirements to provide brachytherapy, (2) intermediate centers such as regional or community hospitals, and (3) optimal centers such as university hospital and cancer centers. This presentation will highlight personnel needs, equipment requirements, academic activities, clinical experience with these systems and proposed quality assurance guidelines

  4. Sandia Software Guidelines, Volume 2. Documentation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    This volume is one in a series of Sandia Software Guidelines intended for use in producing quality software within Sandia National Laboratories. In consonance with the IEEE Standards for software documentation, this volume provides guidance in the selection of an adequate document set for a software project and example formats for many types of software documentation. A tutorial on life cycle documentation is also provided. Extended document thematic outlines and working examples of software documents are available on electronic media as an extension of this volume.

  5. Clinical practice guidelines within the Southern African development community: a descriptive study of the quality of guideline development and concordance with best evidence for five priority diseases

    Science.gov (United States)

    2012-01-01

    Background Reducing the burden of disease relies on availability of evidence-based clinical practice guidelines (CPGs). There is limited data on availability, quality and content of guidelines within the Southern African Development Community (SADC). This evaluation aims to address this gap in knowledge and provide recommendations for regional guideline development. Methods We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated. Findings We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline. Conclusion This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders

  6. Design guidelines for audio presentation of graphs and tables

    OpenAIRE

    Brown, L.M.; Brewster, S.A.; Ramloll, S.A.; Burton, R.; Riedel, B.

    2003-01-01

    Audio can be used to make visualisations accessible to blind and visually impaired people. The MultiVis Project has carried out research into suitable methods for presenting graphs and tables to blind people through the use of both speech and non-speech audio. This paper presents guidelines extracted from this research. These guidelines will enable designers to implement visualisation systems for blind and visually impaired users, and will provide a framework for researchers wishing to invest...

  7. Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed

    DEFF Research Database (Denmark)

    Kottner, Jan; Audigé, Laurent; Brorson, Stig

    2011-01-01

    Results of reliability and agreement studies are intended to provide information about the amount of error inherent in any diagnosis, score, or measurement. The level of reliability and agreement among users of scales, instruments, or classifications is widely unknown. Therefore, there is a need ......, standards, or guidelines for reporting reliability and agreement in the health care and medical field are lacking. The objective was to develop guidelines for reporting reliability and agreement studies....

  8. German disease management guidelines: surgical therapies for chronic heart failure.

    Science.gov (United States)

    Sindermann, J R; Klotz, S; Rahbar, K; Hoffmeier, A; Drees, G

    2010-02-01

    The German Disease Management Guideline "Chronic Heart Failure" intends to guide physicians working in the field of diagnosis and treatment of heart failure. The guideline provides a tool on the background of evidence based medicine. The following short review wants to give insights into the role of some surgical treatment options to improve heart failure, such as revascularization, ventricular reconstruction and aneurysmectomy, mitral valve reconstruction, ventricular assist devices and heart transplantation. (c) Georg Thieme Verlag KG Stuttgart-New York.

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

    Energy Technology Data Exchange (ETDEWEB)

    2004-11-01

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

  10. Host government directorate: London 2012 Olympic and Paralympic emblem guidelines

    OpenAIRE

    2015-01-01

    These guidelines issued by the London Organising Committee of the Olympic Games and Paralympic Games Ltd (“LOCOG”) provide standards, requirements and guidelines for use of the London 2012 Olympic Games Emblem (the “Emblem”), the London 2012 Paralympic Games Emblem (the “Paralympic Emblem”) and the Dual London 2012 Olympic and Paralympic Emblems (“Dual Emblems”) by authorised Host Government Directorate only.

  11. Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers

    National Research Council Canada - National Science Library

    1998-01-01

    .... OSHA s new violence prevention guidelines provide the agency s recommendations for reducing workplace violence developed following a careful review of workplace violence studies, public and private...

  12. 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.

  13. Korean Society of Cardiovascular Imaging Guidelines for Cardiac Computed Tomography

    International Nuclear Information System (INIS)

    Kim, Young Jin; Choi, Byoung Wook; Choe, Kyu Ok; Yong, Hwan Seok; Kim, Yang Min; Choe, Yeon Hyeon; Lim, Tae Hwan; Park, Jae Hyung

    2011-01-01

    The Korean Society of Cardiovascular Imaging (KOCSI) has issued a guideline for the use of cardiac CT imaging in order to assist clinicians and patients in providing adequate level of medical service. In order to establish a guideline founded on evidence based medicine, it was designed based on comprehensive data such as questionnaires conducted in international and domestic hospitals, intensive journal reviews, and with experts in cardiac radiology. The recommendations of this guideline should not be used as an absolute standard and medical professionals can always refer to methods non-adherent to this guideline when it is considered more reasonable and beneficial to an individual patient's medical situation. The guideline has its limitation and should be revised appropriately with the advancement medical equipment technology and public health care system. The guideline should not be served as a measure for standard of care. KOCSI strongly disapproves the use of the guideline to be used as the standard of expected practice in medical litigation processes.

  14. Influence of qualitative research on women's health screening guidelines.

    Science.gov (United States)

    Abadir, Anna Maria; Lang, Ariella; Klein, Talia; Abenhaim, Haim Arie

    2014-01-01

    Considerable time and resources are allocated to carry out qualitative research. The purpose of our study was to evaluate the availability of qualitative research on women's health screening and assess its influence on screening practice guidelines in the United States, Canada, and the United Kingdom. Medline, CINHAL, and WEB of Science databases were used to identify the availability of qualitative research conducted in the past 15 years on 3 different women's health screening topics: cervical cancer screening, breast cancer screening, and prenatal first-trimester screening. Key national practice guidelines on women's health screening were selected using the National Guideline Clearinghouse web site. Bibliometric analysis was used to determine the frequency of qualitative references cited in the guidelines. A total of 272 qualitative research papers on women's health screening was identified: 109 on cervical cancer screening, 104 on breast cancer screening, and 59 on prenatal first-trimester screening. The qualitative studies focused on health care provider perspectives as well as ethical, ethnographic, psychological, and social issues surrounding screening. Fifteen national clinical practice guidelines on women's health screening were identified. A total of 943 references was cited, only 2 of which comprised of qualitative research cited by only 1 clinical practice guideline. Although there is considerable qualitative research that has been carried out on women's health screening, its incorporation into clinical practice guidelines is minimal. Further exploration of the disconnect between the two is important for enhancing knowledge translation of qualitative research within clinical practice. Copyright © 2014 Mosby, Inc. All rights reserved.

  15. [Clinical application evaluation of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine].

    Science.gov (United States)

    Han, Xue-Jie; Liu, Meng-Yu; Lian, Zhi-Hua; Wang, Li-Ying; Shi, Nan-Nan; Zhao, Jun

    2017-09-01

    To evaluate the applicability and clinical applications of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine, so as to provide the basis for the revision of the guidelines. This study was completed by the research and promotion base for traditional Chinese medicine(TCM) standard. The methods of applicability evaluation and application evaluation were used in the study. The questionnaires were filled out to evaluate applicability of the guideline, including doctor's familiarity with the guideline,the quality of the guideline, applicable conditions and clinical applications. The prospective case study analysis method was used to evaluate application of the guideline, including evaluation of clinical application compliance and application results(such as clinical effects, safety and economy). There were two parts in the guideline, which were TCM guideline and Western medicine guideline. The results of applicability evaluation showed that there were no obvious differences between TCM guideline and Western medicine guideline in doctor's familiarity with guideline(85.43%, 84.57%) and the use of the guideline(52.10%, 54.47%); the guidelines with good quality, and higher scores in the scope of application and the use of the term rationality(91.94%, 93.35%); the rationality scores of relevant contents in syndrome differentiation and treatment were more than 75%; the applicable conditions were better, and the safety score was the the highest. The comprehensive applicability evaluation showed that the proportion of the application of TCM guideline and Western medicine guideline were 77.73%, 75.46%, respectively. The results of application evaluation showed that there was high degree coincidence between the guideline with its clinical application; except for "other treatment" and "recuperation and prevention" in TCM, other items got high scores which were more than 90%; in the evaluation of application effects, safety of the guideline

  16. Preliminary format design guidelines

    DEFF Research Database (Denmark)

    Tosello, Guido; Calaon, Matteo; Nørregaard, J.

    2013-01-01

    The strategic research centre PolyNano aims at becoming the Danish competence centre for production-ready fabrication of polymer, nano-scale lab-on-a-chip (LoC) devices. In order to provide a competitive edge for Danish biotech companies launching LoC products by removal of the technology barrier...

  17. Guidelines for Financial Reporting

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

    IDRC CRDI

    The working currency of the project must be provided as well as the ... Please record the total amount of interest earned on bank deposits of IDRC funds in either the ... Amount received from IDRC in: (before bank. Amount transferred in. Rate of.

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

    International Nuclear Information System (INIS)

    2006-12-01

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

  19. Medicare program; Medicare depreciation, useful life guidelines--HCFA. Final rule.

    Science.gov (United States)

    1983-08-18

    These final rules amend Medicare regulations to clarify which useful life guidelines may be used by providers of health care services to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize the Departmental useful life guidelines or, if none have been published by the Department, either the American Hospital Association (AHA) useful life guidelines of 1973 of IRS guidelines. We are eliminating the reference to IRS guidelines because these are now outdated for Medicare purposes since they have been rendered obsolete either by the IRS or by statutory change. We are also deleting the specific reference to the 1973 AHA guidelines since these guidelines are updated by the AHA periodically. In addition, we are clarifying that certain tax legislation on accelerated depreciation, passed by Congress, does not apply to the Medicare program.

  20. Therapy Provider Phase Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...

  1. Guidelines for Authors

    Directory of Open Access Journals (Sweden)

    Abdullah Demir

    2016-06-01

    Full Text Available Guidelines for Authors cumhuriyet theology journal  reguires writers to use the The Chicago Manual of Style “notes and bibliography” system of referencing.First citation: author(s first name and last name, title, (if applicable first and last name of translator or editor, place of publication, publisher, date of publication, page number.Subsequent citations: author’s last name, the short title, and the page number should be indicated in all subsequent citations. Footnote citations should conform to the following examples.References: References should be placed at the end of the text in alphabetical order. If a source has more than one author, the surname and name of the first author should be written, and the other authors should be indicated by et.al. The titles of books and journals should be italicized; article titles and book chapters should be placed in quotation marks. Translator’s and editor’s names (if there are any should follow the title of the work: BOOKa One Author: 
1. Michael Pollan, The Omnivore’s Dilemma: A Natural History of Four Meals (New York: Penguin, 2006, 99–100.2. Pollan, Omnivore’s Dilemma, 3.Bibliography: Pollan, Michael. The Omnivore’s Dilemma: A Natural History of Four Meals. New York: Penguin, 2006.  b Two Authors1. Geoffrey C. Ward and Ken Burns, The War: An Intimate History 1941–1945 (New York: Knopf, 2007, 52.2. Ward and Burns, War, 59–61. Bibliography: Ward, Geoffrey C., and Ken Burns. The War: An Intimate History 1941–1945. New York: Knopf, 2007.c Three or More Authors
For three or more authors, list all of the authors in the bibliography; in the note, list only the first author, followed by et al. (“and others”:1. Mitchell L. Eisen, Jodi A. Quas, and Gail S. Goodman, eds., Memory and Suggestibility in the Forensic Interview (Mahwah, NJ: L. Erlbaum Assoicates, 2002, 65.2. Eisen and et al., Memory and Suggestibility in the Forensic Interview, 67.Bibliography: Eisen, Mitchell

  2. Guidelines for determining design basis ground motions

    International Nuclear Information System (INIS)

    1993-11-01

    This report develops and applies a method for estimating strong earthquake ground motion. The emphasis of this study is on ground motion estimation in Eastern North America (east of the Rocky Mountains), with particular emphasis on the Eastern United States and southeastern Canada. Specifically considered are ground motions resulting from earthquakes with magnitudes from 5 to 8, fault distances from 0 to 500 km, and frequencies from 1 to 35 Hz. The two main objectives were: (1) to develop generic relations for estimating ground motion appropriate for site screening; and (2) to develop a guideline for conducting a thorough site investigation needed to define the seismic design basis. For the first objective, an engineering model was developed to predict the expected ground motion on rock sites, with an additional set of amplification factors to account for the response of the soil column over rock at soil sites. The results incorporate best estimates of ground motion as well as the randomness and uncertainty associated with those estimates. For the second objective, guidelines were developed for gathering geotechnical information at a site and using this information in calculating site response. As a part of this development, an extensive set of geotechnical and seismic investigations was conducted at three reference sites. Together, the engineering model and guidelines provide the means to select and assess the seismic suitability of a site

  3. Development of guidelines for inelastic analysis in design of fast reactor components

    International Nuclear Information System (INIS)

    Nakamura, Kyotada; Kasahara, Naoto; Morishita, Masaki; Shibamoto, Hiroshi; Inoue, Kazuhiko; Nakayama, Yasunari

    2008-01-01

    The interim guidelines for the application of inelastic analysis to design of fast reactor components were developed. These guidelines are referred from 'Elevated Temperature Structural Design Guide for Commercialized Fast Reactor (FDS)'. The basic policies of the guidelines are more rational predictions compared with elastic analysis approach and a guarantee of conservative results for design conditions. The guidelines recommend two kinds of constitutive equations to estimate strains conservatively. They also provide the methods for modeling load histories and estimating fatigue and creep damage based on the results of inelastic analysis. The guidelines were applied to typical design examples and their results were summarized as exemplars to support users

  4. Measure Guideline: Passive Vents

    Energy Technology Data Exchange (ETDEWEB)

    Berger, David [Consortium for Advanced Residential Buildings, Norwalk, CT (United States); Neri, Robin [Consortium for Advanced Residential Buildings, Norwalk, CT (United States)

    2016-02-05

    This document addresses the use of passive vents as a source of outdoor air in multifamily buildings. The challenges associated with implementing passive vents and the factors affecting performance are outlined. A comprehensive design methodology and quantified performance metrics are provided. Two hypothetical design examples are provided to illustrate the process. This document is intended to be useful to designers, decision-makers, and contractors implementing passive ventilation strategies. It is also intended to be a resource for those responsible for setting high-performance building program requirements, especially pertaining to ventilation and outdoor air. To ensure good indoor air quality, a dedicated source of outdoor air is an integral part of high-performance buildings. Presently, there is a lack of guidance pertaining to the design and installation of passive vents, resulting in poor system performance. This report details the criteria necessary for designing, constructing, and testing passive vent systems to enable them to provide consistent and reliable levels of ventilation air from outdoors.

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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)

  11. 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...

  12. Evaluating the effects of the Dietary Guidelines for Americans on consumer behavior and health: methodological challenges.

    Science.gov (United States)

    Guthrie, Joanne F; Smallwood, David M

    2003-12-01

    The Dietary Guidelines for Americans is the official nutrition policy statement for the United States. Government involvement in providing information on private behavior, such as food choice, is justified by the high cost of poor diets, as measured in medical expenses and lost productivity. The Guidelines are intended to provide an up-to-date, consistent information base for federal nutrition education and information efforts and food assistance program regulations. Through these policy mechanisms, the Guidelines are assumed to improve dietary behavior, and, ultimately, health. By law, the Dietary Guidelines for Americans must be updated every five years; however, there is no mandate for evaluation. Evaluation could provide useful information to assess the extent to which the Guidelines positively influence health and provide insights into reasons for their successes and limitations. However, evaluation would also present considerable challenges. This paper discusses the critical data and methodological needs for improving evaluation of the Dietary Guidelines for Americans.

  13. Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project.

    Science.gov (United States)

    Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M

    2016-10-01

    In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.

  14. Revised dietary guidelines for Koreans.

    Science.gov (United States)

    Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

    2008-01-01

    With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

  15. Siting guidelines and their role in repository site selection

    International Nuclear Information System (INIS)

    Hanlon, C.L.

    1985-01-01

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

  16. Barriers to physician adherence to nonsteroidal anti-inflammatory drug guidelines: a qualitative study.

    Science.gov (United States)

    Cavazos, J M; Naik, A D; Woofter, A; Abraham, N S

    2008-09-15

    Despite wide availability of physician guidelines for safer use of nonsteroidal anti-inflammatory drugs (NSAIDs) and widespread use of these drugs in the US, NSAID prescribing guidelines have been only modestly effective. To identify and describe comprehensively barriers to provider adherence to NSAID prescribing guidelines. We conducted interviews with 25 physicians, seeking to identify the major influences explaining physician non-adherence to guidelines. Interviews were standardized and structured probes were used for clarification and detail. All interviews were audio-taped and transcribed. Three independent investigators analysed the transcripts, using the constant-comparative method of qualitative analysis. Our analysis identified six dominant physician barriers explaining non-adherence to established NSAID prescribing guidelines. These included (i) lack of familiarity with guidelines, (ii) perceived limited validity of guidelines, (iii) limited applicability of guidelines among specific patients, (iv) clinical inertia, (v) influences of prior anecdotal experiences and (vi) medical heuristics. A heterogeneous set of influences are barriers to physician adherence to NSAID prescribing guidelines. Suggested measures for improving guideline-concordant prescribing should focus on measures to improve physician education and confidence in guidelines, implementation of physician/pharmacist co-management strategies and expansion of guideline scope.

  17. Prospective systematic review registration: perspective from the Guidelines International Network (G-I-N

    Directory of Open Access Journals (Sweden)

    Van der Wees Philip

    2012-02-01

    Full Text Available Abstract Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO initiative. G-I-N also recently launched a Data Extraction Resource (GINDER to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

  18. Prospective systematic review registration: perspective from the Guidelines International Network (G-I-N).

    Science.gov (United States)

    Van der Wees, Philip; Qaseem, Amir; Kaila, Minna; Ollenschlaeger, Guenter; Rosenfeld, Richard

    2012-02-09

    Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N) aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO) initiative. G-I-N also recently launched a Data Extraction Resource (GINDER) to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

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

    Science.gov (United States)

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

    2013-01-01

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

  20. Landfill gas: development guidelines

    International Nuclear Information System (INIS)

    1996-11-01

    A Guide produced as part of the UK DTI's New and Renewable Energy Programme provides information which forms a framework enabling landfill gas to be exploited fully as a renewable energy resource. The eight chapters cover the resource base of landfill gas in the UK in the wider context, the technology for energy recovery from landfill gas, the utilisation options for landfill gas, the various project development arrangements and their implementation, the assessment of a site's landfill gas resource, the factors which influence the project economies, financing aspects and the management of project liabilities and finally the national waste disposal policy and required consents followed by the overall process for project mobilisation. (UK)

  1. Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

    Science.gov (United States)

    Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

    2014-01-01

    Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

  2. [Clinical practice guidelines and knowledge management in healthcare].

    Science.gov (United States)

    Ollenschläger, Günter

    2013-10-01

    Clinical practice guidelines are key tools for the translation of scientific evidence into everyday patient care. Therefore guidelines can act as cornerstones of evidence based knowledge management in healthcare, if they are trustworthy, and its recommendations are not biased by authors' conflict of interests. Good medical guidelines should be disseminated by means of virtual (digital/electronic) health libraries - together with implementation tools in context, such as guideline based algorithms, check lists, patient information, a.s.f. The article presents evidence based medical knowledge management using the German experiences as an example. It discusses future steps establishing evidence based health care by means of combining patient data, evidence from medical science and patient care routine, together with feedback systems for healthcare providers.

  3. 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.

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

    Science.gov (United States)

    Tu, Samson W.; Musen, Mark A.

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

  5. International Continence Society supported pelvic physiotherapy education guideline.

    Science.gov (United States)

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

    2018-02-01

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

  6. Development of clinical practice guidelines.

    Science.gov (United States)

    Hollon, Steven D; Areán, Patricia A; Craske, Michelle G; Crawford, Kermit A; Kivlahan, Daniel R; Magnavita, Jeffrey J; Ollendick, Thomas H; Sexton, Thomas L; Spring, Bonnie; Bufka, Lynn F; Galper, Daniel I; Kurtzman, Howard

    2014-01-01

    Clinical practice guidelines (CPGs) are intended to improve mental, behavioral, and physical health by promoting clinical practices that are based on the best available evidence. The American Psychological Association (APA) is committed to generating patient-focused CPGs that are scientifically sound, clinically useful, and informative for psychologists, other health professionals, training programs, policy makers, and the public. The Institute of Medicine (IOM) 2011 standards for generating CPGs represent current best practices in the field. These standards involve multidisciplinary guideline development panels charged with generating recommendations based on comprehensive systematic reviews of the evidence. The IOM standards will guide the APA as it generates CPGs that can be used to inform the general public and the practice community regarding the benefits and harms of various treatment options. CPG recommendations are advisory rather than compulsory. When used appropriately, high-quality guidelines can facilitate shared decision making and identify gaps in knowledge.

  7. Heat exchanger performance monitoring guidelines

    International Nuclear Information System (INIS)

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

    1991-12-01

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

  8. Assembly and evaluation of an inventory of guidelines that are available to support clinical hematology laboratory practice.

    Science.gov (United States)

    Hayward, C P M; Moffat, K A; George, T I; Proytcheva, M

    2015-05-01

    Practice guidelines provide helpful support for clinical laboratories. Our goal was to assemble an inventory of publically listed guidelines on hematology laboratory topics, to create a resource for laboratories and for assessing gaps in practice-focused guidelines. PubMed and website searches were conducted to assemble an inventory of hematology laboratory-focused guidelines. Exclusions included annual, technical, or collaborative study reports, clinically focused guidelines, position papers, nomenclature, and calibration documents. Sixty-eight guidelines were identified on hematology laboratory practice topics from 12 organizations, some as joint guidelines. The median year of publication was 2010 and 15% were >10 years old. Coagulation topics had the largest numbers of guidelines, whereas some areas of practice had few guidelines. A minority of guidelines showed evidence of periodic updates, as some organizations did not remove or identify outdated guidelines. This inventory of current practice guidelines will encourage awareness and uptake of guideline recommendations by the worldwide hematology laboratory community, with the International Society for Laboratory Hematology facilitating ongoing updates. There is a need to encourage best guideline development practices, to ensure that hematology laboratory community has current, high-quality, and evidence-based practice guidelines that cover the full scope of hematology laboratory practice. © 2015 John Wiley & Sons Ltd.

  9. Clinical practice guideline: Bell's palsy.

    Science.gov (United States)

    Baugh, Reginald F; Basura, Gregory J; Ishii, Lisa E; Schwartz, Seth R; Drumheller, Caitlin Murray; Burkholder, Rebecca; Deckard, Nathan A; Dawson, Cindy; Driscoll, Colin; Gillespie, M Boyd; Gurgel, Richard K; Halperin, John; Khalid, Ayesha N; Kumar, Kaparaboyna Ashok; Micco, Alan; Munsell, Debra; Rosenbaum, Steven; Vaughan, William

    2013-11-01

    Bell's palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mono-neuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. Bell's palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell's palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur and can be devastating to the patient. Treatments are generally designed to improve facial function and facilitate recovery. There are myriad treatment options for Bell's palsy, and some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, numerous diagnostic tests available are used in the evaluation of patients with Bell's palsy. Many of these tests are of questionable benefit in Bell's palsy. Furthermore, while patients with Bell's palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell's palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell's palsy. The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell's palsy, to improve the quality of care and outcomes for patients with Bell's palsy, and to decrease harmful variations in the evaluation and management of Bell's palsy. This guideline addresses these needs by encouraging

  10. Economics worksheet for builder guidelines

    International Nuclear Information System (INIS)

    Johnson, B.K.

    1994-01-01

    The Builder Guidelines package is used to analyze space heating in residential design. Alternative designs are compared in engineering units (e.g., Btu) with the aid of four simple worksheets. Evaluating designs in economic terms would enhance understanding of decisions to be made in the consideration of several energy efficiency measures. An additional worksheet is proposed for Builder Guidelines. Six easy steps take the user through a simplified economic evaluation, based on auxiliary heating performance. Annual space heating cost, avoided costs, and years to payback are calculated in the procedure

  11. New guidelines for case reports

    Directory of Open Access Journals (Sweden)

    Mario Delgado-Noguera

    2013-09-01

    Full Text Available The case report or case reports are a frequent type of narrative article in the biomedical literature. Case reports are useful to describe unusual clinical cases, identify adverse effects or benefits of therapies. They are also useful for the description of presentation of rare diseases for educational or scientific purposes. Several groups have worked on reporting guidelines for other designs such as the case of clinical trials (CONSORT Statement or observational studies (STROBE Statement and this journal has been adopted as the guide for authors. Recently, there were presented the Guidelines for writing CAseREports (CARE Statement. The aim of this article is to make them known and comment.

  12. 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.

  13. Evaluation process of global environmental impact: assessment guidelines

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  14. Guidelines for residential commissioning

    Energy Technology Data Exchange (ETDEWEB)

    Wray, Craig P.; Walker, Iain S.; Sherman, Max H.

    2003-01-31

    Currently, houses do not perform optimally or even as many codes and forecasts predict, largely because they are field assembled and there is no consistent process to identify problems or to correct them. Residential commissioning is a solution to this problem. This guide is the culmination of a 30-month project that began in September 1999. The ultimate objective of the project is to increase the number of houses that undergo commissioning, which will improve the quality, comfort, and safety of homes for California citizens. The project goal is to lay the groundwork for a residential commissioning industry in California focused on end-use energy and non-energy issues. As such, we intend this guide to be a beginning and not an end. Our intent is that the guide will lead to the programmatic integration of commissioning with other building industry processes, which in turn will provide more value to a single site visit for people such as home energy auditors and raters, home inspectors, and building performance contractors. Project work to support the development of this guide includes: a literature review and annotated bibliography, which facilitates access to 469 documents related to residential commissioning published over the past 20 years (Wray et al. 2000), an analysis of the potential benefits one can realistically expect from commissioning new and existing California houses (Matson et al. 2002), and an assessment of 107 diagnostic tools for evaluating residential commissioning metrics (Wray et al. 2002). In this guide, we describe the issues that non-experts should consider in developing a commissioning program to achieve the benefits we have identified. We do this by providing specific recommendations about: how to structure the commissioning process, which diagnostics to use, and how to use them to commission new and existing houses. Using examples, we also demonstrate the potential benefits of applying the recommended whole-house commissioning approach to

  15. Evaluating Industry Payments Among Dermatology Clinical Practice Guidelines Authors.

    Science.gov (United States)

    Checketts, Jake X; Sims, Matthew Thomas; Vassar, Matt

    2017-12-01

    It is well documented that financial conflicts of interest influence medical research and clinical practice. Prior to the Open Payments provisions of the Affordable Care Act, financial ties became apparent only through self-disclosure. The nature of financial interests has not been studied among physicians who develop dermatology clinical practice guidelines. To evaluate payments received by physicians who author dermatology clinical practice guidelines, compare disclosure statements for accuracy, determine whether pharmaceutical companies from which the authors received payments manufactured products related to the guidelines, and examine the extent to which the American Academy of Dermatology enforced their Administrative Regulations for guideline development. Three American Academy of Dermatology guidelines published from 2013 to 2016 were retrieved. Double data extraction was used to record financial payments received by 49 guideline authors using the Open Payments database. Payments received by the authors from the date of the initial literature search to the date of publication were used to evaluate disclosure statement accuracy, detail the companies providing payments, and evaluate Administrative Regulations enforcement. This study is applicable to clinical practice guideline panels drafting recommendations, physicians using clinical practice guidelines to inform patient care, and those establishing policies for guideline development. Our main outcomes are the monetary values and types of payments received by physicians who author dermatology guidelines and the accuracy of disclosure statements. Data were collected from the Open Payments database and analyzed descriptively. Of the 49 authors evaluated, 40 received at least 1 reported industry payment, 31 accepted more than $1000, 25 accepted more than $10 000, and 18 accepted more than $50 000. Financial payments amounted to a mean of $157 177 per author. The total reimbursement among the 49 authors

  16. Guidelines for generators of hazardous chemical waste at LBL and guidelines for generators of radioactive and mixed waste at LBL

    International Nuclear Information System (INIS)

    1991-09-01

    In part one of this document the Governing Documents and Definitions sections provide general guidelines and regulations applying to the handling of hazardous chemical wastes. The remaining sections provide details on how you can prepare your waste properly for transport and disposal. They are correlated with the steps you must take to properly prepare your waste for pickup. The purpose of the second part of this document is to provide the acceptance criteria for the transfer of radioactive and mixed waste to LBL's Hazardous Waste Handling Facility (HWHF). These guidelines describe how you, as a generator of radioactive or mixed waste, can meet LBL's acceptance criteria for radioactive and mixed waste

  17. Do Clinical Practice Guidelines Improve Quality?

    Science.gov (United States)

    Baldassari, Cristina M

    2017-07-01

    Controversy exists surrounding how to best define and assess quality in the health care setting. Clinical practice guidelines (CPGs) have been developed to improve the quality of medical care by highlighting key clinical recommendations based on recent evidence. However, data linking CPGs to improvements in outcomes in otolaryngology are lacking. Numerous barriers contribute to difficulties in translating CPGs to improvements in quality. Future initiatives are needed to improve CPG adherence and define the impact of CPG recommendations on the quality of otolaryngologic care provided to our patients.

  18. 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.

  19. Guidelines for Waste Accumulation Areas (WAAs)

    International Nuclear Information System (INIS)

    1991-07-01

    The purpose of this document is to set conditions for establishing and maintaining areas for the accumulation of hazardous waste at LBL. Areas designed for accumulation of these wastes in quantities greater than 100 kg (220 lb) per month of solid waste or 55 gallons per month of liquid waste are called Waste Accumulation Areas (WAAs). Areas designed for accumulation of wastes in smaller amounts are called Satellite Accumulation Areas (SAAs). This document provides guidelines for employee and organizational responsibilities for WAAs; constructing a WAA; storing waste in a WAA; operating and maintaining a WAA, and responding to spills in a WAA. 4 figs

  20. Wind energy and aviation interests - interim guidelines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    The impact on aviation of increasing the number of wind farms in the United Kingdom is discussed by the Wind Energy, Defence and Civil Aviation Interests Working Group, comprising the Department of Trade and Industry, the Civil Aviation Authority, the Ministry of Defence, and the British Wind Energy Association. The report offers guidance to wind farm developers, local authorities and statutory consultees within the aviation community: the main thrust of the guidelines is to support the UK Government's wind energy targets. Although the document does not contain in-depth technical discussions, it does provide references to such information.

  1. Measure Guideline. Hybrid Foundation Insulation Retrofits

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, K. [Building Science Corporation, Somerville, MA (United States); Lstiburek, J. [Building Science Corporation, Somerville, MA (United States)

    2012-05-01

    This measure guideline provides recommendations for designs and variations for retrofit hybrid assemblies in improving interior foundation insulation and water management of basements. Variations include closed cell spray foam (ccSPF) with membrane waterproofing or air gap membrane drainage layers, rigid board foam insulation at flat walls (cast concrete or CMU block), a “partial drainage” detail making use of the bulk water drainage that occurs through the field of a rubble stone wall, and non-drained spray foam assemblies (including slab insulation).

  2. Measure Guideline: Hybrid Foundation Insulation Retrofits

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, K.; Lstiburek, J.

    2012-05-01

    This measure guideline provides recommendations for designs and variations for retrofit hybrid assemblies in improving interior foundation insulation and water management of basements. Variations include closed cell spray foam (ccSPF) with membrane waterproofing or air gap membrane drainage layers, rigid board foam insulation at flat walls (cast concrete or CMU block), a 'partial drainage' detail making use of the bulk water drainage that occurs through the field of a rubble stone wall, and non-drained spray foam assemblies (including slab insulation).

  3. International Physical Protection Advisory Service (IPPAS) Guidelines

    International Nuclear Information System (INIS)

    2014-01-01

    The International Physical Protection Advisory Service (IPPAS) was established by the IAEA in 1995 and is a fundamental part of the IAEA’s efforts to assist States, upon request, to establish and maintain an effective national nuclear security regime to protect against the unauthorized removal of nuclear and other radioactive material, and against the sabotage of nuclear and other associated facilities, as well as material during transport, while recognizing that the ultimate responsibility for physical protection lies with the State. IPPAS provides peer review on implementing relevant international instruments, in particular the Convention on the Physical Protection of Nuclear Material (CPPNM), together with the 2005 Amendment, and on implementing the IAEA Nuclear Security Series of guidance publications, in particular Fundamentals and Recommendations. IPPAS missions compare (insofar as this is possible) the procedures and practices employed by a State with the obligations specified under the CPPNM and the 2005 Amendment, as well as with the existing international consensus guidelines provided in relevant IAEA Nuclear Security Series publications. Since 1996, 63 IPPAS missions have been conducted in 40 countries, including 15 follow-up missions, as well as the recent mission to the IAEA Office of Safeguards Analytical Services laboratories, in Seibersdorf. More than 140 experts from 34 Member States have participated in the conduct of IPPAS missions as IPPAS team members or team leaders. The updated IPPAS guidelines reflect a modular approach to make them more flexible and responsive to the needs of States. The modular approach is an innovation of great value, ensuring the degree of flexibility required to fit individual national contexts, practices and objectives as expressed by the requesting States. In particular, it also offers States the opportunity to expand the scope of a requested IPPAS mission to embrace its nuclear security regime for the protection of

  4. Strategy Guideline: High Performance Residential Lighting

    Energy Technology Data Exchange (ETDEWEB)

    Holton, J.

    2012-02-01

    The Strategy Guideline: High Performance Residential Lighting has been developed to provide a tool for the understanding and application of high performance lighting in the home. The high performance lighting strategies featured in this guide are drawn from recent advances in commercial lighting for application to typical spaces found in residential buildings. This guide offers strategies to greatly reduce lighting energy use through the application of high quality fluorescent and light emitting diode (LED) technologies. It is important to note that these strategies not only save energy in the home but also serve to satisfy the homeowner's expectations for high quality lighting.

  5. 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.

  6. 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

  7. 77 FR 13585 - Electricity Subsector Cybersecurity Risk Management Process Guideline

    Science.gov (United States)

    2012-03-07

    ... DEPARTMENT OF ENERGY Electricity Subsector Cybersecurity Risk Management Process Guideline AGENCY... Electricity Subsector Cybersecurity Risk Management Process guideline. The guideline describes a risk... Cybersecurity Risk Management Process Guideline. The primary goal of this guideline is to describe a risk...

  8. Guidelines for interim storage of low level waste

    International Nuclear Information System (INIS)

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

    1992-12-01

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

  9. Measure Guideline. Wood Window Repair, Rehabilitation, and Replacement

    Energy Technology Data Exchange (ETDEWEB)

    Baker, P. [Building Science Corporation, Somerville, MA (United States); Eng, P. [Building Science Corporation, Somerville, MA (United States)

    2012-12-01

    This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

  10. The green city guidelines : techniques for a healthy liveable city

    NARCIS (Netherlands)

    Roo, M.; Kuypers, V.H.M.; Lenzholzer, S.

    2011-01-01

    The Green City Guidelines is an international book that provides information on the social and economic advantages of green spaces in urban environments. The book focuses on decision-makers and people practically involved in the field concerned. It provides tips and advice on ways of using plants,

  11. Guidelines for kangaroo care in district hospitals and primary health ...

    African Journals Online (AJOL)

    Babies with a weight of between 1.5 kg and 1.6 kg are started with ... to provide guidelines for managing babies with insufficient weight gain, and to provide guidance for ... Gender, birth weight and gestational age at birth also did not have a ...

  12. [Shared decision-making based on equal information. Patient guidelines as a tool for patient counseling].

    Science.gov (United States)

    Sänger, Sylvia; Kopp, Ina; Englert, Gerhard; Brunsmann, Frank; Quadder, Bernd; Ollenschläger, Günter

    2007-06-15

    In discussions on the quality of cross-sectorial health-care services high importance is attributed to patient education and patient counseling, with guideline-based patient information being considered a crucial tool. Guideline-based patient information is supposed to serve patients as a decision-making basis and, in addition, to also support the implementation of the guidelines themselves. The article highlights how patient guidelines for National Disease Management Guidelines in Germany--within the scope of patient education and patient counseling--may provide a uniform information platform for physicians and patients aiming to promote shared decision-making. The authors will also address the issue which contents should be included in patient guidelines in order to meet these requirements and which measures are required to review their quality. The present paper continues the series of articles on the Program for German National Disease Management Guidelines.

  13. Examining Data Repository Guidelines for Qualitative Data Sharing.

    Science.gov (United States)

    Antes, Alison L; Walsh, Heidi A; Strait, Michelle; Hudson-Vitale, Cynthia R; DuBois, James M

    2018-02-01

    Qualitative data provide rich information on research questions in diverse fields. Recent calls for increased transparency and openness in research emphasize data sharing. However, qualitative data sharing has yet to become the norm internationally and is particularly uncommon in the United States. Guidance for archiving and secondary use of qualitative data is required for progress in this regard. In this study, we review the benefits and concerns associated with qualitative data sharing and then describe the results of a content analysis of guidelines from international repositories that archive qualitative data. A minority of repositories provide qualitative data sharing guidelines. Of the guidelines available, there is substantial variation in whether specific topics are addressed. Some topics, such as removing direct identifiers, are consistently addressed, while others, such as providing an anonymization log, are not. We discuss the implications of our study for education, best practices, and future research.

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

    Science.gov (United States)

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

    2018-04-01

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

  15. Designing Instructional Materials: Some Guidelines.

    Science.gov (United States)

    Burbank, Lucille; Pett, Dennis

    Guidelines for the design of instructional materials are outlined in this paper. The principles of design are presented in five major categories: (1) general design (structural appeal and personal appeal); (2) instructional design (attention, memory, concept learning, and attitude change); (3) visual design (media considerations, pictures, graphs…

  16. Predoctoral Curriculum Guidelines for Biomaterials.

    Science.gov (United States)

    Journal of Dental Education, 1986

    1986-01-01

    The American Association of Dental Schools' predoctoral guidelines for biomaterials curricula includes notes on interrelationships between this and other fields, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives for each content area, and information on sequencing, faculty and…

  17. Guideline Knowledge Representation Model (GLIKREM)

    Czech Academy of Sciences Publication Activity Database

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

    2008-01-01

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

  18. 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.)

  19. Comprehensive School Alienation Program, Guidelines.

    Science.gov (United States)

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

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

  20. Guidelines for prevention in psychology.

    Science.gov (United States)

    2014-04-01

    The effectiveness of prevention to enhance human functioning and reduce psychological distress has been demonstrated. From infancy through adulthood, access to preventive services and interventions is important to improve the quality of life and human functioning and reduce illness and premature death. The importance of prevention is consistent with the Patient Protection and Affordable Care Act of 2010. Even with the increased focus on prevention, psychology training programs rarely require specific courses on prevention. In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking. Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices. Accordingly, the Guidelines for Prevention in Psychology are intended to "inform psychologists, the public, and other interested parties regarding desirable professional practices" in prevention. The Prevention Guidelines are recommended based on their potential benefits to the public and the professional practice of psychology. They support prevention as an important area of practice, research, and training for psychologists. The Guidelines give increased attention to prevention within APA, encouraging psychologists to become involved with preventive activities relevant to their area of practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved).