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Sample records for risk appraisal guide

  1. Incremental Validity Analyses of the Violence Risk Appraisal Guide and the Psychopathy Checklist: Screening Version in a Civil Psychiatric Sample

    Science.gov (United States)

    Edens, John F.; Skeem, Jennifer L.; Douglas, Kevin S.

    2006-01-01

    This study compares two instruments frequently used to assess risk for violence, the Violence Risk Appraisal Guide (VRAG) and the Psychopathy Checklist: Screening Version (PCL:SV), in a large sample of civil psychiatric patients. Despite a strong bivariate relationship with community violence, the VRAG could not improve on the predictive validity…

  2. A comparison of modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide.

    Science.gov (United States)

    Nunes, Kevin L; Firestone, Philip; Bradford, John M; Greenberg, David M; Broom, Ian

    2002-07-01

    The predictive validity of 2 risk assessment instruments for sex offenders, modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide, was examined and compared in a sample of 258 adult male sex offenders. In addition, the independent contributions to the prediction of recidivism made by each instrument and by various phallometric indices were explored. Both instruments demonstrated moderate levels of predictive accuracy for sexual and violent (including sexual) recidivism. They were not significantly different in terms of their predictive accuracy for sexual or violent recidivism, nor did they contribute independently to the prediction of sexual or violent recidivism. Of the phallometric indices examined, only the pedophile index added significantly to the prediction of sexual recidivism, but not violent recidivism, above the Static-99 alone.

  3. Interrater reliability of Violence Risk Appraisal Guide scores provided in Canadian criminal proceedings.

    Science.gov (United States)

    Edens, John F; Penson, Brittany N; Ruchensky, Jared R; Cox, Jennifer; Smith, Shannon Toney

    2016-12-01

    Published research suggests that most violence risk assessment tools have relatively high levels of interrater reliability, but recent evidence of inconsistent scores among forensic examiners in adversarial settings raises concerns about the "field reliability" of such measures. This study specifically examined the reliability of Violence Risk Appraisal Guide (VRAG) scores in Canadian criminal cases identified in the legal database, LexisNexis. Over 250 reported cases were located that made mention of the VRAG, with 42 of these cases containing 2 or more scores that could be submitted to interrater reliability analyses. Overall, scores were skewed toward higher risk categories. The intraclass correlation (ICCA1) was .66, with pairs of forensic examiners placing defendants into the same VRAG risk "bin" in 68% of the cases. For categorical risk statements (i.e., low, moderate, high), examiners provided converging assessment results in most instances (86%). In terms of potential predictors of rater disagreement, there was no evidence for adversarial allegiance in our sample. Rater disagreement in the scoring of 1 VRAG item (Psychopathy Checklist-Revised; Hare, 2003), however, strongly predicted rater disagreement in the scoring of the VRAG (r = .58). (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Predicting Reoffence in Sexual Offender Subtypes: A Prospective Validation Study of the German Version of the Sexual Offender Risk Appraisal Guide (SORAG)

    OpenAIRE

    Martin Rettenberger; Reinhard Eher

    2007-01-01

    This study is part of a prospective, longitudinal research project to evaluate the reliability and validity of different recidivism risk assessment methods for sexual offenders under community supervision for scientific and practical use in the German-speaking part of Europe. In this paper we present the German adaptation of the Sexual Offender Risk Appraisal Guide (SORAG), a specific risk assessment tool for sexual offenders that was developed and published in 1998 in Canada. We examined int...

  5. Sustainability appraisal and flood risk management

    International Nuclear Information System (INIS)

    Carter, Jeremy G.; White, Iain; Richards, Juliet

    2009-01-01

    This research establishes that sustainability appraisal (SA) has a role to play in strengthening spatial plans in the context of flooding issues. Indeed, evidence has been gathered to indicate that tentative steps are being taken in this direction during the SA of English regional spatial plans, which are used as an illustrative case study. In England as in many other countries, appraisal procedures including SA and strategic environmental assessment (SEA) are enshrined in planning law. An opportunity therefore exists to utilise existing and familiar planning tools to embed flooding considerations within spatial plans at an early stage in the planning process. SA (and similar appraisal tools such as SEA) can therefore usefully aid in the implementation of decision making principles and government policy relating to flooding. Moreover, with the threats associated with climate change becoming increasingly apparent, of which increased flood risk is a particular concern in many countries, there is a need develop appropriate adaptation responses. This article emphasizes the role that SA can play in managing future flood risk in this context

  6. A time series modeling approach in risk appraisal of violent and sexual recidivism.

    Science.gov (United States)

    Bani-Yaghoub, Majid; Fedoroff, J Paul; Curry, Susan; Amundsen, David E

    2010-10-01

    For over half a century, various clinical and actuarial methods have been employed to assess the likelihood of violent recidivism. Yet there is a need for new methods that can improve the accuracy of recidivism predictions. This study proposes a new time series modeling approach that generates high levels of predictive accuracy over short and long periods of time. The proposed approach outperformed two widely used actuarial instruments (i.e., the Violence Risk Appraisal Guide and the Sex Offender Risk Appraisal Guide). Furthermore, analysis of temporal risk variations based on specific time series models can add valuable information into risk assessment and management of violent offenders.

  7. Investment appraisal using quantitative risk analysis.

    Science.gov (United States)

    Johansson, Henrik

    2002-07-01

    Investment appraisal concerned with investments in fire safety systems is discussed. Particular attention is directed at evaluating, in terms of the Bayesian decision theory, the risk reduction that investment in a fire safety system involves. It is shown how the monetary value of the change from a building design without any specific fire protection system to one including such a system can be estimated by use of quantitative risk analysis, the results of which are expressed in terms of a Risk-adjusted net present value. This represents the intrinsic monetary value of investing in the fire safety system. The method suggested is exemplified by a case study performed in an Avesta Sheffield factory.

  8. Enhancing Positive Reactions to Breast Cancer Risk Appraisal

    National Research Council Canada - National Science Library

    Cochrane, Barbara

    1996-01-01

    .... Thus, this study seeks to: (1) assess the psychological distress of 350 women ages 50 to 85 who receive breast cancer risk appraisal and randomization to immediate or delayed group psychosocial counseling (2...

  9. Enhancing Positive Reactions to Breast Cancer Risk Appraisal

    National Research Council Canada - National Science Library

    Cochrane, Barbara

    1997-01-01

    .... Thus, this study seeks to: (1) assess the psychological distress of 350 women ages 50 to 85 who receive breast cancer risk appraisal and randomization to immediate or delayed group psychosocial counseling; (2...

  10. Risk management guide

    International Nuclear Information System (INIS)

    Briscoe, G.J.

    1977-06-01

    Risk management requires an assessment or a knowledge of risk. This, in turn, requires identification of hazards (sources of risk) and a determination of risk (evaluation of the hazard degree). The hazard identification and risk analysis techniques presented in this Guide are, in general, based on the MORT concept that accidents result from unwanted energy flow in the absence of adequate controls and/or barriers. This Guide presents an analytical tree designed to prevent oversight of specific energy sources in risk identification. Hazard identification by field personnel is also discussed. Quantitative risk analysis is discussed in the following section. A method for summary of the risks for each energy classification is given. This method uses a graphical log-normal projection so that low probability events, which are not adequately represented in the experience data, are included in the risk assessment. This permits a more acceptable risk assessment since catastrophes are not ignored, even though the actual risk is only approximated. In addition, a few examples of risk analysis of specific hazards are given. Rudimentary probability and fault tree theory are used in these examples. Total risk assessment and resource allocation and safety performance trend analysis are discussed

  11. Individual Differences in Children's Risk Perception and Appraisals in Outdoor Play Environments

    Science.gov (United States)

    Little, Helen; Wyver, Shirley

    2010-01-01

    Child characteristics including age, gender, risk-taking behaviour and sensation seeking are thought to influence children's ability to appraise risks. The present study investigated children's risk perceptions and appraisals in the context of common outdoor physical play activities. Risk perceptions and appraisal of four- and five-year olds were…

  12. Appraising the Risks of Reefer Madness

    OpenAIRE

    Murray, Robin

    2015-01-01

    Editor?s Note: Studies that have tied cannabis use to schizophrenia in the developing brain are just the tip of the iceberg when it comes to marijuana. Are different strains and synthetic cannabinoids especially dangerous? Are we doing enough to educate young people on the risks? Does marijuana use lower IQ? Where is the line between medical marijuana and recreational use? Our author, a noted British psychiatrist, offers a European perspective on these issues.

  13. Risks, doubt, scientific and technical expert appraisement

    International Nuclear Information System (INIS)

    Decrop, G.

    1993-01-01

    In complex systems which compose modern societies, expert report is going to take an increasing place. In its usual definition, expert is justified by a superior authority, his knowledge comes from experience, he is present as a third party where he has to work. It is often forgotten two other important points, connected with the situation: it is a tangling of technical or natural systems with a social system and above all there is a risk of uncertainty. Then, the job of expert is different from scientific work done in laboratories and different from operational work done by engineers

  14. Environmental protection appraisals: a suggested guide for US Department of Energy field organization. Revision 1

    International Nuclear Information System (INIS)

    Barisas, S.; Polich, J.; Surles, T.; Habegger, L.; Anderson, D.; Opelka, J.; Frangos, T.

    1985-03-01

    This manual has been prepared to assist DOE field organizations in conducting environmental protection appraisals of activities at DOE operating-level facilities. Its primary use will be by DOE operations offices in their appraisal of facilities operating under the authority of the Atomic Energy Act. However, the manual can also be used by other DOE field organizations. This manual is organized in modules that parallel those in the internal environmental audit checklist. It is assumed that the contractor is using the guide previously described (Internal Environmental Protection Audits) and that operations office staff members will have the opportunity to review or be cognizant of the contractor's completed internal audit, and other material generated within the facility, in preparation for the appraisal. This manual was developed to facilitate the appraisal process by providing operations office staff with a choice of modules that can be used independently or as a unit. The manual gives guidelines for reviewing information submitted to the operations office before the site visit and for conducting an on-site operating-level appraisal

  15. A methodology for flood risk appraisal in Lithuania

    Directory of Open Access Journals (Sweden)

    Kriščiukaitienė Irena

    2015-06-01

    Full Text Available This paper presents a methodology for flood risk mapping as envisaged by the Directive on the Assessment and Management of Flood Risks [Directive 2007/60/EC]. Specifically, we aimed at identifying the types of flood damage that can be estimated given data availability in Lithuania. Furthermore, we present the main sources of data and the associated cost functions. The methodology covers the following main types of flood threats: risk to inhabitants, risk to economic activity, and social risk. A multi-criteria framework for aggregation of different risks is proposed to provide a comprehensive appraisal of flood risk. On the basis of the proposed research, flood risk maps have been prepared for Lithuania. These maps are available for each type of flood risk (i.e. inhabitants, economic losses, social risk as well as for aggregate risk. The results indicate that flood risk management is crucial for western and central Lithuania, whereas other parts of the country are not likely to suffer from significant losses due to flooding.

  16. Predicting risk of violence through a self-appraisal questionnaire

    Directory of Open Access Journals (Sweden)

    José Manuel Andreu-Rodríguez

    2016-07-01

    Full Text Available The Self-Appraisal Questionnaire (SAQ is a self-report that predicts the risk of violence and recidivism and provides relevant information about treatment needs for incarcerated populations. The objective of the present study was to evaluate the concurrent and predictive validity of this self-report in Spanish offenders. The SAQ was administered to 276 offenders recruited from several prisons in Madrid (Spain. SAQ total scores presented high levels of internal consistency (alpha = .92. Correlations of the instrument with violence risk instruments were statistically significant and showed a moderate magnitude, indicating a reasonable degree of concurrent validity. The ROC analysis carried out on the SAQ total score revealed an AUC of .80, showing acceptable accuracy discriminating between violent and nonviolent recidivist groups. It is concluded that the SAQ total score is a reliable and valid measure to estimate violence and recidivism risk in Spanish offenders.

  17. Integrating a quantitative risk appraisal in a health impact assessment

    DEFF Research Database (Denmark)

    Adám, Balázs; Molnár, Agnes; Gulis, Gabriel

    2013-01-01

    BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal...... in an HIA performed for the recently adopted Hungarian anti-smoking policy which introduced a smoking ban in closed public places, workplaces and public transport vehicles, and is one of the most effective measures to decrease smoking-related ill health. METHODS: A comprehensive, prospective HIA...... to decrease the prevalence of active and passive smoking and result in a considerably positive effect on several diseases, among which lung cancer, chronic pulmonary diseases, coronary heart diseases and stroke have the greatest importance. The health gain calculated for the quantifiable health outcomes...

  18. Economic scenarios for the real estate market: Incorporating uncertainty and risk in real estate appraisals

    Directory of Open Access Journals (Sweden)

    Carsten Lausberg

    2013-08-01

    Full Text Available Real estate appraisal is usually regarded as both a science and an art: “science” because the appraiser uses mathematical calculations and other objective elements, “art” because he also uses his experience and other subjective elements. This dual character requires—among others—that new insights from other disciplines and current trends are taken into account. The central proposition of the article is that this requirement is not met. The author provides evidence that real estate risk management has made tremendous progress since the mid-1990s which has not found its way into appraisal practice, thereby creating a situation where appraisals by risk analysts differ greatly from appraisals by real estate appraisers. According to the author the gap between real estate appraisal and risk analysis should be closed from both sides. The article begins with an overview of the most important trends which will impact real estate values in the future. From these trends, an exemplary economic scenario for European real estate markets is derived in order to demonstrate that scenario writing is a powerful tool for risk management. After that the author discusses some other methods of risk management and their potential benefits for real estate appraisal.

  19. Using Probabilistic Models to Appraise and Decide on Sovereign Disaster Risk Financing and Insurance

    OpenAIRE

    Ley-Borrás, Roberto; Fox, Benjamin D.

    2015-01-01

    This paper presents an overview of the structure of probabilistic catastrophe risk models, discusses their importance for appraising sovereign disaster risk financing and insurance instruments and strategy, and puts forward a model and a process for improving decision making on the linked disaster risk management strategy and sovereign disaster risk financing and insurance strategy. The pa...

  20. Risk-appraisal, outcome and self-efficacy expectancies: Cognitive factors in preventive behaviour related to cancer

    NARCIS (Netherlands)

    Seydel, E.R.; Taal, Erik; Wiegman, O.

    1990-01-01

    Health education often attempts to influence or persuade through risk-appraisal of impending danger or harm. Risk: appraisal implies cognitive processes concerning the severity of the threatening event and the probability of its occurrence. In two studies we investigated whether risk factors could

  1. Perceived nuclear risk, organizational commitment, and appraisals of management: A study of nuclear power plant personnel

    International Nuclear Information System (INIS)

    Kivimaeki, M.; Kalimo, R.; Salminen, S.

    1995-01-01

    This study examined to what extent nuclear risk perceptions, organizational commitment (OC), and appraisals of management are associated with each other among nuclear power plant personnel. The sample consisted of 428 nuclear power plant workers who completed a questionnaire at their workplace. Perceived nuclear risk and OC were most closely related to the appraisals of the top management of the organization. As the trust in and satisfaction with the top management increased, perceived nuclear safety and acceptance of the organizational goals and values heightened. This result is discussed in the context of industrial safety management. 29 refs., 2 tabs

  2. How Accurate Appraisal of Behavioral Costs and Benefits Guides Adaptive Pain Coping

    Directory of Open Access Journals (Sweden)

    Wiebke Gandhi

    2017-06-01

    Full Text Available Coping with pain is a complex phenomenon encompassing a variety of behavioral responses and a large network of underlying neural circuits. Whether pain coping is adaptive or maladaptive depends on the type of pain (e.g., escapable or inescapable, personal factors (e.g., individual experiences with coping strategies in the past, and situational circumstances. Keeping these factors in mind, costs and benefits of different strategies have to be appraised and will guide behavioral decisions in the face of pain. In this review we present pain coping as an unconscious decision-making process during which accurately evaluated costs and benefits lead to adaptive pain coping behavior. We emphasize the importance of passive coping as an adaptive strategy when dealing with ongoing pain and thus go beyond the common view of passivity as a default state of helplessness. In combination with passive pain coping, we highlight the role of the reward system in reestablishing affective homeostasis and discuss existing evidence on a behavioral and neural level. We further present neural circuits involved in the decision-making process of pain coping when circumstances are ambiguous and, therefore, costs and benefits are difficult to anticipate. Finally, we address the wider implications of this topic by discussing its relevance for chronic pain patients.

  3. Relative Risk Appraisal, the September 11 Attacks, and Terrorism-Related Fears

    Science.gov (United States)

    Marshall, Randall D.; Bryant, Richard A.; Amsel, Lawrence; Suh, Eun Jung; Cook, Joan M.; Neria, Yuval

    2013-01-01

    There are now replicated findings that posttraumatic stress disorder (PTSD) symptoms related to the September 11, 2001, attacks occurred in large numbers of persons who did not fit the traditional definition of exposure to a traumatic event. These data are not explained by traditional epidemiologic “bull’s eye” disaster models, which assume the psychological effects are narrowly, geographically circumscribed, or by existing models of PTSD onset. In this article, the authors develop a researchable model to explain these and other terrorism-related phenomena by synthesizing research and concepts from the cognitive science, risk appraisal, traumatic stress, and anxiety disorders literatures. They propose the new term relative risk appraisal to capture the psychological function that is the missing link between the event and subjective response in these and other terrorism-related studies to date. Relative risk appraisal highlights the core notion from cognitive science that human perception is an active, multidimensional process, such that for unpredictable societal threats, proximity to the event is only one of several factors that influence behavioral responses. Addressing distortions in relative risk appraisal effectively could reduce individual and societal vulnerability to a wide range of adverse economic and ethnopolitical consequences to terrorist attacks. The authors present ways in which these concepts and related techniques can be helpful in treating persons with September 11– or terrorism-related distress or psychopathology. PMID:17516775

  4. Managing information risk a director's guide

    CERN Document Server

    Mitchell, Stewart

    2009-01-01

    This pocket guide addresses the scope of risks involved in a modern IT system, and outlines strategies for working through the process of putting risk management at the heart of your corporate culture. Given that no two companies are the same, this pocket guide should not be taken as a step-by-step guide, but should provide decision makers with a solid overview of the factors they need to consider and a framework for implementing a regime that suits their needs.

  5. Use of the Management Oversight and Risk Tree (MORT) methodology in health-physics program appraisals

    International Nuclear Information System (INIS)

    Essig, T.H.; Gilchrist, R.L.

    1981-06-01

    In January 1980, Pacific Northwest Laboratory (PNL) assumed a major role in helping the Nuclear Regulatory Commission (NRC) conduct comprehensive health physics appraisals at 47 operating nuclear power plants. These appraisals required the development of an analytical technique that permitted a deductive analysis of a health-physics program on an element-by-element basis. The technique employed was a modification of the Management Oversight and risk Tree (MORT) analytical logic methodology used in probabilistic assessments. This paper includes the method used in establishing the appraisal guidelines and assigning the proper level of importance within the analytical tree structure. The system for ensuring the proper subdivision necessary for an adequate assessment of each area (e.g., exposure controls and radioactive waste management) will also be discussed. In addition to these major subjects, the generation of specific review questions that correspond to the analytical trees is addressed

  6. A New Approach to Feasibility Risk Assessment within Transport Infrastructure Appraisal

    DEFF Research Database (Denmark)

    Salling, Kim Bang

    2013-01-01

    This paper introduces a new approach of applying feasibility risk assessment within transport project infrastructure appraisal. The procedure is based upon quantitative risk analysis and Monte Carlo simulation in combination with conventional cost-benefit analysis converting deterministic benefit...... are, hereby, often basing their decisions on wrongful material. The presented approach to transport infrastructure appraisal is to include uncertainties and risks in the evaluation. Correspondingly, the handling of uncertainties and risk within transport project assessment are often made up...... by sensitivity tests producing deterministically based output values. Research has proven that traditional sensitivity analysis seldomnly captures the total variability especially as concerns the costs and demands estimated in the pre-stage of the evaluation. Therefore, this paper introduces an approach...

  7. Focusing on appraisals: how and why anger and fear influence driving risk perception.

    Science.gov (United States)

    Lu, Jingyi; Xie, Xiaofei; Zhang, Ruogu

    2013-06-01

    The present research explores how and why anger and fear influence driving risk perception. Based on appraisal tendency framework, researchers hypothesized that anger and fear would influence driving risk perception in opposite directions due to their differences in appraisals. Study 1 showed that anger reduced risk perception, whereas fear increased it. In Studies 2, 3, and 4, the researchers adopted the paradigm of reappraisal to investigate the causes of the opposite effects found in Study 1. Consistent with our hypothesis, appraisals accounted for these effects: After reappraisals along the dimensions of certainty (Study 2), control (Study 3), and responsibility (Study 4), the different effects between anger and fear on driving risk perception diminished or disappeared. In addition, fearful or angry experience mediated the effects of reappraisals on driving risk perception. The findings highlight the necessity to differentiate anger and fear in road safety management. Additionally, the current research also provides feasible methods (e.g., certainty, control, or responsibility reappraisal) to intervene in driving risk perception, which is important for driving safety. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

  8. Hanford Tanks Initiative risk management guide

    International Nuclear Information System (INIS)

    Schaus, P.S.

    1997-01-01

    This project-specific Risk Management Guide describes the general approach and process being used by the HTI Project to manage risk associated with execution of the HTI mission. It includes the initial identification of risk and the quantification of its likelihood and severity of its consequences. It further addresses the formulation of risk mitigation plans, periodic statusing of the Risk Management List, and risk closure

  9. College Student Smokers' Cognitive Appraisal of High-Risk Activities

    Science.gov (United States)

    Copeland, Amy L.; Kulesza, Magdalena; Patterson, Scott M.; Terlecki, Meredith A.

    2009-01-01

    Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, "Environ Behav." 1999; 23:575-591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk…

  10. ITER risk workshop facilitator guide

    International Nuclear Information System (INIS)

    Medina, Patricia

    2009-01-01

    The goal of planning risk management is to make everyone involved in a program aware that risk should be a consideration in the design, development, and fielding of a system. Risk planning is a tool to assess and mitigate events that might adversely impact the program. Therefore, risk management increases the probability/likelihood of program success and can help to avoid program crisis management and improve problem solving by managing risk early in the acquisition cycle.

  11. ITER risk workshop participant guide

    International Nuclear Information System (INIS)

    Medina, Patricia

    2009-01-01

    The goal of planning risk management is to make everyone involved in a program aware that risk should be a consideration in the design, development, and fielding of a system. Risk planning is a tool to assess and mitigate events that might adversely impact the program. Therefore, risk management increases the probability/likelihood of program success and can help to avoid program crisis management and improve problem solving by managing risk early in the acquisition cycle.

  12. Guiding young adults at risk

    DEFF Research Database (Denmark)

    Andreasen, Karen Egedal; Rasmussen, Palle Damkjær; Ydesen, Christian

    2016-01-01

    Karen Egedal Andreasen, Palle Rasmussen and Christian Ydesen question in their article, how to guide youth in danger of being marginalised or excluded from society in general and the labour market in particular. They analyse the guidance dimension in the youth in development project as described ...... significant persons and guidance about educational system and possible jobs....

  13. Climate Change Risk Appraisal in the Austrian Ski Industry

    Science.gov (United States)

    Wolfsegger, C.

    2009-04-01

    Ski tourism is an economically and culturally important industry in many parts of Europe. A growing number of studies in Europe, North America, Japan, and Australia have concluded that climate change has potentially serious implications for the sustainability of ski operations by reducing the average length of ski seasons and, where applicable, increasing snowmaking costs. To date, however, the climate change risk awareness and adaptive responses of stakeholders in the ski industry have not been examined. A survey of managers at low elevation ski areas in Austria was undertaken to explore their perceptions of climate change (past and future), how climate change had/will affect their operations, and their adaptive responses (past and planned). The results indicate that climate change is not perceived to be a serious threat to ski operations and that with technological adaptation, principally snowmaking, ski area managers believe they will be able to effectively cope with climate change in the 21st century. The consequences of these perceptions for the future operation of these ski areas are discussed and conclusions drawn for the future of ski tourism in Austria.

  14. Critically appraising qualitative research: a guide for clinicians more familiar with quantitative techniques.

    Science.gov (United States)

    Kisely, Stephen; Kendall, Elizabeth

    2011-08-01

    Papers using qualitative methods are increasingly common in psychiatric journals. This overview is an introduction to critically appraising a qualitative paper for clinicians who are more familiar with quantitative methods. Qualitative research uses data from interviews (semi-structured or unstructured), focus groups, observations or written materials. Data analysis is inductive, allowing meaning to emerge from the data, rather than the more deductive, hypothesis centred approach of quantitative research. This overview compares and contrasts quantitative and qualitative research methods. Quantitative concepts such as reliability, validity, statistical power, bias and generalisability have qualitative equivalents. These include triangulation, trustworthiness, saturation, reflexivity and applicability. Reflexivity also shares features of transference. Qualitative approaches include: ethnography, action-assessment, grounded theory, case studies and mixed methods. Qualitative research can complement quantitative approaches. An understanding of both is useful in critically appraising the psychiatric literature.

  15. Green Jobs: Definition and Method of Appraisal of Chemical and Biological Risks.

    Science.gov (United States)

    Cheneval, Erwan; Busque, Marc-Antoine; Ostiguy, Claude; Lavoie, Jacques; Bourbonnais, Robert; Labrèche, France; Bakhiyi, Bouchra; Zayed, Joseph

    2016-04-01

    In the wake of sustainable development, green jobs are developing rapidly, changing the work environment. However a green job is not automatically a safe job. The aim of the study was to define green jobs, and to establish a preliminary risk assessment of chemical substances and biological agents for workers in Quebec. An operational definition was developed, along with criteria and sustainable development principles to discriminate green jobs from regular jobs. The potential toxicity or hazard associated with their chemical and biological exposures was assessed, and the workers' exposure appraised using an expert assessment method. A control banding approach was then used to assess risks for workers in selected green jobs. A double entry model allowed us to set priorities in terms of chemical or biological risk. Among jobs that present the highest risk potential, several are related to waste management. The developed method is flexible and could be adapted to better appraise the risks that workers are facing or to propose control measures. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  16. Guide to diagnosis and appraisal of AAR damage to concrete in structures

    CERN Document Server

    Rooij, Mario; Wood, Jonathan

    2013-01-01

    This book describes procedures and methodologies used predominantly to obtain a diagnosis of damaged concrete possibly caused by Alkali-Aggregate Reaction (AAR). It has two primary objectives, namely firstly to identify the presence of AAR reaction, and whether or not the reaction is the primary or contributory cause of damage in the concrete; and secondly, to establish its intensity (severity) in various members of a structure. It includes aspects such as field inspection of the structure, sampling, petrographic examination of core samples, and supplementary tests and analyses on cores, such as mechanical tests and chemical analysis. Evaluation of test data for prognosis, consequences and appraisal will be more fully set out in AAR-6.2.

  17. Approaches to acceptable risk: a critical guide

    Energy Technology Data Exchange (ETDEWEB)

    Fischhoff, B.; Lichtenstein, S.; Slovic, P.; Keeney, R.; Derby, S.

    1980-12-01

    Acceptable-risk decisions are an essential step in the management of technological hazards. In many situations, they constitute the weak (or missing) link in the management process. The absence of an adequate decision-making methodology often produces indecision, inconsistency, and dissatisfaction. The result is neither good for hazard management nor good for society. This report offers a critical analysis of the viability of various approaches as guides to acceptable-risk decisions. This report seeks to define acceptable-risk decisions and to examine some frequently proposed, but inappropriate, solutions. 255 refs., 22 figs., 25 tabs.

  18. Appraising longitudinal trends in the strategic risks cited by risk managers in the international water utility sector, 2005-2015.

    Science.gov (United States)

    Chalker, Rosemary T C; Pollard, Simon J T; Leinster, Paul; Jude, Simon

    2018-03-15

    We report dynamic changes in the priorities for strategic risks faced by international water utilities over a 10year period, as cited by managers responsible for managing them. A content analysis of interviews with three cohorts of risk managers in the water sector was undertaken. Interviews probed the focus risk managers' were giving to strategic risks within utilities, as well as specific questions on risk analysis tools (2005); risk management cultures (2011) and the integration of risk management with corporate decision-making (2015). The coding frequency of strategic (business, enterprise, corporate) risk terms from 18 structured interviews (2005) and 28 semi-structured interviews (12 in 2011; 16 in 2015) was used to appraise changes in the perceived importance of strategic risks within the sector. The aggregated coding frequency across the study period, and changes in the frequency of strategic risks cited at three interview periods identified infrastructure assets as the most significant risk over the period and suggests an emergence of extrinsic risk over time. Extended interviews with three utility risk managers (2016) from the UK, Canada and the US were then used to contextualise the findings. This research supports the ongoing focus on infrastructure resilience and the increasing prevalence of extrinsic risk within the water sector, as reported by the insurance sector and by water research organisations. The extended interviews provided insight into how strategic risks are now driving the implementation agenda within utilities, and into how utilities can secure tangible business value from proactive risk governance. Strategic external risks affecting the sector are on the rise, involve more players and are less controllable from within a utility's own organisational boundaries. Proportionate risk management processes and structures provide oversight and assurance, whilst allowing a focus on the tangible business value that comes from managing strategic

  19. Living with a `women's disease': risk appraisal and management among men with osteoporosis.

    Science.gov (United States)

    Solimeo, Samantha L

    2011-10-01

    BACKGROUND: There is clear evidence that men suffer from osteoporosis (OP) in increasing numbers, but that men commonly remain underdiagnosed, undertreated and experience poorer outcomes than do women. The widespread sociocultural association of OP with postmenopausal women reflects their greater risk for developing the disorder, but the sexing of OP as a women's disease disadvantages at-risk men. METHODS: This paper reports on qualitative data gathered from 23 community-residing men who have an OP diagnosis. RESULTS: Interviews with men reveal that the sexing of OP as a female disease may affect men's risk appraisal. Men clearly associate OP risk factors with women and accordingly may feel protected from the disorder. Subsequent to diagnosis, men's OP-related risk management strategies reveal that men's gender identity constrains their ability to enact risk-reducing behavior. CONCLUSIONS: Men may internalize the association of OP with women and incorporate it into a sense of perceived invulnerability to the condition, which, in turn, contributes to delayed diagnosis and treatment. Limited male-specific treatment and support options as well as social expectations of male gender performance play roles in men's health behavior.

  20. HOW INTERNAL RISK - BASED AUDIT APPRAISES THE EVALUATION OF RISKS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    N. Dorosh

    2017-09-01

    Full Text Available The article deals with the nature and function of the internal risk-based audit process approach to create patterns of risks and methods of evaluation. Deals with the relationship between the level of maturity of the risk of the company and the method of risk-based internal audit. it was emphasized that internal auditing provides an independent and objective opinion to an organization’s management as to whether its risks are being managed to acceptable levels.

  1. Risk appraisal and risk communication: Some empirical data from the Netherlands reviewed

    NARCIS (Netherlands)

    Wiegman, O.; Gutteling, Jan M.

    1995-01-01

    A discrepancy is observed between the general public's subjective perception 'of environmental hazards, which is characterized by feelings of concern and insecurity, and "objective risk." In this article, theoretical notions about subjective risk perception are reviewed and illustrated with (our

  2. Site remediation guided by risk assessment

    International Nuclear Information System (INIS)

    McBean, E.A.; Gowing, A.; Pieczonka, G.

    2002-01-01

    'Full text:' Risk assessment (RA) provides an effective tool for identifying hazards with respect to human health and ecological receptors, hazards that arise from contaminants in the environment. Risk assessment relies upon: hazard identification/problem formulation; toxicity assessment; exposure assessment; and risk characterization. Hence, risk assessment provides an effective guide for site remediation through the identification of the associated risks arising from pre- and potential post-remediation activities. As a demonstration of this decision-making process, a site-specific risk assessment (SSRA) was performed on a chemical producing facility. Historical waste practices during the production of DDT compounds resulted in impacted site soils and sediment and soils of the creek passing through the facility. The purpose of the SSRA was to derive site-specific cleanup values for the impacted on-site soils, creek sediments, and embankment soils, incorporating human and ecological receptors associated with the environmental media. The human exposure pathways considered were dermal contact, incidental ingestion, and inhalation of the various soils. The potential human receptors were industrial workers, construction workers, trespassers, and off-site residents. Ingestion of fish from the creek by residents was also evaluated in the human health risk assessment (HHRA). Food web analyses were used to evaluate the impact of exposure to chemical compounds in aquatic sediments and related soils by ecological receptors such as the great blue heron, raccoon, and mink. The SSRA involved modelling the daily chemical intake by receptors and the transfer of chemicals to identified secondary media (e.g., ambient air or animal tissues) that are also potential exposure media. These models, while using the site-specific chemical data in the source media, possess uncertainties associated with default parameters that are only approximations and not site-specific (e.g., soil

  3. Engaging with Comparative Risk Appraisals: Public Views on Policy Priorities for Environmental Risk Governance.

    Science.gov (United States)

    Rocks, Sophie A; Schubert, Iljana; Soane, Emma; Black, Edgar; Muckle, Rachel; Petts, Judith; Prpich, George; Pollard, Simon J

    2017-09-01

    Communicating the rationale for allocating resources to manage policy priorities and their risks is challenging. Here, we demonstrate that environmental risks have diverse attributes and locales in their effects that may drive disproportionate responses among citizens. When 2,065 survey participants deployed summary information and their own understanding to assess 12 policy-level environmental risks singularly, their assessment differed from a prior expert assessment. However, participants provided rankings similar to those of experts when these same 12 risks were considered as a group, allowing comparison between the different risks. Following this, when individuals were shown the prior expert assessment of this portfolio, they expressed a moderate level of confidence with the combined expert analysis. These are important findings for the comprehension of policy risks that may be subject to augmentation by climate change, their representation alongside other threats within national risk assessments, and interpretations of agency for public risk management by citizens and others. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  4. Risk assessment and economic appraisal of protection methods for the Tarascon-Arles railway embankment

    Directory of Open Access Journals (Sweden)

    Cheetham Mark

    2016-01-01

    ., existing geotechnical conditions and the railway embankment structure were required to undertake the risk assessment. For each hydraulic loading scenario, a detailed economic appraisal was undertaken for each method of protection involving the evaluation of damages associated with disruption to train services and the associated costs to repair the structure. The final stage of the project involved integrating the economic assessment into a wider reaching multi-criteria analysis including indicators for train security, maintainability and environmental impact aspects. The multi-criteria approach was tested under two management strategies to evaluate the effectiveness of each embankment protection system. This paper outlines how the risk assessment, economic appraisal and management-strategy based multi-criteria approach resulted in a highly optimized system of embankment protection with significant gains in terms of both reduced cost of implementation and environmental enhancement whilst maintaining the high levels of railway security required by SNCF-RESEAU.

  5. Increasing young adults' condom use intentions and behaviour through changing chlamydia risk and coping appraisals: study protocol for a cluster randomised controlled trial of efficacy.

    Science.gov (United States)

    Newby, Katie V; French, David P; Brown, Katherine E; Lecky, Donna M

    2013-05-30

    Chlamydia is the most commonly diagnosed sexually transmitted infection (STI) in England and has serious public health consequences. Young people carry a disproportionate burden of infection. A number of social cognition models identify risk appraisal as a primary motivator of behaviour suggesting that changing risk appraisals for STIs may be an effective strategy in motivating protective behaviour. Meta-analytic evidence indicates that the relationship between risk appraisal and health behaviour is small, but studies examining this relationship have been criticised for their many conceptual and methodological weaknesses. The effect of risk appraisal on health behaviour may therefore be of larger size. The proposed study aims to examine the efficacy of an intervention to increase condom use intentions and behaviour amongst young people through changing chlamydia risk and coping appraisals. Coping appraisal is targeted to avoid the intervention being counterproductive amongst recipients who do not feel able to perform the behaviour required to reduce the threat. An experimental design with follow-up, a conditional measure of risk appraisal, and analysis which controls for past behaviour, enable the relationship between risk appraisal and protective behaviour to be accurately assessed. The proposed study is a two-arm cluster randomised controlled trial using a waiting-list control design to test the efficacy of the intervention compared to a control group. Participants will be school pupils aged 13-16 years old recruited from approximately ten secondary schools. Schools will be randomised into each arm. Participants will receive their usual teaching on STIs but those in the intervention condition will additionally receive a single-session sex education lesson on chlamydia. Measures will be taken at baseline, post-intervention and at follow-up three months later. The primary outcome measure is intention to use condoms with casual sexual partners. As far as the authors

  6. On the new ISO guide on risk management terminology

    International Nuclear Information System (INIS)

    Aven, Terje

    2011-01-01

    A new ISO guide on risk management terminology has recently been issued. The guide provides basic vocabulary for developing a common understanding of risk assessment and risk management concepts and terms among organisations and functions, and across different application areas. It provides the foundation of, for example, the ISO 31000 standard on risk management. The guide strongly influences the risk assessment and risk management field, and its quality is thus of utmost importance. In this paper a critical review of the guide is conducted. We argue that the guide fails in several ways in producing consistent and meaningful definitions of many of the key concepts covered. A main focus is placed on the risk concept, which is defined as the effect of uncertainty on objectives, but also many other definitions are looked into, including probability, vulnerability, hazard, risk identification and risk description. Examples are used to illustrate the problems and show how they can be rectified. Although the focus is on the ISO guide, the discussion is to a large extent general. The overall aim of the paper is to contribute to the further development of the area of risk assessment and risk management by strengthening its conceptual basis.

  7. Biodiesel from Specified Risk Material Tallow: An Appraisal of TSE Risks and their Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Baribeau, A.; Bradley, R.; Brown, P.; Goodwin, J.; Kihm, U.; Lotero, E.; O' Connor, D.; Schuppers, M.; Taylor, D.

    2007-03-15

    This document presents a systematic survey of current knowledge about the risk to human and animal health posed by the processing of tissues from animals potentially infected with transmissible spongiform encephalopathy (TSE, or 'prion disease') into biodiesel. It is organised into an introductory background section on TSE, followed by chapters treating the sequential stages of biodiesel production. The principal conclusions are: Animal tissue sources. The choice of geographic origin, based on published scientific evaluations of the risk of TSE to be present in a given country, can largely reduce or even eliminate the entry of contaminated tissue into the biodiesel feedstock. Further safeguards can be provided by selection of animal species not susceptible to TSE, and of tissues without any detectable infectivity even in susceptible species. None of these measures, however, would be applied to the biodiesel projects under consideration, which have the specific aim of using animals and tissues (including specified risk material, or SRM) considered to have sufficient potential risk to be unacceptable for use in food, feed, fertilisers, or pharmaceuticals (including biologicals and medical devices) and therefore are designated for other approved uses, or destruction. Tissue rendering to produce tallow. Experiments to test the survival of TSE infectivity in the products of rendering failed to detect any infectivity in the crude tallow fraction, even following processing methods that allowed survival of infectivity in the co-produced meat and bone meal fraction. It is therefore extremely unlikely that pure tallow originating from diseased animals would be infectious; however, lower grade tallow might contain infectious impurities. A requirement that tallow derived from SRM for use in biodiesel contain no detectable protein would reduce this possibility. Transesterification of tallow to biodiesel. Several steps in the manufacturing process have at least the

  8. Biodiesel from Specified Risk Material Tallow: An Appraisal of TSE Risks and their Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Baribeau, A; Bradley, R; Brown, P; Goodwin, J; Kihm, U; Lotero, E; O' Connor, D; Schuppers, M; Taylor, D

    2007-03-15

    This document presents a systematic survey of current knowledge about the risk to human and animal health posed by the processing of tissues from animals potentially infected with transmissible spongiform encephalopathy (TSE, or 'prion disease') into biodiesel. It is organised into an introductory background section on TSE, followed by chapters treating the sequential stages of biodiesel production. The principal conclusions are: Animal tissue sources. The choice of geographic origin, based on published scientific evaluations of the risk of TSE to be present in a given country, can largely reduce or even eliminate the entry of contaminated tissue into the biodiesel feedstock. Further safeguards can be provided by selection of animal species not susceptible to TSE, and of tissues without any detectable infectivity even in susceptible species. None of these measures, however, would be applied to the biodiesel projects under consideration, which have the specific aim of using animals and tissues (including specified risk material, or SRM) considered to have sufficient potential risk to be unacceptable for use in food, feed, fertilisers, or pharmaceuticals (including biologicals and medical devices) and therefore are designated for other approved uses, or destruction. Tissue rendering to produce tallow. Experiments to test the survival of TSE infectivity in the products of rendering failed to detect any infectivity in the crude tallow fraction, even following processing methods that allowed survival of infectivity in the co-produced meat and bone meal fraction. It is therefore extremely unlikely that pure tallow originating from diseased animals would be infectious; however, lower grade tallow might contain infectious impurities. A requirement that tallow derived from SRM for use in biodiesel contain no detectable protein would reduce this possibility. Transesterification of tallow to biodiesel. Several steps in the manufacturing process have at least the potential to

  9. Cognitive appraisals of alcohol use in early adolescence: Psychosocial predictors and reciprocal associations with alcohol use.

    Science.gov (United States)

    Colder, Craig R; Read, Jennifer P; Wieczorek, William F; Eiden, Rina D; Lengua, Liliana J; Hawk, Larry W; Trucco, Elisa M; Lopez-Vergara, Hector I

    2017-04-01

    Early adolescence is a dynamic period for the development of alcohol appraisals (expected outcomes of drinking and subjective evaluations of expected outcomes), yet the literature provides a limited understanding of psychosocial factors that shape these appraisals during this period. This study took a comprehensive view of alcohol appraisals and considered positive and negative alcohol outcome expectancies, as well as subjective evaluations of expected outcomes. Developmental-ecological theory guided examination of individual, peer, family, and neighborhood predictors of cognitive appraisals of alcohol and use. A community sample of 378 adolescents (mean age 11.5 years at Wave 1, 52% female) was assessed annually for 4 years. Longitudinal path analysis suggested that the most robust predictors of alcohol appraisals were peer norms. Furthermore, perceived likelihood of positive and negative alcohol outcomes prospectively predicted increases in drinking. There was limited support for appraisals operating as mediators of psychosocial risk and protective factors.

  10. Cyber risks for business professionals a management guide

    CERN Document Server

    Kendrick, Rupert

    2010-01-01

    Cyber Risks for Business Professionals: A Management Guide is a general guide to the origins of cyber risks and to developing suitable strategies for their management. It provides a breakdown of the main risks involved and shows you how to manage them. Covering the relevant legislation on information security and data protection, the author combines his legal expertise with a solid, practical grasp of the latest developments in IT to offer a comprehensive overview of a highly complex subject.

  11. Appraisement and benchmarking of third-party logistic service provider by exploration of risk-based approach

    Directory of Open Access Journals (Sweden)

    Nitin Kumar Sahu

    2015-12-01

    Full Text Available In the present era, Reverse Logistics Support has monitored as a momentous realm, where stuffs are transferred from point of consumption to origin. The companies who provide the logistic equipments, i.e. Truck, Joseph Cyril Bomford, and Shipment, etc. to its partner’s firms called Third-Party Logistics (3PL service provider. Today, the feasible 3PL service provider evaluation-opt problem is yet an amorous dilemma. The appraisement and benchmarking of logistics service providers in extent of index; allied risk-based indices and their interrelated metrics; outlooked as a great tool for each international firm, in order that firm could obtain their core goals. The novelty of manuscript is that here, a hairy-based approach has been integrated and then implemented upon a novel developed multi hierarchical third-party logistics (3PL service providers appraisement index in purpose to umpire the 3PL provider for their strong and ill’s core indices. Moreover, the overall score (Si system has also been carried out for benchmarking the 3PL provider companies, where s1 has been found as the best 3PL service provider. The developed approach enabled the manager of firms to make the verdict towards the best inclusive evaluation process of 3PL performance appraisement and benchmarking. A numerical illustration has also been provided to validate the verdict support system.

  12. MCDA and Risk Analysis in Transport Infrastructure Appraisals: the Rail Baltica Case

    DEFF Research Database (Denmark)

    Ambrasaite, Inga; Barfod, Michael Bruhn; Salling, Kim Bang

    2011-01-01

    This paper sets out a decision support system (DSS), COSIMA, involving the combination of cost-benefit analysis and multicriteria decision analysis (MCDA) for transport infrastructure appraisals embracing both economic and strategic impacts. However, some shortcomings appear in the methodology re...

  13. Socio-economic status by rapid appraisal is highly correlated with mortality risks in rural Africa

    NARCIS (Netherlands)

    van Bodegom, D.; May, L.; Kuningas, M.; Kaptijn, R.; Thomese, G.C.F.; Meij, H.J.; Amankwa, J.; Westendorp, R.G.J.

    2009-01-01

    Socio-economic status is an important determinant of health and survival in rural Africa and necessitates a practical and valid instrument to implement in health studies. Our objective was to investigate the validity of the rapid appraisal method to assess socio-economic status and its ability to

  14. Applied software risk management a guide for software project managers

    CERN Document Server

    Pandian, C Ravindranath

    2006-01-01

    Few software projects are completed on time, on budget, and to their original specifications. Focusing on what practitioners need to know about risk in the pursuit of delivering software projects, Applied Software Risk Management: A Guide for Software Project Managers covers key components of the risk management process and the software development process, as well as best practices for software risk identification, risk planning, and risk analysis. Written in a clear and concise manner, this resource presents concepts and practical insight into managing risk. It first covers risk-driven project management, risk management processes, risk attributes, risk identification, and risk analysis. The book continues by examining responses to risk, the tracking and modeling of risks, intelligence gathering, and integrated risk management. It concludes with details on drafting and implementing procedures. A diary of a risk manager provides insight in implementing risk management processes.Bringing together concepts ...

  15. Do (un)certainty appraisal tendencies reverse the influence of emotions on risk taking in sequential tasks?

    Science.gov (United States)

    Bagneux, Virginie; Bollon, Thierry; Dantzer, Cécile

    2012-01-01

    According to the Appraisal-Tendency Framework (Han, Lerner, & Keltner, 2007), certainty-associated emotions increase risk taking compared with uncertainty-associated emotions. To date, this general effect has only been shown in static judgement and decision-making paradigms; therefore, the present study tested the effect of certainty on risk taking in a sequential decision-making task. We hypothesised that the effect would be reversed due to the kind of processing involved, as certainty is considered to encourage heuristic processing that takes into account the emotional cues arising from previous decisions, whereas uncertainty leads to more systematic processing. One hundred and one female participants were induced to feel one of three emotions (film clips) before performing a decision-making task involving risk (Game of Dice Task; Brand et al., 2005). As expected, the angry and happy participants (certainty-associated emotions) were more likely than the fearful participants (uncertainty-associated emotion) to make safe decisions (vs. risky decisions).

  16. Information risk management a practitioner's guide

    CERN Document Server

    Sutton, David

    2014-01-01

    Information risk management (IRM) is about identifying, assessing and prioritising risks to keep information secure and available. This accessible book provides practical guidance to the principles and development of a strategic approach to an IRM programme. The only textbook for the BCS Practitioner Certificate in Information Risk Management.

  17. Appraisal Report

    DEFF Research Database (Denmark)

    Schleimann, Finn; Enemark, Ulrika; Vagnby, Bo Hellisen

    Appraisal of continued support to Ghana's health sector for a third phase covering 2003 - 2007. Funding recommended with DKK 340 million over five years.......Appraisal of continued support to Ghana's health sector for a third phase covering 2003 - 2007. Funding recommended with DKK 340 million over five years....

  18. Examining individual factors according to health risk appraisal data as determinants of absenteeism among US utility employees.

    Science.gov (United States)

    Marzec, Mary L; Scibelli, Andrew F; Edington, Dee W

    2013-07-01

    To investigate predictors of absenteeism and discuss potential implications for policy/program design. Health Risk Appraisal (HRA) data and self-reported and objective absenteeism (personnel records) were used to develop a structural equation model, controlling for age, sex, and job classification. A Medical Condition Burden Index (MCBI) was created by summing the number of self-reported medical conditions. Higher MCBI and stress were direct predictors of absenteeism. Physical activity was not associated with absenteeism but mediated both stress and MCBI. Because stress impacted both absenteeism and MCBI, organizations may benefit by placing stress management as a priority for wellness program and policy focus. Physical activity was not directly associated with absenteeism but was a mediating variable for stress and MCBI. Measures of stress and physical health may be more meaningful as outcome measures for physical activity programs than absenteeism.

  19. The Impact of Two Workplace-Based Health Risk Appraisal Interventions on Employee Lifestyle Parameters, Mental Health and Work Ability: Results of a Randomized Controlled Trial

    Science.gov (United States)

    Addley, K.; Boyd, S.; Kerr, R.; McQuillan, P.; Houdmont, J.; McCrory, M.

    2014-01-01

    Health risk appraisals (HRA) are a common type of workplace health promotion programme offered by American employers. In the United Kingdom, evidence of their effectiveness for promoting health behaviour change remains inconclusive. This randomized controlled trial examined the effects of two HRA interventions on lifestyle parameters, mental…

  20. Bringing appraisal theory to environmental risk perception: a review of conceptual approaches of the past 40 years and suggestions for future research

    NARCIS (Netherlands)

    Keller, Carmen; Bostrom, Ann; Kuttschreuter, M.; Savadori, Lucia; Spence, Alexia; White, Mathew

    2012-01-01

    An intensive program of 40 years of research has produced various conceptual cognitive and affective approaches to environmental risk perception. In this short review of the most relevant conceptual approaches, appraisal theory is presented as a useful means of integrating cognitive and affective

  1. Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence.

    Science.gov (United States)

    Fergusson, David M; Horwood, L John; Boden, Joseph M

    2013-09-01

    There have been debates about the linkages between abortion and mental health. Few reviews have considered the extent to which abortion has therapeutic benefits that mitigate the mental health risks of abortion. The aim of this review was to conduct a re-appraisal of the evidence to examine the research hypothesis that abortion reduces rates of mental health problems in women having unwanted or unintended pregnancy. Analysis of recent reviews (Coleman, 2011; National Collaborating Centre for Mental Health, 2011) identified eight publications reporting 14 adjusted odds ratios (AORs) spanning five outcome domains: anxiety; depression; alcohol misuse; illicit drug use/misuse; and suicidal behaviour. For each outcome, pooled AORs were estimated using a random-effects model. There was consistent evidence to show that abortion was not associated with a reduction in rates of mental health problems (p>0.75). Abortion was associated with small to moderate increases in risks of anxiety (AOR 1.28, 95% CI 0.97-1.70; pabortion has therapeutic effects in reducing the mental health risks of unwanted or unintended pregnancy. There is suggestive evidence that abortion may be associated with small to moderate increases in risks of some mental health problems.

  2. Understanding self-appraisal of HIV-infection risk among young ...

    African Journals Online (AJOL)

    A major component of HIV prevention is to encourage individuals to appreciate their personal risk of contracting the virus with the aim of encouraging them to take steps to reduce the risks. This article addresses the accuracy of an individual's risk assessment by matching this with individual's reported risk behaviours in order ...

  3. A guide to critiquing a research paper. Methodological appraisal of a paper on nurses in abortion care.

    Science.gov (United States)

    Lipp, Allyson; Fothergill, Anne

    2015-03-01

    In this paper, we have taken a previously published article on nurses' judgements in abortion care performing a systematic critique of the merits of this research using a recognised critiquing framework. The qualitative paper chosen for the critique is a grounded theory design and the research terms and terminology associated with this method such as symbolic interactionism are defined. The published paper reported on findings from a study exploring the characteristics of nurses in abortion care. A published critiquing tool has been applied. It was chosen because it is pragmatic, clearly laid out and accessible as full text to the people likely to need it. It comprises two stages, the first of which centres on the believability of the research. The second stage is more detailed and examines the research process and establishes the credibility of the research in its application to practice. Develop critical and analytical skills through methodically appraising the merits of published research. Nursing as an evidence-based profession requires nurses at both pre- and post-registration levels to be able to understand, synthesise and critique research, this being a fundamental part of many nursing curricula. These have become core skills to acquire since implementing up to date evidence is the cornerstone of contemporary nursing practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Measuring Risk Aversion to Guide Transportation Policy

    DEFF Research Database (Denmark)

    Dixit, Vinayak K.; Harb, Rami C.; Martínez-Correa, Jimmy

    2015-01-01

    Road pricing may provide a solution to increasing traffic congestion in metropolitan areas. Route, departure time and travel mode choices depend on risk attitudes as commuters perceive the options as having uncertain effects on travel times. We propose that Experimental Economics methods can...... deliver data that uses real consequences and where the context can be varied by the researcher. The approach relies on the controlled manipulation of contexts, similar to what is done in the Stated Choice approach, but builds in actual consequences, similar to the Revealed Preference approach. This paper...

  5. Management of the radon-related risk. Guide for local authorities. Guide for employers

    International Nuclear Information System (INIS)

    Struillou, Yves; Gupta, Olivier

    2017-01-01

    A first guide aims at being an aid to decision by specifying obligations of local authorities as owners of buildings open to public or as employers, but also at being a support for their health and social actions in terms of information on radon risk in housing. After a presentation of the risk related to radon (health risks, radon propagation, regulatory areas concerned by radon risk management in France), the report indicates the various obligations and mandatory actions for local authorities as building owner and as employer, and actions to be undertaken for existing and new buildings. Technical sheets are provided regarding radon detection, certifications, simple actions, technical diagnosis, remediation works, efficiency control of technical solutions, expert in radiation protection. The second guide aims at being an aid to decision by specifying obligations for employers in terms of management of radon-related risk to which some workers might be exposed, and at providing some good practice recommendations. After a presentation of the risk related to radon (health risks, radon propagation, regulatory areas concerned by radon risk management in France), the report addresses how to organise the radon-related risk management, how to measure radon in work places, how to interpret results and which actions to undertake. Technical sheets are provided regarding radon detection, certifications, simple actions, technical diagnosis, remediation works, efficiency control of technical solutions, expert in radiation protection

  6. An appraisal profile of nostalgia.

    Science.gov (United States)

    van Tilburg, Wijnand A P; Bruder, Martin; Wildschut, Tim; Sedikides, Constantine; Göritz, Anja S

    2018-03-05

    The authors aimed to (a) identify the cognitive appraisals underlying nostalgia and (b) compare nostalgia with other emotions in terms of its appraisal profile. In Study 1, participants (N = 1,125) generated narratives. Next, they reported the level of nostalgia and 31 other emotions that these narratives elicited. Subsequently, participants evaluated the narrative events on several cognitive appraisals. Events that elicited nostalgia were pleasant, involved an irretrievable loss, felt psychologically distant, and were unique-an appraisal profile that differed from all other emotions. In Study 2 (N = 1,261), the authors experimentally varied these appraisals in a vignette paradigm and measured anticipated nostalgia and 10 other emotions. Participants anticipated most nostalgia when events were pleasant, involved irretrievable loss, were distant, and were unique-a profile shared only with longing. In Study 3 (N = 994), the authors used a guided autobiographical recall procedure in which they manipulated appraisals and measured the resultant emotions. Corroborating Studies 1-2, nostalgia was most intense for events that were pleasant, irretrievably lost, temporally distant, and unique. This appraisal profile was not shared by other emotions. The findings delineate the distinguishing cognitive appraisal profile of nostalgia. Nostalgia occupies a special place in the pantheon of emotions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  7. Quantifying links between stroke and risk factors: a study on individual health risk appraisal of stroke in a community of Chongqing.

    Science.gov (United States)

    Wu, Yazhou; Zhang, Ling; Yuan, Xiaoyan; Wu, Yamin; Yi, Dong

    2011-04-01

    The objective of this study is to investigate the risk factors of stroke in a community in Chongqing by setting quantitative criteria for determining the risk factors of stroke. Thus, high-risk individuals can be identified and laid a foundation for predicting individual risk of stroke. 1,034 cases with 1:2 matched controls (2,068) were chosen from five communities in Chongqing including Shapingba, Xiaolongkan, Tianxingqiao, Yubei Road and Ciqikou. Participants were interviewed with a uniform questionnaire. The risk factors of stroke and the odds ratios of risk factors were analyzed with a logistic regression model, and risk exposure factors of different levels were converted into risk scores using statistical models. For men, ten risk factors including hypertension (5.728), family history of stroke (4.599), and coronary heart disease (5.404), among others, were entered into the main effect model. For women, 11 risk factors included hypertension (5.270), family history of stroke (4.866), hyperlipidemia (4.346), among others. The related risk scores were added to obtain a combined risk score to predict the individual's risk of stoke in the future. An individual health risk appraisal model of stroke, which was applicable to individuals of different gender, age, health behavior, disease and family history, was established. In conclusion, personal diseases including hypertension, diabetes mellitus, etc., were very important to the prevalence of stoke. The prevalence of stroke can be effectively reduced by changing unhealthy lifestyles and curing the positive individual disease. The study lays a foundation for health education to persuade people to change their unhealthy lifestyles or behaviors, and could be used in community health services.

  8. Risk assessment, management, communication: a guide to selected sources. Update. Information guide

    International Nuclear Information System (INIS)

    1987-05-01

    This is the first update to the March 1987 publication entitled Risk Assessment, Management, Communication: A Guide to Selected Sources. The risk update series is divided into three major sections: Assessment, Management, and Communication. This update also includes subsections on hazardous waste, radiation, and a number of specific chemicals. Due to the expanding literature on risk, other subsections may be added to updates in the future. Each Table of Contents contains a complete list of the subsections. Updates are produced on a quarterly basis

  9. User's guide to the repository intrusion risk evaluation code INTRUDE

    International Nuclear Information System (INIS)

    Nancarrow, D.J.; Thorne, M.C.

    1986-05-01

    The report, commissioned by the Department of the Environment as part of its radioactive waste management research programme, constitutes the user's guide to the repository intrusion risk evaluation code INTRUDE. It provides an explanation of the mathematical basis of the code, the database used and the operation of the code. INTRUDE is designed to facilitate the estimation of individual risks arising from the possibility of intrusion into shallow land burial facilities for radioactive wastes. It considers a comprehensive inventory of up to 65 long-lived radionuclides and produces risk estimates for up to 20 modes of intrusion and up to 50 times of evaluation. (author)

  10. Appraisal of Airport Alternatives in Greenland by the use of Risk Analysis and Monte Carlo Simulation

    DEFF Research Database (Denmark)

    Salling, Kim Bang; Leleur, Steen

    2007-01-01

    to the construction cost and the travel time sav-ings. The obtained model results aim to provide an input to informed decision-making based on an account of the level of desired risk as concerns feasibility risks. This level is presented as the probability of obtaining at least a benefit-cost ratio of a specified...

  11. Appraisal of individual radiation risk in the context of probabilistic exposures

    International Nuclear Information System (INIS)

    Bohnenblust, H.; Pretre, S.

    1990-01-01

    There exists a growing desire to base safety criteria in different fields on the same principles. The current approach by the international Commission on Radiological Protection (ICRP) to control radiation exposure touches many aspects such as social, psychological, or economic factors that are important for such principles. This paper attempts to further explore possible ways of defining a common basis for dealing with radiation risks and other safety problems. Specifically, it introduces the following issues: different types of risk are judged differently. To account for this, the concept of risk categories is introduced. The dimension of time may play an important role. There is a difference between an immediate death and a death occurring 20 years after exposure to radiation. Effects such as reduced quality of life after exposure and reduction of lifetime expectancy are discussed. The paper suggests to introduce an individual risk equivalent which allows to compare risks as defined in various fields. Furthermore, it suggests the use of risk acceptance criteria which depend on the different categories of risk

  12. Risk appraisal in the radiotherapy patient: “V. I. Lenin” Hospital in Holguin province

    International Nuclear Information System (INIS)

    González López, Dagoberto Eloy; Borjas Hernández, Pedro

    2015-01-01

    An accident is usually caused by the simultaneous occurrence of human errors and equipment failure. In medical applications, the radiation therapy is the increased risk of complexity presented by treatments in patients. The different accidents that have occurred in the world in this practice show the need for safety analysis in order to identify and prevent accidental exposures. In this regard, the effectiveness of the semiquantitative method of “risk matrices”, which consists of a combined analysis of the frequency of occurrence of the event causing the accident, the chance of human errors or failure of the safety barriers, in addition to recognizing the seriousness of the consequences resulting from such events; which define the acceptability criteria based on risk. In this research, this method was applied for safety evaluation analysis of the radiotherapy service at Holguin hospital, which uses a cobalt 60 Theratron Phoenix equipment. The study allowed to quantify the radiotherapy service strengths, to identify the most significant contributors to risk events from the viewpoint of safety, as well as to adopt the most appropriate mitigation measures in order to decrease the occurrence of such accidents. The risk of a large number of accident sequences caused by all possible human errors and equipment failures in the service was estimated, and it was also observed and consequently concluded that none of the accident sequences was considered as very high risk thus confirming that there is no imminent risk which could result in an accident at this facility. (author)

  13. Probabilistic risk assessment of insecticide concentrations in agricultural surface waters: a critical appraisal.

    Science.gov (United States)

    Stehle, Sebastian; Knäbel, Anja; Schulz, Ralf

    2013-08-01

    Due to the specific modes of action and application patterns of agricultural insecticides, the insecticide exposure of agricultural surface waters is characterized by infrequent and short-term insecticide concentration peaks of high ecotoxicological relevance with implications for both monitoring and risk assessment. Here, we apply several fixed-interval strategies and an event-based sampling strategy to two generalized and two realistic insecticide exposure patterns for typical agricultural streams derived from FOCUS exposure modeling using Monte Carlo simulations. Sampling based on regular intervals was found to be inadequate for the detection of transient insecticide concentrations, whereas event-triggered sampling successfully detected all exposure incidences at substantially lower analytical costs. Our study proves that probabilistic risk assessment (PRA) concepts in their present forms are not appropriate for a thorough evaluation of insecticide exposure. Despite claims that the PRA approach uses all available data to assess exposure and enhances risk assessment realism, we demonstrate that this concept is severely biased by the amount of insecticide concentrations below detection limits and therefore by the sampling designs. Moreover, actual insecticide exposure is of almost no relevance for PRA threshold level exceedance frequencies and consequential risk assessment outcomes. Therefore, we propose a concept that features a field-relevant ecological risk analysis of agricultural insecticide surface water exposure. Our study quantifies for the first time the environmental and economic consequences of inappropriate monitoring and risk assessment concepts used for the evaluation of short-term peak surface water pollutants such as insecticides.

  14. Effects of tailored message education about breast cancer risk appraisal for obese Korean women.

    Science.gov (United States)

    Park, Somi; Chung, ChaeWeon; Cochrane, Barbara B

    2013-11-01

    To examine the effects of tailored message education about breast cancer risk in obese Korean women. Pretest/post-test with two comparison treatments. Rural community settings in South Korea. Non-random sample of 64 obese women. Based on the Health Belief Model, tailored message education involved a one-session individual approach addressing cognitive, emotional, and behavioral domains. The comparison group received a one-time standard education group session. Data on breast cancer risk factors and mammography findings were recorded. Knowledge, awareness, emotional barriers, self-efficacy, and intent to screen and prevent breast cancer. Compared to standard education, tailored message education showed significantly higher score changes on awareness of personal risk (F = 5.21, p message education targeting breast cancer and risk associated with obesity is useful in breast cancer screening education. Future studies should incorporate individualized messages on nutrition, exercise, and cultural barriers to reduce breast cancer risk in obese women. Individual educational strategies can effectively enhance breast cancer prevention and early screening. Public and preventive education should include a focus on cultural, cognitive, and emotional domains. For obese women, a heightened awareness and self-efficacy may influence screening behaviors.

  15. Approaches to the risk assessment of genotoxic carcinogens in food: a critical appraisal.

    Science.gov (United States)

    O'Brien, J; Renwick, A G; Constable, A; Dybing, E; Müller, D J G; Schlatter, J; Slob, W; Tueting, W; van Benthem, J; Williams, G M; Wolfreys, A

    2006-10-01

    The present paper examines the particular difficulties presented by low levels of food-borne DNA-reactive genotoxic carcinogens, some of which may be difficult to eliminate completely from the diet, and proposes a structured approach for the evaluation of such compounds. While the ALARA approach is widely applicable to all substances in food that are both carcinogenic and genotoxic, it does not take carcinogenic potency into account and, therefore, does not permit prioritisation based on potential risk or concern. In the absence of carcinogenicity dose-response data, an assessment based on comparison with an appropriate threshold of toxicological concern may be possible. When carcinogenicity data from animal bioassays are available, a useful analysis is achieved by the calculation of margins of exposure (MOEs), which can be used to compare animal potency data with human exposure scenarios. Two reference points on the dose-response relationship that can be used for MOE calculation were examined; the T25 value, which is derived from linear extrapolation, and the BMDL10, which is derived from mathematical modelling of the dose-response data. The above approaches were applied to selected food-borne genotoxic carcinogens. The proposed approach is applicable to all substances in food that are DNA-reactive genotoxic carcinogens and enables the formulation of appropriate semi-quantitative advice to risk managers.

  16. Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

    Directory of Open Access Journals (Sweden)

    Peñalver Josiah M

    2012-10-01

    Full Text Available Abstract Background Anomalous aortic origin of the coronary artery (AAOCA from the opposite sinus of Valsalva with an interarterial course has received much attention due to its association with sudden death in otherwise healthy individuals. AAOCA is relatively common and may have significant public health implications. While our knowledge of its pathophysiology and natural history remains incomplete, an emphasis has been placed on surgical correction. Discussion In 2005 we published a review examining the rates of sudden death with AAOCA, as well as complications of surgical management. Evidence now points even more strongly to lower rates of sudden death, while surgical outcomes data now better documents associated risks. Summary Armed with this updated information, we agree with the need for a national registry to better track patients with AAOCA. We submit that the risks of surgical management outweigh any benefits in the asymptomatic patient with anomalous right coronary artery, and expectant management should also be strongly considered even in asymptomatic patients with anomalous left coronary artery.

  17. Guide for developing conceptual models for ecological risk assessments

    International Nuclear Information System (INIS)

    Suter, G.W., II.

    1996-05-01

    Ecological conceptual models are the result of the problem formulation phase of an ecological risk assessment, which is an important component of the Remedial Investigation process. They present hypotheses of how the site contaminants might affect the site ecology. The contaminant sources, routes, media, routes, and endpoint receptors are presented in the form of a flow chart. This guide is for preparing the conceptual models; use of this guide will standardize the models so that they will be of high quality, useful to the assessment process, and sufficiently consistent so that connections between sources of exposure and receptors can be extended across operable units (OU). Generic conceptual models are presented for source, aquatic integrator, groundwater integrator, and terrestrial OUs

  18. A risk governance approach for high-level waste in Belgium: A process appraisal

    International Nuclear Information System (INIS)

    Laes, Erik; Eggermont, Gilbert; Bombaerts, Gunter

    2010-09-01

    The Belgian nuclear waste management organisation (NIRAS-ONDRAF) has recently started up a public debate on the strategic waste management options for the intermediate- and high-level radioactive waste (cat. B and C waste). This public debate takes place in the context of a (mandatory) strategic environmental impact assessment (SEA) procedure. The paper proposes a critical investigation of four interrelated aspects of this procedure from the point of view of 'good governance': assessment of the remaining uncertainties, guardianship of the democratic process, the organisation of expertise and the interpretation of transgenerational ethics and distributive justice in the new crisis context of globalization and failure of electricity liberalisation. We argue that - in spite of the overall soundness of the geological disposal option - many uncertainties remain: a new technical concept needs to be demonstrated and international financial management needs to be organised. On the process side we argue that although NIRAS-ONDRAF can take up a role as initiator of a public participation process, it can hardly act as a guardian of this process. The debate must be lifted above the local level, opened up to new actors with an active role of the safety authorities and guarded by a non-involved organisation. A condition for success is the creation of critical awareness and the capacity to manage controversy in future with critical expertise. Referring to the RISCOM model for transparent risk communication, we suggest some improvements to the process that is currently taking place

  19. Real-time appraisal of the spatially distributed heat related health risk and energy demand of cities

    Science.gov (United States)

    Keramitsoglou, Iphigenia; Kiranoudis, Chris T.; Sismanidis, Panagiotis

    2016-08-01

    The Urban Heat Island (UHI) is an adverse environmental effect of urbanization that increases the energy demand of cities, impacts the human health, and intensifies and prolongs heatwave events. To facilitate the study of UHIs the Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing of the National Observatory of Athens (IAASARS/NOA) has developed an operational real-time system that exploits remote sensing image data from Meteosat Second Generation - Spinning Enhanced Visible and Infrared Imager (MSG-SEVIRI) and generates high spatiotemporal land surface temperature (LST) and 2 m air temperature (TA) time series. These datasets form the basis for the generation of higher value products and services related to energy demand and heat-related health issues. These products are the heatwave hazard (HZ); the HUMIDEX (i.e. an index that describes the temperature felt by an individual exposed to heat and humidity); and the cooling degrees (CD; i.e. a measure that reflects the energy needed to cool a building). The spatiotemporal characteristics of HZ, HUMIDEX and CD are unique (1 km/5 min) and enable the appraisal of the spatially distributed heat related health risk and energy demand of cities. In this paper, the real time generation of the high spatiotemporal HZ, HUMIDEX and CD products is discussed. In addition, a case study corresponding to Athens' September 2015 heatwave is presented so as to demonstrate their capabilities. The overall aim of the system is to provide high quality data to several different end users, such as health responders, and energy suppliers. The urban thermal monitoring web service is available at http://snf-652558.vm.okeanos.grnet.gr/treasure/portal/info.html.

  20. The trigger values in the environmental risk assessment for (veterinary) medicines in the European Union: a critical appraisal

    NARCIS (Netherlands)

    Montforts MHMM; SEC

    2005-01-01

    A critical appraisal of the data used for the establishment of the trigger values for the exposure of the aquatic environment to human medicines and the terrestrial environment to veterinary medicines leads to the recommendation to change these values. The (draft) technical guidance documents in

  1. Promoting independence, health and well-being for older people: a feasibility study of computer-aided health and social risk appraisal system in primary care.

    Science.gov (United States)

    Walters, Kate; Kharicha, Kalpa; Goodman, Claire; Handley, Melanie; Manthorpe, Jill; Cattan, Mima; Morris, Steve; Clarke, Caroline S; Round, Jeff; Iliffe, Steve

    2017-03-24

    With population ageing, research is needed into new low-cost, scalable methods of effective promotion of health and wellbeing for older people. We aimed to assess feasibility, reach and costs of implementing a new tailored computer-aided health and social risk appraisal system in primary care. Design: Feasibility study. Five General Practices in London (Ealing) and Hertfordshire, United Kingdom (UK) Participants: Random sample of patients aged 65 + years. The Multi-dimensional Risk Appraisal for Older people (MRA-O) system includes: 1) Postal questionnaire including health, lifestyle, social and environmental domains; 2) Software system generating a personalised feedback report with advice on health and wellbeing; 3) Follow-up of people with new concerning or complex needs by GPs or practice nurses. Feasibility of implementation; participant wellbeing, functional ability and quality of life; social needs, health risks, potential lifestyle changes; and costs of implementation. Response rates to initial postal invitations were low (526/1550, 34%). Of these, 454/526 (86%) completed MRA-O assessments. Compared to local UK Census data on older people, participants were younger, more were owner-occupiers and fewer were from ethnic minority groups than expected. A range of problems was identified by participants, including pain in last week (269/438, 61.4%), low physical activity (173/453, 38.2%), sedentary lifestyle (174/447, 38.3%), falls (117/439, 26.7%), incontinence (111/441 25.2%), impaired vision 116/451 (25.7%), impaired hearing (145/431, 33.6%), depressed mood (71/451, 15.7%), impaired memory (44/444 9.9%), social isolation (46/449, 10.2%) and loneliness (31/442, 7.0%). Self-rated health was good/excellent in 312/437 (71.4%), and quality of life and well-being were slightly above age-specific population norms. Implementation costs were low. Practices reviewed medical records of 143/454 (31.5%) of participants as a consequence of their responses, and actively

  2. Living with risk. The British Medical Association guide

    Energy Technology Data Exchange (ETDEWEB)

    1987-01-01

    Personal risk estimation is discussed under the following headings: history and background of risk study, the nature and measurement of risk, the main causes of death, major risk factors (smoking, alcohol and other drugs, diet), occupational risks, transport, risks in the home, recreational risks, medicine and surgery, natural disasters, chemical risks, the perception, acceptability and management of risk, and risks and energy production. The latter chapter includes consideration of comparative risks in electricity generation. The extraction of fuel for, construction and operation of nuclear power stations is discussed, including references to Sellafield, leukemia clustering, and the Three Mile Island and Chernobyl disasters.

  3. A practical approach to assess depression risk and to guide risk reduction strategies in later life.

    Science.gov (United States)

    Almeida, Osvaldo P; Alfonso, Helman; Pirkis, Jane; Kerse, Ngaire; Sim, Moira; Flicker, Leon; Snowdon, John; Draper, Brian; Byrne, Gerard; Goldney, Robert; Lautenschlager, Nicola T; Stocks, Nigel; Scazufca, Marcia; Huisman, Martijn; Araya, Ricardo; Pfaff, Jon

    2011-03-01

    Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies. A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer. The mean age of participants was 71.7 ± 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors. Our

  4. Liquid Pipeline Operator's Control Room Human Factors Risk Assessment and Management Guide

    Science.gov (United States)

    2008-11-26

    The purpose of this guide is to document methodologies, tools, procedures, guidance, and instructions that have been developed to provide liquid pipeline operators with an efficient and effective means of managing the human factors risks in their con...

  5. Do screening-preventative interventions in asymptomatic pregnancies reduce the risk of preterm delivery--a critical appraisal of the literature.

    Science.gov (United States)

    Varma, Rajesh; Gupta, Janesh K; James, David K; Kilby, Mark D

    2006-08-01

    Recent research has suggested that women who experience preterm delivery (PTD) may be identified earlier in pregnancy and before onset of symptoms. Interventions commenced at this earlier asymptomatic stage may offer an opportunity to prevent PTD or lengthen gestation sufficiently to reduce adverse perinatal outcome. Our objective was to examine the evidence that supports or refutes this approach to preventing PTD. We therefore conducted a systematic search and critical appraisal of the identified literature. We found evidence that introducing screening-preventative strategies for asymptomatic pregnancies may reduce the rate of PTD. Evidence for screening and selective treatment exists for: asymptomatic bacteriuria; bacterial vaginosis in low-risk population groups; elective cervical cerclage in high-risk pregnancies; indicated cervical cerclage in women with short cervical length on ultrasound; prophylactic progesterone supplementation in high-risk pregnancies, and smoking cessation. However, for most other strategies, such as increased antenatal attendance, or routine administration of prophylactic micronutrients, the evidence is inconsistent and conflicting. Information on neonatal outcomes apart from PTD (such as serious neonatal morbidity and mortality) was found to be lacking in most studies. It was therefore not possible to establish whether preventing PTD or prolonging gestation would correlate to improved perinatal outcome, and this lessened the potential clinical usefulness of any proposed preventative strategy. No studies were found that evaluated the effectiveness of combining screening-preventative strategies. The review concludes with a suggested an antenatal management plan designed to prevent PTD based on current practice and the evidence presented in this article.

  6. Auditing Social Media A Governance and Risk Guide

    CERN Document Server

    MOAC

    2011-01-01

    This book provides auditors and risk managers with a primer on social media.  It discusses what social media is, how it is being used as a tool within corporations, and how it should be monitored.  In addition, it discusses the various risks involved with the use of social media (e.g., reputation/brand risk; compliance risks; proprietary information risks; employee privacy risks; and vendor risks).    It also discusses compliance with Federal Trade Commission guidelines (e.g., education and disclosure requirements as well as audit and record keeping requirements). 

  7. Persistent Ratee Contaminants in Performance Appraisal.

    Science.gov (United States)

    Van Fleet, David D.; Chamberlain, Howard

    The hypothesis that conventional approaches to evaluating contaminants in performance appraisal overlook important individual ratee effects was examined. A rating form was developed that consisted of the following dimensions and behaviors: warmth; guided discourse or indirect teaching methods; control of subject matter; enthusiasm and reinforcing;…

  8. F167. ACCESS, UNDERSTAND, APPRAISE AND APPLY TO / OF HEALTH INFORMATION AND HEALTH LITERACY IN INDIVIDUALS AT-RISK FOR PSYCHOSIS: A SYSTEMATIC REVIEW

    Science.gov (United States)

    Seves, Mauro; Haidl, Theresa; Eggers, Susanne; Rostamzadeh, Ayda; Genske, Anna; Jünger, Saskia; Woopen, Christiane; Jessen, Frank; Ruhrmann, Stephan

    2018-01-01

    Abstract Background Numerous studies suggest that health literacy (HL) plays a crucial role in maintaining and improving individual health. Furthermore, empirical findings highlight the relation between levels of a person’s HL and clinical outcomes. So far, there are no reviews, which investigate HL in individuals at-risk for psychosis. The aim of the current review is to assess how individuals at risk of developing a first episode of psychosis gain access to, understand, evaluate and apply risk-related health information. Methods A mixed-methods approach was used to analyze and synthesize a variety of study types including qualitative and quantitative studies. Search strategy, screening and data selection have been carried out according to the PRISMA criteria. The systematic search was applied on peer-reviewed literature in PUBMED, Cochrane Library, PsycINFO and Web of Science. Studies were included if participants met clinical high risk criteria (CHR), including the basic symptom criterion (BS) and the ultra-high risk (UHR) criteria. The UHR criteria comprise the attenuated psychotic symptom criterion (APS), the brief limited psychotic symptom criterion (BLIPS) and the genetic risk and functional decline criterion (GRDP) Furthermore, studies must have used validated HL measures or any operationalization of the HL’s subdimensions (access, understanding, appraisal, decision-making or action) as a primary outcome. A third inclusion criterion comprised that the concept of HL or one of the four dimensions was mentioned in title or abstract. Data extraction and synthesis was implemented according to existing recommendations for appraising evidence from different study types. The quality of the included studies was evaluated and related to the study results. Results The search string returned 10587 papers. After data extraction 15 quantitative as well as 4 qualitative studies and 3 reviews were included. The Quality assessment evaluated 12 publications as

  9. Penentuan Sistem Kompensasi Berdasarkan Risk Assessment dan Performance Appraisal Karyawan (Studi Kasus: Petugas Operasional Pemadam Kebakaran Kota Padang

    Directory of Open Access Journals (Sweden)

    Difana Meilani

    2016-12-01

    Full Text Available Risk is a possibility of the occurrence that may affect the achievement of objectives. Risk can give positive or negative effect. One of the jobs that have a high risk is firefighter job. Furthermore, a firefighter who are disciplined, responsible, and good in team work, they must be given a reward for their motivation. Therefore, the compensation that they get is equal with the potential risk and working achievement. The compensation of the risk and achievement is included in the extra payment of dangerous work (hazard pay and bonus based on working achievement of an employee (merit pay. Comparing to the old system, the compensation system will increase the firefighters' income from Rp 900.000 to Rp 1.297.280 every month. The addition will also increase the budget of Damkar from Rp 550.800.000 to Rp 793.935.156 every year.

  10. U.S. Coast Guard Guide for the Management of Crew Endurance Risk Factors - Version 1.0

    National Research Council Canada - National Science Library

    Comperatore, Carlos

    2001-01-01

    .... This Guide will show you how to identify and manage crew endurance risk factors. The step-by-step process will guide you in selecting and implementing the controls necessary to improve crew endurance...

  11. Risk-based approach to appraise valve closure in the clam Corbicula fluminea in response to waterborne metals

    International Nuclear Information System (INIS)

    Liao, C.-M.; Jou, L.-J.; Chen, B.-C.

    2005-01-01

    We developed a risk-based approach to assess how the valve closure behavior of Asiatic clam Corbicula fluminea responds to waterborne copper (Cu) and cadmium (Cd). We reanalyzed the valve closure response data from published literature to reconstruct the response time-dependent dose-response profiles based on an empirical three-parameter Hill equation model. We integrated probabilistic exposure profiles of measured environmental Cu and Cd concentrations in the western coastal areas of Taiwan with the reconstructed dose-response relationships at different integration times of response to quantitatively estimate the valve response risk. The risk assessment results implicate exposure to waterborne Cu and Cd may pose no significant risk to clam valve activity in the short-time response periods (e.g., <30 min), yet a relative high risk for valve closure response to waterborne Cu at response times greater than 120 min is alarming. We successfully linked reconstructed dose-response profiles and EC50-time relationships associated with the fitted daily valve opening/closing rhythm characterized by a three-parameter lognormal function to predict the time-varying bivalve closure rhythm response to waterborne metals. We parameterized the proposed predictive model that should encourage a risk-management framework for discussion of future design of biological monitoring systems. - A model was developed to link valve closure in clams to concentrations of metals in water

  12. Risk Management: An Accountability Guide for University and College Boards

    Science.gov (United States)

    Abraham, Janice M.

    2013-01-01

    With proven advice and practical best practices for sound risk management, this robust publication written by the CEO of United Educators identifies how engaged board members should collaborate closely with institutional leaders on a variety of operational and strategic risks. All board members, whatever their role or committee assignment, will…

  13. A systematic review and appraisal of methods of developing and validating lifestyle cardiovascular disease risk factors questionnaires.

    Science.gov (United States)

    Nse, Odunaiya; Quinette, Louw; Okechukwu, Ogah

    2015-09-01

    Well developed and validated lifestyle cardiovascular disease (CVD) risk factors questionnaires is the key to obtaining accurate information to enable planning of CVD prevention program which is a necessity in developing countries. We conducted this review to assess methods and processes used for development and content validation of lifestyle CVD risk factors questionnaires and possibly develop an evidence based guideline for development and content validation of lifestyle CVD risk factors questionnaires. Relevant databases at the Stellenbosch University library were searched for studies conducted between 2008 and 2012, in English language and among humans. Using the following databases; pubmed, cinahl, psyc info and proquest. Search terms used were CVD risk factors, questionnaires, smoking, alcohol, physical activity and diet. Methods identified for development of lifestyle CVD risk factors were; review of literature either systematic or traditional, involvement of expert and /or target population using focus group discussion/interview, clinical experience of authors and deductive reasoning of authors. For validation, methods used were; the involvement of expert panel, the use of target population and factor analysis. Combination of methods produces questionnaires with good content validity and other psychometric properties which we consider good.

  14. Homeland Security: A Risk Management Approach Can Guide Preparedness Efforts

    National Research Council Canada - National Science Library

    Decker, Raymond

    2001-01-01

    .... Mail and postal workers. As requested, my testimony will focus on the work we have done over the past five years on combating terrorism and our recommendations advocating a risk management approach for such programs...

  15. Identifying at-risk states beyond positive symptoms: a brief task assessing how neurocognitive impairments impact on misrepresentation of the social world through blunted emotional appraisal

    OpenAIRE

    Galdos,Mariana; Simons,Claudia J.P.; Wichers,Marieke; Fernandez-Rivas,Aranzazu; Martinez-Azumendi,Oscar; Lataster,Tineke; Amer,Guillermo; Myin-Germeys,Inez; Gonzalez-Torres,Miguel Angel; Os,Jim van

    2011-01-01

    OBJECTIVE: Neurocognitive impairments observed in psychotic disorder may impact on emotion recognition and theory of mind, resulting in altered understanding of the social world. Early intervention efforts would be served by further elucidation of this mechanism. METHOD: Patients with a psychotic disorder (n=30) and a reference control group (n=310) were asked to offer emotional appraisals of images of social situations (EASS task). The degree to which case-control differences in appraisals w...

  16. Energy: a background and guide to the assessment of risks

    International Nuclear Information System (INIS)

    Wolff, Heinz

    1986-01-01

    The question of safety and the assessment of risk to personnel has been looked at from the point of view of life underwriting in the nuclear power industry, and the oil, gas and coal industries. Following a brief history of the energy industries and techniques of energy extraction, including reactor types, the medical aspects are considered for each industry. For nuclear energy workers these are exposure to radioactive material and deafness. The accident risks are then considered. For the nuclear industry particular areas of risk are identified as walkways, road traffic accidents, human error and radiation. Accident statistics for 1981-1985 in the UK are given. Safety aspects are then considered and accidents involving increased radiation exposure are mentioned. Suggested ratings are given. For the nuclear industry there is insufficient evidence to suggest that ratings should be imposed. (UK)

  17. Using QA classification to guide design and manage risk

    International Nuclear Information System (INIS)

    Lathrop, J.; DeKlever, R.; Petrie, E.H.

    1993-01-01

    Raytheon Services Nevada has developed a classification process based on probabilistic risk assessment, using accident/impact scenarios for each system classified. Initial classification analyses were performed for the 20 systems of Package IA of the Exploratory Studies Facility (ESF). The analyses demonstrated a solid, defensible methodological basis for classification which minimizes the use of direct engineering judgment. They provide guidance for ESF design and risk management through the identification of: The critical characteristics of each system that need to be controlled; and the parts of the information base that most need to be further developed through performance assessment or other efforts

  18. A Qualitative Study to Appraise Patients and Family Members Perceptions, Knowledge, and Attitudes towards Venous Thromboembolism Risk.

    Directory of Open Access Journals (Sweden)

    Claudie Haxaire

    Full Text Available This study aimed to examine perception, knowledge and concerns developed by patients and their family as regards venous thromboembolism (VTE risk.We conducted a qualitative study. Participants were: (1 patients with unprovoked VTE with either factor V Leiden mutation or G20210A prothrombin gene mutation or not; and (2 their first-degree relatives. Interviews took place mostly at Brest University Hospital. Participants produced narratives of the patient's illness, stressing their perception of the disorder, its mechanisms, etiology, circumstances and risk factors. Interviews were audiotaped and transcribed verbatim. On an ongoing basis, central themes were identified and data from narratives were categorized by these themes.A total of ten patients and 25 first-degree relatives were interviewed. Analyses of patient's narratives suggested 4 main themes: (1 concerns about initial symptoms and suspicion of VTE. The longer the duration of the initial phase, the more likely anxiety took place and persisted after diagnosis; (2 underestimation of potential life-threatening episode once being managed in emergency; (3 possible biographical disruption with inability to cope with the event; and (4 secondary prevention attitudes motivated by remains of the episode and favoring general prevention attitudes. Analyses of the first-degree relatives narratives suggested 3 main themes: (1 common interpretation of the VTE episode shared within the family; (2 diverse and sometimes confusing interpretation of the genetic status; and, (3 interpretation of clinical signs linked to VTE transmission within the family.Construction of the risk of VTE is based on patient's initial experience and shared within the family. Collection of narratives illustrates the gap between these perceptions and current medical knowledge. These results support the need to collect the perceptions of the VTE episode and its consequences, as a prerequisite to any health education process.

  19. Comparison of linear and zero-inflated negative binomial regression models for appraisal of risk factors associated with dental caries.

    Science.gov (United States)

    Batra, Manu; Shah, Aasim Farooq; Rajput, Prashant; Shah, Ishrat Aasim

    2016-01-01

    Dental caries among children has been described as a pandemic disease with a multifactorial nature. Various sociodemographic factors and oral hygiene practices are commonly tested for their influence on dental caries. In recent years, a recent statistical model that allows for covariate adjustment has been developed and is commonly referred zero-inflated negative binomial (ZINB) models. To compare the fit of the two models, the conventional linear regression (LR) model and ZINB model to assess the risk factors associated with dental caries. A cross-sectional survey was conducted on 1138 12-year-old school children in Moradabad Town, Uttar Pradesh during months of February-August 2014. Selected participants were interviewed using a questionnaire. Dental caries was assessed by recording decayed, missing, or filled teeth (DMFT) index. To assess the risk factor associated with dental caries in children, two approaches have been applied - LR model and ZINB model. The prevalence of caries-free subjects was 24.1%, and mean DMFT was 3.4 ± 1.8. In LR model, all the variables were statistically significant. Whereas in ZINB model, negative binomial part showed place of residence, father's education level, tooth brushing frequency, and dental visit statistically significant implying that the degree of being caries-free (DMFT = 0) increases for group of children who are living in urban, whose father is university pass out, who brushes twice a day and if have ever visited a dentist. The current study report that the LR model is a poorly fitted model and may lead to spurious conclusions whereas ZINB model has shown better goodness of fit (Akaike information criterion values - LR: 3.94; ZINB: 2.39) and can be preferred if high variance and number of an excess of zeroes are present.

  20. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics.

    Science.gov (United States)

    Baral, Stefan; Logie, Carmen H; Grosso, Ashley; Wirtz, Andrea L; Beyrer, Chris

    2013-05-17

    Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These factors are representative of social, economic, organizational and political inequities. Associated with an improved understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages. Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is often far more actionable than characterizing individual-level risks. We propose a modified social ecological model (MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM. The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic studies has traditionally been on

  1. Long-term risks of metal contaminants in drinking water: a critical appraisal of guideline values for arsenic and vanadium

    Directory of Open Access Journals (Sweden)

    Riccardo Crebelli

    2012-12-01

    Full Text Available Metal contaminants in drinking water represent a relevant health issue in several areas of the world. In Italy, because of the geological features of the territory, high arsenic and vanadium are frequently reported in ground waters in concentrations above current guideline values. The implications for public health of the presence of contaminants above their legal limit are directly related to the biological basis of the guideline value. In the case of arsenic there are still major uncertainties in the mechanism of carcinogenesis which prevent a precise evaluation of long-term risks. Thus, the guideline value endorsed in the European Community (10 µg/L has to be considered as a pragmatic tool rather than a quality objective, bearing in mind that "every effort should be made to keep concentrations as low as reasonably possible" (WHO, 2011. A reverse situation holds for vanadium, for which a strict national limit (50 µg/L was previously proposed in consideration of data gaps, and for which new evidence indicated a less stringent health-based limit.

  2. Analysis of Developed Country's Export Contract and Contract Risk and Development of Sample Contract and Guide

    International Nuclear Information System (INIS)

    Lee, D. S.; Oh, K. B.; Chung, W. S.; Lee, K. S.; Yun, S. W.; Lee, J. H.; Lee, B. W.; Kim, H. J.; Yang, M. H.

    2008-10-01

    This paper aimed at developing legal support for the non nuclear power plant industry's export. This study aids establishing government policy and promoting export of non nuclear power plant industry. This paper treated analysis of contractual risk and caution before entering into contract. To promote continuing export result, governmental and legal aids and guide will be required continuously. This study showed risks related with export contract and explained export control acts and procedures

  3. Impact of delineation uncertainties on dose to organs at risk in CT-guided intracavitary brachytherapy.

    LENUS (Irish Health Repository)

    Duane, Frances K

    2014-08-07

    This study quantifies the inter- and intraobserver variations in contouring the organs at risk (OARs) in CT-guided brachytherapy (BT) for the treatment of cervical carcinoma. The dosimetric consequences are reported in accordance with the current Gynecological Groupe Européen de Curiethérapie\\/European Society for Therapeutic Radiology and Oncology guidelines.

  4. Heavy metals bioconcentration from soil to vegetables and appraisal of health risk in Koka and Wonji farms, Ethiopia.

    Science.gov (United States)

    Eliku, Temesgen; Leta, Seyoum

    2017-04-01

    Heavy metal accumulation in agricultural crops has grown a major concern globally as a result of a significant health impact on human. The quantification of heavy metals (Cd, Pb, Cr, Zn, Cu, and Ni) in the soil and vegetables at two sites (Koka and Wonji Gefersa) was done using flame atomic absorption spectrophotometer. The mean concentrations of heavy metals in vegetable fields' soil samples obtained from Koka were higher for Pb, Cr, Zn, Cu, and Ni. The overall results of soil samples ranged 0.52-0.93, 13.6-27.3, 10.0-21.8, 44.4-88.5, 11.9-30.3, and 14.7-34.5 mg kg -1 for Cd, Pb, Cr, Zn, Cu, and Ni, respectively. The concentrations of heavy metals were maximum for Cd (0.41 ± 0.03 mg kg -1 ), Pb (0.54 ± 0.11 mg kg -1 ), Zn (14.4 ± 0.72 mg kg -1 ), Cu (2.84 ± 0.27 mg kg -1 ), and Ni (1.09 ± 0.11 mg kg -1 ) in Cabbage and for Cr (2.63 ± 0.11 mg kg -1 ) in green pepper. The result indicated that Cd has high transfer factor value and Pb was the lowest. The transfer pattern for heavy metals in different vegetables showed a trend in the order: Cd > Zn > Cu > Cr > Ni > Pb. Among different vegetables, cabbage showed the highest value of metal pollution index and bean had the lowest value. Hazard index of all the vegetables was less than unity; thus, the consumption of these vegetables is unlikely to pose health risks to the target population.

  5. Identifying at-risk states beyond positive symptoms: a brief task assessing how neurocognitive impairments impact on misrepresentation of the social world through blunted emotional appraisal.

    Science.gov (United States)

    Galdos, Mariana; Simons, Claudia J P; Wichers, Marieke; Fernandez-Rivas, Aranzazu; Martinez-Azumendi, Oscar; Lataster, Tineke; Amer, Guillermo; Myin-Germeys, Inez; Gonzalez-Torres, Miguel Angel; van Os, Jim

    2011-10-01

    Neurocognitive impairments observed in psychotic disorder may impact on emotion recognition and theory of mind, resulting in altered understanding of the social world. Early intervention efforts would be served by further elucidation of this mechanism. Patients with a psychotic disorder (n=30) and a reference control group (n=310) were asked to offer emotional appraisals of images of social situations (EASS task). The degree to which case-control differences in appraisals were mediated by neurocognitive alterations was analyzed. The EASS task displayed convergent and discriminant validity. Compared to controls, patients displayed blunted emotional appraisal of social situations (B=0.52, 95% CI: 0.30, 0.74, Ppsychotic disorder may underlie misrepresentation of the social world, mediated by altered emotion recognition. A task assessing the social impact of cognitive alterations in clinical practice may be useful in detecting key alterations very early in the course of psychotic illness.

  6. Physician Appraisals: Key Challenges

    Directory of Open Access Journals (Sweden)

    Klich Jacek

    2017-06-01

    Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

  7. 77 FR 70846 - Regulatory Guide 1.182, “Assessing and Managing Risk Before Maintenance Activities at Nuclear...

    Science.gov (United States)

    2012-11-27

    ... NUCLEAR REGULATORY COMMISSION [NRC-2012-0285] Regulatory Guide 1.182, ``Assessing and Managing Risk Before Maintenance Activities at Nuclear Power Plants'' AGENCY: Nuclear Regulatory Commission... withdrawing Regulatory Guide (RG)1.182, Revision (Rev.) 0, ``Assessing and Managing Risk Before Maintenance...

  8. Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study.

    Science.gov (United States)

    Kolbe-Alexander, Tracy L; Conradie, Jaco; Lambert, Estelle V

    2013-12-21

    The global increase in the prevalence of NCD's is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs. Employees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, 'Vitality Risk Age' was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2 789). Participants were 36±10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI ≥ 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p Physical inactivity was associated with clustering of risk factors for NCD in SA employees. Employees with lower BMI, better self-reported health status and readiness to change were more likely to meet the PA guidelines. These employees might therefore benefit from physical activity intervention programs that could result in improved risk profile and reduced healthcare expenditure.

  9. 12 CFR 564.5 - Appraiser independence.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appraiser independence. 564.5 Section 564.5 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.5 Appraiser independence. (a) Staff appraisers. If an appraisal is prepared by a staff appraiser, that appraiser must be...

  10. Appraisal of Meconium at Delivery

    Science.gov (United States)

    Paes, Bosco A.; Thompson, Penelope

    1992-01-01

    A critical appraisal of the scientific literature on managing mesconium in labor identified 15 studies which were used to evaluate intervention strategies. Only four were randomized trials: two on the use of amnioinfusion in labor, one on the technique of bulb versus DeLee catheter suction of the newborn, and one on the need for endotracheal intubation and suction in meconium-stained neonates. Current practice is dictated by the most favorable tradeoff between benefit and risk because of limited scientific evidence. PMID:21221284

  11. SCAMPI Lead Appraiser (Service Mark) Body of Knowledge (SLA BOK)

    Science.gov (United States)

    2007-10-01

    University. 34 | CMU/SEI-2007-TR-019 CC 3 Project Planning and Management Moeller, Robert R. COSO Enterprise Risk Management : Understanding the...appraisal participants) to specific amounts of time when the sponsor agrees to having the appraisal. CMP 3.1.2 Employing risk management techniques...contingency and management reserves appropriately • Ensuring the risk management strategy accounts for the OU’s process improvement history • Assessing

  12. The essentials of risk management the definitive guide for the non-risk professional

    CERN Document Server

    Crouhy, Michel; Mark, Robert

    2006-01-01

    Learn what risk management is and how you can effectively implement it in your organisation Essentials of Risk Management eliminates the complex mathematics and minutiae surrounding corporate risk management. It describes key risk concepts and controls in language that you can understand. Topics include organisational issues and regulatory aspects, along with detailed descriptions of tools for controlling key types of market, credit, and operational risk.

  13. A guide to understanding and implementing risk evaluation and mitigation strategies in organ transplantation.

    Science.gov (United States)

    Gabardi, Steven; Tichy, Eric M

    2013-03-01

    To review the components of the Congressional mandate for risk evaluation and mitigation strategies (REMS) managed by the Food and Drug Administration and assess their impact on health care providers practicing within the organ transplant arena. A non-date-limited search of MEDLINE and EMBASE (January 2007-June 2012) was conducted by using the following search terms: risk evaluation and mitigation strategies, REMS, and organ transplant, including a query of the individual organs. Information from the Federal Register and the Food and Drug Administration was also evaluated. REMS are strategies implemented to manage known or potential risks associated with medications and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product. Elements of REMS programs may consist of 3 levels: a medication guide, communication plan, and elements to assure safe use. A medication guide is used to help prevent serious adverse events, aid in patients' decision making, and enhance medication adherence. Communication plans help educate health care providers and encourage adherence with REMS. The elements to assure safe use is a restrictive process implemented when it is deemed necessary to ensure safe access for patients to products with known serious risks. In transplant medicine, REMS currently exist for belatacept (medication guide and communication plan) and the mycophenolic acid derivatives (medication guide and elements to assure safe use). REMS are another step in the evolution of the development and marketing of pharmaceutical agents. Use of REMS in solid-organ transplant is becoming common. Transplant clinicians must provide required patient education and become involved with other aspects of REMS implementation to reduce the serious risks of pharmaceuticals and to improve patients' outcomes.

  14. Conducting effective performance appraisals.

    Science.gov (United States)

    2001-01-01

    According to experts, performance appraisals rate just below firing someone as the least favorite thing managers do. Many factors contribute to this view--one is that current systems do a poor job of evaluating performance and in fact often impede both evaluation and performance. When used as part of an ongoing supportive process of goal setting and feedback, performance appraisals can enhance performance and morale. One alternative to traditional employee evaluation methods is full-circle or 360-degree feedback. Contained in this issue are practical suggestions for preparing employees for performance appraisals which, when followed daily, encourage employees to put their best feet forward as part of their regular routine. Also included is a template specific to assessing the performance of clinical laboratory technologists . Additionally, numerous resources are provided to help you refine appraisal systems to fit your needs. Full-circle feedback is proving to be a boon to managers. It relieves them from being the exclusive "heavies" in evaluating performance, integrates appraisal input from several sources, and incorporates increasing employee skills, competencies, and satisfaction, thus improving productivity of people and processes. And aren't integration and continuous improvement what the laboratory is all about?

  15. PRA Procedures Guide: a guide to the performance of probabilistic risk assessments for nuclear power plants. Final report, Volume 1 - Chapters 1-8

    International Nuclear Information System (INIS)

    1983-01-01

    This document, the Probabilistic Risk Assessment (PRA) Procedures Guide, is intended to provide an overview of the risk-assessment field as it exists today and to identify acceptable techniques for the systematic assessment of the risk from nuclear power plants. Topics discussed include: organization of PRA; accident-sequence definition and system modeling; human-reliability analysis; data-base development; accident-sequence quantification; physical processes of core-melt accidents; and radionuclide release and transport

  16. Appraisal of Transport Projects

    DEFF Research Database (Denmark)

    Jensen, Anders Vestergaard

    and robustness measures have been elaborated, which examine the subjective part of the MCDA (in form of criteria weights) and its role in decision support making. For this purpose both deterministic and stochastic sensitivity analyses have been developed. In addition, the focus has been formulating a framework...... into account the interests and preferences of different stakeholders. These various interests and preferences have been revealed by the use of decision conferencing, which engage the stakeholders and provide a common platform for understanding the decision problem. Leading up to this framework, this thesis has......, as robustness of a recommended solution is major concern in the final steps of decision making. As mentioned, the appraisal of transport projects is a complex issues involving conflict of various interests and this calls for new approaches to the practice of appraisal. The presented appraisal framework...

  17. A Transparent Framework for guiding Radiological and Non-Radiological Contaminated Land Risk Assessments

    International Nuclear Information System (INIS)

    Lee, Alex; Mathers, Dan

    2003-01-01

    A framework is presented that may be used as a transparent guidance to both radiological and non-radiological risk assessments. This framework has been developed by BNFL, with external consultation, to provide a systematic approach for identifying key system drivers and to guide associated research packages in light of data deficiencies and sources of model uncertainty. The process presented represents an advance on existing working practices yet combines regulator philosophy to produce a robust, comprehensive, cost-effective and transparent work package. It aims at lending added confidence to risk models thereby adding value to the decision process

  18. 41 Appraisal of the Performance of Contingency Cost Provision for ...

    African Journals Online (AJOL)

    Arc. Usman A. Jalam

    ATBU Journal of Environmental Technology, 4, (1), December 2011. 41. Appraisal of the ... quantitative risks analysis in the determination of contingency fund. Therefore, to improve the ... the financial performance of constructed facilities ...

  19. Computational reproducibility of "Goal relevance and goal conduciveness appraisals lead to differential autonomic reactivity in emotional responding to performance feedback" (Kreibig, Gendolla, & Scherer, 2012): A guide and new evidence.

    Science.gov (United States)

    Kreibig, Sylvia D

    2017-09-01

    The emerging field of the psychophysiology of motivation bears many new findings, but little replication. Using my own data (Kreibig, Gendolla, & Scherer, 2012), I test the reproducibility of this specific study, provide the necessary materials to make the study reproducible, and instantiate proper reproducibility practices that other researchers can use as a road map toward the same goal. In addition, based on re-analyses of the original data, I report new evidence for the motivational effects of emotional responding to performance feedback. Specifically, greater appraisal of goal relevance amplifies the emotional response to events appraised as conducive (i.e., effort mobilization), but not to those appraised as obstructive to a person's goals (i.e., effort withdrawal). I conclude by providing a ten-step road map of best practices to facilitate computational reproducibility for future studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Risk-based equipment removal guide for on-line maintenance at PSE ampersand G

    International Nuclear Information System (INIS)

    Knoll, A.; Smith, C.; Pollock, J.

    1995-01-01

    On-line maintenance plays an important role in achieving safe and reliable power generation in a nuclear power plant. However, maintenance, if not properly planned and performed, may also be an important contributor to plant risk. Therefore, plant-specific procedures are needed for equipment removal from service to enhance the benefits of on-line maintenance and minimize the risks involved. The problem is to identify and implement the most effective on-line maintenance policy in the form of a proceduralized guide to assure plant safety under various operation and maintenance constraints. This paper presents a methodology to develop plant-specific on-line maintenance strategies and acceptance criteria using a multivariate safety approach based on risk assessment. Based on plant-specific data as modeled in the individual plant evaluation (IPE) and the updated probabilistic safety assessment (PSA), the risk-based methodology is currently being applied to the development of proceduralized equipment removal guides at Hope Creek and Salem units 1 and 2 of Public Service Electric and Gas Company (PSE ampersand G)

  1. Complications and risk factors in transrectal ultrasound-guided prostate biopsies

    Directory of Open Access Journals (Sweden)

    Carlos Márcio Nóbrega de Jesus

    Full Text Available CONTEXT AND OBJECTIVE: Prostate biopsy is not a procedure without risk. There is concern about major complications and which antibiotics are best for routine use before these biopsies. The objective was to determine the rate of complications and the possible risk factors in prostate biopsies. DESIGN AND SETTING: Prospective study, Faculdade de Medicina de Botucatu. METHODS: Transrectal ultrasound (TRUS guided prostate biopsies were carried out in 174 patients presenting either abnormality in digital rectal examinations (DRE or levels higher than 4 ng/ml in prostate-specific antigen (PSA tests, or both. RESULTS: Hemorrhagic complications were the most common (75.3%, while infectious complications occurred in 19% of the cases. Hematuria was the most frequent type (56%. Urinary tract infection (UTI occurred in 16 patients (9.2%. Sepsis was observed in three patients (1.7%. The presence of an indwelling catheter was a risk factor for infectious complications (p < 0.05. Higher numbers of biopsies correlated with hematuria, rectal bleeding and infectious complications (p < 0.05. The other conditions investigated did not correlate with post-biopsy complications. CONCLUSIONS: Post-biopsy complications were mostly self-limiting. The rate of major complications was low, thus showing that TRUS guided prostate biopsy was safe and effective. Higher numbers of fragments taken in biopsies correlated with hematuria, rectal bleeding and infectious complications. An indwelling catheter represented a risk factor for infectious complications. The use of aspirin was not an absolute contraindication for TRUS.

  2. Making decentralised systems viable: a guide to managing decentralised assets and risks.

    Science.gov (United States)

    Willetts, J; Fane, S; Mitchell, C

    2007-01-01

    Decentralised systems have the potential to provide a viable option for long term sustainable management of household wastewater. Yet, at present, such systems hold an uncertain status and are frequently omitted from consideration. Their potential can only be realised with improved approaches to their management, and improved methods to decision-making in planning of wastewater systems. The aim of this paper is to demonstrate the value of a novel framework to guide the planning of decentralised systems so that asset management and risk management are explicitly considered. The framework was developed through a detailed synthesis of literature and practice in the area of asset management of centralised water and wastewater systems, and risk management in the context of decentralised systems. Key aspects of the framework are attention to socio-economic risks as well as engineering, public health and ecological risks, the central place of communication with multiple stakeholders and establishing a shared asset information system. A case study is used to demonstrate how the framework can guide a different approach and lead to different, more sustainable outcomes, by explicitly considering the needs and perspectives of homeowners, water authorities, relevant government agencies and society as a whole.

  3. An introductory guide to uncertainty analysis in environmental and health risk assessment

    International Nuclear Information System (INIS)

    Hoffman, F.O.; Hammonds, J.S.

    1992-10-01

    To compensate for the potential for overly conservative estimates of risk using standard US Environmental Protection Agency methods, an uncertainty analysis should be performed as an integral part of each risk assessment. Uncertainty analyses allow one to obtain quantitative results in the form of confidence intervals that will aid in decision making and will provide guidance for the acquisition of additional data. To perform an uncertainty analysis, one must frequently rely on subjective judgment in the absence of data to estimate the range and a probability distribution describing the extent of uncertainty about a true but unknown value for each parameter of interest. This information is formulated from professional judgment based on an extensive review of literature, analysis of the data, and interviews with experts. Various analytical and numerical techniques are available to allow statistical propagation of the uncertainty in the model parameters to a statement of uncertainty in the risk to a potentially exposed individual. Although analytical methods may be straightforward for relatively simple models, they rapidly become complicated for more involved risk assessments. Because of the tedious efforts required to mathematically derive analytical approaches to propagate uncertainty in complicated risk assessments, numerical methods such as Monte Carlo simulation should be employed. The primary objective of this report is to provide an introductory guide for performing uncertainty analysis in risk assessments being performed for Superfund sites

  4. A practical approach to assess depression risk and to guide risk reduction strategies in later life

    NARCIS (Netherlands)

    Almeida, O.P.; Alfonso, H.; Pirkis, J; Kerse, N.; Sim, M.; Flicker, L.; Snowdon, J.; Draper, B.; Byrne, G.; Goldney, R.; Lautenschlager, N.T.; Stocks, N.; Scazufca, M.; Huisman, M.; Araya, R.; Pfaff, J.

    2011-01-01

    Background: Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors

  5. An ischemia-guided approach for risk stratification in patients with acute coronary syndromes.

    Science.gov (United States)

    Pepine, C J

    2000-12-28

    The optimal management approach for patients with non-ST-segment elevation acute coronary syndromes continues to be an issue of debate. An ischemia-guided strategy appears to be effective as an alternative to either a very conservative "wait-and-see" approach or a very aggressive routine revascularization approach. The need for another approach is supported by the lack of conclusive evidence-based results favoring an early routine invasive treatment strategy. In the Thrombolysis in Myocardial Infarction (TIMI) IIIB trial, there were no differences in the incidence of death or myocardial infarction (MI) between patients treated with an early invasive approach and those treated with a conservative approach to treatment. Significantly worse outcomes were shown in patients assigned to an early invasive strategy in the Veterans Affairs Non-Q-Wave Infarction Strategies in Hospital (VANQWISH) trial at 1-year follow-up (111 clinical events in the invasive group vs 85 in the conservative group; p = 0.05). Registry information, including that from the Organization to Assess Strategies for Ischemic Syndromes (OASIS), which included approximately 8,000 patients with unstable angina or suspected MI, has even suggested an excess hazard with a routine invasive approach. Patients with non-ST-segment elevation MI observed in the Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO)-IIB and Platelet IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trials also fared better with an ischemia-guided strategy. Even the recent FRagmin and Fast Revascularization during InStability in Coronary artery disease (FRISC II) trial investigators had to be very selective relative to eliminating high-risk patients in the first week and treating with intense anti-ischemic therapy and 5-7 days of low-molecular-weight heparin therapy to show an advantage for assigned revascularization. A careful clinical evaluation with

  6. Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

    Science.gov (United States)

    Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

    2017-07-01

    To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

  7. Risk-based Inspection Guide for the Susquehanna Station HPCI system

    International Nuclear Information System (INIS)

    Travis, R.; Higgins, J.; Gunther, W.; Shier, W.

    1992-11-01

    The High Pressure Coolant Injection (HPCI) system has been examined from a risk perspective. A system Risk-based Inspection Guide (S-RIG) has been developed as an aid to HPCI system inspections at the Susquehanna Steam Electric Station (SSES) which is operated by Pennsylvania Power ampersand Light (PP ampersand L). Included in this S-RIG is a discussion of the role of HPCI in mitigating accidents and a presentation of PRA-based failure modes which could prevent proper operation of the system. The S-RIG uses industry operating experience, including plant-specific illustrative examples, to augment the basic PRA failure modes. It is designed to be used as a reference for both routine inspections and the evaluation of the significance of component failures

  8. In-bore transrectal MRI-guided prostate biopsies: Are there risk factors for complications?

    Energy Technology Data Exchange (ETDEWEB)

    Meier-Schroers, Michael, E-mail: michael.meier@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Homsi, Rami, E-mail: rami.homsi@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Kukuk, Guido, E-mail: guido.kukuk@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Wolter, Karsten, E-mail: karsten.wolter@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Decker, Georges, E-mail: georges.decker@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Fischer, Stefan, E-mail: stefan.fischer@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Marx, Christian, E-mail: christian.marx@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Schmeel, Frederic Carsten, E-mail: carsten.schmeel@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Block, Wolfgang, E-mail: wolfgang.block@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Sprinkart, Alois Martin, E-mail: sprinkart@uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Traeber, Frank, E-mail: frank.traeber@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de [Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn (Germany); Willinek, Winfried, E-mail: w.willinek@bk-trier.de [Department of Radiology, Neuroradiology, Sonography and Nuclear Medicine, Hospital of the Barmherzige Brüder Trier, Nordallee 1, 54292 Trier (Germany)

    2016-12-15

    Purpose: To systematically analyze risk factors for complications of in-bore transrectal MRI-guided prostate biopsies (MRGB). Materials and methods: 90 patients, who were scheduled for MRGB were included for this study. Exclusion criteria were coagulation disorders, therapy with anticoagulant drugs, and acute infections of the urinary and the lower gastrointestinal tract. Directly after, one week and one year after the biopsy, we assessed biopsy related complications (e.g. hemorrhages or signs of prostatitis). Differences between patients with and without complications were analyzed regarding possible risk factors: age, prostate volume, number of taken samples, biopsy duration, biopsy of more than one lesion, diabetes, arterial hypertension, hemorrhoids, benign prostate hyperplasia, carcinoma or prostatitis (according to histopathological analysis), and lesion localization. Complications were classified according to the Clavien-Dindo classification. Results: We observed 15 grade I complications in 90 biopsies (16.7%) with slight hematuria in 9 cases (10%), minor vasovagal reactions in 4 cases (4.4%), and urinary retention and positioning-related facial dysesthesia in 1 case each (1.1%). One patient showed acute prostatitis requiring antibiotics as the only grade II complication (1.1%). There were no adverse events that occurred later than one week. Complications grade III or higher such as pelvic abscesses, urosepsis or severe hemorrhages were not seen. There were no significant associations between the assessed risk factors and biopsy-related complications. Conclusion: In-bore transrectal MRI-guided prostate biopsies can be considered safe procedures in the diagnosis of prostate cancer with very low complication rates. There seem to be no risk factors for complications.

  9. In-bore transrectal MRI-guided prostate biopsies: Are there risk factors for complications?

    International Nuclear Information System (INIS)

    Meier-Schroers, Michael; Homsi, Rami; Kukuk, Guido; Wolter, Karsten; Decker, Georges; Fischer, Stefan; Marx, Christian; Schmeel, Frederic Carsten; Block, Wolfgang; Sprinkart, Alois Martin; Traeber, Frank; Schild, Hans Heinz; Willinek, Winfried

    2016-01-01

    Purpose: To systematically analyze risk factors for complications of in-bore transrectal MRI-guided prostate biopsies (MRGB). Materials and methods: 90 patients, who were scheduled for MRGB were included for this study. Exclusion criteria were coagulation disorders, therapy with anticoagulant drugs, and acute infections of the urinary and the lower gastrointestinal tract. Directly after, one week and one year after the biopsy, we assessed biopsy related complications (e.g. hemorrhages or signs of prostatitis). Differences between patients with and without complications were analyzed regarding possible risk factors: age, prostate volume, number of taken samples, biopsy duration, biopsy of more than one lesion, diabetes, arterial hypertension, hemorrhoids, benign prostate hyperplasia, carcinoma or prostatitis (according to histopathological analysis), and lesion localization. Complications were classified according to the Clavien-Dindo classification. Results: We observed 15 grade I complications in 90 biopsies (16.7%) with slight hematuria in 9 cases (10%), minor vasovagal reactions in 4 cases (4.4%), and urinary retention and positioning-related facial dysesthesia in 1 case each (1.1%). One patient showed acute prostatitis requiring antibiotics as the only grade II complication (1.1%). There were no adverse events that occurred later than one week. Complications grade III or higher such as pelvic abscesses, urosepsis or severe hemorrhages were not seen. There were no significant associations between the assessed risk factors and biopsy-related complications. Conclusion: In-bore transrectal MRI-guided prostate biopsies can be considered safe procedures in the diagnosis of prostate cancer with very low complication rates. There seem to be no risk factors for complications.

  10. 78 FR 10367 - Appraisals for Higher-Priced Mortgage Loans

    Science.gov (United States)

    2013-02-13

    ... the current sale. A creditor of a ``higher-risk mortgage'' must also: Provide the applicant, at the... addition, the final rule implements the Act's requirement that the creditor of a ``higher-risk mortgage... provision requiring appraisals for ``higher-risk mortgages'' that was added to TILA by the Dodd-Frank Wall...

  11. Image-Guided Hypofractionated Radiotherapy in Low-Risk Prostate Cancer Patients

    Directory of Open Access Journals (Sweden)

    Maurizio Valeriani

    2014-01-01

    Full Text Available Aim. To evaluate efficacy and toxicity of image-guided hypofractionated radiotherapy (HFRT in the treatment of low-risk prostate cancer. Outcomes and toxicities of this series of patients were compared to another group of 32 low-risk patients treated with conventional fractionation (CFRT. Methods. Fifty-nine patients with low-risk prostate cancer were analysed. Total dose for the prostate and proximal seminal vesicles was 60 Gy delivered in 20 fractions. Results. The median follow-up was 30 months. The actuarial 4-year overall survival, biochemical free survival, and disease specific survival were 100%, 97.4%, and 97.4%, respectively. Acute grade 1-2 gastrointestinal (GI and genitourinary (GU toxicity rates were 11.9% and 40.7%, respectively. Grade 1 GI and GU late toxicity rates were 8.5% and 13.6%, respectively. No grade ≥2 late toxicities were recorded. Acute grade 2-3 GU toxicity resulted significantly lower (P=0.04 in HFRT group compared to the CFRT group. The cumulative 4-year incidence of grade 1-2 GU toxicity was significantly higher (P<0.001 for HFRT patients. Conclusions. Our study demonstrated that hypofractionated regimen provided excellent biochemical control in favorable risk prostate cancer patients. The incidence of GI and GU toxicity was low. However, HFRT presented higher cumulative incidence of low-grade late GU toxicity than CFRT.

  12. Negative Trauma Appraisals and PTSD Symptoms in Sri Lankan Adolescents.

    Science.gov (United States)

    Ponnamperuma, Thyagi; Nicolson, Nancy A

    2016-02-01

    The cognitive model posits that negative appraisals play an important role in posttraumatic stress disorder, in children as well as in adults. This study examined correlates of negative appraisals in relation to trauma exposure and their relationship to posttraumatic stress symptoms (PTSS) in 414 Sri Lankan adolescents, aged 12 to 16, living in areas impacted in varying degrees by the 2004 tsunami. In 2008, participants completed measures of negative appraisals, lifetime traumatic events, posttraumatic stress symptoms, internalizing symptoms, ongoing adversity, and social support. The majority (70 %) of the participants reported multiple traumatic events; 25 % met DSM-IV criteria for full or partial PTSD. Adolescents who had experienced more severe events, abusive events, greater cumulative trauma, or greater current adversity reported more negative appraisals. In regression analyses controlling for known risk factors such as female gender, cumulative trauma, ongoing adversity, and low social support, negative appraisals were the best predictor of PTSS, explaining 22 % of the variance. This relationship appeared specific to PTSS, as negative appraisals did not predict internalizing symptoms. Findings confirm the link between negative cognitions concerning traumatic events and persistent PTSS in adolescents, but longitudinal studies are needed to determine whether appraisals contribute to symptom maintenance over time.

  13. Exposure Risks Among Children Undergoing Radiation Therapy: Considerations in the Era of Image Guided Radiation Therapy

    International Nuclear Information System (INIS)

    Hess, Clayton B.; Thompson, Holly M.; Benedict, Stanley H.; Seibert, J. Anthony; Wong, Kenneth; Vaughan, Andrew T.; Chen, Allen M.

    2016-01-01

    Recent improvements in toxicity profiles of pediatric oncology patients are attributable, in part, to advances in the field of radiation oncology such as intensity modulated radiation (IMRT) and proton therapy (IMPT). While IMRT and IMPT deliver highly conformal dose to targeted volumes, they commonly demand the addition of 2- or 3-dimensional imaging for precise positioning—a technique known as image guided radiation therapy (IGRT). In this manuscript we address strategies to further minimize exposure risk in children by reducing effective IGRT dose. Portal X rays and cone beam computed tomography (CBCT) are commonly used to verify patient position during IGRT and, because their relative radiation exposure is far less than the radiation absorbed from therapeutic treatment beams, their sometimes significant contribution to cumulative risk can be easily overlooked. Optimizing the conformality of IMRT/IMPT while simultaneously ignoring IGRT dose may result in organs at risk being exposed to a greater proportion of radiation from IGRT than from therapeutic beams. Over a treatment course, cumulative central-axis CBCT effective dose can approach or supersede the amount of radiation absorbed from a single treatment fraction, a theoretical increase of 3% to 5% in mutagenic risk. In select scenarios, this may result in the underprediction of acute and late toxicity risk (such as azoospermia, ovarian dysfunction, or increased lifetime mutagenic risk) in radiation-sensitive organs and patients. Although dependent on variables such as patient age, gender, weight, body habitus, anatomic location, and dose-toxicity thresholds, modifying IGRT use and acquisition parameters such as frequency, imaging modality, beam energy, current, voltage, rotational degree, collimation, field size, reconstruction algorithm, and documentation can reduce exposure, avoid unnecessary toxicity, and achieve doses as low as reasonably achievable, promoting a culture and practice of “gentle IGRT.”

  14. Exposure Risks Among Children Undergoing Radiation Therapy: Considerations in the Era of Image Guided Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hess, Clayton B. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Thompson, Holly M. [Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California (United States); Benedict, Stanley H. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Seibert, J. Anthony [Department of Diagnostic Radiology, University of California Davis Medical Center, Sacramento, California (United States); Wong, Kenneth [Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California (United States); Vaughan, Andrew T. [Department of Radiation Oncology, University California Davis Comprehensive Cancer Center, Sacramento, California (United States); Chen, Allen M., E-mail: allenmchen@yahoo.com [Department of Radiation Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, University of California David Geffen School of Medicine, Los Angeles, California (United States)

    2016-04-01

    Recent improvements in toxicity profiles of pediatric oncology patients are attributable, in part, to advances in the field of radiation oncology such as intensity modulated radiation (IMRT) and proton therapy (IMPT). While IMRT and IMPT deliver highly conformal dose to targeted volumes, they commonly demand the addition of 2- or 3-dimensional imaging for precise positioning—a technique known as image guided radiation therapy (IGRT). In this manuscript we address strategies to further minimize exposure risk in children by reducing effective IGRT dose. Portal X rays and cone beam computed tomography (CBCT) are commonly used to verify patient position during IGRT and, because their relative radiation exposure is far less than the radiation absorbed from therapeutic treatment beams, their sometimes significant contribution to cumulative risk can be easily overlooked. Optimizing the conformality of IMRT/IMPT while simultaneously ignoring IGRT dose may result in organs at risk being exposed to a greater proportion of radiation from IGRT than from therapeutic beams. Over a treatment course, cumulative central-axis CBCT effective dose can approach or supersede the amount of radiation absorbed from a single treatment fraction, a theoretical increase of 3% to 5% in mutagenic risk. In select scenarios, this may result in the underprediction of acute and late toxicity risk (such as azoospermia, ovarian dysfunction, or increased lifetime mutagenic risk) in radiation-sensitive organs and patients. Although dependent on variables such as patient age, gender, weight, body habitus, anatomic location, and dose-toxicity thresholds, modifying IGRT use and acquisition parameters such as frequency, imaging modality, beam energy, current, voltage, rotational degree, collimation, field size, reconstruction algorithm, and documentation can reduce exposure, avoid unnecessary toxicity, and achieve doses as low as reasonably achievable, promoting a culture and practice of “gentle IGRT.”.

  15. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy

    International Nuclear Information System (INIS)

    Khan, M.F.; Straub, R.; Moghaddam, S.R.; Maataoui, A.; Gurung, J.; Thalhammer, A.; Vogl, T.J.; Jacobi, V.; Wagner, T.O.F.; Ackermann, H.

    2008-01-01

    The influence of various variables on the rate of pneumothorax and intrapulmonal hemorrhage associated with computed tomography (CT)-guided transthoracic needle biopsy of the lung were evaluated retrospectivly. One hundred and thirty-three patients underwent CT guided biopsy of a pulmonary lesion. Two patients were biopsied twice. Variables analyzed were lesion size, lesion location, number of pleural needle passes, lesion margin, length of intrapulmonal biopsy path and puncture time. Eighteen-gauge (18G) cutting needles (Trucut, Somatex, Teltow, Germany) were used for biopsy. Pneumothorax occured in 23 of 135 biopsies (17%). Chest tube placement was required in three out of 23 cases of pneumothorax (2% of all biopsies). Pneumothorax rate was significantly higher when the lesions were located in the lung parenchyma compared with locations at the pleura or chest wall (P < 0.05), but all pneumothorax cases which required chest tube treatment occured in lesions located less than 2 cm from the pleura. Longer puncture time led to an increase in pneumothorax rate (P < 0.05). Thirty-seven (27%) out of 135 biopsies showed perifocal hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage and pneumothorax (P < 0.05). Significantly more hemorrhage occured when the pleura was penetrated twice during the puncture (P < 0.05). Lesion size <4 cm is strongly correlated with higher occurence of perifocal hemorrhage (P < 0.05). Lesion margination showed no significant effect on complication rate. CT-guided biopsy of smaller lesions correlates with a higher bleeding rate. Puncture time should be minimized to reduce pneumothorax rate. Passing the pleura twice significantly increases the risk of hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage as well as pneumothorax. (orig.)

  16. 32 CFR 644.44 - Fee appraisals.

    Science.gov (United States)

    2010-07-01

    ... HANDBOOK Appraisal § 644.44 Fee appraisals. (a) Definitions and procedures. (1) The complete and.... The keynote of this approach lies in the sound development of a proper rate. The appraiser must have a...

  17. Risk of disseminated intravascular coagulation in patients undergoing US-guided transperineal prostatic biopsy

    International Nuclear Information System (INIS)

    Stella, M.S.; Comparato, D.; Camici, M.; Evangelisti, L.; Gaudio, V.; De Negri, F.; Talarico, L.; Giusti, C.; Morelli, G.

    1991-01-01

    Disseminated intravascular coagulation (DIC) is a severe life-threatening acute bleeding disorder. Traumatized tissues, tumors, necrotic tissues, or bacterial endotoxines release similar material in the blood to the tissutal factors activating the coagulation cascade. This preliminary study was aimed at verifying the risk of DIV in patients undergoing US-guided transperineal prostatic biopsy with Chiba and Tru-Cut needles. To evaluate the activation degree of coagulation factors in the circulation, the authors measured the concentrations of urinary fibrin degradation products in 10 patients undergoing US-guided transperineal prostatic biopsy, both before and after biopsy, every second hour, for 24 hours. Every tube of urine sample contained soya bean trypsin inhibitor and bovine thrombin to prevent any further fibrin degradation during incubation period for the possible presence of blood in urine samples. The results showed that 7/10 patients had marked increase in urinary fibrin degradation product levels (up to 800 XXXX%), with a 3-phase trend: early peak after 2-6 hours, middle peak after 6-14 hours, and late peak after 18-24 hours, which proved the activation of the coagulation cascade

  18. Current practices in economic appraisal

    NARCIS (Netherlands)

    Mossink, J.C.M.

    2000-01-01

    By means of economic appraisal, the costs and the benefits of health, environment and safety management can be made clear, both at the national level and at the company level. As such it is a tool in advocating good practices. This paper explores the possibilities of economic appraisal for policy

  19. Etiopathogenesis of cataract: An appraisal

    Directory of Open Access Journals (Sweden)

    Varun B Gupta

    2014-01-01

    Full Text Available Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc., traumatic, complicated (inflammatory and degenerative diseases of eye, metabolic (diabetes, galactosemia etc., toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc. are implicated as significant risk factors in the development of cataract.

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

    Science.gov (United States)

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

    2007-11-01

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

  1. A critical appraisal of the use of umbilical artery Doppler ultrasound in high-risk pregnancies: use of meta-analyses in evidence-based obstetrics

    DEFF Research Database (Denmark)

    Westergaard, H.B.; Langhoff-Roos, J.; Lingman, G.

    2001-01-01

    Doppler velocimetry; high-risk pregnancy; meta-analysis; intrauterine growth restriction; perinatal mortality; umbilical artery......Doppler velocimetry; high-risk pregnancy; meta-analysis; intrauterine growth restriction; perinatal mortality; umbilical artery...

  2. Stress appraisals and cellular aging: A key role for anticipatory threat in the relationship between psychological stress and telomere length

    Science.gov (United States)

    O’Donovan, Aoife; Tomiyama, A. Janet; Lin, Jue; Puterman, Eli; Adler, Nancy E.; Kemeny, Margaret; Wolkowitz, Owen M.; Blackburn, Elizabeth H.; Epel, Elissa S.

    2012-01-01

    Chronic psychological stressis a risk factor formultiple diseases of aging. Accelerated cellular aging as indexed by short telomere length has emerged as a potential common biological mechanism linking various forms of psychological stress and diseases of aging. Stress appraisals determine the degree and type of biological stress responses and altered stress appraisals may be a common psychological mechanism linking psychological stress and diseases of aging. However, no previous studies have examined the relationship between stress appraisals and telomere length. We exposed chronically stressed female caregivers and non-caregiving controls (N= 50; M age = 62.14±6.10) to a standardized acute laboratory stressor and measured their anticipatory and retrospective threat and challenge appraisals of the stressor. We hypothesized that threat and challenge appraisals would be associated with shorter and longer telomere length respectively, and that chronic care giving stress would influence telomere length through altered stress appraisals. Higher anticipatory threat appraisals were associated with shorter age-adjusted telomere length (β = −.32, p = .03), but challenge appraisals and retrospective threat appraisals showed no independent association with telomere length. Caregivers reported significantly higher anticipatory (β = −.36, p = .006)and retrospective (β = −.29, p = .03) threat appraisals than controls, but similar challenge appraisals. Although there was no significant main effect of caregiver status on telomere length, care giving had a significant indirect effect on telomere length through anticipatory threat appraisals. Exaggerated anticipatory threat appraisals may be a common and modifiable psychological mechanism of psychological stress effects on cellular aging. PMID:22293459

  3. MAPS Appraisal Report Form

    CERN Multimedia

    HR Department

    2005-01-01

    As announced in Weekly Bulletin 48/2004, from now onwards, the paper MAPS appraisal report form has been replaced by an electronic form, which is available via EDH (on the EDH desktop under Other Tasks / HR & Training) No changes have been made to the contents of the form. Practical information will be available on the web page http://cern.ch/ais/projs/forms/maps/info.htm, and information meetings will be held on the following dates: 18 January 2005: MAIN AUDITORIUM (500-1-001) from 14:00 to 15:30. 20 January 2005: AB AUDITORIUM II (864-1-D02) from14:00 to 15:30. 24 January 2005: AT AUDITORIUM (30-7-018) from 10:00 to 11:30. Human Resources Department Tel. 73566

  4. Appraising Adaptive Management

    Directory of Open Access Journals (Sweden)

    Kai N. Lee

    1999-12-01

    Full Text Available Adaptive management is appraised as a policy implementation approach by examining its conceptual, technical, equity, and practical strengths and limitations. Three conclusions are drawn: (1 Adaptive management has been more influential, so far, as an idea than as a practical means of gaining insight into the behavior of ecosystems utilized and inhabited by humans. (2 Adaptive management should be used only after disputing parties have agreed to an agenda of questions to be answered using the adaptive approach; this is not how the approach has been used. (3 Efficient, effective social learning, of the kind facilitated by adaptive management, is likely to be of strategic importance in governing ecosystems as humanity searches for a sustainable economy.

  5. Photo guide for estimating risk to hardwood trees during prescribed burning operations in eastern oak forests

    Science.gov (United States)

    Patrick H. Brose

    2009-01-01

    A field guide of 40 photographs of common hardwood trees of eastern oak forests and fuel loadings surrounding their bases. The guide contains instructions on how to rapidly assess a tree's likelihood to be damaged or killed by prescribed burning.

  6. Risks and benefits in treatment of mediastinal abscess by endobronchial ultrasound-guided transbronchial needle aspiration.

    Science.gov (United States)

    Tian, Lei; Krimsky, William S; Wu, Qingchen; Sun, Jiayuan

    2017-07-01

    Mediastinal abscess is a fatal condition, treatment of mediastinal abscess is with antibiotics and sometimes surgery for debridement and drainage. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe assessment and candidate treatment method of mediastinal lesions. This study aimed to HYPERLINK "javascript:void(0);" discuss risks and benefits in treatment of mediastinal abscess by EBUS-TBNA. We noticed a 56-year-old man with developed bilateral pneumonia and sepsis after puncture of mediastinal abscess by EBUS-TBNA. The patient was successfully treated with a combination of systemic anti-infection treatment and intracavitary administration of antibiotics, antifungal and repeated drainage and lavage via EBUS-TBNA, in 1 year follow-up without recurrence. This study indicated infection spread risk of mediastinal abscess after EBUS-TBNA, and mediastinal abscess was successfully cured by combination of systemic anti-infection and local intervention through EBUS-TBNA. EBUS-TBNA is a potential effective minimally invasive treatment for mediastinal abscess, and it is necessary to be aware of clinical complications after puncture of mediastinal infectious lesions by EBUS-TBNA. © 2015 John Wiley & Sons Ltd.

  7. Integrated Reliability and Risk Analysis System (IRRAS) Version 2.0 user's guide

    International Nuclear Information System (INIS)

    Russell, K.D.; Sattison, M.B.; Rasmuson, D.M.

    1990-06-01

    The Integrated Reliability and Risk Analysis System (IRRAS) is a state-of-the-art, microcomputer-based probabilistic risk assessment (PRA) model development and analysis tool to address key nuclear plant safety issues. IRRAS is an integrated software tool that gives the user the ability to create and analyze fault trees and accident sequences using a microcomputer. This program provides functions that range from graphical fault tree construction to cut set generation and quantification. Also provided in the system is an integrated full-screen editor for use when interfacing with remote mainframe computer systems. Version 1.0 of the IRRAS program was released in February of 1987. Since that time, many user comments and enhancements have been incorporated into the program providing a much more powerful and user-friendly system. This version has been designated IRRAS 2.0 and is the subject of this user's guide. Version 2.0 of IRRAS provides all of the same capabilities as Version 1.0 and adds a relational data base facility for managing the data, improved functionality, and improved algorithm performance. 9 refs., 292 figs., 4 tabs

  8. Environmental hazard and risk characterisation of petroleum substances: a guided "walking tour" of petroleum hydrocarbons.

    Science.gov (United States)

    Bierkens, Johan; Geerts, Lieve

    2014-05-01

    Petroleum substances are used in large quantities, primarily as fuels. They are complex mixtures whose major constituents are hydrocarbons derived from crude oil by distillation and fractionation. Determining the complete molecular composition of petroleum and its refined products is not feasible with current analytical techniques because of the huge number of molecular components. This complex nature of petroleum products, with their varied number of constituents, all of them exhibiting different fate and effect characteristics, merits a dedicated hazard and risk assessment approach. From a regulatory perspective they pose a great challenge in a number of REACH processes, in particular in the context of dossier and substance evaluation but also for priority setting activities. In order to facilitate the performance of hazard and risk assessment for petroleum substances the European oil company association, CONCAWE, has developed the PETROTOX and PETRORISK spreadsheet models. Since the exact composition of many petroleum products is not known, an underlying assumption of the PETROTOX and PETRORISK tools is that the behaviour and fate of a total petroleum substance can be simulated based on the physical-chemical properties of representative structures mapped to hydrocarbon blocks (HBs) and on the relative share of each HB in the total mass of the product. To assess how differing chemical compositions affect the simulated chemical fate and toxicity of hydrocarbon mixtures, a series of model simulations were run using an artificial petroleum substance, containing 386 (PETROTOX) or 160 (PETRORISK) HBs belonging to different chemical classes and molecular weight ranges, but with equal mass assigned to each of them. To this artificial petroleum substance a guided series of subsequent modifications in mass allocation to a delineated number of HBs belonging to different chemical classes and carbon ranges was performed, in what we perceived as a guided "walking tour

  9. Legionellosis prevention in building water and HVAC systems a practical guide for design, operation and maintenance to minimize the risk

    CERN Document Server

    Joppolo, Cesare Maria; Pitera, Luca Alberto; Angermann, Jean Pierre; Izard, Mark

    2013-01-01

    This Guidebook is a practical guide for design, operation and maintenance to minimize the risk of legionellosis in building water and HVAC systmes. It is devided into several themes such as: Air conditioning of the air (by water – humidification), Production of hot water for washing (fundamentally but not only hot water for washing) and Evaporative cooling tower.

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

    Science.gov (United States)

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

    2016-06-01

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

  11. Methodological guide for risk assessment and management of industrial sites contaminated with radionuclides

    International Nuclear Information System (INIS)

    Oudiz, A.; Brenot, J.; Cessac, B.; Charbonneau, P.; Maigne, J.P.; Santucci, P.

    2000-01-01

    At the request of the French ministries of health and environment, IPSN was asked to elaborate a methodological guide for risk assessment and management of industrial sites contaminated with radionuclides. This guide is devoted to local administration, technical organisms and more generally to all the relevant stakeholders involved with the choice of a rehabilitation strategy, according to the future use of the site. The methodology to be presented is designed to fit with the different types of 'risk governance', according to circumstances: - when an industrial site is relatively small, with rather restricted zones of contamination, and no specific social concern, management may rely essentially upon radiological expertise, using generic reference levels, - when the site is larger, with spread out contamination, risk assessment and management of the site may become more controversial, namely because uncertainties remain about the effective magnitude of the contamination and no low cost solution appears to exist in view of rehabilitation. In this case, an open procedure is required, which combines technical expertise and involvement of stakeholders, in view of improving the risk assessment process as well as trying to get a better understanding of the benefits and drawbacks of different rehabilitation strategies. The methodology consists of six main steps : - Initiating the process, Pre-diagnosis, Initial diagnosis, Simplified risk assessment, Detailed risk assessment, Decision aiding in view of letting the stakeholders defining the solution appropriate to the local context. The paper will present how the risk assessment and management process can be aportionated to the importance of the problem to be solved. As far as possible, simplified risk assessment should provide information allowing the definition of the appropriate strategy. In this case, stakeholders involvement is mainly devoted to determine: - whether the site can be affected to a given use without

  12. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews.

    Science.gov (United States)

    Pluye, Pierre; Gagnon, Marie-Pierre; Griffiths, Frances; Johnson-Lafleur, Janique

    2009-04-01

    A new form of literature review has emerged, Mixed Studies Review (MSR). These reviews include qualitative, quantitative and mixed methods studies. In the present paper, we examine MSRs in health sciences, and provide guidance on processes that should be included and reported. However, there are no valid and usable criteria for concomitantly appraising the methodological quality of the qualitative, quantitative and mixed methods studies. To propose criteria for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies or study components. A three-step critical review was conducted. 2322 references were identified in MEDLINE, and their titles and abstracts were screened; 149 potentially relevant references were selected and the full-text papers were examined; 59 MSRs were retained and scrutinized using a deductive-inductive qualitative thematic data analysis. This revealed three types of MSR: convenience, reproducible, and systematic. Guided by a proposal, we conducted a qualitative thematic data analysis of the quality appraisal procedures used in the 17 systematic MSRs (SMSRs). Of 17 SMSRs, 12 showed clear quality appraisal procedures with explicit criteria but no SMSR used valid checklists to concomitantly appraise qualitative, quantitative and mixed methods studies. In two SMSRs, criteria were developed following a specific procedure. Checklists usually contained more criteria than needed. In four SMSRs, a reliability assessment was described or mentioned. While criteria for quality appraisal were usually based on descriptors that require specific methodological expertise (e.g., appropriateness), no SMSR described the fit between reviewers' expertise and appraised studies. Quality appraisal usually resulted in studies being ranked by methodological quality. A scoring system is proposed for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies for SMSRs. This

  13. Uranium-mill appraisal program

    International Nuclear Information System (INIS)

    Everett, R.J.; Cain, C.L.

    1982-08-01

    The results of special team appraisals at NRC-licensed uranium mills in the period May to November 1981 are reported. Since the Three Mile Island accident, NRC management has instituted a program of special team appraisals of radiation protection programs at certain NRC-licensed facilities. These appraisals were designed to identify weaknesses and strengths in NRC-licensed programs, including those areas not covered by explicit regulatory requirements. The regulatory requirements related to occupational radiation protection and environmental monitoring at uranium mills have been extensively upgraded in the past few years. In addition, there was some NRC staff concern with respect to the effectiveness of NRC licensing and inspection programs. In response to this concern and to changes in mill requirements, the NRC staff recommended that team appraisals be conducted at mills to determine the adequacy of mill programs, the effectiveness of the new requirements, and mill management implementation of programs and requirements. This report describes the appraisal scope and methodology as well as summary findings and conclusions. Significant weaknesses identified during the mill appraisals are discussed as well as recommendations for improvements in uranium mill programs and mill licensing and inspection

  14. Managing Water for African Cities Johannesburg City Implementation Plan Environmental Component Appraisal Report

    OpenAIRE

    Damhaug, T.

    2000-01-01

    Årsliste 2000 This is an appraisal of the environmental component of the Johannesburg City Implementation Plan under the Habitat guided programme "Managing Water for African Cities". The objective of this appraisal was to ensure the conformity of the plan with the objectives of the Regional Project and South Africa's needs and to explore the availability of domestic resources (human, institutional, and financial) required for efficient project implementation. The environmental component wi...

  15. How to appraise a diagnostic test

    Directory of Open Access Journals (Sweden)

    Ramanitharan Manikandan

    2011-01-01

    Full Text Available Urologists frequently encounter problems in making a clinical diagnosis whose resolution requires the use of diagnostic tests. With an ever increasing choice of investigations being available, the urologist often has to decide which diagnostic test(s will best resolve the patient′s diagnostic problem. In this article, we aim to help the urologist understand how to critically appraise studies on diagnostic tests and make a rational choice. This article presents the guiding principles in scientifically assessing studies on diagnostic tests by proposing a clinical scenario. The authors describe a standardized protocol to assess the validity of the test and its relevance to the clinical problem that can help the urologist in decision making. The three important issues to be considered when evaluating the validity of the study are to identify how the study population was chosen, how the test was performed and whether there is a comparison to the gold standard test so as to confirm or refute the diagnosis. Then, the urologist would need to know the probability of the test in providing the correct diagnosis in an individual patient in order to decide about its utility in solving the diagnostic dilemma. By performing the steps described in this article, the urologist would be able to critically appraise diagnostic studies and draw meaningful conclusions about the investigations in terms of validity, results and its applicability to the patient′s problem. This would provide a scientific basis for using diagnostic tests for improving patient care.

  16. Concomitant Imaging Dose and Cancer Risk in Image Guided Thoracic Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yibao; Wu, Hao [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Chen, Zhe [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Knisely, Jonathan P.S. [Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York (United States); Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Feng, Zhongsu [Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing (China); Bao, Shanglian [Beijing Key Laboratory of Medical Physics and Engineering, Peking University, Beijing (China); Deng, Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States)

    2015-11-01

    Purpose: Kilovoltage cone beam computed tomography (CT) (kVCBCT) imaging guidance improves the accuracy of radiation therapy but imposes an extra radiation dose to cancer patients. This study aimed to investigate concomitant imaging dose and associated cancer risk in image guided thoracic radiation therapy. Methods and Materials: The planning CT images and structure sets of 72 patients were converted to CT phantoms whose chest circumferences (C{sub chest}) were calculated retrospectively. A low-dose thorax protocol on a Varian kVCBCT scanner was simulated by a validated Monte Carlo code. Computed doses to organs and cardiac substructures (for 5 selected patients of various dimensions) were regressed as empirical functions of C{sub chest}, and associated cancer risk was calculated using the published models. The exposures to nonthoracic organs in children were also investigated. Results: The structural mean doses decreased monotonically with increasing C{sub chest}. For all 72 patients, the median doses to the heart, spinal cord, breasts, lungs, and involved chest were 1.68, 1.33, 1.64, 1.62, and 1.58 cGy/scan, respectively. Nonthoracic organs in children received 0.6 to 2.8 cGy/scan if they were directly irradiated. The mean doses to the descending aorta (1.43 ± 0.68 cGy), left atrium (1.55 ± 0.75 cGy), left ventricle (1.68 ± 0.81 cGy), and right ventricle (1.85 ± 0.84 cGy) were significantly different (P<.05) from the heart mean dose (1.73 ± 0.82 cGy). The blade shielding alleviated the exposure to nonthoracic organs in children by an order of magnitude. Conclusions: As functions of patient size, a series of models for personalized estimation of kVCBCT doses to thoracic organs and cardiac substructures have been proposed. Pediatric patients received much higher doses than did the adults, and some nonthoracic organs could be irradiated unexpectedly by the default scanning protocol. Increased cancer risks and disease adverse events in the

  17. Employees' perceptions of justice in performance appraisals.

    Science.gov (United States)

    Vasset, Frøydis; Marnburg, Einar; Furunes, Trude

    2010-05-01

    Of all the tasks undertaken by human resource managers, performance appraisals (PAs) are one of the most unpopular among employees (Meyer 1991, Murphy and Cleveland 1995, Holbrook 2002, Jackman and Strober 2003). As PA guides and plans show (Fletcher 2004, CatalystOne 2010), PAs can be implemented in similar ways in organisations throughout Europe and developed countries elsewhere. But, if employees perceive PA processes as unfair, they may reject the usefulness and validity of the information they receive and so may not be motivated to change behaviour. This article concerns perceptions of organisational justice and explains the results of a study of perceived fairness in PAs among nurses and auxiliary nurses in Norway's municipal health service.

  18. Risk Informed Approach for Nuclear Security Measures for Nuclear and Other Radioactive Material out of Regulatory Control. Implementing Guide

    International Nuclear Information System (INIS)

    2015-01-01

    This publication provides guidance to States for developing a risk informed approach and for conducting threat and risk assessments as the basis for the design and implementation of sustainable nuclear security systems and measures for prevention of, detection of, and response to criminal and intentional unauthorised acts involving nuclear and other radioactive material out of regulatory control. It describes concepts and methodologies for a risk informed approach, including identification and assessment of threats, targets, and potential consequences; threat and risk assessment methodologies, and the use of risk informed approaches as the basis for informing the development and implementation of nuclear security systems and measures. The publication is an Implementing Guide within the IAEA Nuclear Security Series and is intended for use by national policy makers, law enforcement agencies and experts from competent authorities and other relevant organizations involved in the establishment, implementation, maintenance or sustainability of nuclear security systems and measures related to nuclear and other radioactive material out of regulatory control

  19. Multicomponent Musculoskeletal Movement Assessment Tools: A Systematic Review and Critical Appraisal of Their Development and Applicability to Professional Practice.

    Science.gov (United States)

    Bennett, Hunter; Davison, Kade; Arnold, John; Slattery, Flynn; Martin, Max; Norton, Kevin

    2017-10-01

    Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.

  20. HIV epidemic appraisals for assisting in the design of effective prevention programmes: shifting the paradigm back to basics.

    Directory of Open Access Journals (Sweden)

    Sharmistha Mishra

    Full Text Available To design HIV prevention programmes, it is critical to understand the temporal and geographic aspects of the local epidemic and to address the key behaviours that drive HIV transmission. Two methods have been developed to appraise HIV epidemics and guide prevention strategies. The numerical proxy method classifies epidemics based on current HIV prevalence thresholds. The Modes of Transmission (MOT model estimates the distribution of incidence over one year among risk-groups. Both methods focus on the current state of an epidemic and provide short-term metrics which may not capture the epidemiologic drivers. Through a detailed analysis of country and sub-national data, we explore the limitations of the two traditional methods and propose an alternative approach.We compared outputs of the traditional methods in five countries for which results were published, and applied the numeric and MOT model to India and six districts within India. We discovered three limitations of the current methods for epidemic appraisal: (1 their results failed to identify the key behaviours that drive the epidemic; (2 they were difficult to apply to local epidemics with heterogeneity across district-level administrative units; and (3 the MOT model was highly sensitive to input parameters, many of which required extraction from non-regional sources. We developed an alternative decision-tree framework for HIV epidemic appraisals, based on a qualitative understanding of epidemiologic drivers, and demonstrated its applicability in India. The alternative framework offered a logical algorithm to characterize epidemics; it required minimal but key data.Traditional appraisals that utilize the distribution of prevalent and incident HIV infections in the short-term could misguide prevention priorities and potentially impede efforts to halt the trajectory of the HIV epidemic. An approach that characterizes local transmission dynamics provides a potentially more effective tool with

  1. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention.

    Science.gov (United States)

    Bakkaloglu, Huseyin; Yanar, Hakan; Guloglu, Recep; Taviloglu, Korhan; Tunca, Fatih; Aksoy, Murat; Ertekin, Cemalettin; Poyanli, Arzu

    2006-11-28

    To assess the efficacy and safety of ultrasound guided percutaneous cholecystostomy (PC) in the treatment of acute cholecystitis in a well-defined high risk patients under general anesthesia. The data of 27 consecutive patients who underwent percutaneous transhepatic cholecystostomy for the management of acute cholecystitis from January 1999 to June 2003 was retrospectively evaluated. All of the patients had both clinical and sonographic signs of acute cholecystitis and had comorbid diseases. Ultrasound revealed gallbladder stones in 25 patients and acalculous cholecystitis in two patients. Cholecystostomy catheters were removed 14-32 d (mean 23 d) after the procedure in cases where complete regression of all symptoms was achieved. There were statistically significant reductions in leukocytosis, (13.7 x 10(3)+/-1.3 x 10(3) microg/L vs 13 x 10(3)+/-1 x 10(3) microg/L, P extraction was performed successfully with endoscopic retrograde cholangio-pancreatography (ERCP) in three patients. After cholecystostomy, 5 (18%) patients underwent delayed cholecystectomy without any complications. Three out of 22 patients were admitted with recurrent acute cholecystitis during the follow-up and recovered with medical treatment. Catheter dislodgement occurred in three patients spontaneously, and two of them were managed by reinsertion of the catheter. As an alternative to surgery, percutaneous cholecystostomy seems to be a safe method in critically ill patients with acute cholecystitis and can be performed with low mortality and morbidity. Delayed cholecystectomy and ERCP, if needed, can be performed after the acute period has been resolved by percutaneous cholecystostomy.

  2. HOW APPRAISERS DEVELOP FAIR VALUE

    Directory of Open Access Journals (Sweden)

    MIROSLAV ŠKODA

    2012-01-01

    Full Text Available Management is responsible for its own financial decisions. If we take into account, that fair value concept was shown in financial crisis as something that does not work anymore in this way; there is a big need to develop it for the future. Non-professional readers of financial statements believe, however, that company financials are the work of the public accounting firm that had signed the audit certificate. The main reason for bringing this point up is that when companies disclose Fair Value (FV information in their financial statements, they are taking responsibility for the values disclosed. Management may often be encouraged to utilize the services of an outside professional, but at the end of the day, the outside appraiser is a hired gun. Although the appraiser has to take responsibility for his own work, hiring the appraiser does not absolve management of its ultimate responsibility. The obverse of this is also true. Management does not have to hire the appraiser to develop any fair value disclosures made in the financial statements. Developing FV information is not recommended as a do-it yourself undertaking, there is nothing in Generally Accepted Accounting Principles (GAAP or Securities Exchange Commission (SEC regulations, however, that requires an outside appraiser.

  3. Differential Contributions of Nucleus Accumbens Subregions to Cue-Guided Risk/Reward Decision Making and Implementation of Conditional Rules.

    Science.gov (United States)

    Floresco, Stan B; Montes, David R; Tse, Maric M T; van Holstein, Mieke

    2018-02-21

    The nucleus accumbens (NAc) is a key node within corticolimbic circuitry for guiding action selection and cost/benefit decision making in situations involving reward uncertainty. Preclinical studies have typically assessed risk/reward decision making using assays where decisions are guided by internally generated representations of choice-outcome contingencies. Yet, real-life decisions are often influenced by external stimuli that inform about likelihoods of obtaining rewards. How different subregions of the NAc mediate decision making in such situations is unclear. Here, we used a novel assay colloquially termed the "Blackjack" task that models these types of situations. Male Long-Evans rats were trained to choose between one lever that always delivered a one-pellet reward and another that delivered four pellets with different probabilities [either 50% (good-odds) or 12.5% (poor-odds)], which were signaled by one of two auditory cues. Under control conditions, rats selected the large/risky option more often on good-odds versus poor-odds trials. Inactivation of the NAc core caused indiscriminate choice patterns. In contrast, NAc shell inactivation increased risky choice, more prominently on poor-odds trials. Additional experiments revealed that both subregions contribute to auditory conditional discrimination. NAc core or shell inactivation reduced Pavlovian approach elicited by an auditory CS+, yet shell inactivation also increased responding during presentation of a CS-. These data highlight distinct contributions for NAc subregions in decision making and reward seeking guided by discriminative stimuli. The core is crucial for implementation of conditional rules, whereas the shell refines reward seeking by mitigating the allure of larger, unlikely rewards and reducing expression of inappropriate or non-rewarded actions. SIGNIFICANCE STATEMENT Using external cues to guide decision making is crucial for adaptive behavior. Deficits in cue-guided behavior have been

  4. Ranking Businesses and Municipal Locations by Spatiotemporal Cardiac Arrest Risk to Guide Public Defibrillator Placement.

    Science.gov (United States)

    Sun, Christopher L F; Brooks, Steven C; Morrison, Laurie J; Chan, Timothy C Y

    2017-03-21

    Efforts to guide automated external defibrillator placement for out-of-hospital cardiac arrest (OHCA) treatment have focused on identifying broadly defined location categories without considering hours of operation. Broad location categories may be composed of many businesses with varying accessibility. Identifying specific locations for automated external defibrillator deployment incorporating operating hours and time of OHCA occurrence may improve automated external defibrillator accessibility. We aim to identify specific businesses and municipal locations that maximize OHCA coverage on the basis of spatiotemporal assessment of OHCA risk in the immediate vicinity of franchise locations. This study was a retrospective population-based cohort study using data from the Toronto Regional RescuNET Epistry cardiac arrest database. We identified all nontraumatic public OHCAs occurring in Toronto, ON, Canada, from January 2007 through December 2015. We identified 41 unique businesses and municipal location types with ≥20 locations in Toronto from the YellowPages, Canadian Franchise Association, and the City of Toronto Open Data Portal. We obtained their geographic coordinates and hours of operation from Web sites, by phone, or in person. We determined the number of OHCAs that occurred within 100 m of each location when it was open (spatiotemporal coverage) for Toronto overall and downtown. The businesses and municipal locations were then ranked by spatiotemporal OHCA coverage. To evaluate temporal stability of the rankings, we calculated intraclass correlation of the annual coverage values. There were 2654 nontraumatic public OHCAs. Tim Hortons ranked first in Toronto, covering 286 OHCAs. Starbucks ranked first in downtown, covering 110 OHCAs. Coffee shops and bank machines from the 5 largest Canadian banks occupied 8 of the top 10 spots in both Toronto and downtown. The rankings exhibited high temporal stability with intraclass correlation values of 0.88 (95

  5. Ranking businesses and municipal locations by spatiotemporal cardiac arrest risk to guide public defibrillator placement

    Science.gov (United States)

    Sun, Christopher L. F.; Brooks, Steven C.; Morrison, Laurie J.; Chan, Timothy C.Y.

    2017-01-01

    Background Efforts to guide automated external defibrillator (AED) placement for out-of-hospital cardiac arrest (OHCA) treatment have focused on identifying broadly defined location categories without considering hours of operation. Broad location categories may be composed of many businesses with varying accessibility. Identifying specific locations for AED deployment incorporating operating hours and time of OHCA occurrence may improve AED accessibility. We aim to identify specific businesses and municipal locations that maximize OHCA coverage based on spatiotemporal assessment of OHCA risk in the immediate vicinity of franchise locations. Methods This study was a retrospective population-based cohort study using data from the Toronto Regional RescuNET Epistry cardiac arrest database. We identified all non-traumatic public OHCAs occurring in Toronto, Canada from Jan. 2007–Dec. 2015. We identified 41 unique businesses and municipal location types with 20 or more locations in Toronto from the YellowPages, Canadian Franchise Association, and the City of Toronto Open Data Portal. We obtained their geographic coordinates and hours of operation from websites, phone, or in-person. We determined the number of OHCAs that occurred within 100 m of each location when it was open (spatiotemporal coverage) for Toronto overall and downtown. The businesses and municipal locations were then ranked by spatiotemporal OHCA coverage. To evaluate temporal stability of the rankings, we calculated intra-class correlation (ICC) of the annual coverage values. Results There were 2,654 non-traumatic public OHCAs. Tim Hortons ranked first in Toronto covering 286 OHCAs. Starbucks ranked first in downtown covering 110 OHCAs. Coffee shops and bank machines from the five largest Canadian banks occupied eight of the top 10 spots in both Toronto and downtown. The rankings exhibited high temporal stability with ICC values of 0.88 (95% CI, 0.83–0.93) in Toronto and 0.79 (95% CI, 0.71–0.86) in

  6. Appraisal of the Performance of Contingency Cost Provision for ...

    African Journals Online (AJOL)

    The paper appraised performance of contingency allowance in addressing projects' cost risk. To achieve this aim, impact of contingency provision in some selected building projects were evaluated. Data for the study was collected by means of checklist from 40 completed projects' files. Furthermore, 100 questionnaires on ...

  7. Risk evaluations of aging: Procedures guide for an age-dependent PSA with emphasis on prioritization and sensitivity studies

    International Nuclear Information System (INIS)

    Vesely, W.E.

    1991-01-01

    Based on the previous work which has been performed in the project, a procedures guide is being developed for carrying out an age-dependent probabilistic safety assessment (PSA) for evaluating the core damage frequency with aging effects explicitly treated. A PSA is basically a Level 1 Probabilistic Risk Assessment (PRA). The emphasis of the guide is on prioritization and sensitivity studies. Focus is also on active components although consideration of aging effects in passive components is also treated. The guide is intended to become a NUREG/CR and is the first of three volumes which are being developed. The following topics with demonstrations and applications are described in the presentation: (1) the age-dependent PSA versus the standard PSA; (2) component reliability models used in an age-dependent PSA; (3) approaches for transforming a PSA into an age-dependent PSA; (4) application of an age-dependent PSA; (5) using a PSA to evaluate the risk effects from aging passive components; (6) evaluation of the risk importance of passive components; (7) prioritizations of aging contributors; (8) evaluations of test and maintenance effectiveness; and (9) sensitivity studies and uncertainty analyses of aging effects

  8. Characterising bias in regulatory risk and decision analysis: An analysis of heuristics applied in health technology appraisal, chemicals regulation, and climate change governance.

    Science.gov (United States)

    MacGillivray, Brian H

    2017-08-01

    In many environmental and public health domains, heuristic methods of risk and decision analysis must be relied upon, either because problem structures are ambiguous, reliable data is lacking, or decisions are urgent. This introduces an additional source of uncertainty beyond model and measurement error - uncertainty stemming from relying on inexact inference rules. Here we identify and analyse heuristics used to prioritise risk objects, to discriminate between signal and noise, to weight evidence, to construct models, to extrapolate beyond datasets, and to make policy. Some of these heuristics are based on causal generalisations, yet can misfire when these relationships are presumed rather than tested (e.g. surrogates in clinical trials). Others are conventions designed to confer stability to decision analysis, yet which may introduce serious error when applied ritualistically (e.g. significance testing). Some heuristics can be traced back to formal justifications, but only subject to strong assumptions that are often violated in practical applications. Heuristic decision rules (e.g. feasibility rules) in principle act as surrogates for utility maximisation or distributional concerns, yet in practice may neglect costs and benefits, be based on arbitrary thresholds, and be prone to gaming. We highlight the problem of rule-entrenchment, where analytical choices that are in principle contestable are arbitrarily fixed in practice, masking uncertainty and potentially introducing bias. Strategies for making risk and decision analysis more rigorous include: formalising the assumptions and scope conditions under which heuristics should be applied; testing rather than presuming their underlying empirical or theoretical justifications; using sensitivity analysis, simulations, multiple bias analysis, and deductive systems of inference (e.g. directed acyclic graphs) to characterise rule uncertainty and refine heuristics; adopting "recovery schemes" to correct for known biases

  9. Combination of the deterministic and probabilistic approaches for risk-informed decision-making in US NRC regulatory guides

    International Nuclear Information System (INIS)

    Patrik, M.; Babic, P.

    2001-06-01

    The report responds to the trend where probabilistic safety analyses are attached, on a voluntary basis (as yet), to the mandatory deterministic assessment of modifications of NPP systems or operating procedures, resulting in risk-informed type documents. It contains a nearly complete Czech translation of US NRC Regulatory Guide 1.177 and presents some suggestions for improving a) PSA study applications; b) the development of NPP documents for the regulatory body; and c) the interconnection between PSA and traditional deterministic analyses as contained in the risk-informed approach. (P.A.)

  10. Strategic appraisal of environmental risks: a contrast between the United Kingdom's Stern Review on the Economics of Climate Change and its Committee on Radioactive Waste Management.

    Science.gov (United States)

    Dietz, Simon; Morton, Alec

    2011-01-01

    In this article, we compare two high-profile strategic policy reviews undertaken for the U.K. government on environmental risks: radioactive waste management and climate change. These reviews took very different forms, both in terms of analytic approach and deliberation strategy. The Stern Review on the Economics of Climate Change was largely an exercise in expert modeling, building, within a cost-benefit framework, an argument for immediate reductions in carbon emissions. The Committee on Radioactive Waste Management, on the other hand, followed a much more explicitly deliberative and participative process, using multicriteria decision analysis to bring together scientific evidence and stakeholder and public values. In this article, we ask why the two reviews were different, and whether the differences are justified. We conclude that the differences were mainly due to political context, rather than the underpinning science, and as a consequence that, while in our view "fit for purpose," they would both have been stronger had they been less different. Stern's grappling with ethical issues could have been strengthened by a greater degree of public and stakeholder engagement, and the Committee on Radioactive Waste Management's handling of issues of uncertainty could have been strengthened by the explicitly probabilistic framework of Stern. © 2010 Society for Risk Analysis.

  11. Uranium from Africa - An overview on past and current mining activities: Re-appraising associated risks and chances in a global context

    Science.gov (United States)

    Winde, Frank; Brugge, Doug; Nidecker, Andreas; Ruegg, Urs

    2017-05-01

    In 2003, nuclear power received renewed interest as a perceived climate-neutral way to meet high energy demands of large industrialized countries, such as China, India, Russia and the USA. It triggered a growing demand for uranium (U) as nuclear fuel. Dubbed the 'nuclear renaissance', the U-price rose over tenfold before the global credit crisis dampend the rush. Many efforts to capitalise on the renewed demand focused on Africa. This paper provides an overview on the type and extent of uranium mining, production and exploration on the African continent and discusses the economic benefits as well as the potential environmental and health risks and the long-term needs for remediation of legacy sites. The actual historical results of uranium mining activities in more than thirty African countries provide data against which to assess the existing risks of uranium development. The already existing uraniferous waste in several African countries threatens scarce water resources and the health of adjacent residents. Responsibility should rest with the governments and the companies to ensure that these threats are not realized.

  12. High Pressure Coolant Injection (HPCI) System Risk-Based Inspection Guide for Browns Ferry Nuclear Power Station

    International Nuclear Information System (INIS)

    Wong, S.; DiBiasio, A.; Gunther, W.

    1993-09-01

    The High Pressure Coolant Injection (HPCI) system has been examined from a risk perspective. A System Risk-Based Inspection Guide (S-RIG) has been developed as an aid to HPCI system inspections at the Browns Ferry Nuclear Power Plant, Units 1, 2 and 3. The role of. the HPCI system in mitigating accidents is discussed in this S-RIG, along with insights on identified risk-based failure modes which could prevent proper operation of the system. The S-RIG provides a review of industry-wide operating experience, including plant-specific illustrative examples to augment the PRA and operational considerations in identifying a catalogue of basic PRA failure modes for the HPCI system. It is designed to be used as a reference for routine inspections, self-initiated safety system functional inspections (SSFIs), and the evaluation of risk significance of component failures at the nuclear power plant

  13. High Pressure Coolant Injection (HPCI) System Risk-Based Inspection Guide for Browns Ferry Nuclear Power Station

    Energy Technology Data Exchange (ETDEWEB)

    Wong, S.; DiBiasio, A.; Gunther, W. [Brookhaven National Lab., Upton, NY (United States)

    1993-09-01

    The High Pressure Coolant Injection (HPCI) system has been examined from a risk perspective. A System Risk-Based Inspection Guide (S-RIG) has been developed as an aid to HPCI system inspections at the Browns Ferry Nuclear Power Plant, Units 1, 2 and 3. The role of. the HPCI system in mitigating accidents is discussed in this S-RIG, along with insights on identified risk-based failure modes which could prevent proper operation of the system. The S-RIG provides a review of industry-wide operating experience, including plant-specific illustrative examples to augment the PRA and operational considerations in identifying a catalogue of basic PRA failure modes for the HPCI system. It is designed to be used as a reference for routine inspections, self-initiated safety system functional inspections (SSFIs), and the evaluation of risk significance of component failures at the nuclear power plant.

  14. Evidence from epidemic appraisals in Nigeria

    Directory of Open Access Journals (Sweden)

    Idoteyin O. Ezirim

    2015-10-01

    Full Text Available Although HIV prevalence has increased in most-at-risk populations (MARPs across Nigeria, effective programming was difficult because Nigeria lacked information for prevention programmes to target interventions that maximise coverage and cost effectiveness. Epidemic appraisals (EA were conducted in eight states to provide evidence for the planning, implementation and co-ordination of prevention interventions. Component 1: Mapping determined the size, typology and locations of MARPs. Component 2: Venue profiling identified and profiled venues where general populations engaged in high-risk behaviours. Component 3: Rural appraisals provided insights into risk behaviours and sexual networking in villages. States used mapping results to prioritise areas with a MARP coverage of 70% – 80% and then scale up interventions for non-brothel-based female sex workers (FSWs instead of focusing on brothel-based FSWs. The eight states prioritisedf unding for the high-coverage areas to ensure a minimum coverage level of 70% – 80% of MARPs was reached. The refocused resources led to cost efficiencies. Applying venue profiling results, six states implemented interventions at bars and night clubs – previously not covered. States also maximised intervention coverage for high-risk general populations; this led to the use of resources for general population interventions in a focused way rather than across an entire state. States focused on condom programmes in rural areas. EA results provided the evidence for focusing interventions for high MARP coverage as well as forhigh-risk general populations. The states applied the results and rapidly refocused their interventions, increasing the likelihood of having an impact on HIV transmission in those states. Nigeria is now implementing EAs in the remaining 29 states to effect national-level impact.

  15. 9 CFR 50.9 - Appraisals.

    Science.gov (United States)

    2010-01-01

    ... part must be appraised at their fair market value by an appraiser selected by APHIS. APHIS may decline... veterinarian in charge may grant a reasonable time for the presentation of their registration papers. [67 FR...

  16. Using Expectancy Theory to Explain Performance Appraisal ...

    African Journals Online (AJOL)

    pc

    2018-03-05

    Mar 5, 2018 ... appraisal conducting style, the relation between the performance appraisal system and task ... the article first explains the theory model which is based expectancy theory. II. ... which in return lead to rewards. According to [12],.

  17. 12 CFR 564.3 - Appraisals required; transactions requiring a State certified or licensed appraiser.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appraisals required; transactions requiring a State certified or licensed appraiser. 564.3 Section 564.3 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.3 Appraisals required; transactions requiring a State...

  18. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention

    Science.gov (United States)

    Bakkaloglu, Huseyin; Yanar, Hakan; Guloglu, Recep; Taviloglu, Korhan; Tunca, Fatih; Aksoy, Murat; Ertekin, Cemalettin; Poyanli, Arzu

    2006-01-01

    AIM: To assess the efficacy and safety of ultrasound guided percutaneous cholecystostomy (PC) in the treatment of acute cholecystitis in a well-defined high risk patients under general anesthesia. METHODS: The data of 27 consecutive patients who underwent percutaneous transhepatic cholecystostomy for the management of acute cholecystitis from January 1999 to June 2003 was retrospectively evaluated. All of the patients had both clinical and sonographic signs of acute cholecystitis and had comorbid diseases. RESULTS: Ultrasound revealed gallbladder stones in 25 patients and acalculous cholecystitis in two patients. Cholecystostomy catheters were removed 14-32 d (mean 23 d) after the procedure in cases where complete regression of all symptoms was achieved. There were statistically significant reductions in leukocytosis, (13.7 × 103 ± 1.3 × 103 μg/L vs 13 × 103 ± 1 × 103 μg/L, P < 0.05 for 24 h after PC; 13.7 × 103 ± 1.3 × 103 μg/L vs 8.3 × 103 ± 1.2 × 103 μg/L, P < 0.0001 for 72 h after PC), C -reactive protein (51.2 ± 18.5 mg/L vs 27.3 ± 10.4 mg/L, P < 0.05 for 24 h after PC; 51.2 ± 18.5 mg/L vs 5.4 ± 1.5 mg/L, P < 0.0001 for 72 h after PC), and fever (38 ± 0.35°C vs 37.3 ± 0.32°C, P < 0.05 for 24 h after PC; 38 ± 0.35°C vs 36.9 ± 0.15°C, P < 0.0001 for 72 h after PC). Sphincterotomy and stone extraction was performed successfully with endoscopic retrograde cholangio-pancreatography (ERCP) in three patients. After cholecystostomy, 5 (18%) patients underwent delayed cholecystectomy without any complications. Three out of 22 patients were admitted with recurrent acute cholecystitis during the follow-up and recovered with medical treatment. Catheter dislodgement occurred in three patients spontaneously, and two of them were managed by reinsertion of the catheter. CONCLUSION: As an alternative to surgery, percutan-eous cholecystostomy seems to be a safe method in critically ill patients with acute cholecystitis and can be performed with low

  19. Appraisal of family doctors: an evaluation study.

    NARCIS (Netherlands)

    Lewis, M.I.; Elwyn, G.; Wood, F.

    2003-01-01

    BACKGROUND: Appraisal has evolved to become a key component of workforce management. However, it is not clear from existing proposals for appraisal of doctors whether employers, health authorities or primary care organisations should take responsibility for appraisal processes. AIMS: To evaluate the

  20. 7 CFR 4279.144 - Appraisals.

    Science.gov (United States)

    2010-01-01

    ... value of the collateral. All real property appraisals associated with Agency guaranteed loanmaking and... appraise the property in question. All appraisals will include consideration of the potential effects from... value of the collateral. For additional guidance and information concerning the completion of real...

  1. Insights into Flood-Coping Appraisals of Protection Motivation Theory: Empirical Evidence from Germany and France.

    Science.gov (United States)

    Bubeck, Philip; Wouter Botzen, W J; Laudan, Jonas; Aerts, Jeroen C J H; Thieken, Annegret H

    2017-11-17

    Protection motivation theory (PMT) has become a popular theory to explain the risk-reducing behavior of residents against natural hazards. PMT captures the two main cognitive processes that individuals undergo when faced with a threat, namely, threat appraisal and coping appraisal. The latter describes the evaluation of possible response measures that may reduce or avert the perceived threat. Although the coping appraisal component of PMT was found to be a better predictor of protective intentions and behavior, little is known about the factors that influence individuals' coping appraisals of natural hazards. More insight into flood-coping appraisals of PMT, therefore, are needed to better understand the decision-making process of individuals and to develop effective risk communication strategies. This study presents the results of two surveys among more than 1,600 flood-prone households in Germany and France. Five hypotheses were tested using multivariate statistics regarding factors related to flood-coping appraisals, which were derived from the PMT framework, related literature, and the literature on social vulnerability. We found that socioeconomic characteristics alone are not sufficient to explain flood-coping appraisals. Particularly, observational learning from the social environment, such as friends and neighbors, is positively related to flood-coping appraisals. This suggests that social norms and networks play an important role in flood-preparedness decisions. Providing risk and coping information can also have a positive effect. Given the strong positive influence of the social environment on flood-coping appraisals, future research should investigate how risk communication can be enhanced by making use of the observed social norms and network effects. © 2017 Society for Risk Analysis.

  2. Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis.

    Science.gov (United States)

    Scott, A J; Mason, S E; Arunakirinathan, M; Reissis, Y; Kinross, J M; Smith, J J

    2015-04-01

    Current management of suspected appendicitis is hampered by the overadmission of patients with non-specific abdominal pain and a significant negative exploration rate. The potential benefits of risk stratification by the Appendicitis Inflammatory Response (AIR) score to guide clinical decision-making were assessed. During this 50-week prospective observational study at one institution, the AIR score was calculated for all patients admitted with suspected appendicitis. Appendicitis was diagnosed by histological examination, and patients were classified as having non-appendicitis pain if histological findings were negative or surgery was not performed. The diagnostic performance of the AIR score and the potential for risk stratification to reduce admissions, optimize imaging and prevent unnecessary explorations were quantified. A total of 464 patients were included, of whom 210 (63·3 per cent) with non-appendicitis pain were correctly classified as low risk. However, 13 low-risk patients had appendicitis. Low-risk patients accounted for 48·1 per cent of admissions (223 of 464), 57 per cent of negative explorations (48 of 84) and 50·7 per cent of imaging requests (149 of 294). An AIR score of 5 or more (intermediate and high risk) had high sensitivity for all severities of appendicitis (90 per cent) and also for advanced appendicitis (98 per cent). An AIR score of 9 or more (high risk) was very specific (97 per cent) for appendicitis, and the majority of patients with appendicitis in the high-risk group (21 of 30, 70 per cent) had perforation or gangrene. Ultrasound imaging could not exclude appendicitis in low-risk patients (negative likelihood ratio (LR) 1·0) but could rule-in the diagnosis in intermediate-risk patients (positive LR 10·2). CT could exclude appendicitis in low-risk patients (negative LR 0·0) and rule-in appendicitis in the intermediate group (positive LR 10·9). Risk stratification of patients with suspected appendicitis by the AIR score could

  3. Appraisal Psychology, Neurobiology, and Language.

    Science.gov (United States)

    Schumann, John H.

    2001-01-01

    Proposes that the confluence of stimulus appraisal and social cognition that is effected by the neural system in the brain has important implications for language and learning theories. Describes the anatomy and functions of this neural system and discusses how it may operate in motivation for second language acquisition and how in conjunction…

  4. Forgiveness and the appraisal-coping process in response to relationship conflicts: implications for depressive symptoms.

    Science.gov (United States)

    Ysseldyk, Renate; Matheson, Kimberly; Anisman, Hymie

    2009-03-01

    The present investigation assessed the mediating role of appraisal-coping processes in the relation between forgiveness and depressive symptoms associated with intimate relationship conflicts. Study 1 assessed the role of forgiveness in the context of a severe relationship stressor, namely women experiencing dating abuse, along with the appraisal-coping responses and depressive symptoms associated with such a stressor. Study 2 evaluated the function served by forgiveness among men and women in response to non-abusive relationship stressors, including the dissolution of the relationship, and also assessed the relations among forgiveness, appraisal-coping processes, and depressive symptoms. Women who encountered dating abuse were less likely to forgive their partners, and this was linked to higher levels of depressive symptoms. The relation between forgiveness and lower depressive symptoms was partially mediated by lower threat appraisals, secondary appraisals of the effectiveness of emotion-focused coping, and the reduced endorsements of this coping strategy (Study 1). Appraisal-coping processes similarly mediated the relation between forgiveness and depressive symptoms among men and women reporting conflict in an ongoing (non-abusive) relationship or a relationship break-up (Study 2). It is suggested that the relation between forgiveness and diminished distress operates primarily by guiding individuals' appraisals of the conflict and by diminishing the reliance on emotion-focused coping.

  5. Affecting others: social appraisal and emotion contagion in everyday decision making.

    Science.gov (United States)

    Parkinson, Brian; Simons, Gwenda

    2009-08-01

    In a diary study of interpersonal affect transfer, 41 participants reported on decisions involving other people over 3 weeks. Reported anxiety and excitement were reliably related to the perceived anxiety and excitement of another person who was present during decision making. Risk and importance appraisals partially mediated effects of other's anxiety on own anxiety as predicted by social appraisal theory. However, other's emotion remained a significant independent predictor of own emotion after controlling for appraisals, supporting the additional impact of more direct forms of affect transfer such as emotion contagion. Significant affect-transfer effects remained even after controlling for participants' perceptions of the other's emotion in addition to all measured appraisals, confirming that affect transfer does not require explicit registration of someone else's feelings. This research provides some of the clearest evidence for the operation of both social appraisal and automatic affect transfer in everyday social life.

  6. Fluoroscopy-Guided Percutaneous Gallstone Removal Using a 12-Fr Sheath in High-Risk Surgical Patients with Acute Cholecystitis

    International Nuclear Information System (INIS)

    Kim, Young Hwan; Kim, Yong Joo; Shin, Tae Beom

    2011-01-01

    To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis. Sixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique. Gallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days). Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis

  7. Fluoroscopy-Guided Percutaneous Gallstone Removal Using a 12-Fr Sheath in High-Risk Surgical Patients with Acute Cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan [Keimyung University, College of Medicine, Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andong (Korea, Republic of); Shin, Tae Beom [Gyeonsang National University, College of Medicine, Jinju (Korea, Republic of)

    2011-04-15

    To evaluate the technical feasibility and clinical efficacy of percutaneous transhepatic cholecystolithotomy under fluoroscopic guidance in high-risk surgical patients with acute cholecystitis. Sixty-three consecutive patients of high surgical risk with acute calculous cholecystitis underwent percutaneous transhepatic gallstone removal under conscious sedation. The stones were extracted through the 12-Fr sheath using a Wittich nitinol stone basket under fluoroscopic guidance on three days after performing a percutaneous cholecystostomy. Large or hard stones were fragmented using either the snare guide wire technique or the metallic cannula technique. Gallstones were successfully removed from 59 of the 63 patients (94%). Reasons for stone removal failure included the inability to grasp a large stone in two patients, and the loss of tract during the procedure in two patients with a contracted gallbladder. The mean hospitalization duration was 7.3 days for acute cholecystitis patients and 9.4 days for gallbladder empyema patients. Bile peritonitis requiring percutaneous drainage developed in two patients. No symptomatic recurrence occurred during follow-up (mean, 608.3 days). Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath is technically feasible and clinically effective in high-risk surgical patients with acute cholecystitis

  8. Health system guidance appraisal--concept evaluation and usability testing.

    Science.gov (United States)

    Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

    2016-01-05

    Health system guidance (HSG) provides recommendations aimed to address health system challenges. However, there is a paucity of methods to direct, appraise, and report HSG. Earlier research identified 30 candidate criteria (concepts) that can be used to evaluate the quality of HSG and guide development and reporting requirements. The objective of this paper was to describe two studies aimed at evaluating the importance of these 30 criteria, design a draft HSG appraisal tool, and test its usability. This study involved a two-step survey process. In step 1, respondents rated the 30 concepts for appropriateness to, relevance to, and priority for health system decisions and HSG. This led to a draft tool. In step 2, respondents reviewed HSG documents, appraised them using the tool, and answered a series of questions. Descriptive analyses were computed. Fifty participants were invited in step 1, and we had a response rate of 82 %. The mean response rates for each concept within each survey question were universally favorable. There was also an overall agreement about the need for a high-quality tool to systematically direct the development, appraisal, and reporting of HSG. Qualitative feedback and a consensus process by the team led to refinements to some of the concepts and the creation of a beta (draft) version of the HSG tool. In step 2, 35 participants were invited and we had a response rate of 74 %. Exploratory analyses showed that the quality of the HSGs reviewed varied as a function of the HSG item and the specific document assessed. A favorable consensus was reached with participants agreeing that the HSG items were easy to understand and easy to apply. Moreover, the overall agreement was high for the usability of the tool to systematically direct the development (85 %), appraisal (92 %), and reporting (81 %) of HSG. From this process, version 1.0 of the HSG appraisal tool was generated complete with 32 items (and their descriptions) and 4 domains. The final

  9. Realisation of dosimetric studies for working stations with a risk of exposure to ionizing radiations. Practical guide

    International Nuclear Information System (INIS)

    Donadille, L.; Queinnec, F.; Bottollier-Depois, J.F.; Clairand, I.; Rehel, J.L.; Deligne, J.M.; Aubert, B.; Jourdain, J.R.; Rannou, A.

    2007-01-01

    This guide proposes a methodological approach to help carry out dosimetric workplace studies complying with the French regulation, and necessary to identify risks of radiological exposure, optimize radiation protection, classify the workers into different categories and the workplaces into different areas. Additional information is provided relating the main objectives of a workplace study, the French regulatory context, main sources and pathways of exposure to ionizing radiation. Radiation protection and operational quantities are reminded. Recommendations about the selection and use of detectors and about the implementation of calculation methods are also provided. The general methodological approach is applied and developed into 'workplace sheets', each one devoted to a particular type of workplace. (author)

  10. Realisation of dosimetric studies for workplaces with a risk of exposure to ionizing radiations (version 2). Practical guide

    International Nuclear Information System (INIS)

    Donadille, L.; Rehel, J.L.; Deligne, J.M.; Queinnec, F.; Aubert, B.; Bottollier-Depois, J.F.; Clairand, I.; Jourdain, J.R.; Rannou, A.

    2010-01-01

    This guide proposes a methodological approach to help carry out dosimetric workplace studies complying with the french regulation, and necessary to identify risks of radiological exposure, optimize radiation protection, classify the workers into different categories and the workplaces into different areas. Additional information is provided relating the main objectives of a workplace study, the French regulatory context, main sources and pathways of exposure to ionizing radiation. Radiation protection and operational quantities are reminded. Recommendations about the selection and use of detectors and about the implementation of calculation methods are also provided. The general methodological approach is applied and developed into 'workplace sheets', each one devoted to a particular type of workplace. (authors)

  11. Decision making for wildfires: A guide for applying a risk management process at the incident level

    Science.gov (United States)

    Mary A. Taber; Lisa M. Elenz; Paul G. Langowski

    2013-01-01

    This publication focuses on the thought processes and considerations surrounding a risk management process for decision making on wildfires. The publication introduces a six element risk management cycle designed to encourage sound risk-informed decision making in accordance with Federal wildland fire policy, although the process is equally applicable to non-Federal...

  12. [Assessment of venous thromboembolism risk in hospitalized medical patients. Concordance between PRETEMED guide and the recommendations of the viii conference of the American College of Chest Physicians].

    Science.gov (United States)

    Gallardo Jiménez, Patricia; Guijarro Merino, Ricardo; Vallejo Herrera, Verónica; Sánchez Morales, David; Villalobos Sánchez, Aurora; Perelló González-Moreno, Juan Ignacio; Gómez-Huelgas, Ricardo

    2012-11-03

    The aim of this study is to evaluate the use of venous thromboembolism prophylaxis in hospitalized medical patients using 2 clinical practice guidelines and to analyze the agreement between them. Cross-sectional study of medical services in a third level hospital. We calculated the thromboembolic risk and the thromboprophylaxis adequacy by implementing the recommendations of viii conference of the American College of Chest Physicians (ACCP) and PRETEMED guide as well as their agreement. One hundred and twenty eight patients were included in the study. According to the PRETEMED guide, 34.4% of patients were low risk, 6.3% moderate and 59.4% high, with appropriate prophylaxis in 72.7% of patients (CI95%: 64.4-79.9), 18.8% (CI95%: 12.7-26.2) were undertreated and 8.6% (CI95%: 4.6-14.4) overtreated. According to ACCP recommendations, 50% of patients were low risk and 50% high, with appropriate prophylaxis in 74.2% of patients (CI95%: 66.1-81.2), 10.9% (CI95%: 6.4-17.3) were undertreated and 14.8% (CI95%: 9.4-21.8) overtreated. When PRETEMED risk was classified into low or moderate-high group versus ACCP risk low or high, the grade of concordance between both guides was 0.68 (CI95%: 0.56-0.81). When PRETEMED risk was classified into low-moderate or high group versus ACCP risk low or high, the grade of concordance between both guides was 0.81 (CI95%: 0.71-0.91). About a quarter of hospitalized medical patients did not receive adequate prophylaxis, showing an important room for improvement. PRETEMED guide and ACCP recommendations differ in risk assessment mainly because PRETEMED guide overestimates the risk of venous thromboembolism since it includes more risk factors. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  13. Inspection of the nasopharynx prior to fiberoptic-guided nasotracheal intubation reduces the risk epistaxis.

    Science.gov (United States)

    Kwon, Min A; Song, Jaegyok; Kim, Seokkon; Ji, Seong-Mi; Bae, Jeongho

    2016-08-01

    Various complications may occur during nasotracheal intubation. This may include epistaxis and damage to the nasopharyngeal airway. We tested the hypothesis that the use of fiberoptic bronchoscopy (FOB)-guided intubation is superior to endotracheal tube (ETT) obturated with an inflated esophageal stethoscope. Patients were randomly assigned to 1 of 2 groups (n=22 each): either an FOB-guided intubation group or ETT obturated with an inflated esophageal stethoscope group. After the induction of general anesthesia, patients in the FOB group received an FOB inspection through the nostril without advancement of ETT. Then, after confirming the placement of the bronchoscope tip in the trachea, the lubricated ETT was advanced via the nostril to the trachea along the bronchoscope. In the obturated ETT insertion group, the proximal opening of the ETT was blunted with an inflated esophageal stethoscope. The ETT was inserted into the selected nostril and advanced blindly into the posterior oropharynx. Then, the esophageal stethoscope was removed and tracheal intubation was performed with the bronchoscope. The number of attempts for successful tracheal intubation, the degree of difficulty during insertion, and bleeding during bronchoscopy were recorded. Another anesthesiologist, blinded to the intubation method, estimated the severity of epistaxis 5minutes after the intubation and postoperative complications. The FOB group had significantly less epistaxis during bronchoscopy, better navigability, and fewer intubation attempts and redirections. Fiberoptic-guided nasotracheal intubation was associated with less epistaxis. It also showed better navigability and less redirection rate. Therefore, FOB as an intubation guide is superior to ETT with an inflated esophageal stethoscope when intubating a patient via the nasotracheal route. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Analysis of Appraising Agricultural Intangible Asset Value by Cost Method

    OpenAIRE

    Li, Xiao-Juan

    2010-01-01

    On the basis of describing the connotation of agricultural intangible asset and cost method, the technical ideas of appraising by cost method are introduced. The article analyzes the advantages (simple appraisal principle and easy to understand and grasp; overall consideration of various factors related to appraisal result value) and disadvantages (high appraisal cost; difficult to appraise and grasp various appraisal factors) of appraising by cost method. The article also summarizes the prec...

  15. High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

    Energy Technology Data Exchange (ETDEWEB)

    Crystal, Pavel [Mount Sinai Hospital, University Health Network, Division of Breast Imaging, Toronto, ON (Canada); Mount Sinai Hospital, Toronto, ON (Canada); Sadaf, Arifa; Bukhanov, Karina; Helbich, Thomas H. [Mount Sinai Hospital, University Health Network, Division of Breast Imaging, Toronto, ON (Canada); McCready, David [Princess Margaret Hospital, Department of Surgical Oncology, Toronto, ON (Canada); O' Malley, Frances [Mount Sinai Hospital, Department of Pathology, Laboratory Medicine, Toronto, ON (Canada)

    2011-03-15

    To evaluate the frequency of diagnosis of high-risk lesions at MRI-guided vacuum-assisted breast biopsy (MRgVABB) and to determine whether underestimation may be predicted. Retrospective review of the medical records of 161 patients who underwent MRgVABB was performed. The underestimation rate was defined as an upgrade of a high-risk lesion at MRgVABB to malignancy at surgery. Clinical data, MRI features of the biopsied lesions, and histological diagnosis of cases with and those without underestimation were compared. Of 161 MRgVABB, histology revealed 31 (19%) high-risk lesions. Of 26 excised high-risk lesions, 13 (50%) were upgraded to malignancy. The underestimation rates of lobular neoplasia, atypical apocrine metaplasia, atypical ductal hyperplasia, and flat epithelial atypia were 50% (4/8), 100% (5/5), 50% (3/6) and 50% (1/2) respectively. There was no underestimation in the cases of benign papilloma without atypia (0/3), and radial scar (0/2). No statistically significant differences (p > 0.1) between the cases with and those without underestimation were seen in patient age, indications for breast MRI, size of lesion on MRI, morphological and kinetic features of biopsied lesions. Imaging and clinical features cannot be used reliably to predict underestimation at MRgVABB. All high-risk lesions diagnosed at MRgVABB require surgical excision. (orig.)

  16. Coastal and river flood risk analyses for guiding economically optimal flood adaptation policies: a country-scale study for Mexico

    Science.gov (United States)

    Haer, Toon; Botzen, W. J. Wouter; van Roomen, Vincent; Connor, Harry; Zavala-Hidalgo, Jorge; Eilander, Dirk M.; Ward, Philip J.

    2018-06-01

    Many countries around the world face increasing impacts from flooding due to socio-economic development in flood-prone areas, which may be enhanced in intensity and frequency as a result of climate change. With increasing flood risk, it is becoming more important to be able to assess the costs and benefits of adaptation strategies. To guide the design of such strategies, policy makers need tools to prioritize where adaptation is needed and how much adaptation funds are required. In this country-scale study, we show how flood risk analyses can be used in cost-benefit analyses to prioritize investments in flood adaptation strategies in Mexico under future climate scenarios. Moreover, given the often limited availability of detailed local data for such analyses, we show how state-of-the-art global data and flood risk assessment models can be applied for a detailed assessment of optimal flood-protection strategies. Our results show that especially states along the Gulf of Mexico have considerable economic benefits from investments in adaptation that limit risks from both river and coastal floods, and that increased flood-protection standards are economically beneficial for many Mexican states. We discuss the sensitivity of our results to modelling uncertainties, the transferability of our modelling approach and policy implications. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  17. Hanford Site cleanup and transition: Risk data needs for decision making (Hanford risk data gap analysis decision guide)

    International Nuclear Information System (INIS)

    Gajewski, S.; Glantz, C.; Harper, B.; Bilyard, G.; Miller, P.

    1995-10-01

    Given the broad array of environmental problems, technical alternatives, and outcomes desired by different stakeholders at Hanford, DOE will have to make difficult resource allocations over the next few decades. Although some of these allocations will be driven purely by legal requirements, almost all of the major objectives of the cleanup and economic transition missions involve choices among alternative pathways. This study examined the following questions: what risk information is needed to make good decisions at Hanford; how do those data needs compare to the set(s) of risk data that will be generated by regulatory compliance activities and various non-compliance studies that are also concerned with risk? This analysis examined the Hanford Site missions, the Hanford Strategic Plan, known stakeholder values, and the most important decisions that have to be made at Hanford to determine a minimum domain of risk information required to make good decisions that will withstand legal, political, and technical scrutiny. The primary risk categories include (1) public health, (2) occupational health and safety, (3) ecological integrity, (4) cultural-religious welfare, and (5) socio-economic welfare

  18. Sociospatial Knowledge Networks: Appraising Community as Place.

    Science.gov (United States)

    Skelly, Anne H.; Arcury, Thomas A.; Gesler, Wilbert M.; Cravey, Altha J.; Dougherty, Molly C.; Washburn, Sarah A.; Nash, Sally

    2002-01-01

    A new theory of geographical analysis--sociospatial knowledge networks--provides a framework for understanding the social and spatial locations of a community's health knowledge and beliefs. This theory is guiding an ethnographic study of health beliefs, knowledge, and knowledge networks in a diverse rural community at high risk for type-2…

  19. Guide for the self-assessment of risks brought upon patients in external radiotherapy - ASN guide nr 4, Index 0, Release of the 15/01/2009

    International Nuclear Information System (INIS)

    2009-01-01

    This document contains a user's guide for radiotherapy centres which is to be read before completing the form of analysis of failure modes, their effects and criticality (AMDEC), this form which must be completed by each radiotherapy centre, and a report explaining the methodology which has been adopted to elaborate this guide

  20. The Power of Developmental Performance Appraisal

    Directory of Open Access Journals (Sweden)

    Nasser Salim Alghanabousi

    2013-02-01

    Full Text Available Development of employee performance is a must that any organization should take into account to be a successful in achieving its goals. However, the tools of developing that performance are varying based on the type of the organization and the nature of the work performed. Performance appraisal is one of the effective tools that help the organization to measure the accomplishment of its goals, if implemented effectively. In education, it became evident that performance appraisal of educators is an essential element of the development of any educational institution. To make the performance appraisal fruitful, the development element should be dominant in the sense that other elements of the appraisal should serve the broad aim of the appraisal process. Therefore, a well-designed and comprehensive system is needed to cover all the aspects of appraisal process that include of the goals, criteria, instruments, and continuous support.

  1. Predicting the onset of psychosis in patients at clinical high risk: practical guide to probabilistic prognostic reasoning.

    Science.gov (United States)

    Fusar-Poli, P; Schultze-Lutter, F

    2016-02-01

    Prediction of psychosis in patients at clinical high risk (CHR) has become a mainstream focus of clinical and research interest worldwide. When using CHR instruments for clinical purposes, the predicted outcome is but only a probability; and, consequently, any therapeutic action following the assessment is based on probabilistic prognostic reasoning. Yet, probabilistic reasoning makes considerable demands on the clinicians. We provide here a scholarly practical guide summarising the key concepts to support clinicians with probabilistic prognostic reasoning in the CHR state. We review risk or cumulative incidence of psychosis in, person-time rate of psychosis, Kaplan-Meier estimates of psychosis risk, measures of prognostic accuracy, sensitivity and specificity in receiver operator characteristic curves, positive and negative predictive values, Bayes' theorem, likelihood ratios, potentials and limits of real-life applications of prognostic probabilistic reasoning in the CHR state. Understanding basic measures used for prognostic probabilistic reasoning is a prerequisite for successfully implementing the early detection and prevention of psychosis in clinical practice. Future refinement of these measures for CHR patients may actually influence risk management, especially as regards initiating or withholding treatment. 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/

  2. Appraisal patterns of envy and related emotions

    OpenAIRE

    van de Ven, Niels; Zeelenberg, Marcel; Pieters, Rik

    2011-01-01

    Envy is a frustrating emotion that arises from upward social comparison. Two studies investigated the appraisals that distinguish benign envy (aimed at improving one’s own situation) from malicious envy (aimed at pulling down the superior other). Study 1 found that appraisals of deservingness and control potential differentiated both types of envy. We manipulated these appraisals in Study 2 and found that while both did not influence the intensity of envy, they did determine the type of envy ...

  3. Non-financial analysis in project appraisal – an empirical study

    OpenAIRE

    Moutinho, Nuno; Lopes, MDS

    2011-01-01

    Recent literature has been emphasising the need to take both financial and nonfinancial aspects into consideration when considering capital budgeting decisions. This is to be done since the early stages of project appraisal, and not only when risks become reality. We wanted to know to what extent portuguese companies are aware of the importance of non financial aspects at their project appraisal processes, and, in their practices, what exactly they are doing and considering as more or less i...

  4. Social behavior, interaction appraisals, and suicidal ideation in schizophrenia: The dangers of being alone

    OpenAIRE

    Depp, Colin A.; Moore, Raeanne C.; Perivoliotis, Dimitri; Holden, Jason L.; Swendsen, Joel; Granholm, Eric L.

    2016-01-01

    Despite the increasing attention to social appraisals in suicide risk, the interpersonal correlates of suicidal thoughts and behavior in schizophrenia are not well understood. Ecological momentary assessment could reveal whether dysfunctional social appraisals and behavior are evident in people with schizophrenia with suicidal ideation. A total of 93 outpatients with diagnoses of schizophrenia with (n = 18, 19%) and without (N = 75; 81%) suicidal ideation participated in one week of intensive...

  5. Family Typology and Appraisal of Preschoolers' Behavior by Female Caregivers.

    Science.gov (United States)

    Coke, Sallie P; Moore, Leslie C

    2015-01-01

    Children with vulnerable caregivers may be at risk for being labeled as having behavior problems when typical behaviors are viewed by their caregivers as problematic, and therefore, research examining the accuracy of the caregivers' perceptions of children's behaviors is needed. The purpose of this study was to use the resiliency model of family stress, adjustment, and adaptation as the theoretical foundation to explore family factors associated with the primary female caregiver's appraisal of her child's behavior, the extent to which the primary female caregiver's appraisal of her child's behavior may be distorted, and the child's level of risk of having a behavioral problem. A cross-sectional, correlational design was used. Data were collected from female caregivers of preschoolers (N = 117). Family factors, demographic characteristics, comfort in parenting, appraisal of behaviors, daily stress, parenting stress, depressive symptoms, social support, ratings of children's behaviors, and distortion in the ratings were measured. Associations were studied using ANOVA, ANCOVA, and chi-squared tests. Family typology was not associated with the female caregiver's appraisals of her child's behavior (p = .31). Distortion of the caregiver's rating of her child's behavior was not associated with family hardiness (high or low; p = .20.) but was associated with having a child with an elevated risk for behavioral problems (p < .01). Families classified as vulnerable were significantly more likely to have a child with elevated risks of having behavioral problems than families classified as secure or regenerative. Findings emphasized the association between family factors (hardiness and coherence) and young children's behaviors. Additional research is needed into how these factors affect the young child's behavior and what causes a caregiver to have a distorted view of her child's behavior.

  6. Health systems guidance appraisal--a critical interpretive synthesis.

    Science.gov (United States)

    Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

    2016-01-22

    Health systems guidance (HSG) are systematically developed statements that assist with decisions about options for addressing health systems challenges, including related changes in health systems arrangements. However, the development, appraisal, and reporting of HSG poses unique conceptual and methodological challenges related to the varied types of evidence that are relevant, the complexity of health systems, and the pre-eminence of contextual factors. To address this gap, we are conducting a program of research that aims to create a tool to support the appraisal of HSG and further enhance HSG development and reporting. The focus of this paper was to conduct a knowledge synthesis of the published and grey literatures to determine quality criteria (concepts) relevant for this process. We applied a critical interpretive synthesis (CIS) approach to knowledge synthesis that enabled an iterative, flexible, and dynamic analysis of diverse bodies of literature in order to generate a candidate list of concepts that will constitute the foundational components of the HSG tool. Using our review questions as compasses, we were able to guide the search strategy to look for papers based on their potential relevance to HSG appraisal, development, and reporting. The search strategy included various electronic databases and sources, subject-specific journals, conference abstracts, research reports, book chapters, unpublished data, dissertations, and policy documents. Screening the papers and data extraction was completed independently and in duplicate, and a narrative approach to data synthesis was executed. We identified 43 papers that met eligibility criteria. No existing review was found on this topic, and no HSG appraisal tool was identified. Over one third of the authors implicitly or explicitly identified the need for a high-quality tool aimed to systematically evaluate HSG and contribute to its development/reporting. We identified 30 concepts that may be relevant to the

  7. Climate risk screening tools and their application: A guide to the guidance

    Energy Technology Data Exchange (ETDEWEB)

    Traerup, S.; Olhoff, A.

    2011-07-01

    Climate risk screening is an integral part of efforts to ascertain current and future vulnerabilities and risks related to climate change. It is a prerequisite for identifying and designing adaptation measures, and an important element in the process of integrating, or mainstreaming, climate change adaptation into development project, planning and policy processes. There is an increasing demand and attention among national stakeholders in developing countries to take into account potential implications of climate variability and change for planning and prioritizing of development strategies and activities. Subsequently, there is a need for user friendly guidance on climate risk screening tools and their potentials for application that targets developing country stakeholders. This need is amplified by the sheer volume of climate change mainstreaming guidance documents and risk screening and assessment tools available and currently under development. Against this background, this paper sets out to provide potential users in developing countries, including project and programme developers and managers, with an informational entry point to climate risk screening tools. The emphasis in this report is on providing: 1) An overview of available climate risk screening and assessment tools along with indications of the tools available and relevant for specific purposes and contexts (Section 3). 2) Examples of application of climate risk screening and assessment tools along with links to further information (Section 4). Before turning to the respective sections on available climate risk screening tools and examples of their application, a delimitation of the tools included in this paper is included in Section 2. This section also provides a brief overview of how climate screening and related tools fit into decision making steps at various planning and decision making levels in conjunction with an outline of overall considerations to make when choosing a tool. The paper is

  8. Probabilistic Risk Assessment Procedures Guide for NASA Managers and Practitioners (Second Edition)

    Science.gov (United States)

    Stamatelatos,Michael; Dezfuli, Homayoon; Apostolakis, George; Everline, Chester; Guarro, Sergio; Mathias, Donovan; Mosleh, Ali; Paulos, Todd; Riha, David; Smith, Curtis; hide

    2011-01-01

    Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and logical analysis method aimed at identifying and assessing risks in complex technological systems for the purpose of cost-effectively improving their safety and performance. NASA's objective is to better understand and effectively manage risk, and thus more effectively ensure mission and programmatic success, and to achieve and maintain high safety standards at NASA. NASA intends to use risk assessment in its programs and projects to support optimal management decision making for the improvement of safety and program performance. In addition to using quantitative/probabilistic risk assessment to improve safety and enhance the safety decision process, NASA has incorporated quantitative risk assessment into its system safety assessment process, which until now has relied primarily on a qualitative representation of risk. Also, NASA has recently adopted the Risk-Informed Decision Making (RIDM) process [1-1] as a valuable addition to supplement existing deterministic and experience-based engineering methods and tools. Over the years, NASA has been a leader in most of the technologies it has employed in its programs. One would think that PRA should be no exception. In fact, it would be natural for NASA to be a leader in PRA because, as a technology pioneer, NASA uses risk assessment and management implicitly or explicitly on a daily basis. NASA has probabilistic safety requirements (thresholds and goals) for crew transportation system missions to the International Space Station (ISS) [1-2]. NASA intends to have probabilistic requirements for any new human spaceflight transportation system acquisition. Methods to perform risk and reliability assessment in the early 1960s originated in U.S. aerospace and missile programs. Fault tree analysis (FTA) is an example. It would have been a reasonable extrapolation to expect that NASA would also become the world leader in the application of PRA. That was

  9. Determination of Altitude Sickness Risk (DASR) User’s Guide for Apple Mobile Devices

    Science.gov (United States)

    2015-06-01

    Android Smartphone Relevance to Military Weather Applications”.2 2.  DASR Inputs  To launch DASR, simply tap the DASR icon on the device start screen...risk due to sleep deprivation). TB MED 505 should be consulted for additional details if necessary. 5 Fig. 4 Individual Factors view The risk...armypubs.army.mil/med/index.html]. 2. Sauter, D. Android smartphone relevance to military weather applications. White Sands Missile Range (NM); Army Research

  10. 76 FR 72306 - Federal Housing Administration (FHA) Appraiser Roster: Appraiser Qualifications for Placement on...

    Science.gov (United States)

    2011-11-23

    ... disciplinary action in any state in which the appraiser is certified; * * * * * (c) * * * (1) Appraisers subject to state disciplinary action. An appraiser whose state certification in any state has been revoked, suspended, or surrendered as a result of a state disciplinary action is automatically suspended from the...

  11. Positive emotion, appraisal, and the role of appraisal overlap in positive emotion co-occurrence.

    Science.gov (United States)

    Tong, Eddie M W; Jia, Lile

    2017-02-01

    Appraisal research has traditionally focused on negative emotions but has not addressed issues concerning the relationships between several positive emotions and appraisals in daily life and the extent to which co-occurrence of positive emotions can be explained by overlap in appraisals. Driven by a priori hypotheses on appraisal-emotion relationships, this study investigated 12 positive emotions and 13 appraisal dimensions using Ecological Momentary Assessment. The results provide strong evidence that positive emotions and appraisals correlate significantly in daily life. Importantly, we found that the positive emotions' overlap on theoretically relevant, as compared to irrelevant, appraisals was stronger and more predictive of their co-occurrence. Furthermore, appraisal overlap on theoretically relevant appraisals predicted the co-occurrence of positive emotions even when the appraisal of pleasantness was excluded, indicating that positive emotions do not co-occur just by virtue of their shared valence. Our findings affirmed and refined the appraisal profiles of positive emotions and underscore the importance of appraisals in accounting for the commonality and differences among positive emotions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Test Takers' Performance Appraisals, Appraisal Calibration, and Cognitive and Metacognitive Strategy Use

    Science.gov (United States)

    Phakiti, Aek

    2016-01-01

    The current study explores the nature and relationships among test takers' performance appraisals, appraisal calibration, and reported cognitive and metacognitive strategy use in a language test situation. Performance appraisals are executive processes of strategic competence for judging test performance (e.g., evaluating the correctness or…

  13. B plant/WESF integrated annual safety appraisal

    International Nuclear Information System (INIS)

    Anderson, J.K.

    1990-12-01

    This report provides the results of the Fiscal Year 1990 Annual Integrated Safety Appraisal of the B Plant and Waste Encapsulation and Storage Facility in the Hanford Site 200 East Area. The appraisal was conducted in August and September 1990, by the Defense Waste Disposal Safety group, in conjunction with Health Physics and Emergency Preparedness. Reports of these three organizations for their areas of responsibility are presented. The purpose of the appraisal was to determine if the areas being appraised meet US Department of Energy (DOE) and Westinghouse Hanford Company (WHC) requirements and current industry standards of good practice. A further purpose was to identify areas in which program effectiveness could be improved. In accordance with the guidance of WHC Management Requirements and Procedures 5.6, previously identified deficiencies which are being resolved by line management were not repeated as Findings or Observations unless progress or intended disposition was considered to be unsatisfactory. The overall assessment is that there are no major safety problems associated with current operations. Programs are in place to provide the necessary safety controls, evaluations, overviews, and support. In most respects these programs are being implemented effectively. However, there are a number of deficiencies in details of program design and implementation. The appraisal identified a total of 23 Findings and 27 Observations of deficiencies. All Observations are Seriousness Category 3. Fifteen Findings were Category 2 and 8 were Category 3. Most of the Category 2 Findings were so categorized on the basis of noncompliance with mandatory DOE Orders or WHC policies and procedures, rather than potential risk to personnel

  14. Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Monroe, Alan T.; Peddada, Anuj V. [Dept. of Radiation Oncology, Penrose Cancer Center, Colorado Springs (United States); Pikaart, Dirk [Dept. of Gynecologic Oncology, Penrose Cancer Center, Colorado Springs (United States)

    2013-06-15

    Objective. To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients. Methods . Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique. Brachytherapy followed external radiation in 11 patients to a median dose of 18 Gy in 3 fractions. The median external beam dose delivered was 47.5 Gy in 25 fractions. Results. All 656 fractions were successfully imaged and treated. The median overall translational shift required for correction was 9.1 mm (standard deviation, 5.2 mm) relative to clinical set-up with skin tattoos. Shifts of 1 cm, 1.5 cm, and 2 cm or greater were performed in 43%, 14%, and 4% of patients, respectively. Acute grade 2 gastrointestinal (GI) toxicity occurred in eight patients (30%) and grade 3 toxicity occurred in one. At two years, there have been no local or regional failures and actuarial overall survival is 95%. Conclusion. Daily image guidance for high-risk endometrial cancer results in a low incidence of acute GI/genitourinary (GU) toxicity with uncompromised tumor control at two years. Vaginal cuff translations can be substantial and may possibly result in underdosing if not properly considered.

  15. Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer

    International Nuclear Information System (INIS)

    Monroe, Alan T.; Peddada, Anuj V.; Pikaart, Dirk

    2013-01-01

    Objective. To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients. Methods . Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique. Brachytherapy followed external radiation in 11 patients to a median dose of 18 Gy in 3 fractions. The median external beam dose delivered was 47.5 Gy in 25 fractions. Results. All 656 fractions were successfully imaged and treated. The median overall translational shift required for correction was 9.1 mm (standard deviation, 5.2 mm) relative to clinical set-up with skin tattoos. Shifts of 1 cm, 1.5 cm, and 2 cm or greater were performed in 43%, 14%, and 4% of patients, respectively. Acute grade 2 gastrointestinal (GI) toxicity occurred in eight patients (30%) and grade 3 toxicity occurred in one. At two years, there have been no local or regional failures and actuarial overall survival is 95%. Conclusion. Daily image guidance for high-risk endometrial cancer results in a low incidence of acute GI/genitourinary (GU) toxicity with uncompromised tumor control at two years. Vaginal cuff translations can be substantial and may possibly result in underdosing if not properly considered

  16. Estimate of the shielding effect on secondary cancer risk due to cone-beam CT in image-guided radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Jiwon; Baek, Taeseong; Yoon, Myonggeun [Korea University, Seoul (Korea, Republic of); Kim, Dongwook; Kim, Donghyun [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2014-09-15

    This study evaluated the effect of a simple shielding method using a thin lead sheet on the imaging dose caused by cone-beam computed tomography (CBCT) in image-guided radiation therapy (IGRT). Reduction of secondary doses from CBCT was measured using a radio-photoluminescence glass dosimeter (RPLGD) placed inside an anthropomorphic phantom. The entire body, except for the region scanned by using CBCT, was shielded by wrapping it with a 2-mm lead sheet. Changes in secondary cancer risk due to shielding were calculated using BEIR VII models. Doses to out-of-field organs for head-and-neck, chest, and pelvis scans were decreased 15 ∼ 100%, 23 ∼ 90%, and 23 ∼ 98%, respectively, and the average reductions in lifetime secondary cancer risk due to the 2-mm lead shielding were 1.6, 11.5, and 12.7 persons per 100,000, respectively. These findings suggest that a simple, thin-lead-sheet-based shielding method can effectively decrease secondary doses to out-of-field regions for CBCT, which reduces the lifetime cancer risk on average by 9 per 100,000 patients.

  17. An introductory guide to uncertainty analysis in environmental and health risk assessment. Environmental Restoration Program

    International Nuclear Information System (INIS)

    Hammonds, J.S.; Hoffman, F.O.; Bartell, S.M.

    1994-12-01

    This report presents guidelines for evaluating uncertainty in mathematical equations and computer models applied to assess human health and environmental risk. Uncertainty analyses involve the propagation of uncertainty in model parameters and model structure to obtain confidence statements for the estimate of risk and identify the model components of dominant importance. Uncertainty analyses are required when there is no a priori knowledge about uncertainty in the risk estimate and when there is a chance that the failure to assess uncertainty may affect the selection of wrong options for risk reduction. Uncertainty analyses are effective when they are conducted in an iterative mode. When the uncertainty in the risk estimate is intolerable for decision-making, additional data are acquired for the dominant model components that contribute most to uncertainty. This process is repeated until the level of residual uncertainty can be tolerated. A analytical and numerical methods for error propagation are presented along with methods for identifying the most important contributors to uncertainty. Monte Carlo simulation with either Simple Random Sampling (SRS) or Latin Hypercube Sampling (LHS) is proposed as the most robust method for propagating uncertainty through either simple or complex models. A distinction is made between simulating a stochastically varying assessment endpoint (i.e., the distribution of individual risks in an exposed population) and quantifying uncertainty due to lack of knowledge about a fixed but unknown quantity (e.g., a specific individual, the maximally exposed individual, or the mean, median, or 95%-tile of the distribution of exposed individuals). Emphasis is placed on the need for subjective judgement to quantify uncertainty when relevant data are absent or incomplete

  18. Evaluation of safety assessment methodologies in Rocky Flats Risk Assessment Guide (1985) and Building 707 Final Safety Analysis Report (1987)

    International Nuclear Information System (INIS)

    Walsh, B.; Fisher, C.; Zigler, G.; Clark, R.A.

    1990-01-01

    FSARs. Rockwell International, as operating contractor at the Rocky Flats plant, conducted a safety analysis program during the 1980s. That effort resulted in Final Safety Analysis Reports (FSARs) for several buildings, one of them being the Building 707 Final Safety Analysis Report, June 87 (707FSAR) and a Plant Safety Analysis Report. Rocky Flats Risk Assessment Guide, March 1985 (RFRAG85) documents the methodologies that were used for those FSARs. Resources available for preparation of those Rocky Flats FSARs were very limited. After addressing the more pressing safety issues, some of which are described below, the present contractor (EG ampersand G) intends to conduct a program of upgrading the FSARs. This report presents the results of a review of the methodologies described in RFRAG85 and 707FSAR and contains suggestions that might be incorporated into the methodology for the FSAR upgrade effort

  19. Social appraisal influences recognition of emotions.

    Science.gov (United States)

    Mumenthaler, Christian; Sander, David

    2012-06-01

    The notion of social appraisal emphasizes the importance of a social dimension in appraisal theories of emotion by proposing that the way an individual appraises an event is influenced by the way other individuals appraise and feel about the same event. This study directly tested this proposal by asking participants to recognize dynamic facial expressions of emotion (fear, happiness, or anger in Experiment 1; fear, happiness, anger, or neutral in Experiment 2) in a target face presented at the center of a screen while a contextual face, which appeared simultaneously in the periphery of the screen, expressed an emotion (fear, happiness, anger) or not (neutral) and either looked at the target face or not. We manipulated gaze direction to be able to distinguish between a mere contextual effect (gaze away from both the target face and the participant) and a specific social appraisal effect (gaze toward the target face). Results of both experiments provided evidence for a social appraisal effect in emotion recognition, which differed from the mere effect of contextual information: Whereas facial expressions were identical in both conditions, the direction of the gaze of the contextual face influenced emotion recognition. Social appraisal facilitated the recognition of anger, happiness, and fear when the contextual face expressed the same emotion. This facilitation was stronger than the mere contextual effect. Social appraisal also allowed better recognition of fear when the contextual face expressed anger and better recognition of anger when the contextual face expressed fear. 2012 APA, all rights reserved

  20. 12 CFR 34.45 - Appraiser independence.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Appraiser independence. 34.45 Section 34.45 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REAL ESTATE LENDING AND... appraiser shall be engaged directly by the regulated institution or its agent, and have no direct or...

  1. 12 CFR 722.5 - Appraiser independence.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Appraiser independence. 722.5 Section 722.5 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS APPRAISALS... interest, financial or otherwise, in the property. If the only qualified persons available to perform an...

  2. Appraisal patterns of envy and related emotions

    NARCIS (Netherlands)

    van de Ven, N.; Zeelenberg, M.; Pieters, R.

    2012-01-01

    Envy is a frustrating emotion that arises from upward social comparison. Two studies investigated the appraisals that distinguish benign envy (aimed at improving one’s own situation) from malicious envy (aimed at pulling down the superior other). Study 1 found that appraisals of deservingness and

  3. Performance appraisal of coaches: Acomparative study | Surujlal ...

    African Journals Online (AJOL)

    Within the sport environment, the performance appraisal of coaches continues to be an issue. The performance appraisal of coaches is critical to sport organizations since major decisions like rewarding or terminating coaches is based on it. The purpose of this study was to examine whether any differences exist with regard ...

  4. 45 CFR 1160.12 - Appraisal procedures.

    Science.gov (United States)

    2010-10-01

    ... the amount of partial loss, or damage to, or any reduction in the fair market value as a result..., any reduction in the fair market value of, the indemnified item(s). The appraisers' agreement with... appropriate, such reduction in the fair market value. Disputes between the appraisers with respect to partial...

  5. Percutaneous ultrasound-guided radiofrequency ablation for kidney tumors in patients with surgical risk

    International Nuclear Information System (INIS)

    Salagierski, Marek; Salagierski, Maciej; Sosnowski, Marek; Salagierska-Barwinska, Anna

    2006-01-01

    The aim of this study was to describe our experience with percutaneous ultrasound-guided radiofrequency ablation of kidney tumors. From July 2002 to August 2005, 45 radiofrequency ablations (RFA) in 42 selected patients with kidney tumor were performed. The patients had either contraindications to surgery procedures or had a solitary kidney. The average tumor size was 37.5 mm (range, 18-59 mm) with the mean age of 68 years (range, 28-83 years). RFA were performed based on radiographic findings. Needle biopsy was made only twice. Monopolar Cool-tip Tyco or bipolar Celon Olympus radiofrequency devices were used. The procedure was performed under conscious sedation with local anesthesia. Treatment efficacy was assessed by computed tomography and by Doppler ultrasound. The absence of contrast enhancement on computed tomography was considered to be a successful treatment. The average follow up was 14 months (range, 3-36 months). In 42 tumors (93%), total absence of contrast enhancement was obtained after the initial RFA and in three tumors (7%) after the second ablation session. There were no complications following 41 procedures, including all ablations in small (<35 mm) renal masses. In four procedures, minor complications were observed. All patients are alive. There has been no need for chronic hemodialysis and, until now, we have not observed any local recurrences with the exception of one metastasis to an ipsilateral adrenal gland. RFA of kidney tumors is a promising alternative treatment which could be considered for patients who are not suitable for surgery. (author)

  6. Appraisal patterns of envy and related emotions.

    Science.gov (United States)

    van de Ven, Niels; Zeelenberg, Marcel; Pieters, Rik

    2012-06-01

    Envy is a frustrating emotion that arises from upward social comparison. Two studies investigated the appraisals that distinguish benign envy (aimed at improving one's own situation) from malicious envy (aimed at pulling down the superior other). Study 1 found that appraisals of deservingness and control potential differentiated both types of envy. We manipulated these appraisals in Study 2 and found that while both did not influence the intensity of envy, they did determine the type of envy that resulted. The more a situation was appraised as undeserved, the more participants experienced malicious envy. Benign envy was experienced more when the situation was not undeserved, and the most when the situation was appraised as both deserved and controllable. The current research also clarifies how the types of envy differ from the related emotions admiration and resentment.

  7. The appraisal of clinical guidelines in dentistry.

    Science.gov (United States)

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

    2009-01-01

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

  8. Reconstitution as a Guiding Principle to US Army Force Structure: High Risk or Prudent Hedge?

    Science.gov (United States)

    2014-05-20

    integrated process, does offer the United States a means to mitigate these risks. The United States is uniquely postured to take advantage of reconstitution...Advanced Mili tary Studies Hen Accepted this 22"d day of May 20 14 b irector, Graduate Degree ProQ.ram The op inions and conclusions expressed...to conven th ese resources into actual capability w hen needed req uires a disc iplined approach that accounts for the doctr inal organiza tional

  9. SU-E-J-10: Imaging Dose and Cancer Risk in Image-Guided Radiotherapy of Cancers

    International Nuclear Information System (INIS)

    Zhou, L; Bai, S; Zhang, Y; Deng, J

    2015-01-01

    Purpose: To systematically evaluate imaging doses and cancer risks to organs-at-risk as a Result of cumulative doses from various radiological imaging procedures in image-guided radiotherapy (IGRT) in a large cohort of cancer patients. Methods: With IRB approval, imaging procedures (computed tomography, kilo-voltage portal imaging, megavoltage portal imaging and kilo-voltage cone-beam computed tomography) of 4832 cancer patients treated during 4.5 years were collected with their gender, age and circumference. Correlations between patient’s circumference and Monte Carlo simulated-organ dose were applied to estimate organ doses while the cancer risks were reported as 1+ERR using BEIR VII models. Results: 80 cGy or more doses were deposited to brain, lungs and RBM in 273 patients (maximum 136, 278 and 267 cGy, respectively), due largely to repetitive imaging procedures and non-personalized imaging settings. Regardless of gender, relative cancer risk estimates for brain, lungs, and RBM were 3.4 (n = 55), 2.6 (n = 49), 1.8 (n = 25) for age group of 0–19; 1.2 (n = 87), 1.4 (n = 98), 1.3 (n = 51) for age group of 20–39; 1.0 (n = 457), 1.1 (n = 880), 1.8 (n=360) for age group of 40–59; 1.0 (n = 646), 1.1 (n = 1400), 2.3 (n = 716) for age group of 60–79 and 1.0 (n = 108),1.1 (n = 305),1.6 (n = 147) for age group of 80–99. Conclusion: The cumulative imaging doses and associated cancer risks from multi-imaging procedures were patient-specific and site-dependent, with up to 2.7 Gy imaging dose deposited to critical structures in some pediatric patients. The associated cancer risks in brain and lungs for children of age 0 to 19 were 2–3 times larger than those for adults. This study indicated a pressing need for personalized imaging protocol to maximize its clinical benefits while reducing associated cancer risks. Sichuan University Scholarship

  10. Auxiliary feedwater system risk-based inspection guide for the North Anna nuclear power plants

    International Nuclear Information System (INIS)

    Nickolaus, J.R.; Moffitt, N.E.; Gore, B.F.; Vo, T.V.

    1992-10-01

    In a study sponsored by the US Nuclear regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. North Anna was selected as a plant for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by the NRC inspectors in preparation of inspection plans addressing AFW risk important components at the North Anna plant

  11. Auxiliary feedwater system risk-based inspection guide for the Palo Verde Nuclear Power Plant

    International Nuclear Information System (INIS)

    Bumgardner, J.D.; Moffitt, N.E.; Gore, B.F.; Vo, T.V.; Sloan, J.A.

    1993-02-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. Palo Verde was selected as one of a series of plants for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at the Palo Verde plants

  12. Ranking malaria risk factors to guide malaria control efforts in African highlands.

    Directory of Open Access Journals (Sweden)

    Natacha Protopopoff

    Full Text Available INTRODUCTION: Malaria is re-emerging in most of the African highlands exposing the non immune population to deadly epidemics. A better understanding of the factors impacting transmission in the highlands is crucial to improve well targeted malaria control strategies. METHODS AND FINDINGS: A conceptual model of potential malaria risk factors in the highlands was built based on the available literature. Furthermore, the relative importance of these factors on malaria can be estimated through "classification and regression trees", an unexploited statistical method in the malaria field. This CART method was used to analyse the malaria risk factors in the Burundi highlands. The results showed that Anopheles density was the best predictor for high malaria prevalence. Then lower rainfall, no vector control, higher minimum temperature and houses near breeding sites were associated by order of importance to higher Anopheles density. CONCLUSIONS: In Burundi highlands monitoring Anopheles densities when rainfall is low may be able to predict epidemics. The conceptual model combined with the CART analysis is a decision support tool that could provide an important contribution toward the prevention and control of malaria by identifying major risk factors.

  13. Ranking malaria risk factors to guide malaria control efforts in African highlands.

    Science.gov (United States)

    Protopopoff, Natacha; Van Bortel, Wim; Speybroeck, Niko; Van Geertruyden, Jean-Pierre; Baza, Dismas; D'Alessandro, Umberto; Coosemans, Marc

    2009-11-25

    Malaria is re-emerging in most of the African highlands exposing the non immune population to deadly epidemics. A better understanding of the factors impacting transmission in the highlands is crucial to improve well targeted malaria control strategies. A conceptual model of potential malaria risk factors in the highlands was built based on the available literature. Furthermore, the relative importance of these factors on malaria can be estimated through "classification and regression trees", an unexploited statistical method in the malaria field. This CART method was used to analyse the malaria risk factors in the Burundi highlands. The results showed that Anopheles density was the best predictor for high malaria prevalence. Then lower rainfall, no vector control, higher minimum temperature and houses near breeding sites were associated by order of importance to higher Anopheles density. In Burundi highlands monitoring Anopheles densities when rainfall is low may be able to predict epidemics. The conceptual model combined with the CART analysis is a decision support tool that could provide an important contribution toward the prevention and control of malaria by identifying major risk factors.

  14. Auxiliary feedwater system risk-based inspection guide for the McGuire nuclear power plant

    International Nuclear Information System (INIS)

    Bumgardner, J.D.; Lloyd, R.C.; Moffitt, N.E.; Gore, B.F.; Vo, T.V.

    1994-05-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. McGuire was selected as one of a series of plants for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at the McGuire plant

  15. Auxiliary feedwater system risk-based inspection guide for the South Texas Project nuclear power plant

    International Nuclear Information System (INIS)

    Bumgardner, J.D.; Nickolaus, J.R.; Moffitt, N.E.; Gore, B.F.; Vo, T.V.

    1993-12-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. South Texas Project was selected as a plant for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by the NRC inspectors in preparation of inspection plans addressing AFW risk important components at the South Texas Project plant

  16. Auxiliary feedwater system risk-based inspection guide for the Maine Yankee Nuclear Power Plant

    International Nuclear Information System (INIS)

    Gore, B.F.; Vo, T.V.; Moffitt, N.E.; Bumgardner, J.D.

    1992-10-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. The information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. Maine Yankee was selected as one of a series of plants for study. ne product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at the Maine Yankee plant

  17. Auxiliary feedwater system risk-based inspection guide for the Byron and Braidwood nuclear power plants

    International Nuclear Information System (INIS)

    Moffitt, N.E.; Gore, B.F.; Vo, T.V.

    1991-07-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. Byron and Braidwood were selected for the fourth study in this program. The produce of this effort is a prioritized listing of AFW failures which have occurred at the plants and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at the Byron/Braidwood plants. 23 refs., 1 fig., 1 tab

  18. Auxiliary feedwater system risk-based inspection guide for the H. B. Robinson nuclear power plant

    International Nuclear Information System (INIS)

    Moffitt, N.E.; Lloyd, R.C.; Gore, B.F.; Vo, T.V.; Garner, L.W.

    1993-08-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. H. B. Robinson was selected as one of a series of plants for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at the H. B. Robinson plant

  19. Auxiliary feedwater system risk-based inspection guide for the Point Beach nuclear power plant

    International Nuclear Information System (INIS)

    Lloyd, R.C.; Moffitt, N.E.; Gore, B.F.; Vo, T.V.; Vehec, T.A.

    1993-02-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. Point Beach was selected as one of a series of plants for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRS. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at the Point Beach plant

  20. Auxiliary feedwater system risk-based inspection guide for the Ginna Nuclear Power Plant

    International Nuclear Information System (INIS)

    Pugh, R.; Gore, B.F.; Vo, T.V.; Moffitt, N.E.

    1991-09-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. Ginna was selected as the eighth plant for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at the Ginna plant. 23 refs., 1 fig., 1 tab

  1. Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States.

    Directory of Open Access Journals (Sweden)

    Shan Liu

    Full Text Available No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74 year-olds given newly available hepatitis C treatments.A Markov model evaluated alternative risk-factor guided and birth-cohort screening and treatment strategies. Risk factors included drug use history, blood transfusion before 1992, and multiple sexual partners. Analyses of the National Health and Nutrition Examination Survey provided sex-, race-, age-, and risk-factor-specific hepatitis C prevalence and mortality rates. Nine strategies combined screening (no screening, risk-factor guided screening, or birth-cohort screening and treatment (standard therapy-peginterferon alfa and ribavirin, Interleukin-28B-guided (IL28B triple-therapy-standard therapy plus a protease inhibitor, or universal triple therapy. Response-guided treatment depended on HCV genotype. Outcomes include discounted lifetime costs (2010 dollars and quality adjusted life-years (QALYs. Compared to no screening, risk-factor guided and birth-cohort screening for 50 year-olds gained 0.7 to 3.5 quality adjusted life-days and cost $168 to $568 per person. Birth-cohort screening provided more benefit per dollar than risk-factor guided screening and cost $65,749 per QALY if followed by universal triple therapy compared to screening followed by IL28B-guided triple therapy. If only 10% of screen-detected, eligible patients initiate treatment at each opportunity, birth-cohort screening with universal triple therapy costs $241,100 per QALY. Assuming treatment with triple therapy, screening all individuals aged 40-64 years costs less than $100,000 per QALY.The cost-effectiveness of one-time birth-cohort hepatitis C screening for 40-64 year olds

  2. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method.

    Science.gov (United States)

    Kakizawa, Hideaki; Toyota, Naoyuki; Hieda, Masashi; Hirai, Nobuhiko; Tachikake, Toshihiro; Matsuura, Noriaki; Oda, Miyo; Ito, Katsuhide

    2010-09-01

    The purpose of this study is to evaluate the risk factors for the severity of pneumothorax after computed tomography (CT)-guided percutaneous lung biopsy using the single-needle method. We reviewed 91 biopsy procedures for 90 intrapulmonary lesions in 89 patients. Patient factors were age, sex, history of ipsilateral lung surgery and grade of emphysema. Lesion factors were size, location and pleural contact. Procedure factors were position, needle type, needle size, number of pleural punctures, pleural angle, length of needle passes in the aerated lung and number of harvesting samples. The severity of pneumothorax after biopsy was classified into 4 groups: "none", "mild", "moderate" and "severe". The risk factors for the severity of pneumothorax were determined by multivariate analyzing of the factors derived from univariate analysis. Pneumothorax occurred in 39 (43%) of the 91 procedures. Mild, moderate, and severe pneumothorax occurred in 24 (26%), 8 (9%) and 7 (8%) of all procedures, respectively. Multivariate analysis showed that location, pleural contact, number of pleural punctures and number of harvesting samples were significantly associated with the severity of pneumothorax (p < 0.05). In conclusion, lower locations and non-pleural contact lesions, increased number of pleural punctures and increased number of harvesting samples presented a higher severity of pneumothorax.

  3. Diagnosis of myocardial infarction using the new universal definition: is it enough for risk stratification and guiding decision for revascularization?

    Science.gov (United States)

    Calé, Rita; Ferreira, Jorge; Aguiar, Carlos; Santos, Nuno; Carmo, Pedro; Figueira, João; Raposo, Luis; Gonçalves, Pedro; Silva, José Aniceto

    2010-12-01

    Abstract Objectives: Evaluate the new ESC/ACCF/AHA/WHF universal definition of myocardial infarction (MI) in relation to its prognostic implications and the role for guiding decision for revascularization. It was also compared with the multivariable based GRACE Risk Score (GRS). Single centre registry of 389 consecutive patients admitted with non-ST-segment elevation (NSTE) ACS. We calculated the adjusted HR & 95%CI for death/MI at 30-days and one-year follow-up, between the presence or absence of MI using: (1) universal definition: > 99th URL for cTnI (> 0.06 ng/ml) or MBm (> 3.2 ng/ml); (2) MBm > 2 × URL (> 12.2 ng/ml); 3) old WHO: MBact > 2 × URL (> 32U/l). Logistic analysis was performed to test the interaction between tertiles of biomarkers or GRS and the effect of revascularization on the outcome. The universal definition increased the incidence of MI in 3.5-fold for cTnI, but was not an independent predictor of outcome. The GRS was the only independent predictor of prognosis at 30-days and one-year. The interaction with the prognostic impact of revascularization was only present for the GRS categorized by tertiles. In a contemporary unselected population with NSTE-ACS, the universal definition of MI alone was not adequate for risk assessment and revascularization decision making. These purposes were fully addressed with the GRS.

  4. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method

    International Nuclear Information System (INIS)

    Kakizawa, Hideaki; Hieda, Masashi; Oda, Miyo; Toyota, Naoyuki; Hirai, Nobuhiko; Tachikake, Toshihiro; Matsuura, Noriaki; Ito, Katsuhide

    2010-01-01

    The purpose of this study is to evaluate the risk factors for the severity of pneumothorax after computed tomography (CT)-guided percutaneous lung biopsy using the single-needle method. We reviewed 91 biopsy procedures for 90 intrapulmonary lesions in 89 patients. Patient factors were age, sex, history of ipsilateral lung surgery and grade of emphysema. Lesion factors were size, location and pleural contact. Procedure factors were position, needle type, needle size, number of pleural punctures, pleural angle, length of needle passes in the aerated lung and number of harvesting samples. The severity of pneumothorax after biopsy was classified into 4 groups: 'none', 'mild', 'moderate' and 'severe'. The risk factors for the severity of pneumothorax were determined by multivariate analyzing of the factors derived from univariate analysis. Pneumothorax occurred in 39 (43%) of the 91 procedures. Mild, moderate, and severe pneumothorax occurred in 24 (26%), 8 (9%) and 7 (8%) of all procedures, respectively. Multivariate analysis showed that location, pleural contact, number of pleural punctures and number of harvesting samples were significantly associated with the severity of pneumothorax (p<0.05). In conclusion, lower locations and non-pleural contact lesions, increased number of pleural punctures and increased number of harvesting samples presented a higher severity of pneumothorax. (author)

  5. The Risk of Transplant Failure With HLA Mismatch in First Adult Kidney Allografts 2: Living Donors, Summary, Guide.

    Science.gov (United States)

    Williams, Robert C; Opelz, Gerhard; Weil, E Jennifer; McGarvey, Chelsea J; Chakkera, Harini A

    2017-05-01

    Allografts from living donors survive longer than those from deceased donors but the role of HLA mismatching in living kidney donation is still in question. We examined the effect of HLA compatibility on kidney allograft survival from living donors by studying all first adult kidney transplants performed in the United States over 25 years. Using the United Network for Organ Sharing data, we identified first kidney transplants between October 1, 1987, and December 31, 2013. Recipients were classified by their number of HLA mismatches and stratified by donor origin. Cox multivariate regression analyses adjusting for recipient and donor transplant characteristics were performed to determine impact of HLA compatibility on kidney allograft survival for all living donors and for living related and living unrelated subsets. There were 66 596 first adult transplants from living donors with 348 960 years of follow-up. We found a linear relationship between HLA mismatch and allograft survival. In adjusted analyses, among all living donors, 1 mismatch conferred a 44% higher risk, whereas 6 mismatches conferred a twofold higher risk of allograft failure. When using 0-mismatched full siblings as a reference, living-donor kidneys reduce the hazard of failure by approximately 34% when compared with deceased donors. Twenty-five years of transplant experience, stratified by donor source, was summarized and presented as a guide for allocation. These data reinforce the importance of optimizing HLA matching to further improve survival in first adult kidney allografts in the future, especially in living unrelated donations, when possible.

  6. Applicator-guided volumetric-modulated arc therapy for low-risk endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cilla, Savino, E-mail: savinocilla@gmail.com [Medical Physics Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Macchia, Gabriella [Radiation Oncology Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Sabatino, Domenico [Medical Physics Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Digesù, Cinzia; Deodato, Francesco [Radiation Oncology Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Piermattei, Angelo [Physics Institute, Università Cattolica del Sacro Cuore, Rome (Italy); De Spirito, Marco [Medical Physics Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Morganti, Alessio G. [Radiation Oncology Unit, Fondazione di ricerca e cura “Giovanni Paolo II,” Università Cattolica del Sacro Cuore, Campobasso (Italy); Radiation Oncology Unit, Università Cattolica del Sacro Cuore, Rome (Italy)

    2013-04-01

    The aim of this study was to report the feasibility of volumetric-modulated arc therapy (VMAT) in the postoperative irradiation of the vaginal vault. Moreover, the VMAT technique was compared with 3D conformal radiotherapy (3D-CRT) and fixed-field intensity-modulated radiotherapy (IMRT), in terms of target coverage and organs at risk sparing. The number of monitor units and the delivery time were analyzed to score the treatment efficiency. All plans were verified in a dedicated solid water phantom using a 2D array of ionization chambers. Twelve patients with endometrial carcinoma who underwent radical hystero-adenexectomy and fixed-field IMRT treatments were retrospectively included in this analysis; for each patient, plans were compared in terms of dose-volume histograms, homogeneity index, and conformity indexes. All techniques met the prescription goal for planning target volume coverage, with VMAT showing the highest level of conformity at all dose levels. VMAT resulted in significant reduction of rectal and bladder volumes irradiated at all dose levels compared with 3D-CRT. No significant differences were found with respect to IMRT. Moreover, a significant improvement of the dose conformity was reached by VMAT technique not only at the 95% dose level (0.74 vs. 0.67 and 0.62) but also at 50% and 75% levels of dose prescription. In addition, VMAT plans showed a significant reduction of monitor units by nearly 28% with respect to IMRT, and reduced treatment time from 11 to <3 minutes for a single 6-Gy fraction. In conclusion, VMAT plans can be planned and carried out with high quality and efficiency for the irradiation of vaginal vault alone, providing similar or better sparing of organs at risk to fixed-field IMRT and resulting in the most efficient treatment option. VMAT is currently our standard approach for radiotherapy of low-risk endometrial cancer.

  7. High Pressure Coolant Injection (HPCI) system risk-based inspection guide: Pilgrim Nuclear Power Station

    International Nuclear Information System (INIS)

    Shier, W.; Gunther, W.

    1992-10-01

    A review of the operating experience for the High Pressure Coolant Injection (HPCI) system at the Pilgrim Nuclear Power Station is described in this report. The information for this review was obtained from Pilgrim Licensee Event Reports (LERs) that were generated between 1980 and 1989. These LERs have been categorized into 23 failure modes that have been prioritized based on probabilistic risk assessment considerations. In addition, the results of the Pilgrim operating experience review have been compared with the results of of a similar, industry wide operating experience review. this comparison provides an indication of areas in the Pilgrim HPCI system that should be given increased attention in the prioritization of inspection resources

  8. Optimal use of β-blockers in high-risk hypertension: A guide to dosing equivalence

    Directory of Open Access Journals (Sweden)

    Janet B McGill

    2010-05-01

    Full Text Available Janet B McGillDepartment of Medicine, Washington University School of Medicine, St. Louis, Missouri, USAAbstract: Hypertension is the number one diagnosis made by primary care physicians, placing them in a unique position to prescribe the antihypertensive agent best suited to the individual patient. In individuals with diabetes mellitus, blood pressure (BP levels > 130/80 mmHg confer an even higher risk for cardiovascular and renal disease, and these patients will benefit from aggressive antihypertensive treatment using a combination of agents. β‑blockers are playing an increasingly important role in the management of hypertension in high-risk patients. β‑blockers are a heterogeneous class of agents, and this review presents the differences between β‑blockers and provides evidence-based protocols to assist in understanding dose equivalence in the selection of an optimal regimen in patients with complex needs. The clinical benefits provided by β‑blockers are only effective if patients adhere to medication treatment long term. β‑blockers with proven efficacy, once-daily dosing, and lower side effect profiles may become instrumental in the treatment of hypertensive diabetic and nondiabetic patients.Keywords: antihypertensive, blood pressure, atenolol, carvedilol, labetalol, metoprolol, nebivolol

  9. User's Guide and Metadata to Coastal Biodiversity Risk Analysis Tool (CBRAT): Framework for the Systemization of Life History and Biogeographic Information

    Science.gov (United States)

    ABSTRACTUser’s Guide & Metadata to Coastal Biodiversity Risk Analysis Tool (CBRAT): Framework for the Systemization of Life History and Biogeographic Information(EPA/601/B-15/001, 2015, 123 pages)Henry Lee II, U.S. EPA, Western Ecology DivisionKatharine Marko, U.S. EPA,...

  10. Critical appraisal of published literature

    Science.gov (United States)

    Umesh, Goneppanavar; Karippacheril, John George; Magazine, Rahul

    2016-01-01

    With a large output of medical literature coming out every year, it is impossible for readers to read every article. Critical appraisal of scientific literature is an important skill to be mastered not only by academic medical professionals but also by those involved in clinical practice. Before incorporating changes into the management of their patients, a thorough evaluation of the current or published literature is an important step in clinical practice. It is necessary for assessing the published literature for its scientific validity and generalizability to the specific patient community and reader's work environment. Simple steps have been provided by Consolidated Standard for Reporting Trial statements, Scottish Intercollegiate Guidelines Network and several other resources which if implemented may help the reader to avoid reading flawed literature and prevent the incorporation of biased or untrustworthy information into our practice. PMID:27729695

  11. Critical appraisal of published literature

    Directory of Open Access Journals (Sweden)

    Goneppanavar Umesh

    2016-01-01

    Full Text Available With a large output of medical literature coming out every year, it is impossible for readers to read every article. Critical appraisal of scientific literature is an important skill to be mastered not only by academic medical professionals but also by those involved in clinical practice. Before incorporating changes into the management of their patients, a thorough evaluation of the current or published literature is an important step in clinical practice. It is necessary for assessing the published literature for its scientific validity and generalizability to the specific patient community and reader′s work environment. Simple steps have been provided by Consolidated Standard for Reporting Trial statements, Scottish Intercollegiate Guidelines Network and several other resources which if implemented may help the reader to avoid reading flawed literature and prevent the incorporation of biased or untrustworthy information into our practice.

  12. The Effects of Parental Depressive Symptoms, Appraisals, and Physical Punishment on Later Child Externalizing Behavior

    Science.gov (United States)

    Callender, Kevin A.; Olson, Sheryl L.; Choe, Daniel E.; Sameroff, Arnold J.

    2012-01-01

    Examined a cognitive-behavioral pathway by which depressive symptoms in mothers and fathers increase risk for later child externalizing problem behavior via parents' appraisals of child behavior and physical discipline. Participants were 245 children (118 girls) at risk for school-age conduct problems, and their parents and teachers. Children were…

  13. Frequency and Risk Factors of Various Complications After Computed Tomography-Guided Radiofrequency Ablation of Lung Tumors

    International Nuclear Information System (INIS)

    Okuma, Tomohisa; Matsuoka, Toshiyuki; Yamamoto, Akira; Oyama, Yoshimasa; Toyoshima, Masami; Nakamura, Kenji; Inoue, Yuichi

    2008-01-01

    Objective. To retrospectively determine the frequency and risk factors of various side effects and complications after percutaneous computed tomography-guided radiofrequency (RF) ablation of lung tumors. Methods. We reviewed and analyzed records of 112 treatment sessions in 57 of our patients (45 men and 12 women) with unresectable lung tumors treated by ablation. Risk factors, including sex, age, tumor diameter, tumor location, history of surgery, presence of pulmonary emphysema, electrode gauge, array diameter, patient position, maximum power output, ablation time, and minimum impedance during ablation, were analyzed using univariate and multivariate analyses. Results. Total rates of side effects and minor and major complications occurred in 17%, 50%, and 8% of treatment sessions, respectively. Side effects, including pain during ablation (46% of sessions) and pleural effusion (13% of sessions), occurred with RF ablation. Minor complications, including pneumothorax not requiring chest tube drainage (30% of sessions), subcutaneous emphysema (16% of sessions), and hemoptysis (9% of sessions) also occurred after the procedure. Regarding major complications, three patients developed fever >38.5 deg. C; three patients developed abscesses; two patients developed pneumothorax requiring chest tube insertion; and one patient had air embolism and was discharged without neurologic deficit. Univariate and multivariate analyses suggested that a lesion located ≤1 cm of the chest wall was significantly related to pain (p < 0.01, hazard index 5.76). Risk factors for pneumothorax increased significantly with previous pulmonary surgery (p < 0.05, hazard index 6.1) and presence of emphysema (p <0.01, hazard index 13.6). Conclusion. The total complication rate for all treatment sessions was 58%, and 25% of patients did not have any complications after RF ablation. Although major complications can occur, RF ablation of lung tumors can be considered a safe and minimally invasive

  14. High Pressure Coolant Injection system risk-based inspection guide for Hatch Nuclear Power Station

    International Nuclear Information System (INIS)

    DiBiasio, A.M.

    1993-05-01

    A review of the operating experience for the High Pressure Coolant Injection (HPCI) system at the Hatch Nuclear Power Station, Units 1 and 2, is described in this report. The information for this review was obtained from Hatch Licensee Event Reports (LERs) that were generated between 1980 and 1992. These LERs have been categorized into 23 failure modes that have been prioritized based on probabilistic risk assessment considerations. In addition, the results of the Hatch operating experience review have been compared with the results of a similar, industry wide operating, experience review. This comparison provides an indication of areas in the Hatch HPCI system that should be given increased attention in the prioritization of inspection resources

  15. Managing complex, high risk projects a guide to basic and advanced project management

    CERN Document Server

    Marle, Franck

    2016-01-01

    Maximizing reader insights into project management and handling complexity-driven risks, this book explores propagation effects, non-linear consequences, loops, and the emergence of positive properties that may occur over the course of a project. This book presents an introduction to project management and analysis of traditional project management approaches and their limits regarding complexity. It also includes overviews of recent research works about project complexity modelling and management as well as project complexity-driven issues. Moreover, the authors propose their own new approaches, new methodologies and new tools which may be used by project managers and/or researchers and/or students in the management of their projects. These new elements include project complexity definitions and frameworks, multi-criteria approaches for project complexity measurement, advanced methodologies for project management (propagation studies to anticipate potential behaviour of the project, and clustering approaches...

  16. Commercial Off-The-Shelf (COTS) Parts Risk and Reliability User and Application Guide

    Science.gov (United States)

    White, Mark

    2017-01-01

    All COTS parts are not created equal. Because they are not created equal, the notion that one can force the commercial industry to follow a set of military specifications and standards, along with the certifications, audits and qualification commitments that go with them, is unrealistic for the sale of a few parts. The part technologies that are Defense Logistics Agency (DLA) certified or Military Specification (MS) qualified, are several generations behind the state-of-the-art high-performance parts that are required for the compact, higher performing systems for the next generation of spacecraft and instruments. The majority of the part suppliers are focused on the portion of the market that is producing high-tech commercial products and systems. To that end, in order to compete in the high performance and leading edge advanced technological systems, an alternative approach to risk assessment and reliability prediction must be considered.

  17. The appraisal rationalisation of real estate expertise

    Directory of Open Access Journals (Sweden)

    Marina Ciuna

    2013-12-01

    Full Text Available The Italian appraisal practice is characterized by valuations developed in subjective opinions formulated by the valuers, according to the experience and the competence rather than on the survey of the market data of comparable properties. This practice makes up for the lack of information on the real estate market and to the consequent absence of systematic collections of market data. This tradition is in the cadastral appraisal for the rural (1886 and urban properties (1939. The assessed income is appraised for a representative property and wide to all the other properties with arbitrary scores (pure number. The assessed value is derived from the income with fixed multipliers. The reform of the cadastral appraisals (2013 provides the employment of predetermined statistic functions rather than the automated valuation models applied in the mass appraisal. There are therefore ample spaces to rationalize the Italian valuations. For the market appraisal the process of rationalization is based on the comparison between the expertise and the market comparison approach. For the cadastral appraisal the process of rationalization is based on the statistic application to the fixed functions with the survey of a sample of market prices and the ratios study according to the valuation standards.

  18. MRI screening-detected breast lesions in high-risk young women: the value of targeted second-look ultrasound and imaging-guided biopsy.

    Science.gov (United States)

    Peter, P; Dhillon, R; Bose, S; Bourke, A

    2016-10-01

    To analyse the value of targeted second-look ultrasound and imaging-guided biopsy in high-risk young women eligible for screening magnetic resonance imaging (MRI) in a tertiary referral centre in Perth, Western Australia. A retrospective analysis of eligible high-risk young women who underwent screening breast MRI and targeted second-look ultrasound between June 2012 and June 2014 was performed with review of data. Over a 2-year period, 139 women underwent high-risk screening MRI. Of these, 30 women (with a total of 45 lesions) were recalled for targeted second-look ultrasound. Thirty-four MRI-detected lesions were identified on targeted ultrasound with 19 of them proceeding to ultrasound-guided biopsy, while the remaining 15 lesions were considered benign on ultrasound, were not biopsied, and were stable on follow-up imaging 12 months later. One lesion proceeded to an MRI-guided biopsy to confirm a benign result. Of the 11 lesions not seen on ultrasound, nine underwent MRI biopsy, one proceeded directly to hook wire localisation and excision, and one did not return for biopsy and was lost to follow-up. The overall biopsy rate was 14.4%. The cancer detection rate was 1.4%. The results of this study indicate that targeted second-look ultrasound and ultrasound-guided biopsy is a cost-effective and time-efficient approach for MRI-detected lesions in young women at high risk of developing breast cancer. MRI-guided biopsy should be considered for ultrasonographically occult suspicious lesions as there is a low, but definite, risk of cancer. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  19. The McDonaldization of appraisal? Doctors' views of the early impacts of medical revalidation in the United Kingdom.

    Science.gov (United States)

    Archer, Julian; Nunn, Suzanne; Regan de Bere, Sam

    2017-09-01

    Medical regulation is rapidly changing with claims that systems such as revalidation/relicensing will reassure the public. Yet the impact of such initiatives is unknown. Using the principles of efficiency, calculability, predictability and control through technology, identified by Ritzer, and exampled by the McDonalds business model, we analyzed interviews with doctors between May 2012-Dec 2013 which focused on doctor experiences of appraisal and revalidation in SW England. The research found significant changes in appraisals since the launch of revalidation in December 2012. Appraisal has been standardized with a list of supporting information that must be collected by doctors. The success of implementation is measured in the numbers of appraisals completed but less is known about the quality of the appraisal itself. Such efficiencies have been supported by IT systems that themselves might be at risk of driving the process. There are potential advantages to McDonaldization including appraisals available to all, not just for doctors working in the NHS, and a potentially more appetizing recipe for their completion. As yet a state of McAppraisal has not been reached; with a complete transfer of trust in the doctor to trust in the appraisal process within revalidation. However policymakers will need to continue to ensure that regulatory initiatives, such as revalidation, are not just a process for their own sake. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. 12 CFR 564.4 - Minimum appraisal standards.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Minimum appraisal standards. 564.4 Section 564.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.4 Minimum appraisal standards. For federally related transactions, all appraisals shall, at a minimum: (a...

  1. Stigma, Reflected Appraisals, and Recovery Outcomes in Mental Illness

    Science.gov (United States)

    Markowitz, Fred E.; Angell, Beth; Greenberg, Jan S.

    2011-01-01

    Drawing on modified labeling theory and the reflected appraisals process and using longitudinal data from 129 mothers and their adult children with schizophrenia, we estimate models of the effects of mothers' stigmatized identity appraisals of their mentally ill children on reflected and self-appraisals, and how appraisals affect outcomes…

  2. 9 CFR 52.3 - Appraisal of swine.

    Science.gov (United States)

    2010-01-01

    ... an APHIS employee alone. (b) The appraisal of swine will be based on the fair market value as determined by the meat or breeding value of the animals. Animals may be appraised in groups, provided that where appraisal is by the head, each animal in the group is the same value per head, and where appraisal...

  3. Using functional analysis in archival appraisal a practical and effective alternative to traditional appraisal methodologies

    CERN Document Server

    Robyns, Marcus C

    2014-01-01

    In an age of scarcity and the challenge of electronic records, can archivists and records managers continue to rely upon traditional methodology essentially unchanged since the early 1950s? Using Functional Analysis in Archival Appraisal: A Practical and Effective Alternative to Traditional Appraisal Methodologies shows how archivists in other countries are already using functional analysis, which offers a better, more effective, and imminently more practical alternative to traditional appraisal methodologies that rely upon an analysis of the records themselves.

  4. Non-Invasive Brain Stimulation in Children With Unilateral Cerebral Palsy: A Protocol and Risk Mitigation Guide

    Directory of Open Access Journals (Sweden)

    Bernadette T. Gillick

    2018-03-01

    Full Text Available Non-invasive brain stimulation has been increasingly investigated, mainly in adults, with the aims of influencing motor recovery after stroke. However, a consensus on safety and optimal study design has not been established in pediatrics. The low incidence of reported major adverse events in adults with and without clinical conditions has expedited the exploration of NIBS in children with paralleled purposes to influence motor skill development after neurological injury. Considering developmental variability in children, with or without a neurologic diagnosis, adult dosing and protocols may not be appropriate. The purpose of this paper is to present recommendations and tools for the prevention and mitigation of adverse events (AEs during NIBS in children with unilateral cerebral palsy (UCP. Our recommendations provide a framework for pediatric NIBS study design. The key components of this report on NIBS AEs are (a a summary of related literature to provide the background evidence and (b tools for anticipating and managing AEs from four international pediatric laboratories. These recommendations provide a preliminary guide for the assessment of safety and risk mitigation of NIBS in children with UCP. Consistent reporting of safety, feasibility, and tolerability will refine NIBS practice guidelines contributing to future clinical translations of NIBS.

  5. 32 CFR 644.42 - Appraisal report.

    Science.gov (United States)

    2010-07-01

    ... appraisal report shall be divided into four parts as outlined below: PART I—INTRODUCTION 1. TITLE PAGE. This... photograph. The use of color film and photographs is encouraged, especially wherein development cost either...

  6. Theoretical foundations of shareholders' right to appraisal

    Directory of Open Access Journals (Sweden)

    Vasiljević Mirko

    2017-01-01

    Full Text Available Shareholders' right to appraisal represents a controversial topic of corporation law, which is why a relatively small number of countries accept it. In this article, the authors analyze the goals that are supposed to be achieved with the introduction of shareholders' appraisal rights. In this respect, traditional and modern explanations for the introduction or maintaining of this right have been presented. In the second part of this article, shareholders' right to appraisal has been critically examined, mostly from corporations' perspective. Afterwards, several potential causes of inefficiency of using this right have been identified. Perceiving pros and cons of shareholders' right to appraisal is of particular importance for Serbia, in order to draw a conclusion about harmonization of our legislative solutions with the theoretical foundations of this right.

  7. APPRAISAL ANALYSIS IN FREEDOM WRITERS MOVIE

    Directory of Open Access Journals (Sweden)

    Nani Hidayati

    2017-02-01

    Full Text Available This study attempts to find out conveyed messages in the movie from the realization of the appraisal and narrative structure as well as to describe the use of the Appraisal System to express LaGravenese's (a Attitudes, (bEngagement & (c Graduation towards the main characters in Freedom Writers movie screenplay. Using both quantitative and qualitative descriptive approach for discourse appraisal system analysis, the result of this study reveals several messages of tolerance, earning respect and trust, honor diversity, and striving for success and trust from the realization of Appraisal and Narrative Structure either in the dialogues or monologues of Freedom Writers’ characters. The result from the Appraisal Devices realizing (a Attitudes reveals that LaGravenese likes to express characters’ negative emotion explicitly than implicitly. He likes to express characters’ negative capability than other kinds of Judgments. He appreciates the characters using more Negative Value which denotes that in his opinion, they see each other negatively. (bEngagement used in the screenplay describes that he emphasizes more on characters’ denial towards each other’s opinion and existence with the use of more Disclaim Heterogloss in the screenplay. (cGraduation used in the screenplay describes that the use of more Sharpening Focus indicates he emphasizes on characters’ category boundary more than scaling of intensity. Keywords: Appraisal Devices, Attitude, Engagement, and Graduation.

  8. The Myth of Offenders' Deception on Self-Report Measure Predicting Recidivism: Example from the Self-Appraisal Questionnaire (SAQ)

    Science.gov (United States)

    Loza, Wagdy; Loza-Fanous, Amel; Heseltine, Karen

    2007-01-01

    Two studies were conducted to investigate the vulnerability of the Self-Appraisal Questionnaire (SAQ) to deception and self-presentation biases. The SAQ is a self-report measure used to predict recidivism and guide institutional and program assignments. In the first study, comparisons were made between 429 volunteer offenders who completed the SAQ…

  9. Critical appraisal of nonrandomized studies-A review of recommended and commonly used tools.

    Science.gov (United States)

    Quigley, Joan M; Thompson, Juliette C; Halfpenny, Nicholas J; Scott, David A

    2018-02-27

    When randomized controlled trial data are limited or unavailable, or to supplement randomized controlled trial evidence, health technology assessment (HTA) agencies may rely on systematic reviews of nonrandomized studies (NRSs) for evidence of the effectiveness of health care interventions. NRS designs may introduce considerable bias into systematic reviews, and several methodologies by which to evaluate this risk of bias are available. This study aimed to identify tools commonly used to assess bias in NRS and determine those recommended by HTA bodies. Appraisal tools used in NRS were identified through a targeted search of systematic reviews (January 2013-March 2017; MEDLINE and EMBASE [OVID SP]). Recommendations for the critical appraisal of NRS by expert review groups and HTA bodies were reviewed. From the 686 studies included in the narrative synthesis, 48 critical appraisal tools were identified. Commonly used tools included the Newcastle-Ottawa Scale, the methodological index for NRS, and bespoke appraisal tools. Neither the Cochrane Handbook nor the Centre for Reviews and Dissemination recommends a particular instrument for the assessment of risk of bias in NRS, although Cochrane has recently developed their own NRS critical appraisal tool. Among HTA bodies, only the Canadian Agency for Drugs and Technologies in Health recommends use of a specific critical appraisal tool-SIGN 50 (for cohort or case-control studies). Several criteria including reporting, external validity, confounding, and power were examined. There is no consensus between HTA groups on the preferred appraisal tool. Reviewers should select from a suite of tools on the basis of the design of studies included in their review. © 2018 John Wiley & Sons, Ltd.

  10. CT fluoroscopy-guided renal tumour cutting needle biopsy: retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure.

    Science.gov (United States)

    Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

    2018-01-01

    To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. • CT fluoroscopy-guided renal tumour biopsy has a high diagnostic yield. • CT fluoroscopy-guided renal tumour biopsy is safe. • Small tumour size (≤1.5 cm) is a risk factor for diagnostic failure.

  11. Emotional and Utilitarian Appraisals of Moral Dilemmas Are Encoded in Separate Areas and Integrated in Ventromedial Prefrontal Cortex

    Science.gov (United States)

    Montaser-Kouhsari, Leila; Woodward, James; Rangel, Antonio

    2015-01-01

    Moral judgment often requires making difficult tradeoffs (e.g., is it appropriate to torture to save the lives of innocents at risk?). Previous research suggests that both emotional appraisals and more deliberative utilitarian appraisals influence such judgments and that these appraisals often conflict. However, it is unclear how these different types of appraisals are represented in the brain, or how they are integrated into an overall moral judgment. We addressed these questions using an fMRI paradigm in which human subjects provide separate emotional and utilitarian appraisals for different potential actions, and then make difficult moral judgments constructed from combinations of these actions. We found that anterior cingulate, insula, and superior temporal gyrus correlated with emotional appraisals, whereas temporoparietal junction and dorsomedial prefrontal cortex correlated with utilitarian appraisals. Overall moral value judgments were represented in an anterior portion of the ventromedial prefrontal cortex. Critically, the pattern of responses and functional interactions between these three sets of regions are consistent with a model in which emotional and utilitarian appraisals are computed independently and in parallel, and passed to the ventromedial prefrontal cortex where they are integrated into an overall moral value judgment. SIGNIFICANCE STATEMENT Popular accounts of moral judgment often describe it as a battle for control between two systems, one intuitive and emotional, the other rational and utilitarian, engaged in winner-take-all inhibitory competition. Using a novel fMRI paradigm, we identified distinct neural signatures of emotional and utilitarian appraisals and used them to test different models of how they compete for the control of moral behavior. Importantly, we find little support for competitive inhibition accounts. Instead, moral judgments resembled the architecture of simple economic choices: distinct regions represented emotional

  12. Emotional and Utilitarian Appraisals of Moral Dilemmas Are Encoded in Separate Areas and Integrated in Ventromedial Prefrontal Cortex.

    Science.gov (United States)

    Hutcherson, Cendri A; Montaser-Kouhsari, Leila; Woodward, James; Rangel, Antonio

    2015-09-09

    Moral judgment often requires making difficult tradeoffs (e.g., is it appropriate to torture to save the lives of innocents at risk?). Previous research suggests that both emotional appraisals and more deliberative utilitarian appraisals influence such judgments and that these appraisals often conflict. However, it is unclear how these different types of appraisals are represented in the brain, or how they are integrated into an overall moral judgment. We addressed these questions using an fMRI paradigm in which human subjects provide separate emotional and utilitarian appraisals for different potential actions, and then make difficult moral judgments constructed from combinations of these actions. We found that anterior cingulate, insula, and superior temporal gyrus correlated with emotional appraisals, whereas temporoparietal junction and dorsomedial prefrontal cortex correlated with utilitarian appraisals. Overall moral value judgments were represented in an anterior portion of the ventromedial prefrontal cortex. Critically, the pattern of responses and functional interactions between these three sets of regions are consistent with a model in which emotional and utilitarian appraisals are computed independently and in parallel, and passed to the ventromedial prefrontal cortex where they are integrated into an overall moral value judgment. Significance statement: Popular accounts of moral judgment often describe it as a battle for control between two systems, one intuitive and emotional, the other rational and utilitarian, engaged in winner-take-all inhibitory competition. Using a novel fMRI paradigm, we identified distinct neural signatures of emotional and utilitarian appraisals and used them to test different models of how they compete for the control of moral behavior. Importantly, we find little support for competitive inhibition accounts. Instead, moral judgments resembled the architecture of simple economic choices: distinct regions represented emotional

  13. Investment Decision Making: A Guide to Good Practice.

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

    This "good practice" guide is aimed at anyone in higher education in England who is involved in making decisions on investments. It focuses on the principles to be followed, rather than the techniques of appraisal. The guide outlines the steps for developing an outline business case and then refining it into a full business case for the…

  14. Disgust, Sadness, and Appraisal: Disgusted Consumers Dislike Food More Than Sad Ones

    Science.gov (United States)

    Motoki, Kosuke; Sugiura, Motoaki

    2018-01-01

    According to the affect-as-information framework, consumers base judgments on their feelings. Disgust is associated with two kinds of appraisal: one in which the consumer avoids and distances him/herself immediately from the object concerned, and another in which the consumer is disgusted due to contamination and impurities within the environment. The first instance indicates that disgust can decrease a consumer’s preference for a product, regardless of its category. In contrast, the second case suggests that a product’s degree of depreciation is greater in products vulnerable to contamination, such as foods. However, it remains largely unknown how incidental disgust affects product preferences in accordance with the two appraisal-related goals. The present research investigates how incidental disgust (as opposed to sadness, an equally valenced but distinct emotion of appraisal) influences consumer preferences for products with or without a risk of contamination. Twenty-four participants repeatedly judged foods or household products after seeing an emotional image (conveying disgust, sadness, or neutrality). Foods and household products are the two representative product categories in grocery stores, but only foods are associated with a risk of contamination. The results showed that incidental disgust led to negative evaluations of both types of products; however, compared to sadness, incidental disgust demonstrated a stronger negative effect on preference for foods than household products. These findings elucidate that disgust and the appraisal of contamination specifically devalue foods, and broaden the application of the appraisal-information framework in consumer settings. PMID:29467697

  15. Disgust, Sadness, and Appraisal: Disgusted Consumers Dislike Food More Than Sad Ones

    Directory of Open Access Journals (Sweden)

    Kosuke Motoki

    2018-02-01

    Full Text Available According to the affect-as-information framework, consumers base judgments on their feelings. Disgust is associated with two kinds of appraisal: one in which the consumer avoids and distances him/herself immediately from the object concerned, and another in which the consumer is disgusted due to contamination and impurities within the environment. The first instance indicates that disgust can decrease a consumer’s preference for a product, regardless of its category. In contrast, the second case suggests that a product’s degree of depreciation is greater in products vulnerable to contamination, such as foods. However, it remains largely unknown how incidental disgust affects product preferences in accordance with the two appraisal-related goals. The present research investigates how incidental disgust (as opposed to sadness, an equally valenced but distinct emotion of appraisal influences consumer preferences for products with or without a risk of contamination. Twenty-four participants repeatedly judged foods or household products after seeing an emotional image (conveying disgust, sadness, or neutrality. Foods and household products are the two representative product categories in grocery stores, but only foods are associated with a risk of contamination. The results showed that incidental disgust led to negative evaluations of both types of products; however, compared to sadness, incidental disgust demonstrated a stronger negative effect on preference for foods than household products. These findings elucidate that disgust and the appraisal of contamination specifically devalue foods, and broaden the application of the appraisal-information framework in consumer settings.

  16. Disgust, Sadness, and Appraisal: Disgusted Consumers Dislike Food More Than Sad Ones.

    Science.gov (United States)

    Motoki, Kosuke; Sugiura, Motoaki

    2018-01-01

    According to the affect-as-information framework, consumers base judgments on their feelings. Disgust is associated with two kinds of appraisal: one in which the consumer avoids and distances him/herself immediately from the object concerned, and another in which the consumer is disgusted due to contamination and impurities within the environment. The first instance indicates that disgust can decrease a consumer's preference for a product, regardless of its category. In contrast, the second case suggests that a product's degree of depreciation is greater in products vulnerable to contamination, such as foods. However, it remains largely unknown how incidental disgust affects product preferences in accordance with the two appraisal-related goals. The present research investigates how incidental disgust (as opposed to sadness, an equally valenced but distinct emotion of appraisal) influences consumer preferences for products with or without a risk of contamination. Twenty-four participants repeatedly judged foods or household products after seeing an emotional image (conveying disgust, sadness, or neutrality). Foods and household products are the two representative product categories in grocery stores, but only foods are associated with a risk of contamination. The results showed that incidental disgust led to negative evaluations of both types of products; however, compared to sadness, incidental disgust demonstrated a stronger negative effect on preference for foods than household products. These findings elucidate that disgust and the appraisal of contamination specifically devalue foods, and broaden the application of the appraisal-information framework in consumer settings.

  17. Quality Appraisal of Single-Subject Experimental Designs: An Overview and Comparison of Different Appraisal Tools

    Science.gov (United States)

    Wendt, Oliver; Miller, Bridget

    2012-01-01

    Critical appraisal of the research literature is an essential step in informing and implementing evidence-based practice. Quality appraisal tools that assess the methodological quality of experimental studies provide a means to identify the most rigorous research suitable for evidence-based decision-making. In single-subject experimental research,…

  18. Potential of a Pharmacogenetic-Guided Algorithm to Predict Optimal Warfarin Dosing in a High-Risk Hispanic Patient

    Directory of Open Access Journals (Sweden)

    Dagmar F. Hernandez-Suarez MD

    2016-12-01

    Full Text Available Deep abdominal vein thrombosis is extremely rare among thrombotic events secondary to the use of contraceptives. A case to illustrate the clinical utility of ethno-specific pharmacogenetic testing in warfarin management of a Hispanic patient is reported. A 37-year-old Hispanic Puerto Rican, non-gravid female with past medical history of abnormal uterine bleeding on hormonal contraceptive therapy was evaluated for abdominal pain. Physical exam was remarkable for unspecific diffuse abdominal tenderness, and general initial laboratory results—including coagulation parameters—were unremarkable. A contrast-enhanced computed tomography showed a massive thrombosis of the main portal, splenic, and superior mesenteric veins. On admission the patient was started on oral anticoagulation therapy with warfarin at 5 mg/day and low-molecular-weight heparin. The prediction of an effective warfarin dose of 7.5 mg/day, estimated by using a recently developed pharmacogenetic-guided algorithm for Caribbean Hispanics, coincided with the actual patient’s warfarin dose to reach the international normalized ratio target. We speculate that the slow rise in patient’s international normalized ratio observed on the initiation of warfarin therapy, the resulting high risk for thromboembolic events, and the required warfarin dose of 7.5 mg/day are attributable in some part to the presence of the NQO1 *2 (g.559C>T, p.P187S polymorphism, which seems to be significantly associated with resistance to warfarin in Hispanics. By adding genotyping results of this novel variant, the predictive model can inform clinicians better about the optimal warfarin dose in Caribbean Hispanics. The results highlight the potential for pharmacogenetic testing of warfarin to improve patient care.

  19. Risks of Being Malignant or High Risk and Their Characteristics in Breast Lesions 20 mm or Larger After Benign Results on Ultrasonography-Guided 14-Gauge Core Needle Biopsy.

    Science.gov (United States)

    Moon, Hee Jung; Kim, Min Jung; Yoon, Jung Hyun; Kim, Eun-Kyung

    2016-06-01

    The malignancy risk, risk of being high-risk lesions after benign results on ultrasonography-guided 14-gauge core needle biopsies (US-CNBs), and their characteristics in breast lesions of 20 mm or greater were investigated. Eight hundred forty-seven breast lesions with benign results on US-CNB were classified as benign, high risk, and malignant through excision and clinical follow-up. The risks of being malignant or high risk were analyzed in all lesions, lesions 20 to 29 mm, and lesions 30 mm or greater. Their clinicopathological characteristics were evaluated. Of 847, 18 (2.1%) were malignant, 53 (6.3%) were high-risk lesions, and 776 (91.6%) were benign. Of 18 malignancies, 6 (33.3%) were malignant phyllodes tumors and 12 (66.7%) were carcinomas. In benign lesions 20 to 29 mm, risks of being malignant or high risk were 1.6% (9 of 566) and 4.4% (25 of 566). In 281 lesions 30 mm or greater, the risks of being malignant or high risk were 3.2% and 10%. The risk of being high risk in lesions 30 mm or greater was 10%, significantly higher than 4.4% of lesions 20 to 29 mm (P = 0.002). Excision can be considered in lesions measuring 20 mm or larger because of the 2.1% malignancy risk and the 6.3% risk of being high-risk lesions despite benign results on US-CNB. Excision should be considered in lesions measuring 30 mm or larger because of the 3.2% malignancy risk and the 10% risk of being high-risk lesions.

  20. Managing employees’ talk about problems in work in performance appraisal interviews

    DEFF Research Database (Denmark)

    Scheuer, Jann

    2014-01-01

    Performance appraisal interviews are carried out on the basis of known-in-advance written materials such as preparation forms and interview guides. This article demonstrates how participants manage interviews by following a question–answer–response format fit to address interview guide entries one...... norms emanating from literature on management communication. Results obtained in interviews are put down in writing along the way and subsequently summarized in documents to be signed by both participants, that is, employee and supervisor. The article demonstrates how participants use positive...

  1. Towards a nanorisk appraisal framework

    DEFF Research Database (Denmark)

    Senjen, Rye; Hansen, Steffen Foss

    2011-01-01

    The article discusses, in the context of nanotechnology, whether current concepts of chemical risk assessment can be used to assess nanorisk. Nanorisk can be defined from the narrow (eco)toxicological perspective to the broader sense to include societal/cultural impacts or even to the fundamental...... philosophical level, i.e. questioning societies need for the technology. We outline here the limitations of chemical risk assessment and other recent proposed risk governance paradigms in relation to nanotechnology and nanomaterials, including its inability to include societal risks (ownership, privacy......, security, nanodivide,1 convergence of nano-, bio-, etc.) and metaphysical risk (including the lay persons perspective on the risks of nanotechnology). Finally, we outline the fundamental principles and criteria that an alternative comprehensive framework should be based on....

  2. Towards a nanorisk appraisal framework

    OpenAIRE

    Senjen , Rye; Hansen , Steffen Foss

    2011-01-01

    The paper discusses in the context of nanotechnology whether current concepts of chemical risk assessment can be used to assess nanorisk. Nanorisk can be defined from the narrow (eco) toxicological perspective to the broader sense to include societal/cultural impacts or even to the fundamental philosophical level i.e. questioning societies need for the technology. We outline here the limitations of chemical risk assessment and other recent proposed risk governance paradigms in relation to nan...

  3. Lobular neoplasia detected in MRI-guided core biopsy carries a high risk for upgrade: a study of 63 cases from four different institutions

    Science.gov (United States)

    Khoury, Thaer; Kumar, Prasanna R; Li, Zaibo; Karabakhtsian, Rouzan G; Sanati, Souzan; Chen, Xiwei; Wang, Dan; Liu, Song; Reig, Beatriu

    2017-01-01

    There are certain criteria to recommend surgical excision for lobular neoplasia diagnosed in mammographically detected core biopsy. The aims of this study are to explore the rate of upgrade of lobular neoplasia detected in magnetic resonance imaging (MRI)-guided biopsy and to investigate the clinicopathological and radiological features that could predict upgrade. We reviewed 1655 MRI-guided core biopsies yielding 63 (4%) cases of lobular neoplasia. Key clinical features were recorded. MRI findings including mass vs non-mass enhancement and the reason for biopsy were also recorded. An upgrade was defined as the presence of invasive carcinoma or ductal carcinoma in situ in subsequent surgical excision. The overall rate of lobular neoplasia in MRI-guided core biopsy ranged from 2 to 7%, with an average of 4%. A total of 15 (24%) cases had an upgrade, including 5 cases of invasive carcinoma and 10 cases of ductal carcinoma in situ. Pure lobular neoplasia was identified in 34 cases, 11 (32%) of which had upgrade. In this group, an ipsilateral concurrent or past history of breast cancer was found to be associated with a higher risk of upgrade (6/11, 55%) than contralateral breast cancer (1 of 12, 8%; P = 0.03). To our knowledge, this is the largest series of lobular neoplasia diagnosed in MRI-guided core biopsy. The incidence of lobular neoplasia is relatively low. Lobular neoplasia detected in MRI-guided biopsy carries a high risk for upgrade warranting surgical excision. However, more cases from different types of institutions are needed to verify our results. PMID:26564004

  4. User's guide for PRISM (Plant Risk Status Information Management System) Arkansas Nuclear One-Unit 1: Volume 1, Program for inspectors

    International Nuclear Information System (INIS)

    Campbell, D.J.; Guthrie, V.H.; Kirchner, J.R.; Kirkman, J.Q.; Paula, H.M.; Ellison, B.C.; Dycus, F.M.; Farquharson, J.A.; Flanagan, G.F.

    1988-03-01

    This user's guide is a two-volume document designed to teach NRC inspectors and NRC regulators how to access probabilistic risk assessment information from the two Plant Risk Status Information Management System (PRISIM) programs developed for Arkansas Nuclear One -- Unit One (ANO-1). This document, Volume 1, describes how the PRA information available in Version 1.0 of PRISIM is useful for planning inspections. Using PRISIM, inspectors can quickly access PRA information and use that information to update risk analysis results, reflecting a plant's status at any particular time. Both volumes are stand-alone documents, and each volume presents several sample computer sessions designed to lead the user through a variety of PRISIM applications used to obtain PRA-related information for monitoring and controlling plant risk

  5. User's guide for PRISM (Plant Risk Status Information Management System) Arkansas Nuclear One-Unit 1: Volume 1, Program for inspectors

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, D.J.; Guthrie, V.H.; Kirchner, J.R.; Kirkman, J.Q.; Paula, H.M.; Ellison, B.C.; Dycus, F.M.; Farquharson, J.A.; Flanagan, G.F.

    1988-03-01

    This user's guide is a two-volume document designed to teach NRC inspectors and NRC regulators how to access probabilistic risk assessment information from the two Plant Risk Status Information Management System (PRISIM) programs developed for Arkansas Nuclear One -- Unit One (ANO-1). This document, Volume 1, describes how the PRA information available in Version 1.0 of PRISIM is useful for planning inspections. Using PRISIM, inspectors can quickly access PRA information and use that information to update risk analysis results, reflecting a plant's status at any particular time. Both volumes are stand-alone documents, and each volume presents several sample computer sessions designed to lead the user through a variety of PRISIM applications used to obtain PRA-related information for monitoring and controlling plant risk.

  6. [Evaluation of Wits appraisal with superimposition method].

    Science.gov (United States)

    Xu, T; Ahn, J; Baumrind, S

    1999-07-01

    To compare the conventional Wits appraisal with superimposed Wits appraisal in evaluation of sagittal jaw relationship change between pre and post orthodontic treatment. The sample consists of 48-case pre and post treatment lateral head films. Computerized digitizing is used to get the cephalometric landmarks and measure conventional Wits value, superimposed Wits value and ANB angle. The correlation analysis among these three measures was done by SAS statistical package. The change of ANB angle has higher correlation with the change of superimposed Wits than that of the conventional Wits. The r-value is as high as 0.849 (P < 0.001). The superimposed Wits appraisal reflects the change of sagittal jaw relationship more objectively than the conventional one.

  7. Financial capital appraisal in the system of industrial enterprise development management

    Directory of Open Access Journals (Sweden)

    Akhtyamov M.K.

    2017-01-01

    Full Text Available The paper studies an objective appraisal of financial capital value in industrial enterprise development management. The authors draw attention to a limited scope of work in the area of financial management under application of a traditional approach to appraisal of enterprise financial capital value and describe a new advanced approach to this problem solving. The paper focuses on reformation of balance sheet statement, in which economic benefit and reserves of financial capital are included by the authors; the author’s methodology for appraisal of financial capital value and its application sphere are denoted. In accordance with a case study, we confirm possibility of more accurate appraisal of enterprise investment opportunities by taking into account economic benefit from reserve of liquidity and borrowing capacity, which increases financial capital value. The practical approval results affirm that application of proprietary methodology for appraisal of financial capital and its elements has practical utility in solving problems of determination of required amount of attracted foreign investments and problems of determination of fair value of company take of an external investor, which are aimed at minimizing risks of corporate ownership dissemination and improving managerial efficiency of an industrial enterprise.

  8. A new composite decision support framework for strategic and sustainable transport appraisals

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn; Salling, Kim Bang

    2015-01-01

    . The proposed framework is based on the use of cost-benefit analysis featuring feasibility risk assessment in combination with multi-criteria decision analysis and is supported by the concept of decision conferencing. The framework is applied for a transport related case study dealing with the complex decision....... The outcome of the case study demonstrates the decision making framework as a valuable decision support system (DSS), and it is concluded that appraisals of transport projects can be effectively supported by the use of the DSS. Finally, perspectives of the future modelling work are given.......This paper concerns the development of a new decision support framework for the appraisal of transport infrastructure projects. In such appraisals there will often be a need for including both conventional transport impacts as well as criteria of a more strategic and/or sustainable character...

  9. Performance appraisal and merit recognition exercise 2007

    CERN Multimedia

    HR Department

    2006-01-01

    The 2007 performance appraisal and merit recognition exercise will start in the usual way with annual interviews between staff and their supervisors. This year, these interviews should be held in the period from 8 January 2007 to 16 April 2007. Interconnection with the 5-yearly review, a number of modifications to the procedures relating to the performance appraisal and merit recognition are currently under study. Administrative Circular No. 26 (Procedures governing the Career Development of Staff Members) and the electronic MAPS form in EDH are being reviewed and will be available from January onwards. HR Department will shortly provide further information on this subject. Human Resources Department Tel. 73566

  10. Religion, Psychology and Globalisation Process: Attitudinal Appraisal

    Directory of Open Access Journals (Sweden)

    Emmanuel Orok Duke

    2016-10-01

    Full Text Available A key consequence of globalisation is the integrative approach to reality whereby emphasis is placed on interdependence. Religion being an expression of human culture is equally affected by this cultural revolution. The main objective of this paper is to examine how religious affiliation, among Christians, influences attitudes towards the application of psychological sciences to the assuagement of human suffering. The sociological theory of structural functionalism was deployed to explain attitudinal appraisal. Ethnographic methodology, through quantitative analysis of administered questionnaire, was also used. The study reveals that religious tenets largely shape attitudinal appraisal and redefine the borders of globalisation’s metanarratives.

  11. CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

    International Nuclear Information System (INIS)

    Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu

    2018-01-01

    To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

  12. CT fluoroscopy-guided renal tumour cutting needle biopsy. Retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

    Energy Technology Data Exchange (ETDEWEB)

    Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Sakurai, Jun; Masaoka, Yoshihisa; Gobara, Hideo; Kanazawa, Susumu [Okayama University Medical School, Department of Radiology, Okayama (Japan)

    2018-01-15

    To evaluate retrospectively the diagnostic yield, safety, and risk factors for diagnostic failure of computed tomography (CT) fluoroscopy-guided renal tumour biopsy. Biopsies were performed for 208 tumours (mean diameter 2.3 cm; median diameter 2.1 cm; range 0.9-8.5 cm) in 199 patients. One hundred and ninety-nine tumours were ≤4 cm. All 208 initial procedures were divided into diagnostic success and failure groups. Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for diagnostic failure. After performing 208 initial and nine repeat biopsies, 180 malignancies and 15 benign tumours were pathologically diagnosed, whereas 13 were not diagnosed. In 117 procedures, 118 Grade I and one Grade IIIa adverse events (AEs) occurred. Neither Grade ≥IIIb AEs nor tumour seeding were observed within a median follow-up period of 13.7 months. Logistic regression analysis revealed only small tumour size (≤1.5 cm; odds ratio 3.750; 95% confidence interval 1.362-10.326; P = 0.011) to be a significant risk factor for diagnostic failure. CT fluoroscopy-guided renal tumour biopsy is a safe procedure with a high diagnostic yield. A small tumour size (≤1.5 cm) is a significant risk factor for diagnostic failure. (orig.)

  13. Statistical analysis of the uncertainty related to flood hazard appraisal

    Science.gov (United States)

    Notaro, Vincenza; Freni, Gabriele

    2015-12-01

    The estimation of flood hazard frequency statistics for an urban catchment is of great interest in practice. It provides the evaluation of potential flood risk and related damage and supports decision making for flood risk management. Flood risk is usually defined as function of the probability, that a system deficiency can cause flooding (hazard), and the expected damage, due to the flooding magnitude (damage), taking into account both the exposure and the vulnerability of the goods at risk. The expected flood damage can be evaluated by an a priori estimation of potential damage caused by flooding or by interpolating real damage data. With regard to flood hazard appraisal several procedures propose to identify some hazard indicator (HI) such as flood depth or the combination of flood depth and velocity and to assess the flood hazard corresponding to the analyzed area comparing the HI variables with user-defined threshold values or curves (penalty curves or matrixes). However, flooding data are usually unavailable or piecemeal allowing for carrying out a reliable flood hazard analysis, therefore hazard analysis is often performed by means of mathematical simulations aimed at evaluating water levels and flow velocities over catchment surface. As results a great part of the uncertainties intrinsic to flood risk appraisal can be related to the hazard evaluation due to the uncertainty inherent to modeling results and to the subjectivity of the user defined hazard thresholds applied to link flood depth to a hazard level. In the present work, a statistical methodology was proposed for evaluating and reducing the uncertainties connected with hazard level estimation. The methodology has been applied to a real urban watershed as case study.

  14. ORIGINAL Is the Role of Teacher Performance Appraisal in Ethiopia ...

    African Journals Online (AJOL)

    aware of the purposes of the current teacher performance appraisal. However, the ... building, and expensive equipment (Daniel,. 2009). ... development of teachers, teachers' job ...... Appraisers' tend to rate high a person who is similar.

  15. Effect of Natriuretic Peptide-Guided Therapy on Hospitalization or Cardiovascular Mortality in High-Risk Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.

    Science.gov (United States)

    Felker, G Michael; Anstrom, Kevin J; Adams, Kirkwood F; Ezekowitz, Justin A; Fiuzat, Mona; Houston-Miller, Nancy; Januzzi, James L; Mark, Daniel B; Piña, Ileana L; Passmore, Gayle; Whellan, David J; Yang, Hongqiu; Cooper, Lawton S; Leifer, Eric S; Desvigne-Nickens, Patrice; O'Connor, Christopher M

    2017-08-22

    The natriuretic peptides are biochemical markers of heart failure (HF) severity and predictors of adverse outcomes. Smaller studies have evaluated adjusting HF therapy based on natriuretic peptide levels ("guided therapy") with inconsistent results. To determine whether an amino-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided treatment strategy improves clinical outcomes vs usual care in high-risk patients with HF and reduced ejection fraction (HFrEF). The Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) study was a randomized multicenter clinical trial conducted between January 16, 2013, and September 20, 2016, at 45 clinical sites in the United States and Canada. This study planned to randomize 1100 patients with HFrEF (ejection fraction ≤40%), elevated natriuretic peptide levels within the prior 30 days, and a history of a prior HF event (HF hospitalization or equivalent) to either an NT-proBNP-guided strategy or usual care. Patients were randomized to either an NT-proBNP-guided strategy or usual care. Patients randomized to the guided strategy (n = 446) had HF therapy titrated with the goal of achieving a target NT-proBNP of less than 1000 pg/mL. Patients randomized to usual care (n = 448) had HF care in accordance with published guidelines, with emphasis on titration of proven neurohormonal therapies for HF. Serial measurement of NT-proBNP testing was discouraged in the usual care group. The primary end point was the composite of time-to-first HF hospitalization or cardiovascular mortality. Prespecified secondary end points included all-cause mortality, total hospitalizations for HF, days alive and not hospitalized for cardiovascular reasons, the individual components on the primary end point, and adverse events. The data and safety monitoring board recommended stopping the study for futility when 894 (median age, 63 years; 286 [32%] women) of the planned 1100 patients had been enrolled with

  16. The System of Employee Appraisal in a Company

    OpenAIRE

    Vaverová, Lucie

    2011-01-01

    This bachelor study called "The System of Employee Appraisal in a Company" deals with a general subscription of a personal process "Employee appraisal". It describes the principles of the system of employee appraisal and also covers the conditions necessary for its efficiency and operation. The bachelor study is focused on the system of employee appraisal centrally implemented in company ČEZ, a. s. This system is analyzed and compared with generally stated theoretical principles. The study in...

  17. Synthesis strategy: building a culturally sensitive mid-range theory of risk perception using literary, quantitative, and qualitative methods.

    Science.gov (United States)

    Siaki, Leilani A; Loescher, Lois J; Trego, Lori L

    2013-03-01

    This article presents a discussion of development of a mid-range theory of risk perception. Unhealthy behaviours contribute to the development of health inequalities worldwide. The link between perceived risk and successful health behaviour change is inconclusive, particularly in vulnerable populations. This may be attributed to inattention to culture. The synthesis strategy of theory building guided the process using three methods: (1) a systematic review of literature published between 2000-2011 targeting perceived risk in vulnerable populations; (2) qualitative and (3) quantitative data from a study of Samoan Pacific Islanders at high risk of cardiovascular disease and diabetes. Main concepts of this theory include risk attention, appraisal processes, cognition, and affect. Overarching these concepts is health-world view: cultural ways of knowing, beliefs, values, images, and ideas. This theory proposes the following: (1) risk attention varies based on knowledge of the health risk in the context of health-world views; (2) risk appraisals are influenced by affect, health-world views, cultural customs, and protocols that intersect with the health risk; (3) strength of cultural beliefs, values, and images (cultural identity) mediate risk attention and risk appraisal influencing the likelihood that persons will engage in health-promoting behaviours that may contradict cultural customs/protocols. Interventions guided by a culturally sensitive mid-range theory may improve behaviour-related health inequalities in vulnerable populations. The synthesis strategy is an intensive process for developing a culturally sensitive mid-range theory. Testing of the theory will ascertain its usefulness for reducing health inequalities in vulnerable groups. © 2012 Blackwell Publishing Ltd.

  18. High and intermediate risk prostate cancer treated with three-dimensional computed tomography-guided brachytherapy: 2-8-year follow-up

    International Nuclear Information System (INIS)

    Koutrouvelis, Panos G.; Gillenwater, Jay; Lailas, Niko; Hendricks, Fred; Katz, Stuart; Sehn, James; Gil-Montero, Guillermo; Khawand, Nabil

    2003-01-01

    Purpose: To report post-brachytherapy results in high and intermediate risk patients of prostatic adenocarcinoma. Methods and materials: From June 1994 to June 2000, 356 consecutive high and intermediate risk patients were treated with three-dimensional computed tomography-guided stereotactic pararectal brachytherapy. The age was 42-90 years (median, 68 years), the initial prostate volume was 14-180 cm 3 (median, 59 cm 3 ), and initial PSA was 1.7-143 ng/ml (median, 10.5 ng/ml). Three hundred forty-eight patients were available for follow-up for 2 - 8 years (median, 4.5 years). Two hundred eighty patients had one or more high risk factors (PSA >20 ng/ml, Gleason>7, Stage T2b, T3a, or T3b). Sixty-eight patients had only one intermediate risk factor (PSA 10-20 ng/ml or Gleason=7). Patients with both intermediate risks were considered high risk. The high-risk group was further stratified into subgroups with similar risk profile. A dose of 144 Gy with 125 I or 120 Gy with 103 Pd was achieved in 90-100% of the target. Thirty (30) patients (9%) had prior transurethral resection and 229 (64%) were treated with 3 months neoadjuvant androgen ablation. Results: Biochemical disease-free survival was 92% of 280 high risk patients and 96% of 68 intermediate risk patients. Seven patients (2%) required catheterization during the first year for urinary retention, nine patients (3%) required TUR 1-3 years post-implant, three patients (1%) developed grade 1 or 2 incontinence after a second TUR, and four patients (1%) developed grade 3 rectal complications. Conclusion: This method produces a high level of biochemical control 2-8 years (median 4.5 years). Morbidity is acceptable regardless of risk profile or initial prostate volume

  19. 12 CFR 528.2a - Nondiscriminatory appraisal and underwriting.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Nondiscriminatory appraisal and underwriting. 528.2a Section 528.2a Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY NONDISCRIMINATION REQUIREMENTS § 528.2a Nondiscriminatory appraisal and underwriting. (a) Appraisal. No savings...

  20. Problems of Clinical Nurse Performance Appraisal System: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Nasrin Nikpeyma

    2014-03-01

    Conclusion: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.

  1. Characteristics of Appraisal Systems That Promote Job Satisfaction of Teachers

    Science.gov (United States)

    Deneire, Alexia; Vanhoof, Jan; Faddar, Jerich; Gijbels, David; Van Petegem, Peter

    2014-01-01

    This article examines if and how characteristics of appraisal systems used for secondary school teachers affect job satisfaction. Using multilevel analyses on data of 3 473 teachers in Flanders (Belgium), we found that appraisals with a developmental purpose and appraisals perceived as being a fair judgement, both have a positive impact on job…

  2. Handbook for Conducting Standard CMMI Appraisal Method for Process Improvement (SCAMPI) B and C Appraisals, Version 1.1

    National Research Council Canada - National Science Library

    Hayes, Will; Miluk, Gene; Ming, Lisa; Glover, Margaret; Bisgrove, Jane; Cort, Corrine; Penn, Lynn; Jacobson, Nils; Beynon, Don; Allgood, Bruce

    2005-01-01

    The Standard CMMI Appraisal Method for Process Improvement (SCAMPI) provides a well-defined, publicly available set of methodologies for providing appraisals relative to Capability Maturity Model (trademark) Integration (CMMI) models...

  3. Comparative Risk Assessment to Inform Adaptation Priorities for the Natural Environment: Observations from the First UK Climate Change Risk Assessment

    Directory of Open Access Journals (Sweden)

    Iain Brown

    2015-11-01

    Full Text Available Risk assessment can potentially provide an objective framework to synthesise and prioritise climate change risks to inform adaptation policy. However, there are significant challenges in the application of comparative risk assessment procedures to climate change, particularly for the natural environment. These challenges are evaluated with particular reference to the first statutory Climate Change Risk Assessment (CCRA and evidence review procedures used to guide policy for the UK government. More progress was achieved on risk identification, screening and prioritisation compared to risk quantification. This was due to the inherent complexity and interdependence of ecological risks and their interaction with socio-economic drivers as well as a climate change. Robust strategies to manage risk were identified as those that coordinate organisational resources to enhance ecosystem resilience, and to accommodate inevitable change, rather than to meet specific species or habitats targets. The assessment also highlighted subjective and contextual components of risk appraisal including ethical issues regarding the level of human intervention in the natural environment and the proposed outcomes of any intervention. This suggests that goals for risk assessment need to be more clearly explicated and assumptions on tolerable risk declared as a primer for further dialogue on expectations for managed outcomes. Ecosystem-based adaptation may mean that traditional habitats and species conservation goals and existing regulatory frameworks no longer provide the best guide for long-term risk management thereby challenging the viability of some existing practices.

  4. Evaluating Housing Problems through Participatory Rural Appraisal ...

    African Journals Online (AJOL)

    Lokoja, a medium sized community in the Middle Belt of Nigeria experienced a massive influx of population in the last twelve years. This study examined housing problems that resulted thereafter. Through a participatory appraisal using group discussion and brainstorming, transect walk and matrix ranking, a sampled ...

  5. Evaluating Housing Problems through Participatory Rural Appraisal ...

    African Journals Online (AJOL)

    Nekky Umera

    Whether in research, development or policy analysis, in social, forestry, irrigation ... Action, Participatory Rural Appraisal involves interaction between the planners and the ..... Park, Obasanjo Layout, the Kogi People Consumer Shops as well as the confluence .... The institutional arrangements under which a person gains ...

  6. Energy considerations in real estate appraising

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-04-01

    Purposes of the seminar on the subject, the basis of this report, include the following: (1) to provide the appraiser an opportunity to learn how to identify and analyze the actual physical consumption of energy as well as the energy-saving improvements in properties under appraisal and in comparable sale and lease properties; (2) to help the appraiser in developing methods to keep meaningful records on the energy consumption of subject and comparable properties so as to observe in an orderly way the behavior of buyers, sellers, tenants, landlords, borrowers, and lenders with respect to energy efficiency; and (3) to assist the appraiser in learning to measure the relative sensitivities of the various segments of the market to energy considerations as indicated by differences in sale prices and rentals. To achieve these goals, the seminar employed two case studies, one for a angle-family residence and one for a multi-family building, both in Topeka, Kansas. The case studies are for illustrative purposes only; in applying the lessons of the seminar to their own daily work, students should be careful to develop information that is pertinent to their subject properties and subject areas and not rely on any of the particulars laid out in the cases.

  7. Implementing performance appraisal : Exploring the employee experience

    NARCIS (Netherlands)

    Farndale, E.; Kelliher, C.

    2013-01-01

    Line managers play an important role as implementers of performance appraisal, enacting procedures designed by the HR function. However, the actual employee experience of these procedures (which may differ from how they were intended or enacted) in terms of perceptions of justice in the process is

  8. Embodied Appraisals and Non-emotional States

    Czech Academy of Sciences Publication Activity Database

    Hvorecký, Juraj

    2010-01-01

    Roč. 20, č. 3 (2010), s. 215-223 ISSN 1210-3055 R&D Projects: GA AV ČR(CZ) KJB900090802 Institutional research plan: CEZ:AV0Z90090514 Keywords : embodied appraisal * non-emotional mental states * valence * emotion Subject RIV: AA - Philosophy ; Religion

  9. Appraisal and financing of electric power projects

    International Nuclear Information System (INIS)

    Sheehan, R.H.

    1975-01-01

    This paper starts with the origin, nature and functions of the World Bank Group, reviews the past lending, describes the criteria used by the Bank in its power project appraisals, discusses the Bank's views on nuclear power, and concludes with a look at the probable future sources of financing of electrical expansion in the less developed countries. (orig./UA) [de

  10. 7 CFR 1955.128 - Appraisers.

    Science.gov (United States)

    2010-01-01

    ... type of properties (such as large farms and business property) requiring valuation. For Farmer Programs... REGULATIONS (CONTINUED) PROPERTY MANAGEMENT Disposal of Inventory Property Use of Contractors to Dispose of Inventory Property § 1955.128 Appraisers. (a) Real property. The State Director may authorize the County...

  11. Intelligence Defined and Undefined: A Relativistic Appraisal

    Science.gov (United States)

    Wechsler, David

    1975-01-01

    Major reasons for the continuing divergency of opinion as regards the nature and meaning of intelligence are examined. An appraisal of intelligence as a relative concept is proposed which advocates the necessity of specifying the reference systems to which a statement about intelligence refers. (EH)

  12. Evaluating Library Staff: A Performance Appraisal System.

    Science.gov (United States)

    Belcastro, Patricia

    This manual provides librarians and library managers with a performance appraisal system that measures staff fairly and objectively and links performance to the goals of the library. The following topics are addressed: (1) identifying expectations for quality service or standards of performance; (2) the importance of a library's code of service,…

  13. Elective abdominal hysterectomy: Appraisal of indications and ...

    African Journals Online (AJOL)

    of hysterectomy did not occur until the 19th century, earlier attempts are known. Some references to hysterectomy date back to 5th century BC, in the time of Hippocrates. In. 1600, Schenck of Grabenberg cataloged 26 cases of vaginal hysterectomy in Europe.[2]. Elective abdominal hysterectomy: Appraisal of indications and.

  14. Understanding cohort differences in appraisals of reconstruction ...

    African Journals Online (AJOL)

    Understanding cohort differences in appraisals of reconstruction priorities of mental health systems in postconflict Liberia. ... Conclusion: This study provides additional support for the premise that the utilization of ... of Liberians and that there are differences in preferences across groups. ... AJOL African Journals Online.

  15. 78 FR 31924 - Appraisal Subcommittee; Policy Statements

    Science.gov (United States)

    2013-05-28

    ... financial institutions regulatory agency engages in, contracts for, or regulates; and b) requires the... officer, director, employee or agent of a federally regulated financial institution would not be permitted... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS13-13] Appraisal Subcommittee...

  16. United Nations and multilateralism: appraising USA's unilateralism ...

    African Journals Online (AJOL)

    Multilateralism as symbolized by the United Nations Organization, seems to have come under threat today, and nowhere is this more evident than in the United States-United Nations relations particularly in the area of military interventions around the world. The aim of this paper is to appraise the practice of the principle of ...

  17. 36 CFR 254.9 - Appraisals.

    Science.gov (United States)

    2010-07-01

    ....9 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LANDOWNERSHIP... contributory value of any interest in land such as water rights, minerals, or timber, to the extent they are... the physical characteristics of the land being appraised; a statement of all encumbrances; title...

  18. An Integrative Review of Pediatric Fall Risk Assessment Tools.

    Science.gov (United States)

    DiGerolamo, Kimberly; Davis, Katherine Finn

    Patient fall prevention begins with accurate risk assessment. However, sustained improvements in prevention and quality of care include use of validated fall risk assessment tools (FRATs). The goal of FRATs is to identify patients at highest risk. Adult FRATs are often borrowed from to create tools for pediatric patients. Though factors associated with pediatric falls in the hospital setting are similar to those in adults, such as mobility, medication use, and cognitive impairment, adult FRATs and the factors associated with them do not adequately assess risk in children. Articles were limited to English language, ages 0-21years, and publish date 2006-2015. The search yielded 22 articles. Ten were excluded as the population was primarily adult or lacked discussion of a FRAT. Critical appraisal and findings were synthesized using the Johns Hopkins Nursing evidence appraisal system. Twelve articles relevant to fall prevention in the pediatric hospital setting that discussed fall risk assessment and use of a FRAT were reviewed. Comparison between and accuracy of FRATs is challenged when different classifications, definitions, risk stratification, and inclusion criteria are used. Though there are several pediatric FRATs published in the literature, none have been found to be reliable and valid across institutions and diverse populations. This integrative review highlights the importance of choosing a FRAT based on an institution's identified risk factors and validating the tool for one's own patient population as well as using the tool in conjunction with nursing clinical judgment to guide interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Collegiate Drug Management Guide.

    Science.gov (United States)

    Janosik, Steven M.; Anderson, David S.

    A checklist to help colleges and universities reevaluate their policies and procedures regarding drug use among college students is presented. It is designed to supplement the "Collegiate Alcohol Risk Assessment Guide." In this guide drugs other than alcohol are of concern, although alcohol is viewed by many as the "drug of choice" among college…

  20. The Challenge of Integrating OHS into Industrial Project Risk Management: Proposal of a Methodological Approach to Guide Future Research (Case of Mining Projects in Quebec, Canada

    Directory of Open Access Journals (Sweden)

    Adel Badri

    2015-06-01

    Full Text Available Although risk management tools are put to good use in many industrial sectors, some large projects have been met with numerous problems due to failure to take occupational health and safety (OHS into consideration. In spite of the high level of risk and uncertainty associated with many industrial projects, the number of studies of methods for managing all known risks systematically remains small. Under effervescent economic conditions, industries must meet several challenges associated with frequent project start-ups. In highly complex and uncertain environments, rigorous management of risk remains indispensable for avoiding threats to the success of projects. Many businesses seek continually to create and improve integrated approaches to risk management. This article puts into perspective the complexity of the challenge of integrating OHS into industrial project risk management. A conceptual and methodological approach is proposed to guide future research focused on meeting this challenge. The approach is based on applying multi-disciplinary research modes to a complex industrial context in order to identify all scenarios likely to contain threats to humans or the environment. A case study is used to illustrate the potential of the proposed approach for application and its contribution to meeting the challenge of taking OHS into consideration. On-site researchers were able to develop a new approach that helped two mining companies in Quebec (Canada to achieve successful integration of OHS into expansion projects.

  1. The importance of coping, threat appraisal, and beliefs in understanding and responding to fear of victimization: applications to a male prisoner sample.

    Science.gov (United States)

    Ireland, Jane L

    2011-08-01

    The current study explores conceptualizations of victimization by men, focusing on threat appraisal, coping appraisal, and beliefs, and seeking to apply protection motivation theory, the applied fear response model, and social cognition. Five hundred and sixty-six male prisoners, comprising adults and adolescents, completed a measure of victimization and perpetration (DIPC-SCALED) and of fear, appraisal, and beliefs (TAB). It was predicted that increased threat appraisal and ineffective coping appraisal would predict increased fear of victimization, particularly among the mutual perpetrator/victim group. This group was expected to select strategies for managing the threat of victimization, which carried more risk to them (e.g., such as an aggressive reaction) and to present with beliefs supporting the use of aggression as a response to victimization. Fear of victimization was predicted by threat and coping appraisal although the deficit for victims appeared in coping appraisal only. Mutual perpetrator/victims presented with a specific difficulty in appraising their ability to cope with threat. Differences in beliefs supporting an aggressive response to threat were also noted across perpetrator and/or victimization groups. The article concludes by outlining the implications for theory and clinical practice.

  2. How Should an Effective Performance Appraisal Be: EFL Teachers’ Perspective

    Directory of Open Access Journals (Sweden)

    Holi Ibrahim Holi Ali

    2012-11-01

    Full Text Available This study is set to examine EFL teachers’ perceptions, views about what makes an effective performance appraisal system by adopting a quantitative survey design for data collection. A total number of 45 college instructors in the Sultanate of Oman responded to survey on: how is an effective performance appraisal perceived by EFL teachers? How do teachers perceive their participation in developing the appraisal system? And how might the present performance appraisal practices be improved? The result reveals that staff participation in developing performance appraisal system and goals, feedback confidentiality, quality appraiser, quality of place and time of appraisal, appraiser-appraisee relationships, and developmental nature of performance appraisal would help in making effective appraisal and the overall PA effectiveness depends mostly on these factors. The result has a significant implication for improving the process of teacher performance appraisal in Oman and enriches the body knowledge of PA in general. The study puts forwards suggestions and recommendations for improving PA practices and exercises in EFL contexts.

  3. Anosognosia in mild cognitive impairment: Relationship to activation of cortical midline structures involved in self-appraisal

    Science.gov (United States)

    Ries, Michele L.; Jabbar, Britta M.; Schmitz, Taylor W.; Trivedi, Mehul A.; Gleason, Carey E.; Carlsson, Cynthia M.; Rowley, Howard A.; Asthana, Sanjay; Johnson, Sterling C.

    2009-01-01

    Awareness of cognitive dysfunction shown by individuals with Mild Cognitive Impairment (MCI), a condition conferring risk for Alzheimer’s disease (AD), is variable. Anosognosia, or unawareness of loss of function, is beginning to be recognized as an important clinical symptom of MCI. However, little is known about the brain substrates underlying this symptom. We hypothesized that MCI participants’ activation of cortical midline structures (CMS) during self-appraisal would covary with level of insight into cognitive difficulties (indexed by a discrepancy score between patient and informant ratings of cognitive decline in each MCI participant). To address this hypothesis, we first compared 16 MCI participants and 16 age-matched controls, examining brain regions showing conjoint or differential BOLD response during self-appraisal. Second, we used regression to investigate the relationship between awareness of deficit in MCI and BOLD activity during self-appraisal, controlling for extent of memory impairment. Between-group comparisons indicated that MCI participants show subtly attenuated CMS activity during self-appraisal. Regression analysis revealed a highly-significant relationship between BOLD response during self-appraisal and self-awareness of deficit in MCI. This finding highlights the level of anosognosia in MCI as an important predictor of response to self-appraisal in cortical midline structures, brain regions vulnerable to changes in early AD. PMID:17445294

  4. User's guide for PRISIM (Plant Risk Status Information Management System) Arkansas Nuclear One--Unit 1: Volume 2, Program for regulators

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, D.J.; Guthrie, V.H.; Kirchner, J.R.; Kirkman, J.Q.; Paula, H.M.; Ellison, B.C.; Dycus, F.M.; Farquharson, J.A.; Flanagan, G.F.

    1988-03-01

    This user's guide is a two-volume document designed to teach NRC inspectors and NRC regulators how to access probabilistic risk assessment information from the two Plant Risk Status Information Management System (PRISIM) programs developed for Arkansas Nuclear One--Unit One (ANA-1). This document, Volume 2, describes how the PRA information available in Version 2.0 of PRISIM is useful as an evaluation tool for regulatory activities. Using PRISIM is useful as an evaluation tool for regulatory activities. Using PRISIM, regulators can both access PRA information and modify the information to assess the impact these changes may have on plant safety. Each volume is a stand-alone document.

  5. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax.

    Science.gov (United States)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Miyoshi, Shinichiro; Kanazawa, Susumu

    2016-01-01

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P =0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. Complications are usually minor and asymptomatic. A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

  6. Methodological systematic review: mortality in elderly patients with cervical spine injury: a critical appraisal of the reporting of baseline characteristics, follow-up, cause of death, and analysis of risk factors.

    NARCIS (Netherlands)

    Middendorp, J.J. van; Albert, T.J.; Veth, R.P.H.; Hosman, A.J.F.

    2010-01-01

    STUDY DESIGN: Methodologic systematic review. OBJECTIVE: To determine the validity of reported risk factors for mortality in elderly patients with cervical spine injury. SUMMARY OF BACKGROUND DATA: In elderly patients with cervical spine injury, mortality has frequently been associated with the type

  7. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance.

    Science.gov (United States)

    Sveistrup, Joen; af Rosenschöld, Per Munck; Deasy, Joseph O; Oh, Jung Hun; Pommer, Tobias; Petersen, Peter Meidahl; Engelholm, Svend Aage

    2014-02-04

    Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1-2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5-7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. The 2-year actuarial likelihood of developing grade > = 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p analysis, 3DCRT was associated with a significantly increased risk of developing grade > = 2 GI toxicity compared to IG-IMRT (p analysis there was no difference in biochemical progression-free survival between 3DCRT and IG-IMRT. The difference in toxicity can be attributed to the combination of the IMRT technique with reduced dose to organs-at-risk, daily image guidance and margin reduction.

  8. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

    Energy Technology Data Exchange (ETDEWEB)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Kanazawa, Susumu [Okayama University Medical School, Departments of Radiology, Okayama (Japan); Miyoshi, Shinichiro [Okayama University Medical School, General Thoracic Surgery, Okayama (Japan)

    2016-01-15

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. (orig.)

  9. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

    International Nuclear Information System (INIS)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Kanazawa, Susumu; Miyoshi, Shinichiro

    2016-01-01

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. (orig.)

  10. Performance appraisal and advancement exercise 2006

    CERN Multimedia

    Human Resources Department

    2005-01-01

    The 2006 performance appraisal and advancement exercise will start in the usual way with annual interviews between staff and their supervisors. This year, these interviews should be held in the period from 1 December 2005 to 31 March 2006. In this connection, a number of improvements to the procedures relating to the interviews and performance appraisal are currently under study. Administrative Circular No 26 (Procedures governing the Career Development of Staff Members) and the electronic MAPS form in EDH are being reviewed and will be available from December onwards. In the meantime supervisors can start the interview procedure. HR Department will shortly provide further information on this subject. The 2005 MAPS report can be retrieved for consultation at any time via EDH. Human Resources Department Tel. 73566

  11. Performance appraisal and advancement exercise 2006 (Rev)

    CERN Multimedia

    Human Resources Department

    2005-01-01

    The 2006 performance appraisal and advancement exercise will start in the usual way with annual interviews between staff and their supervisors. This year, these interviews should be held in the period from 1 December 2005 to 15 March 2006*. In this connection, a number of improvements to the procedures relating to the interviews and performance appraisals are currently under study. Administrative Circular No. 26 (Procedures Governing the Career Development of Staff Members) and the electronic MAPS form in EDH are being reviewed and will be available from December onwards. In the meantime supervisors can start the interview procedure. HR Department will shortly provide further information on this subject. The 2005 MAPS report can be retrieved for consultation at any time via EDH. * Instead of 31 March, as indicated in the electronic Bulletin No. 47 of 21 November 2005 Human Resources Department Tel. 73566

  12. Naturalizing language: human appraisal and (quasi) technology

    DEFF Research Database (Denmark)

    Cowley, Stephen

    2013-01-01

    Using contemporary science, the paper builds on Wittgenstein’s views of human language. Rather than ascribing reality to inscription-like entities, it links embodiment with distributed cognition. The verbal or (quasi) technological aspect of language is traced to not action, but human specific...... interactivity. This species-specific form of sense-making sustains, among other things, using texts, making/construing phonetic gestures and thinking. Human action is thus grounded in appraisals or sense-saturated coordination. To illustrate interactivity at work, the paper focuses on a case study. Over 11 s......, a crime scene investigator infers that she is probably dealing with an inside job: she uses not words, but intelligent gaze. This connects professional expertise to circumstances and the feeling of thinking. It is suggested that, as for other species, human appraisal is based in synergies. However, since...

  13. Not so critical appraisal of dapagliflozin

    Directory of Open Access Journals (Sweden)

    Doggrell SA

    2014-08-01

    Full Text Available Sheila A Doggrell School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, AustraliaA recent review by Salvo et al published in Patient Preference and Adherence concerned dapagliflozin, and was titled “Patient considerations in the management of type 2 diabetes – critical appraisal of dapagliflozin”.1 Having read the article, I do not consider it to be a critical appraisal of dapagliflozin. Thus, after comparing dapagliflozin with other oral antidiabetic medications, the authors concluded that “Dapagliflozin’s noted blood pressure reduction, weight loss, and low potential to cause hypoglycemia are advantageous, when compared with currently available oral medications”.1 This statement is not supported by the content of the review and/or the literature. Read the original article 

  14. Appraising and comparing pressure ulcer guidelines.

    Science.gov (United States)

    Wimpenny, Peter; van Zelm, Ruben

    2007-01-01

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

  15. Appraisal of emotions in media use

    OpenAIRE

    Bartsch, Anne; Vorderer, Peter; Mangold, Roland; Reinhold, Viehoff

    2008-01-01

    Over the past 20 years, research on meta-emotion and related concepts such as meta-mood and need for affect has become fruitful and prominent across a variety of disciplines, including media psychology. This paper reviews the literature on meta-emotion and considers problems regarding the definition and operationalization of this construct. We propose a process model of meta-emotion and emotion regulation to integrate and extend existing work. Drawing on appraisal theories of emotion, we unde...

  16. The problem of appraising qualitative research

    OpenAIRE

    Dixon-Woods, M; Shaw, R; Agarwal, S; Smith, J

    2004-01-01

    

 Qualitative research can make a valuable contribution to the study of quality and safety in health care. Sound ways of appraising qualitative research are needed, but currently there are many different proposals with few signs of an emerging consensus. One problem has been the tendency to treat qualitative research as a unified field. We distinguish universal features of quality from those specific to methodology and offer a set of minimally prescriptive prompts to assist with the assessme...

  17. Bristol cylinder. Vol. 3A - technical appraisal

    Energy Technology Data Exchange (ETDEWEB)

    1983-06-01

    A consultants' report is presented on a UK funded wave energy device known as the Bristol Cylinder. A detailed engineering appraisal is given for each component and aspects of the device including installation, power generation and maintenance. Finally the discounted cost of energy from the device is assessed. For all topics the views of the consultants are compared with those of the team developing the Bristol Cylinder and where discrepancies occur, these are explained and discussed.

  18. Endothelial dysfunction: a comprehensive appraisal

    Directory of Open Access Journals (Sweden)

    Vilariño Jorge O

    2006-02-01

    Full Text Available Abstract The endothelium is a thin monocelular layer that covers all the inner surface of the blood vessels, separating the circulating blood from the tissues. It is not an inactive organ, quite the opposite. It works as a receptor-efector organ and responds to each physical or chemical stimulus with the release of the correct substance with which it may maintain vasomotor balance and vascular-tissue homeostasis. It has the property of producing, independently, both agonistic and antagonistic substances that help to keep homeostasis and its function is not only autocrine, but also paracrine and endocrine. In this way it modulates the vascular smooth muscle cells producing relaxation or contraction, and therefore vasodilatation or vasoconstriction. The endothelium regulating homeostasis by controlling the production of prothrombotic and antithrombotic components, and fibrynolitics and antifibrynolitics. Also intervenes in cell proliferation and migration, in leukocyte adhesion and activation and in immunological and inflammatory processes. Cardiovascular risk factors cause oxidative stress that alters the endothelial cells capacity and leads to the so called endothelial "dysfunction" reducing its capacity to maintain homeostasis and leads to the development of pathological inflammatory processes and vascular disease. There are different techniques to evaluate the endothelium functional capacity, that depend on the amount of NO produced and the vasodilatation effect. The percentage of vasodilatation with respect to the basal value represents the endothelial functional capacity. Taking into account that shear stress is one of the most important stimulants for the synthesis and release of NO, the non-invasive technique most often used is the transient flow-modulate "endothelium-dependent" post-ischemic vasodilatation, performed on conductance arteries such as the brachial, radial or femoral arteries. This vasodilatation is compared with the

  19. T-HERPS Version 1.0 User's Guide for Risk to Amphibians and Reptiles from Pesticides

    Science.gov (United States)

    T-HERPS estimates dietary exposure and risk to terrestrial-phase amphibians and reptiles from pesticide use. Currently approved for assessing exposure and risk to the California red-legged frog and terrestrial-phase herptiles with similar dietary behavior

  20. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients

    Energy Technology Data Exchange (ETDEWEB)

    Nour-Eldin, Nour-Eldin A., E-mail: nour410@hotmail.com [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Cairo University Hospital, Cairo (Egypt); Alsubhi, Mohammed [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Naguib, Nagy N. [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Alexandria University Hospital, Alexandria (Egypt); Lehnert, Thomas; Emam, Ahmed; Beeres, Martin; Bodelle, Boris; Koitka, Karen; Vogl, Thomas J.; Jacobi, Volkmar [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany)

    2014-10-15

    Purpose: To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques. Materials and methods: Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant. Results: Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion

  1. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients

    International Nuclear Information System (INIS)

    Nour-Eldin, Nour-Eldin A.; Alsubhi, Mohammed; Naguib, Nagy N.; Lehnert, Thomas; Emam, Ahmed; Beeres, Martin; Bodelle, Boris; Koitka, Karen; Vogl, Thomas J.; Jacobi, Volkmar

    2014-01-01

    Purpose: To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques. Materials and methods: Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant. Results: Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion

  2. MASS APPRAISAL AND REAL ESTATE TAXATION

    Directory of Open Access Journals (Sweden)

    VORONIN V. О.

    2015-12-01

    Full Text Available Raising of problem. The government at the legislative level fixed the definition of market value for tax purposes as mandatory in the implementation of real estate transactions. In order to meet the requirements of objectivity, uniformity and consistency of the results obtained during the evaluation procedures, as well as minimize the influence of subjective factors, there is a need to develop a methodology for evaluating an automated procedure for determining the estimated value of the property based on its market value. To solve this problem, we use special techniques and methods of mass appraisal that incorporates computer-supported statistical analyses, such as multiple regression analysis and adaptive estimation procedure for use in the field of property valuation and property rights. Purpose. Realization of this goal involves the development of the concept of a computer-assisted mass appraisal. The basis of this concept is an adaptive hybrid models of market pricing in different market segments that incorporates software adaptive algorithms for determining the market value by the three evaluation approaches using the results of a multi-level real estate market analysis. It was proposed the utility automated valuation models which is intended for the implementation of a computerized real estate valuation based on the developed software adaptive algorithms. Con-clusion. To achieve this goal have been developed and used concepts underlying of computerized mass appraisal. The basis of this concept is adaptive hybrid pricing models in various segments of the real estate market of Ukraine. The problem is solved by the application of the developed software-based adaptive algorithms for determining the market value of three evaluation approaches using the results of a multi-level analysis of the real estate market. It was pro-posed the model of automated appraisal, according to it was implemented computerization of appraisal procedures on the

  3. Social behavior, interaction appraisals, and suicidal ideation in schizophrenia: The dangers of being alone

    Science.gov (United States)

    Depp, Colin A.; Moore, Raeanne C.; Perivoliotis, Dimitri; Holden, Jason L.; Swendsen, Joel; Granholm, Eric L.

    2016-01-01

    Despite the increasing attention to social appraisals in suicide risk, the interpersonal correlates of suicidal thoughts and behavior in schizophrenia are not well understood. Ecological momentary assessment could reveal whether dysfunctional social appraisals and behavior are evident in people with schizophrenia with suicidal ideation. A total of 93 outpatients with diagnoses of schizophrenia with (n = 18, 19%) and without (N = 75; 81%) suicidal ideation participated in one week of intensive daily monitoring via mobile devices, generating real-time reports on the quantity of social interactions and appraisals about them, as well as information concerning concurrent affect and symptoms. The presence of suicidal ideation was not associated with the quantity of social interactions or time spent alone, but it was associated with the anticipation of being alone as well as greater negative and lower positive affect when alone. Despite this aversive experience of being alone, people with suicidal ideation reported negative appraisals about the value of recent and potential social interactions. These findings suggest that suicidal ideation in schizophrenia may not be associated with the quantity of social interactions, but with negative expectations about the quality of social interactions coupled with an aversive experience of being alone. Cognitive therapy interventions that address negative expectations and pleasure about social interactions, especially when alone, may reduce suicidal ideation. PMID:26948502

  4. Research report appraisal: how much understanding is enough?

    Science.gov (United States)

    Lipscomb, Martin

    2014-07-01

    When appraising research papers, how much understanding is enough? More specifically, in deciding whether research results can inform practice, do appraisers need to substantively understand how findings are derived or is it sufficient simply to grasp that suitable analytic techniques were chosen and used by researchers? The degree or depth of understanding that research appraisers need to attain before findings can legitimately/sensibly inform practice is underexplored. In this paper it is argued that, where knowledge/justified beliefs derived from research evidence prompt actions that materially affect patient care, appraisers have an epistemic duty to demand high (maximal) rather than low (minimal) levels of understanding regards finding derivation (i.e. appraisers have a duty to seek a superior epistemic situation). If this argument holds assumptions about appraiser competence/ability and the feasibility of current UK conceptions of evidence based practice are destabilized. © 2014 John Wiley & Sons Ltd.

  5. Influence able and Avoidable Risk Factors for Systemic Air Embolism due to Percutaneous CT-Guided Lung Biopsy: Patient Positioning and Coaxial Biopsy Technique-Case Report, Systematic Literature Review, and a Technical Note

    International Nuclear Information System (INIS)

    Rott, G.; Boecker, F.

    2014-01-01

    Following the first case of a systemic air embolism due to percutaneous CT-guided lung biopsy in our clinic we analysed the literature regarding this matter in view of influence able or avoidable risk factors. A systematic review of literature reporting cases of systemic air embolism due to CT-guided lung biopsy was performed to find out whether prone positioning might be a risk factor regarding this issue. In addition, a technical note concerning coaxial biopsy practice is presented. Prone position seems to have relevance for the development and/or clinical manifestation of air embolism due to CT-guided lung biopsy and should be considered a risk factor, at least as far as lesions in the lower parts of the lung are concerned. Biopsies of small or cavitary lesions in coaxial technique should be performed using a hemo static valve.

  6. Using clinical parameters to guide fluid therapy in high-risk thoracic surgery. A retrospective, observational study

    DEFF Research Database (Denmark)

    Bjerregaard, Lars Stryhn; Møller-Sørensen, Hasse; Hansen, Kristoffer Lindskov

    2015-01-01

    the use of central venous oxygen saturation and intended low urine output to guide therapy in the early postoperative period. Here we evaluate the consequences of our changes. METHODS: Retrospective, observational study of 30 consecutive patients undergoing EPP; 18 who had surgery before and 12 who had...... surgery after the changes. Data were collected from patient files and from institutional databases. Outcome measures included: Volumes of administered fluids, fluid balances, length of stays and postoperative complications. Dichotomous variables were compared with Fisher's exact test, whereas continuous...... increasing the incidence of postoperative complications. Mean length of stay in the intensive care unit (LOSI) was reduced from three to one day (p = 0.04) after the changes. CONCLUSION: The use of clinical parameters to balance fluid restriction and a sufficient circulation in patients undergoing EPP...

  7. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance

    International Nuclear Information System (INIS)

    Sveistrup, Joen; Rosenschöld, Per Munck af; Deasy, Joseph O; Oh, Jung Hun; Pommer, Tobias; Petersen, Peter Meidahl; Engelholm, Svend Aage

    2014-01-01

    Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1–2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5–7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. The 2-year actuarial likelihood of developing grade > = 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p < 0.001). For GU toxicity the numbers were 41.8% and 29.7%, respectively (p = 0.011). On multivariate analysis, 3DCRT was associated with a significantly increased risk of developing grade > = 2 GI toxicity compared to IG-IMRT (p < 0.001, HR = 11.59 [CI: 6.67-20.14]). 3DCRT was also associated with an increased risk of developing GU toxicity compared to IG-IMRT. The 3-year actuarial biochemical progression-free survival probability was 86.0% for 3DCRT and 90.3% for IG-IMRT (p = 0.386). On multivariate analysis there was no difference in biochemical progression-free survival between 3DCRT and IG-IMRT. The difference in toxicity can be attributed to the combination of the IMRT technique with reduced dose to organs-at-risk, daily image guidance and margin reduction

  8. Validation of the What Matters Index: A brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models.

    Science.gov (United States)

    Wasson, John H; Ho, Lynn; Soloway, Laura; Moore, L Gordon

    2018-01-01

    Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models. Five measures with well-documented impacts on the use of health services are summed to create a "What Matters Index." These measures are: 1) insufficient confidence to self-manage health problems, 2) pain, 3) bothersome emotions, 4) polypharmacy, and 5) adverse medication effects. We compare the sensitivity and predictive values of this index with two representative risk models in a population of 8619 Medicaid recipients. The patient-reported "What Matters Index" and the conventional risk models are found to exhibit similar sensitivities and predictive values for subsequent hospital or emergency room use. The "What Matters Index" is also reliable: akin to its performance during development, for patients with index scores of 1, 2, and ≥3, the odds ratios (with 95% confidence intervals) for subsequent hospitalization within 1 year, relative to patients with a score of 0, are 1.3 (1.1-1.6), 2.0 (1.6-2.4), and 3.4 (2.9-4.0), respectively; for emergency room use, the corresponding odds ratios are 1.3 (1.1-1.4), 1.9 (1.6-2.1), and 2.9 (2.6-3.3). Similar findings were replicated among smaller populations of 1061 mostly older patients from nine private practices and 4428 Medicaid patients without chronic conditions. In contrast to complex computer-generated risk models, the brief patient-reported "What Matters Index" immediately and unambiguously identifies fundamental, remediable needs for each patient and more sensibly directs the delivery of services to patient categories based on

  9. Evidence appraisal: a scoping review, conceptual framework, and research agenda.

    Science.gov (United States)

    Goldstein, Andrew; Venker, Eric; Weng, Chunhua

    2017-11-01

    Critical appraisal of clinical evidence promises to help prevent, detect, and address flaws related to study importance, ethics, validity, applicability, and reporting. These research issues are of growing concern. The purpose of this scoping review is to survey the current literature on evidence appraisal to develop a conceptual framework and an informatics research agenda. We conducted an iterative literature search of Medline for discussion or research on the critical appraisal of clinical evidence. After title and abstract review, 121 articles were included in the analysis. We performed qualitative thematic analysis to describe the evidence appraisal architecture and its issues and opportunities. From this analysis, we derived a conceptual framework and an informatics research agenda. We identified 68 themes in 10 categories. This analysis revealed that the practice of evidence appraisal is quite common but is rarely subjected to documentation, organization, validation, integration, or uptake. This is related to underdeveloped tools, scant incentives, and insufficient acquisition of appraisal data and transformation of the data into usable knowledge. The gaps in acquiring appraisal data, transforming the data into actionable information and knowledge, and ensuring its dissemination and adoption can be addressed with proven informatics approaches. Evidence appraisal faces several challenges, but implementing an informatics research agenda would likely help realize the potential of evidence appraisal for improving the rigor and value of clinical evidence. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  10. Feasibility of Tomotherapy-based image-guided radiotherapy to reduce aspiration risk in patients with non-laryngeal and non-pharyngeal head and neck cancer.

    Directory of Open Access Journals (Sweden)

    Nam P Nguyen

    Full Text Available PURPOSE: The study aims to assess the feasibility of Tomotherapy-based image-guided radiotherapy (IGRT to reduce the aspiration risk in patients with non-laryngeal and non-hypopharyngeal cancer. A retrospective review of 48 patients undergoing radiation for non-laryngeal and non-hypopharyngeal head and neck cancers was conducted. All patients had a modified barium swallow (MBS prior to treatment, which was repeated one month following radiotherapy. Mean middle and inferior pharyngeal dose was recorded and correlated with the MBS results to determine aspiration risk. RESULTS: Mean pharyngeal dose was 23.2 Gy for the whole group. Two patients (4.2% developed trace aspiration following radiotherapy which resolved with swallowing therapy. At a median follow-up of 19 months (1-48 months, all patients were able to resume normal oral feeding without aspiration. CONCLUSION AND CLINICAL RELEVANCE: IGRT may reduce the aspiration risk by decreasing the mean pharyngeal dose in the presence of large cervical lymph nodes. Further prospective studies with IGRT should be performed in patients with non-laryngeal and non-hypopharyngeal head and neck cancers to verify this hypothesis.

  11. Early perinatal diagnosis of mothers at risk of developing post-partum depression--a concise guide for obstetricians, midwives, neonatologists and paediatricians.

    Science.gov (United States)

    Ambrosini, Alessandra; Donzelli, Gianpaolo; Stanghellini, Giovanni

    2012-07-01

    In this article, we tried to provide all those involved in perinatal medicine with a concise guide to detect mothers at risk of developing post-partum depression. Motherhood is a critical situation characterized by role conflicts because conflicts among the role of mother, worker and wife are the norm in the post-partum period and may jeopardize the mother's existence. We have described a kind of personality that is at great risk of developing post-partum depression because of the incapacity to creatively manage situations of role conflict. This personality structure is called typus melancholicus, and we operationally defined its main features: orderliness, conscientiousness, hypernomia/heteronomia and intolerance of ambiguity. We have shown how these mothers may typically behave during pregnancy and early motherhood: they cannot avoid behaving with feverish perfectionism, developing an exaggerated preoccupation towards the unborn child and hostility towards persons and events that are experienced as an obstacle to their search for perfection. They ultra-carefully follow all the steps concerning paediatric check-ups and feel all the responsibility relating to the care of the child, without being able to delegate to someone else or share their feelings. We hope to provide those clinicians who are engaged in the care of pregnant women and their children with a valuable and user-friendly instrument for understanding and making a timely diagnoses of at-risk psychopathological phenomena.

  12. The SPOT Project (Potentially Triggerable Offshore Seismicity and Tsunamis): a First Appraisal of the Possible Impact of Oil and Gas Platforms on the Seismic and Tsunami Risks along the Italian Coasts

    Science.gov (United States)

    Basili, R.; Di Bucci, D.; Antoncecchi, I.; Ciccone, F.; Teofilo, G.; Argnani, A.; Rovere, M.; Ligi, M.; Coltelli, M.; Lorito, S.; Borzi, B.; Germagnoli, F.; Di Ludovico, M.; Lignola, G. P.; Prota, A.

    2017-12-01

    The majority of oil and gas production in Europe takes place offshore and Italy is one of the European countries with the longest coastlines facing these operations. Given the generally growing energy demand, and the increasing concern toward human-driven hazards, scientists are called to provide background information for helping ensure a safe energy supply. We here present the activities of the project SPOT, which is aimed to help Italian authorities comply with the application of the Safety of Offshore Oil and Gas Operations European Directive (2013/30/EU) and the ensuing Italian codes. We carry out a reconstruction of offshore geological structures to assess the existence of potentially seismogenic faults in the surroundings of off-shore platforms. This study is a propaedeutic step for the assessment of potentially triggered seismicity connected with operations on such platforms. The descriptive parameters (3D geometry and behavior) of the identified faults will be used to estimate their natural earthquake rates. The impact of these natural earthquakes along the coasts will then be modeled in terms of expected ground shaking and tsunamis. The tsunamis potentially generated by submarine landslides induced by earthquake shaking will also be analyzed. In turn, these models will be used to estimate potential human and economic losses in a multi-hazard approach to risk assessment. Wherever the combined earthquake and tsunami modeling indicates a relevant impact along the coasts, a more detailed analysis will be carried out, also involving the operators of the related platforms, to perform specific models which also take into account production and/or storage data. Activities with a consolidated background, such as those concerning the impact scenarios of earthquakes, and more innovative activities, such as those dedicated to build up the first vulnerability/fragility curves related to tsunamis for the Italian building stock, will be integrated within the project

  13. Organs at risk in the brain and their dose-constraints in adults and in children: A radiation oncologist’s guide for delineation in everyday practice

    International Nuclear Information System (INIS)

    Scoccianti, Silvia; Detti, Beatrice; Gadda, Davide; Greto, Daniela; Furfaro, Ilaria; Meacci, Fiammetta; Simontacchi, Gabriele; Di Brina, Lucia; Bonomo, Pierluigi; Giacomelli, Irene; Meattini, Icro; Mangoni, Monica; Cappelli, Sabrina; Cassani, Sara; Talamonti, Cinzia; Bordi, Lorenzo; Livi, Lorenzo

    2015-01-01

    Purpose: Accurate organs at risk definition is essential for radiation treatment of brain tumors. The aim of this study is to provide a stepwise and simplified contouring guide to delineate the OARs in the brain as it would be done in the everyday practice of planning radiotherapy for brain cancer treatment. Methods: Anatomical descriptions and neuroimaging atlases of the brain were studied. The dosimetric constraints used in literature were reviewed. Results: A Computed Tomography and Magnetic Resonance Imaging based detailed atlas was developed jointly by radiation oncologists, a neuroradiologist and a neurosurgeon. For each organ brief anatomical notion, main radiological reference points and useful considerations are provided. Recommended dose-constraints both for adult and pediatric patients were also provided. Conclusions: This report provides guidelines for OARs delineation and their dose-constraints for the treatment planning of patients with brain tumors

  14. Fear, anger, and risk.

    Science.gov (United States)

    Lerner, J S; Keltner, D

    2001-07-01

    Drawing on an appraisal-tendency framework (J. S. Lerner & D. Keltner, 2000), the authors predicted and found that fear and anger have opposite effects on risk perception. Whereas fearful people expressed pessimistic risk estimates and risk-averse choices, angry people expressed optimistic risk estimates and risk-seeking choices. These opposing patterns emerged for naturally occurring and experimentally induced fear and anger. Moreover, estimates of angry people more closely resembled those of happy people than those of fearful people. Consistent with predictions, appraisal tendencies accounted for these effects: Appraisals of certainty and control moderated and (in the case of control) mediated the emotion effects. As a complement to studies that link affective valence to judgment outcomes, the present studies highlight multiple benefits of studying specific emotions.

  15. RADTRAN 4: User guide

    International Nuclear Information System (INIS)

    Neuhauser, K.S.; Kanipe, F.L.

    1992-01-01

    RADTRAN 4 is used to evaluate radiological consequences of incident-free transportation, as well as the radiological risks from vehicular accidents occurring during transportation. This User Guide is Volume 3 in a series of four volume of the documentation of the RADTRAN 4 computer code for transportation risk analysis. The other three volumes are Volume 1, the Executive Summary; Volume 2, the Technical Manual; and Volume 4, the Programmer's Manual. The theoretical and calculational basis for the operations performed by RADTRAN 4 are discussed in Volume 2. Throughout this User Guide the reader will be referred to Volume 2 for detailed discussions of certain RADTRAN features. This User Guide supersedes the document ''RADTRAN III'' by Madsen et al. (1983). This RADTRAN 4 User Guide specifies and describes the required data, control inputs, input sequences, user options, program limitations, and other activities necessary for execution of the RADTRAN 4 computer code

  16. A Strategic Project Appraisal framework for ecologically sustainable urban infrastructure

    International Nuclear Information System (INIS)

    Morrissey, John; Iyer-Raniga, Usha; McLaughlin, Patricia; Mills, Anthony

    2012-01-01

    Actors in the built environment are progressively considering environmental and social issues alongside functional and economic aspects of development projects. Infrastructure projects represent major investment and construction initiatives with attendant environmental, economic and societal impacts across multiple scales. To date, while sustainability strategies and frameworks have focused on wider national aspirations and strategic objectives, they are noticeably weak in addressing micro-level integrated decision making in the built environment, particularly for infrastructure projects. The proposed approach of this paper is based on the principal that early intervention is the most cost-effective and efficient means of mitigating the environmental effects of development projects, particularly macro infrastructure developments. A strategic overview of the various project alternatives, taking account for stakeholder and expert input, could effectively reduce project impacts/risks at low cost to the project developers but provide significant benefit to wider communities, including communities of future stakeholders. This paper is the first exploratory step in developing a more systematic framework for evaluating strategic alternatives for major metropolitan infrastructure projects, based on key sustainability principles. The developed Strategic Project Appraisal (SPA) framework, grounded in the theory of Strategic Environmental Assessment (SEA), provides a means of practically appraising project impacts and alternatives in terms of quantified ecological limits; addresses the neglected topic of metropolitan infrastructure as a means of delivering sustainability outcomes in the urban context and more broadly, seeks to open a debate on the potential for SEA methodology to be more extensively applied to address sustainability challenges in the built environment. Practically applied and timed appropriately, the SPA framework can enable better decision-making and more

  17. 76 FR 41441 - Federal Housing Administration (FHA) Appraiser Roster: Appraiser Qualifications for Placement on...

    Science.gov (United States)

    2011-07-14

    ... verifiable education in the appraisal requirements established by FHA. Under amended section 202(g) of the... areas and hinder use of FHA single-family programs at a time when use of those programs has increased... higher education and experience standards that HERA sought to be used for FHA-insured transactions (all...

  18. The 2008 Circum-Arctic Resource Appraisal

    Science.gov (United States)

    Moore, Thomas E.; Gautier, Donald L.

    2017-11-15

    Professional Paper 1824 comprises 30 chapters by various U.S. Geological Survey authors, including introduction and methodology chapters, which together provide documentation of the geological basis and methodology of the 2008 Circum-Arctic Resource Appraisal, results of which were first released in August 2008.  Twenty-eight chapters summarize the petroleum geology and resource potential of individual, geologically defined provinces north of the Arctic Circle, including those of northern Alaska, northern Canada, east and west Greenland, and most of Arctic Russia, as well as certain offshore areas of the north Atlantic Basin and the Polar Sea. Appendixes tabulate the input and output information used during the assessment.

  19. Performance appraisal and advancement exercise 2005

    CERN Multimedia

    Human Resources Department

    2004-01-01

    The 2005 performance appraisal and advancement exercise will start in the usual way with annual interviews between staff and their supervisors. These interviews should be held in the period from 15 November 2004 to 15 February 2005 [see Administrative Circular No 26 (Rev. 5) Annex II, § 3. For this exercise, the paper MAPS form has been replaced by an electronic form in the EDH system, which is available via EDH (on the EDH desktop under Other Tasks / HR & Training) No changes have been made to the contents of the form. HR Department will shortly provide further information on this subject. Human Resources Department Tel. 73566

  20. Coping with acute stress in the military : The influence of coping style, coping self-efficacy and appraisal emotions

    NARCIS (Netherlands)

    Delahaij, R.; Dam, K. van

    2017-01-01

    It is of utmost importance to better understand how professionals in high-risk organizations, such as the military and police, appraise and cope with acute stress situations. The goal of this two-wave study was to investigate the role of two individual characteristics, coping style and coping

  1. Digging the pupfish out of its hole: risk analyses to guide harvest of Devils Hole pupfish for captive breeding

    Directory of Open Access Journals (Sweden)

    Steven R. Beissinger

    2014-09-01

    Full Text Available The Devils Hole pupfish is restricted to one wild population in a single aquifer-fed thermal pool in the Desert National Wildlife Refuge Complex. Since 1995 the pupfish has been in a nearly steady decline, where it was perched on the brink of extinction at 35–68 fish in 2013. A major strategy for conserving the pupfish has been the establishment of additional captive or “refuge” populations, but all ended in failure. In 2013 a new captive propagation facility designed specifically to breed pupfish was opened. I examine how a captive population can be initiated by removing fish from the wild without unduly accelerating extinction risk for the pupfish in Devils Hole. I construct a count-based PVA model, parameterized from estimates of the intrinsic rate of increase and its variance using counts in spring and fall from 1995–2013, to produce the first risk assessment for the pupfish. Median time to extinction was 26 and 27 years from spring and fall counts, respectively, and the probability of extinction in 20 years was 26–33%. Removing individuals in the fall had less risk to the wild population than harvest in spring. For both spring and fall harvest, risk increased rapidly when levels exceeded six adult pupfish per year for three years. Extinction risk was unaffected by the apportionment of total harvest among years. A demographic model was used to examine how removal of different stage classes affects the dynamics of the wild population based on reproductive value (RV and elasticity. Removing eggs had the least impact on the pupfish in Devils Hole; RV of an adult was roughly 25 times that of an egg. To evaluate when it might be prudent to remove all pupfish from Devils Hole for captive breeding, I used the count-based model to examine how extinction risk related to pupfish population size. Risk accelerated when initial populations were less than 30 individuals. Results are discussed in relation to the challenges facing pupfish recovery

  2. Auxiliary feedwater system risk-based inspection guide for the Diablo Canyon Unit 1 Nuclear Power Plant

    International Nuclear Information System (INIS)

    Gore, B.F.; Vo, T.V.; Harrison, D.G.

    1990-08-01

    This document presents a compilation of auxiliary feedwater (AFW) system failure information which has been screened for risk significance in terms of failure frequency and degradation of system performance. It is a risk-prioritized listing of failure events and their causes that are significant enough to warrant consideration in inspection planning at Diablo Canyon. This information is presented to provide inspectors with increased resources for inspection planning at Diablo Canyon. The risk importance of various component failure modes was identified by analysis of the results of probabilistic risk assessments (PRAs) for many pressurized water reactors (PWRs). However, the component failure categories identified in PRAs are rather broad, because the failure data used in the PRAs is an aggregate of many individual failures having a variety of root causes. In order to help inspectors to focus on specific aspects of component operation, maintenance and design which might cause these failures, an extensive review of component failure information was performed to identify and rank the root causes of these component failures. Both Diablo Canyon and industry-wide failure information was analyzed. Failure causes were sorted on the basis of frequency of occurrence and seriousness of consequence, and categorized as common cause failures, human errors, design problems, or component failures. This information permits an inspector to concentrate on components important to the prevention of core damage. Other components which perform essential functions, but which are not included because of high reliability or redundancy, must also be addressed to ensure that degradation does not increase their failure probabilities, and hence their risk importances. 23 refs., 1 fig., 1 tab

  3. A qualitative descriptive study of risk reduction for coronary disease among the Hong Kong Chinese.

    Science.gov (United States)

    Chan, Choi Wan; Lopez, Violeta

    2014-01-01

    Achieving optimal control and reduction in coronary heart disease (CHD) risks in Hong Kong (HK) remains significant and requires exploring. This article addresses the ability to reduce CHD risks among the HK Chinese. Through secondary analysis, a qualitative descriptive design using focus group interviews and content analysis were adopted. Older and younger adults were invited for the study. An interview schedule was used to guide discussions during focus group interviews. Four categories emerged from the data: planning of health actions, control of risk-reducing behavior, perceived opportunities for understanding CHD, and chest pain appraisal. Local culture and population needs play a central role in disease perception and prevention. The findings are essential to target strategies for initiating health acts for younger adults and establish public education resources that underscore understanding of CHD risk, symptom recognition, and disease management, particularly among those middle-aged and older people at high risk and with the diseased populations. © 2013 Wiley Periodicals, Inc.

  4. 76 FR 49787 - Rural Water Supply Program Approved Appraisal Reports; Availability

    Science.gov (United States)

    2011-08-11

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Rural Water Supply Program Approved Appraisal...: Reclamation provides assistance for appraisal investigations and feasibility studies for rural water supply... the findings and conclusions of the appraisal investigations that identified the water supply problems...

  5. Light Water Reactor Sustainability Program Technical Basis Guide Describing How to Perform Safety Margin Configuration Risk Management

    Energy Technology Data Exchange (ETDEWEB)

    Curtis Smith; James Knudsen; Bentley Harwood

    2013-08-01

    The INL has carried out a demonstration of the RISMC approach for the purpose of configuration risk management. We have shown how improved accuracy and realism can be achieved by simulating changes in risk – as a function of different configurations – in order to determine safety margins as the plant is modified. We described the various technical issues that play a role in these configuration-based calculations with the intent that future applications can take advantage of the analysis benefits while avoiding some of the technical pitfalls that are found for these types of calculations. Specific recommendations have been provided on a variety of topics aimed at improving the safety margin analysis and strengthening the technical basis behind the analysis process.

  6. Importance of change appraisal for employee well-being during organizational restructuring: findings from the Finnish paper industry's extensive transition.

    Science.gov (United States)

    Pahkin, Krista; Nielsen, Karina; Väänänen, Ari; Mattila-Holappa, Pauliina; Leppänen, Anneli; Koskinen, Aki

    2014-01-01

    The global recession has forced the Finnish forest industry to carry out major restructuring activities. Employees have faced different kinds of restructuring, mainly aimed at reducing staff and production. Many studies have shown the negative consequences of restructuring on employee well-being by using negative, ill-health indicators. Our aim is to examine the extent to which change appraisal influences both the negative and positive aspects of work-related well-being among employees who continue working in the organization after the restructuring process. We also examine the role of different actors (top management, immediate supervisor, employees themselves) in how the change is appraised. The study investigated blue-collar employees working in the Finnish forest industry during a period of extensive transition (2008-2009). All six participating factories underwent restructuring between baseline and the follow-up survey (n=369). After adjustment for gender, age and baseline well-being, negative change appraisal increased the risk of experiencing more stress and less work enjoyment. Negative change appraisals thus also damaged the positive, motivational aspects of employee well-being. The results showed the importance of offering employees the opportunity to participate in the planning of changes related to their work as regards positive change appraisal.

  7. Risk of punishment influences discrete and coordinated encoding of reward-guided actions by prefrontal cortex and VTA neurons

    Science.gov (United States)

    Park, Junchol

    2017-01-01

    Actions motivated by rewards are often associated with risk of punishment. Little is known about the neural representation of punishment risk during reward-seeking behavior. We modeled this circumstance in rats by designing a task where actions were consistently rewarded but probabilistically punished. Spike activity and local field potentials were recorded during task performance simultaneously from VTA and mPFC, two reciprocally connected regions implicated in reward-seeking and aversive behaviors. At the single unit level, we found that ensembles of putative dopamine and non-dopamine VTA neurons and mPFC neurons encode the relationship between action and punishment. At the network level, we found that coherent theta oscillations synchronize VTA and mPFC in a bottom-up direction, effectively phase-modulating the neuronal spike activity in the two regions during punishment-free actions. This synchrony declined as a function of punishment probability, suggesting that during reward-seeking actions, risk of punishment diminishes VTA-driven neural synchrony between the two regions. PMID:29058673

  8. Auxiliary feedwater system risk-based inspection guide for the Beaver Valley, Units 1 and 2 nuclear power plants

    International Nuclear Information System (INIS)

    Lloyd, R.C.; Vehec, T.A.; Moffitt, N.E.; Gore, B.F.; Vo, T.V.; Rossbach, L.W.; Sena, P.P. III

    1993-02-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment (PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance information recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. Beaver Valley Units 1 and 2 were selected as two of a series of plants for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important components at Beaver Valley Units 1 and 2

  9. Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

    Directory of Open Access Journals (Sweden)

    Chen Yu-Jen

    2011-01-01

    Full Text Available Abstract Background The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT for postoperative high-risk oral cavity cancer. Methods From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84% or without (16% chemotherapy. Results The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. Conclusions HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings.

  10. Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

    International Nuclear Information System (INIS)

    Hsieh, Chen-Hsi; Hsieh, Yen-Ping; Lin, Shoei Long; Chen, Chun-Yi; Chen, Chien-An; Shueng, Pei-Wei; Kuo, Ying-Shiung; Liao, Li-Jen; Hu, Kawang-Yu; Lin, Shih-Chiang; Wu, Le-Jung; Lin, Yu-Chin; Chen, Yu-Jen; Wang, Li-Ying

    2011-01-01

    The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT) for postoperative high-risk oral cavity cancer. From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84%) or without (16%) chemotherapy. The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings

  11. Unquestioned answers or unanswered questions: beliefs about science guide responses to uncertainty in climate change risk communication.

    Science.gov (United States)

    Rabinovich, Anna; Morton, Thomas A

    2012-06-01

    In two experimental studies we investigated the effect of beliefs about the nature and purpose of science (classical vs. Kuhnian models of science) on responses to uncertainty in scientific messages about climate change risk. The results revealed a significant interaction between both measured (Study 1) and manipulated (Study 2) beliefs about science and the level of communicated uncertainty on willingness to act in line with the message. Specifically, messages that communicated high uncertainty were more persuasive for participants who shared an understanding of science as debate than for those who believed that science is a search for absolute truth. In addition, participants who had a concept of science as debate were more motivated by higher (rather than lower) uncertainty in climate change messages. The results suggest that achieving alignment between the general public's beliefs about science and the style of the scientific messages is crucial for successful risk communication in science. Accordingly, rather than uncertainty always undermining the effectiveness of science communication, uncertainty can enhance message effects when it fits the audience's understanding of what science is. © 2012 Society for Risk Analysis.

  12. Auxiliary feedwater system risk-based inspection guide for the J.M. Farley Nuclear Power Plant

    International Nuclear Information System (INIS)

    Vo, T.V.; Pugh, R.; Gore, B.F.; Harrison, D.G.

    1990-10-01

    In a study sponsored by the US Nuclear Regulatory Commission (NRC), Pacific Northwest Laboratory has developed and applied a methodology for deriving plant-specific risk-based inspection guidance for the auxiliary feedwater (AFW) system at pressurized water reactors that have not undergone probabilistic risk assessment(PRA). This methodology uses existing PRA results and plant operating experience information. Existing PRA-based inspection guidance recently developed for the NRC for various plants was used to identify generic component failure modes. This information was then combined with plant-specific and industry-wide component information and failure data to identify failure modes and failure mechanisms for the AFW system at the selected plants. J. M. Farley was selected as the second plant for study. The product of this effort is a prioritized listing of AFW failures which have occurred at the plant and at other PWRs. This listing is intended for use by NRC inspectors in the preparation of inspection plans addressing AFW risk-important at the J. M. Farley plant. 23 refs., 1 fig., 1 tab

  13. Assessment vs. appraisal of ethical aspects of health technology assessment: can the distinction be upheld?

    Directory of Open Access Journals (Sweden)

    Sandman, Lars

    2014-11-01

    of the ethical analysis on appraisal of the technology. It is considered important to uphold the distinction between assessment and appraisal, primarily to avoid the influence of preconceived values and political interests on the assessment. Hence, as long as it is not based on the subjective value judgments of the HTA-agency (or its representative, such an appraising conclusion would not seem to conflict with the rationale for the separation of these tasks. Moreover, it should be noted that if HTA agencies abstain from including full ethical analyses because of the risk of issuing an appraisal, they may fail to provide the best possible basis for decision-makers. Hence, we argue that as long as the ethical analysis and its conclusions are presented transparently, disclosing how well-founded the conclusions are and/or whether there are alternative conclusions, the HTA-agencies should not avoid taking the ethical analysis as close as possible to a definite conclusion.

  14. Teaching critical appraisal skills for nursing research.

    Science.gov (United States)

    Jones, Sandra C; Crookes, Patrick A; Johnson, Keryn M

    2011-09-01

    Evidence-based practice is a major focus in nursing, yet the literature continues to document a research-practice gap. Reasons for this gap stem partly from a lack of skills to critique and synthesize the literature, a lack of search skills and difficulty in understanding research articles, and limited knowledge of research by nursing professionals. An innovative and quality driven subject to improve critical appraisal and critical thinking skills was developed for the School of Nursing, Midwifery and Indigenous Health at the University of Wollongong, based on formative research with postgraduate students and supervisors. Through face-to-face and online teaching modules students worked through a structured process of analysing the key aspects of published papers using structured analysis tools for each study design. Pre and post surveys of students found improvements in perceived knowledge of all key skills of critical appraisal. External independent evaluation determined that it was a high quality subject showing many hallmarks of good assessment practice and good practice in use of information and communication technology (ICT) in support of the learning outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Risk of whole body radiation exposure and protective measures in fluoroscopically guided interventional techniques: a prospective evaluation

    Directory of Open Access Journals (Sweden)

    Rivera Jose

    2003-08-01

    Full Text Available Abstract Background Fluoroscopic guidance is frequently utilized in interventional pain management. The major purpose of fluoroscopy is correct needle placement to ensure target specificity and accurate delivery of the injectate. Radiation exposure may be associated with risks to physician, patient and personnel. While there have been many studies evaluating the risk of radiation exposure and techniques to reduce this risk in the upper part of the body, the literature is scant in evaluating the risk of radiation exposure in the lower part of the body. Methods Radiation exposure risk to the physician was evaluated in 1156 patients undergoing interventional procedures under fluoroscopy by 3 physicians. Monitoring of scattered radiation exposure in the upper and lower body, inside and outside the lead apron was carried out. Results The average exposure per procedure was 12.0 ± 9.8 seconds, 9.0 ± 0.37 seconds, and 7.5 ± 1.27 seconds in Groups I, II, and III respectively. Scatter radiation exposure ranged from a low of 3.7 ± 0.29 seconds for caudal/interlaminar epidurals to 61.0 ± 9.0 seconds for discography. Inside the apron, over the thyroid collar on the neck, the scatter radiation exposure was 68 mREM in Group I consisting of 201 patients who had a total of 330 procedures with an average of 0.2060 mREM per procedure and 25 mREM in Group II consisting of 446 patients who had a total of 662 procedures with average of 0.0378 mREM per procedure. The scatter radiation exposure was 0 mREM in Group III consisting of 509 patients who had a total 827 procedures. Increased levels of exposures were observed in Groups I and II compared to Group III, and Group I compared to Group II. Groin exposure showed 0 mREM exposure in Groups I and II and 15 mREM in Group III. Scatter radiation exposure for groin outside the apron in Group I was 1260 mREM and per procedure was 3.8182 mREM. In Group II the scatter radiation exposure was 400 mREM and with 0.6042 m

  16. 25 CFR 11.706 - Appointment and duties of appraiser.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Appointment and duties of appraiser. 11.706 Section 11... OFFENSES AND LAW AND ORDER CODE Probate Proceedings § 11.706 Appointment and duties of appraiser. (a) Upon ordering an estate to be probated, the court shall appoint a disinterested and competent person as an...

  17. 107 an appraisal of the scope of provisions under

    African Journals Online (AJOL)

    Fr. Ikenga

    EZE & EZE: An Appraisal of the Scope of Provisions Under The 1999 Nigerian Constitution for the Control of Pollution. Arising from the Oil and Gas Industry. AN APPRAISAL OF THE .... However, in a historic judgment, a Federal High Court sitting in Benin-City and presided over by Nwokorie J, held that continued gas flaring ...

  18. Employee performance appraisal and productivity levels in selected ...

    African Journals Online (AJOL)

    The focus of this study was on performance appraisal of academic staff of Universities in Nigeria and their productivity levels. The prime problem that necessitated this study was to examine the effectiveness of the subjective methods used in appraising qualitative work attributes of the employees and to assess the extent to ...

  19. Appraisal patterns of emotions in human-product interaction

    NARCIS (Netherlands)

    Demir, E.; Desmet, P.M.A.; Hekkert, P.

    2009-01-01

    Emotional design, i.e., designing with an intention to evoke or to prevent a particular emotion, can be facilitated by understanding the processes underlying emotions. A promising approach to understanding these processes in the current psychological literature is appraisal theory. Appraisal theory

  20. 12 CFR 950.10 - Collateral valuation; appraisals.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Collateral valuation; appraisals. 950.10...-BALANCE SHEET ITEMS ADVANCES Advances to Members § 950.10 Collateral valuation; appraisals. (a) Collateral valuation. Each Bank shall determine the value of collateral securing the Bank's advances in accordance with...

  1. Linking the Teacher Appraisal Process to the School Improvement Plan

    Science.gov (United States)

    Reddekopp, Therese

    2007-01-01

    If a school improvement plan includes input from all stakeholders and focuses on data-driven processes that are linked to teacher appraisal, it can be powerful in leading the school toward the common mission of achieving student success. Linking the school improvement plan to the teacher appraisal process creates a system whereby all individuals…

  2. Evaluating School Health Appraisal scheme in Primary Schools ...

    African Journals Online (AJOL)

    Objectives: This study assessed school health appraisal implementation in primary schools within Abakaliki Metropolis. Materials and Methods: This was a cross sectional descriptive study of the forms of health appraisal in all 31 primary schools in Abakaliki metropolis. Relevant information was obtained from the head ...

  3. A Composite Model for Employees' Performance Appraisal and Improvement

    Science.gov (United States)

    Manoharan, T. R.; Muralidharan, C.; Deshmukh, S. G.

    2012-01-01

    Purpose: The purpose of this paper is to develop an innovative method of performance appraisal that will be useful for designing a structured training programme. Design/methodology/approach: Employees' performance appraisals are conducted using new approaches, namely data envelopment analysis and an integrated fuzzy model. Interpretive structural…

  4. The merits of measuring challenge and hindrance appraisals.

    Science.gov (United States)

    Searle, Ben J; Auton, Jaime C

    2015-01-01

    The challenge-hindrance framework has shown that challenge stressors (work characteristics associated with potential personal gain) tend to have positive outcomes, whereas hindrance stressors (those which obstruct goals) have negative outcomes. However, typical research methods assume that stressors allocated to these categories are appraised consistently by different people and across different situations. We validate new measures of challenge and hindrance appraisals and demonstrate their utility in stress research. We used a cross-sectional survey of American employees (Study 1, n = 333), a diary survey of Australian employees (Study 2, n = 241), and a survey of Australian college students whose performance was evaluated independently (Study 3, n = 350). Even after accounting for the effects of stressors, challenge and hindrance appraisals consistently explained unique variance in affective states, with indications that stressors have indirect effects via appraisals. Such effects were seen within- as well as between-participants (Study 2). Appraisals also had expected associations with specific coping behaviors (Study 1), while challenge appraisal was associated with task performance (Study 3). The scales of challenge and hindrance appraisals were psychometrically sound across multiple contexts. RESULTS highlight the merit of considering appraisal in stress research.

  5. Student feedback on an adapted appraisal model in resource ...

    African Journals Online (AJOL)

    Background. An appraisal model, a type of formal mentorship programme for a cohort of student doctors, is used at the University of Leeds, UK. The University of the Witwatersrand, Johannesburg, South Africa implemented an adapted version of the appraisal process that uses fewer resources. Objective. To explore ...

  6. 50 CFR 34.6 - Schedule of appraisals.

    Science.gov (United States)

    2010-10-01

    ... Secretary shall make fair market value appraisals of areas administered by the Service within five years... reappraised on a schedule of at least once every five years. Until areas are appraised, the fair market value... fee lands added to such areas after that date shall be on the basis of fair market value. ...

  7. Precompetitive achievement goals, stress appraisals, emotions, and coping among athletes.

    Science.gov (United States)

    Nicholls, Adam R; Perry, John L; Calmeiro, Luis

    2014-10-01

    Grounded in Lazarus's (1991, 1999, 2000) cognitive-motivational-relational theory of emotions, we tested a model of achievement goals, stress appraisals, emotions, and coping. We predicted that precompetitive achievement goals would be associated with appraisals, appraisals with emotions, and emotions with coping in our model. The mediating effects of emotions among the overall sample of 827 athletes and two stratified random subsamples were also explored. The results of this study support our proposed model in the overall sample and the stratified subsamples. Further, emotion mediated the relationship between appraisal and coping. Mediation analyses revealed that there were indirect effects of pleasant and unpleasant emotions, which indicates the importance of examining multiple emotions to reveal a more accurate representation of the overall stress process. Our findings indicate that both appraisals and emotions are just as important in shaping coping.

  8. Dose-effect relationship and risk factors for vaginal stenosis after definitive radio(chemo)therapy with image-guided brachytherapy for locally advanced cervical cancer in the EMBRACE study

    DEFF Research Database (Denmark)

    Kirchheiner, Kathrin; Nout, Remi A; Lindegaard, Jacob C

    2016-01-01

    Background/purpose To identify risk factors for vaginal stenosis and to establish a dose–effect relationship for image-guided brachytherapy in locally advanced cervical cancer. Materials/Methods Patients from the ongoing EMBRACE study with prospectively assessed morbidity (CTCAEv3.0) at baseline ...

  9. Exclusive image guided IMRT vs. radical prostatectomy followed by postoperative IMRT for localized prostate cancer: a matched-pair analysis based on risk-groups

    International Nuclear Information System (INIS)

    Azelie, Caroline; Créhange, Gilles; Gauthier, Mélanie; Mirjolet, Céline; Cormier, Luc; Martin, Etienne; Peignaux-Casasnovas, Karine; Truc, Gilles; Chamois, Jérôme; Maingon, Philippe

    2012-01-01

    To investigate whether patients treated for a localized prostate cancer (PCa) require a radical prostatectomy followed by postoperative radiotherapy or exclusive radiotherapy, in the modern era of image guided IMRT. 178 patients with PCa were referred for daily exclusive image guided IMRT (IG-IMRT) using an on-line 3D ultra-sound based system and 69 patients were referred for postoperative IMRT without image guidance after radical prostatectomy (RP + IMRT). Patients were matched in a 1:1 ratio according to their baseline risk group before any treatment. Late toxicity was scored using the CTV v3.0 scale. Biochemical failure was defined as a postoperative PSA ≤ 0.1 ng/mL followed by 1 consecutive rising PSA for the postoperative group of patients and by the Phoenix definition (nadir + 2 ng/mL) for the group of patients treated with exclusive radiotherapy. A total of 98 patients were matched (49:49). From the start of any treatment, the median follow-up was 56.6 months (CI 95% = [49.6-61.2], range [18.2-115.1]). No patient had late gastrointestinal grade ≥ 2 toxicity in the IG-IMRT group vs. 4% in the RP + IMRT group. Forty two percent of the patients in both groups had late grade ≥ 2 genitourinary toxicity. The 5-year FFF rates in the IG-IMRT group and in the RP + IMRT groups were 93.1% [80.0-97.8] and 76.5% [58.3-87.5], respectively (p = 0.031). Patients with a localized PCa treated with IG-IMRT had better oncological outcome than patients treated with RP + IMRT. Further improvements in postoperative IMRT using image guidance and dose escalation are urgently needed

  10. A multi-level rapid prototyping drill guide template reduces the perforation risk of pedicle screw placement in the lumbar and sacral spine.

    Science.gov (United States)

    Merc, Matjaz; Drstvensek, Igor; Vogrin, Matjaz; Brajlih, Tomaz; Recnik, Gregor

    2013-07-01

    The method of free-hand pedicle screw placement is generally safe although it carries potential risks. For this reason, several highly accurate computer-assisted systems were developed and are currently on the market. However, these devices have certain disadvantages. We have developed a method of pedicle screw placement in the lumbar and sacral region using a multi-level drill guide template, created with the rapid prototyping technology and have validated it in a clinical study. The aim of the study was to manufacture and evaluate the accuracy of a multi-level drill guide template for lumbar and first sacral pedicle screw placement and to compare it with the free-hand technique under fluoroscopy supervision. In 2011 and 2012, a randomized clinical trial was performed on 20 patients. 54 screws were implanted in the trial group using templates and 54 in the control group using the fluoroscopy-supervised free-hand technique. Furthermore, applicability for the first sacral level was tested. Preoperative CT-scans were taken and templates were designed using the selective laser sintering method. Postoperative evaluation and statistical analysis of pedicle violation, displacement, screw length and deviation were performed for both groups. The incidence of cortex perforation was significantly reduced in the template group; likewise, the deviation and displacement level of screws in the sagittal plane. In both groups there was no significantly important difference in deviation and displacement level in the transversal plane as not in pedicle screw length. The results for the first sacral level resembled the main investigated group. The method significantly lowers the incidence of cortex perforation and is therefore potentially applicable in clinical practice, especially in some selected cases. The applied method, however, carries a potential for errors during manufacturing and practical usage and therefore still requires further improvements.

  11. US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Kara, Gulcan; Torun, Dilek; Kizilkilic, Osman; Yildirim, Tulin

    2005-01-01

    Objective: : To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients. Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis. Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein

  12. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review.

    Science.gov (United States)

    Gray, Selena; Carmichael, Laurence; Barton, Hugh; Mytton, Julie; Lease, Helen; Joynt, Jennifer

    2011-11-24

    Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries.The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether recommendations arising from health

  13. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review

    Directory of Open Access Journals (Sweden)

    Gray Selena

    2011-11-01

    Full Text Available Abstract Background Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. Methods A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. Results A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries. The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes, lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Conclusion Research is needed to assess (i the degree to which statutory plan appraisal processes (SA in the UK

  14. Effects of appraisal purpose and rating format on performance appraisal accuracy

    OpenAIRE

    Carter, Marta L.

    1989-01-01

    The principle of encoding specificity states that effective information retrieval relies upon consistency of encoding and retrieval cues. The present study generalized this principle to a complex social interaction in order to investigate the relation between certain combinations of pre- and post-observational cues and their effects on information categorization, recognition accuracy, and judgment accuracy. It was hypothesized that two experimental factors, appraisal pur...

  15. Nailfold capillaroscopy microscopy - an interdisciplinary appraisal.

    Science.gov (United States)

    Klein-Weigel, Peter Franz; Sunderkötter, Cord; Sander, Oliver

    2016-09-01

    Nailfold capillaroscopy is a method of great diagnostic value in the differential diagnosis of primary versus secondary Raynaud´s phenomenon, of systemic sclerosis versus other so called connective tissue diseases and of additional diagnostic value in other entities. Rheumatologists, dermatologists, and angiologists in Germany have convened in an interdisciplinary working group in which they synergistically combined their expertise to develop a common nomenclature and standards for the technical performance of nailfold capillary microscopy. The article gives an overview of historical and technical aspects of capillaroscopy, morphologic findings, and disease-specific patterns. It also provides a critical appraisal of its significance in the diagnosis and sequelae of these interdisciplinarily-managed diseases including its performance in children and gives an excursion in the potential perspectives of capillaroscopy in less common indications.

  16. Photographic appraisal of crystal lattice growth technique

    Directory of Open Access Journals (Sweden)

    Kapoor D

    2005-01-01

    Full Text Available Concept of creating mechanical retention for bonding through crystal growth has been successfully achieved in the present study. By using polyacrylic acid, sulphated with sulphuric acid as etchant, abundant crystal growth was demonstrated. Keeping in view the obvious benefits of crystal growth technique, the present SEM study was aimed to observe and compare the changes brought about by different etching agents (phosphoric acid, polyacrylic acid and polyacrylic acid sulphated and to evaluate their advantages and disadvantages in an attempt to reduce iatrogenic trauma caused due to surface enamel alteration. Control and experimental groups were made of 24 and 30 premolars, respectively, for scanning electron microscopic appraisal of normal unetched and etched enamel surface and fracture site and finished surface evaluation. When compared with conventional phosphoric acid and weaker polyacrylic acid, investigations indicated that crystal growth treatment on enamel surface caused minimal iatrogenic trauma and surface alteration were restored to the original untreated condition to a large extent.

  17. 77 FR 54721 - Appraisals for Higher-Risk Mortgage Loans

    Science.gov (United States)

    2012-09-05

    ... Truth in Lending Act (TILA), and the official interpretation to the regulation. The proposed revisions... submitted must include ``FDIC'' and ``Truth in Lending Act (Regulation Z).'' Comments received will be... at http://www.ncua.gov/Legal/Regs/Pages/PropRegs.aspx as submitted, except for those we cannot post...

  18. A psychometric appraisal of the DREEM

    Directory of Open Access Journals (Sweden)

    Hammond Sean M

    2012-01-01

    Full Text Available Abstract Background The quality of the Educational environment is a key determinant of a student centred curriculum. Evaluation of the educational environment is an important component of programme appraisal. In order to conduct such evaluation use of a comprehensive, valid and reliable instrument is essential. One of most widely used contemporary tools for evaluation of the learning environment is the Dundee Ready Education Environment Measure (DREEM. Apart from the initial psychometric evaluation of the DREEM, few published studies report its psychometric properties in detail. The aim of this study was to examine the psychometric quality of the DREEM measure in the context of medical education in Ireland and to explore the construct validity of the device. Methods 239 final year medical students were asked to complete the DREEM inventory. Anonymised responses were entered into a database. Data analysis was performed using PASW 18 and confirmatory factor analysis performed. Results Whilst the total DREEM score had an acceptable level of internal consistency (alpha 0.89, subscale analysis shows that two subscales had sub-optimal internal consistency. Multiple group confirmatory factor analysis (using Fleming's indices shows an overall fit of 0.76, representing a weak but acceptable level of fit. 17 of the 50 items manifest fit indices less than 0.70. We sought the best fitting oblique solution to the 5-subscale structure, which showed large correlations, suggesting that the independence of the separate scales is open to question. Conclusions There has perhaps been an inadequate focus on establishing and maintaining the psychometric credentials of the DREEM. The present study highlights two concerns. Firstly, the internal consistency of the 5 scales is quite variable and, in our sample, appears rather low. Secondly, the construct validity is not well supported. We suggest that users of the DREEM will provide basic psychometric appraisal of the

  19. A psychometric appraisal of the DREEM

    LENUS (Irish Health Repository)

    Hammond, Sean M

    2012-01-12

    Abstract Background The quality of the Educational environment is a key determinant of a student centred curriculum. Evaluation of the educational environment is an important component of programme appraisal. In order to conduct such evaluation use of a comprehensive, valid and reliable instrument is essential. One of most widely used contemporary tools for evaluation of the learning environment is the Dundee Ready Education Environment Measure (DREEM). Apart from the initial psychometric evaluation of the DREEM, few published studies report its psychometric properties in detail. The aim of this study was to examine the psychometric quality of the DREEM measure in the context of medical education in Ireland and to explore the construct validity of the device. Methods 239 final year medical students were asked to complete the DREEM inventory. Anonymised responses were entered into a database. Data analysis was performed using PASW 18 and confirmatory factor analysis performed. Results Whilst the total DREEM score had an acceptable level of internal consistency (alpha 0.89), subscale analysis shows that two subscales had sub-optimal internal consistency. Multiple group confirmatory factor analysis (using Fleming\\'s indices) shows an overall fit of 0.76, representing a weak but acceptable level of fit. 17 of the 50 items manifest fit indices less than 0.70. We sought the best fitting oblique solution to the 5-subscale structure, which showed large correlations, suggesting that the independence of the separate scales is open to question. Conclusions There has perhaps been an inadequate focus on establishing and maintaining the psychometric credentials of the DREEM. The present study highlights two concerns. Firstly, the internal consistency of the 5 scales is quite variable and, in our sample, appears rather low. Secondly, the construct validity is not well supported. We suggest that users of the DREEM will provide basic psychometric appraisal of the device in future

  20. Exams? Why worry? Interpreting anxiety as facilitative and stress appraisals.

    Science.gov (United States)

    Strack, Juliane; Esteves, Francisco

    2015-01-01

    The present study examined why people differ in how they appraise the same stressful situation (an approaching exam). We explored whether interpreting anxiety as a facilitative emotion can affect the type of stress appraisal people make. One hundred and three undergraduate students took part in this study, which lasted for 10 days (leading up to an exam). The students completed a daily self-reported evaluation of anxiety, emotional exhaustion, and stress experienced. The findings suggest a process by which a stressful time can be experienced as motivating rather than threatening or emotionally exhausting. For example, interpreting anxiety as facilitative moderated the relationship between anxiety and stress appraisals. When interpreting their anxiety as facilitative, individuals showed a higher tendency to make challenge stress appraisals and a lower tendency to appraising the stressor as a threat. These differences were especially visible with high levels of anxiety. Furthermore, interpreting anxiety as facilitative was negatively associated with emotional exhaustion, but positively associated with the academic performance. These findings suggest an explanation why people differ in how they appraise the same stressor: how people interpret their anxiety may to a large part affect how they appraise difficult events and situations.

  1. Reduction of Dose Delivered to Organs at Risk in Prostate Cancer Patients via Image-Guided Radiation Therapy

    International Nuclear Information System (INIS)

    Pawlowski, Jason M.; Yang, Eddy S.; Malcolm, Arnold W.; Coffey, Charles W.; Ding, George X.

    2010-01-01

    Purpose: To determine whether image guidance can improve the dose delivered to target organs and organs at risk (OARs) for prostate cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eight prostate cancer patients were treated with IMRT to 76 Gy at 2 Gy per fraction. Daily target localization was performed via alignment of three intraprostatic fiducials and weekly kV-cone beam computed tomography (CBCT) scans. The prostate and OARs were manually contoured on each CBCT by a single physician. Daily patient setup shifts were obtained by comparing alignment of skin tattoos with the treatment position based on fiducials. Treatment fields were retrospectively applied to CBCT scans. The dose distributions were calculated using actual treatment plans (an 8-mm PTV margin everywhere except for 6-mm posteriorly) with and without image guidance shifts. Furthermore, the feasibility of margin reduction was evaluated by reducing planning margins to 4 mm everywhere except for 3 mm posteriorly. Results: For the eight treatment plans on the 56 CBCT scans, the average doses to 98% of the prostate (D98) were 102% (range, 99-104%) and 99% (range, 45-104%) with and without image guidance, respectively. Using margin reduction, the average D98s were 100% (range, 84-104%) and 92% (range, 40-104%) with and without image guidance, respectively. Conclusions: Currently, margins used in IMRT plans are adequate to deliver a dose to the prostate with conventional patient positioning using skin tattoos or bony anatomy. The use of image guidance may facilitate significant reduction of planning margins. Future studies to assess the efficacy of decreasing margins and improvement of treatment-related toxicities are warranted.

  2. Racing with friends: Resistance to peer influence, gist and specific risk beliefs.

    Science.gov (United States)

    Mirman, Jessica H; Curry, Allison E

    2016-11-01

    Studies assessing young drivers' risk appraisals with their driving behavior have shown both positive and inverse associations, possibly due to differences in survey items that cue gist appraisals about risk (i.e., beliefs that are focused on meaning) or specific appraisals (i.e., beliefs that are focused on discrete instances). Prior research has indicated that gist-based reasoning is protective against engaging in risk behavior and that use of gist appraisals increases with development. Additionally, although much of adolescents' risk-taking occurs in groups, almost no research examines how adolescents' resistance to peer influence may relate to their specific and gist beliefs about socially-bound risk behavior, as well as their future engagement in such behavior. One hundred and thirty-two adolescent drivers participated in a prospective self-report study on racing behavior. Surveys measured specific and gist risk appraisals, resistance to peer influence, and racing behavior at two time points three months apart. We hypothesized that stronger specific appraisals would be associated with greater likelihood of racing, and stronger gist appraisals would be protective. Further, we hypothesized that resistance to peer influence would be positively associated with gist appraisals and negatively associated with specific risk appraisals; and would also be inversely associate with racing. Specific risk appraisals and gist appraisals were predictive of racing behavior as hypothesized. Resistance to peer influence did not predict racing, but was associated with each type of risk appraisal as predicted at Time 1, although the association between specific risk and resistance to peer influence was non-significant at the second time point. Gist beliefs and the ability to resist influence from friends might be indicative of an underlying strength of one's own beliefs about the self as a non-risk taking person who stands up for his or her beliefs, which is protective against

  3. Preliminary ethical appraisal of a trial - what's it all about?

    Science.gov (United States)

    Siipi, Helena

    Preliminary ethical appraisal of medical trials is often based on the following four principles: respect for autonomy, beneficence, non-maleficence, and justice. Preliminary ethical appraisal should, however, not be understood solely as application of these four principles to practice. Ethical committees will inevitably interpret the principles and make decisions about their reciprocal importance in connection with each trial. Reasoning does not always proceed from above towards practical recommendations of action, but can instead also be based on a moral rule or practice relating to a certain action. A good preliminary ethical appraisal will also take into account everyday standards of morality, law and shared moral values of the society.

  4. Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation

    Directory of Open Access Journals (Sweden)

    Ramin Jaberi

    2017-12-01

    Full Text Available Purpose : Intra-fractional organs at risk (OARs deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT. The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods : Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. Results : A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in ‘organs-applicators’, while maintaining target dose at the original level. Conclusions : There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients’ plans to be able to serve as a clinical tool.

  5. Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation.

    Science.gov (United States)

    Jaberi, Ramin; Siavashpour, Zahra; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

    2017-12-01

    Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in 'organs-applicators', while maintaining target dose at the original level. There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients' plans to be able to serve as a clinical tool.

  6. The economic burden of physical inactivity: a systematic review and critical appraisal.

    Science.gov (United States)

    Ding, Ding; Kolbe-Alexander, Tracy; Nguyen, Binh; Katzmarzyk, Peter T; Pratt, Michael; Lawson, Kenny D

    2017-10-01

    comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors. © 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.

  7. 7 CFR 1980.444 - Appraisal of property serving as collateral.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Appraisal of property serving as collateral. 1980.444... Program § 1980.444 Appraisal of property serving as collateral. (a) Appraisal reports prepared by independent qualified fee appraisers will be required on all property that will serve as collateral. In the...

  8. 41 CFR 102-42.40 - When is an appraisal necessary?

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL OF FOREIGN GIFTS AND DECORATIONS General Provisions Appraisals § 102-42.40 When is an appraisal necessary? An appraisal is necessary when— (a) An employee indicates an interest in purchasing a gift or decoration. In this situation, the appraisal must be obtained before the gift or decoration is reported to...

  9. An Investigation into Appraisal Bias: The Role of Decision Support Tools in Debiasing Valuation Judgments

    Science.gov (United States)

    Tidwell, Owen Alan

    2011-01-01

    Given the nature of the valuation task environment appraisers are often made aware of previous value opinions rendered by appraisers, commonly in the form of an historic appraisal. And, because an appraisal task involves the rendering of market value, a hypothetical, unobservable construct based on probabilities, direct feedback against this…

  10. Guided labworks

    DEFF Research Database (Denmark)

    Jacobsen, Lærke Bang

    For the last 40 years physics education research has shown poor learning outcomes of guided labs. Still this is found to be a very used teaching method in the upper secodary schools. This study explains the teacher's choice of guided labs throught the concept of redesign as obstacle dislodgement...

  11. Small Steps Forward Through Critical Appraisal (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2006-03-01

    Full Text Available As a vocal proponent of evidence based information practice, I have actively encouraged my co‐workers and anyone else who might listen, to take small steps in order to move towards incorporating research evidence into their decision making. I prompt colleagues to search in databases for research articles that may be useful, gather these articles and incorporate research results as part of their decision making process. I am often told of the difficulties faced despite one’s best attempts to make their practice more evidence‐based. A major difficulty is access to the research itself since librarians and information professionals often lack access to databases and journals in our field, particularly those of us working outside of academic libraries. An even more daunting question is how to critically read the existing research to determine whether it is valuable in a specific situation. Not all research is good, and how do we sort out the good from the bad? This inaugural issue of Evidence Based Library and Information Practice brings us one small step closer to addressing some of these concerns by equipping practitioners with information to help in their decision making process. Every issue of Evidence Based Library and Information Practice will incorporate approximately 10 evidence summaries to help readers sort through recently published research and determine if that research was done well. Evidence summaries provide a critical appraisal synthesis for a specific research article, so that practitioners may more readily determine if the evidence in that research study is valid and reliable, and whether they can apply it to their own practice. Evidence summaries are indeed a small step, but an important one. Published in an open‐access forum, these summaries will address three barriers to evidence based practice that we have faced in the past. First of all, they will bring awareness of previously published research to readers who may

  12. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Rosenthal, Daniel I. [Massachusetts General Hospital, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute of Technology Assessment, Boston, MA (United States)

    2013-01-15

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  13. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    International Nuclear Information System (INIS)

    Huang, Ambrose J.; Rosenthal, Daniel I.; Halpern, Elkan F.

    2013-01-01

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  14. Facing the truth: An appraisal of the potential contributions ...

    African Journals Online (AJOL)

    Facing the truth: An appraisal of the potential contributions, paradoxes and challenges of implementing the United Nations conventions on Contracts for the International Sale of Goods (CISG) in Nigeria.

  15. Managerial Competencies and the Managerial Performance Appraisal Process.

    Science.gov (United States)

    Abraham, Steven E.; Karns, Lanny A.; Shaw, Kenneth; Mena, Manuel A.

    2001-01-01

    Human resource managers (n=277) identified six management competencies as critical: leadership, customer focus, results orientation, problem solving, communication skills, and teamwork. However, many companies do not assess these competencies in the management performance appraisal process. (Contains 22 references.) (SK)

  16. 77 FR 40051 - Appraisal Subcommittee; Notice of Meeting

    Science.gov (United States)

    2012-07-06

    ... Foundation March 2012 Grant Reimbursement Request. ASC Appraisal Foundation Grant Policy. How To Attend and... requests, the ASC may refuse attendance on that reasonable basis. The use of any video or audio tape...

  17. Appraisal of seven critical reading strategies employed by teachers ...

    African Journals Online (AJOL)

    Appraisal of seven critical reading strategies employed by teachers in Ogun State senior secondary schools to teach reading comprehension. ... as a result of the teachers' ability to engage the students in skilful and well- framed questions.

  18. 7 CFR 1781.14 - Planning, options, and appraisals.

    Science.gov (United States)

    2010-01-01

    ... designated agent when a WS loan, WS advance or RCD loan is made. (d) Options and appraisals related to the purchase of real estate for which a WS loan, WS advance, or RCD loan is made must be developed in...

  19. "The nature of morality‟ in Gilbert Harman: As appraisal | Oyedola ...

    African Journals Online (AJOL)

    "The nature of morality‟ in Gilbert Harman: As appraisal. ... characteristic of scientific beliefs, as espoused by Harman has not undermined the nature of ... Nevertheless, the study concedes that the fact that liar man's grounds are appealing, his ...

  20. An appraisal of the state fund and empowerment programme in ...

    African Journals Online (AJOL)

    An appraisal of the state fund and empowerment programme in Nigeria. ... Distributive politics is one of the most important and controversial aspects of the policy ... all stakeholders in the federal polity should thread softly, be objective, rational, ...

  1. 38 CFR 36.4347 - Lender Appraisal Processing Program.

    Science.gov (United States)

    2010-07-01

    ... appropriate corrective action(s) in the appraisal review process when discrepancies or problems are identified...) Fees. The Secretary may require mortgagees to pay an application fee and/or annual fees, including...

  2. 38 CFR 36.4348 - Servicer Appraisal Processing Program.

    Science.gov (United States)

    2010-07-01

    ... prescribe appropriate corrective action(s) in the appraisal review process when discrepancies or problems... of SAPP authority. (g) Fees. The Secretary will require servicers to pay a $100.00 application fee...

  3. Methodical features of appraisal of partial rights on land

    OpenAIRE

    Makarova, V. V.; Semenenko, B. A.

    2015-01-01

    The theoretical and practical questions of appraisal of right for the permanent using lot lands, and rights for their lease, are examined. The methods of decision of the indicated tasks are offered in evaluation practice.

  4. 36 CFR 228.48 - Appraisal and measurement.

    Science.gov (United States)

    2010-07-01

    ... based on knowledge of the extent of the deposit, quality of material, and economic value. A sale must not be made at less than the appraised value which may be expressed as either price per cubic yard or...

  5. Appraisal of biochemical and genetic diversity of mango cultivars ...

    African Journals Online (AJOL)

    Appraisal of biochemical and genetic diversity of mango cultivars using molecular markers. ... Mango (Mangifera indica L.) is one of the oldest fruit crops and is broadly cultivated worldwide. To determine the level of ... HOW TO USE AJOL.

  6. An Appraisal Of The Operation And Management Of Unit Trust ...

    African Journals Online (AJOL)

    An Appraisal Of The Operation And Management Of Unit Trust Schemes In Nigeria. ... Open Access DOWNLOAD FULL TEXT ... instead of being invested in shares or in money market instruments as a result of widespread financial illiteracy.

  7. Naturalizing aesthetics: brain areas for aesthetic appraisal across sensory modalities.

    Science.gov (United States)

    Brown, Steven; Gao, Xiaoqing; Tisdelle, Loren; Eickhoff, Simon B; Liotti, Mario

    2011-09-01

    We present here the most comprehensive analysis to date of neuroaesthetic processing by reporting the results of voxel-based meta-analyses of 93 neuroimaging studies of positive-valence aesthetic appraisal across four sensory modalities. The results demonstrate that the most concordant area of activation across all four modalities is the right anterior insula, an area typically associated with visceral perception, especially of negative valence (disgust, pain, etc.). We argue that aesthetic processing is, at its core, the appraisal of the valence of perceived objects. This appraisal is in no way limited to artworks but is instead applicable to all types of perceived objects. Therefore, one way to naturalize aesthetics is to argue that such a system evolved first for the appraisal of objects of survival advantage, such as food sources, and was later co-opted in humans for the experience of artworks for the satisfaction of social needs. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. An appraisal of construction management practice in Nigeria | Ugwu ...

    African Journals Online (AJOL)

    An appraisal of construction management practice in Nigeria. ... 108 questionnaires were distributed to the key construction actors as follows: 45 to ... conflicting design information, effective co-ordination of resources, critical path method, ...

  9. Radiological design guide

    International Nuclear Information System (INIS)

    Evans, R.A.

    1994-01-01

    The purpose of this design guide is to provide radiological safety requirements, standards, and information necessary for designing facilities that will operate without unacceptable risk to personnel, the public, or the environment as required by the US Department of Energy (DOE). This design guide, together with WHC-CM-4-29, Nuclear Criticality Safety, WHC-CM-4-46, Nonreactor Facility Safety Analysis, and WHC-CM-7-5, Environmental Compliance, covers the radiation safety design requirements at Westinghouse Hanford Company (WHC). This design guide applies to the design of all new facilities. The WHC organization with line responsibility for design shall determine to what extent this design guide shall apply to the modifications to existing facilities. In making this determination, consideration shall include a cost versus benefit study. Specifically, facilities that store, handle, or process radioactive materials will be covered. This design guide replaces WHC-CM-4-9 and is designated a living document. This design guide is intended for design purposes only. Design criteria are different from operational criteria and often more stringent. Criteria that might be acceptable for operations might not be adequate for design

  10. Performance appraisal for green/environmental friendliness of a supply chain department

    Directory of Open Access Journals (Sweden)

    Solomon Olasunkanmi Odeyale

    2014-10-01

    Full Text Available Purpose: This paper aims at proposing a method for evaluating the environmental friendliness of a supply chain department in any organization. Supply chain involves activities that could affect the natural environment and if these activities are not properly evaluated and monitored, it could affect the natural environment and also generate ecological performance change. Design/methodology/approach: The model for the appraisal consists of 5 criteria and 30 subcriteria. The method is applied at 3 level; beginning with finding the relative weight of the subcriteria under each criterion using Analytic Hierarchy Process (AHP, followed by computing the value associated with each level descriptor in a scale. Some subcriteria have 5 level descriptors (very strong/moderate /weak/very weak / no, some subcriteria have 3 level descriptors (always / sometimes/ never and some have 2 levels descriptor (yes/no. Finally the method is concluded by the means of an additive model, whereby the weight associated with each subcriteria is multiplied by the corresponding level descriptor and summed up to get the limit/state. This methodology is called the weighing multiplication and additive model (WMAAM. Finding: Supply chain (SC involves operational activities and for these activities to be environmental friendly, they have been categorized under criteria namely; green design, green procurement, green manufacturing, environmental management and green marketing. These criteria which consist of 30 subcriteria are evaluated in other to compute the overall environmental friendly appraisal of the SC department. Practical Implication: The study plays important role in understanding various areas to be monitored and considered during supply chain activities in order to achieve a green supply chain management or an environmental friendly supply chain. Originality/value: The main contribution of this work is to propose an effective methodology that guides SC practitioners on

  11. Appraisal tools for clinical practice guidelines: a systematic review.

    Directory of Open Access Journals (Sweden)

    Ulrich Siering

    Full Text Available Clinical practice guidelines can improve healthcare processes and patient outcomes, but are often of low quality. Guideline appraisal tools aim to help potential guideline users in assessing guideline quality. We conducted a systematic review of publications describing guideline appraisal tools in order to identify and compare existing tools.Among others we searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from 1995 to May 2011 for relevant primary and secondary publications. We also handsearched the reference lists of relevant publications. On the basis of the available literature we firstly generated 34 items to be used in the comparison of appraisal tools and grouped them into thirteen quality dimensions. We then extracted formal characteristics as well as questions and statements of the appraisal tools and assigned them to the items.We identified 40 different appraisal tools. They covered between three and thirteen of the thirteen possible quality dimensions and between three and 29 of the possible 34 items. The main focus of the appraisal tools were the quality dimensions "evaluation of evidence" (mentioned in 35 tools; 88%, "presentation of guideline content" (34 tools; 85%, "transferability" (33 tools; 83%, "independence" (32 tools; 80%, "scope" (30 tools; 75%, and "information retrieval" (29 tools; 73%. The quality dimensions "consideration of different perspectives" and "dissemination, implementation and evaluation of the guideline" were covered by only twenty (50% and eighteen tools (45% respectively.Most guideline appraisal tools assess whether the literature search and the evaluation, synthesis and presentation of the evidence in guidelines follow the principles of evidence-based medicine. Although conflicts of interest and norms and values of guideline developers, as well as patient involvement, affect the trustworthiness of guidelines, they are currently insufficiently considered. Greater focus should be

  12. The IAEA Transport Safety Appraisal Service (TranSAS)

    International Nuclear Information System (INIS)

    Dicke, G.J.

    2004-01-01

    Representatives of all Member States of the IAEA meet once a year in September at the General Conference in Vienna, Austria, to consider and approve the Agency's programme and budget and to address matters brought before it by the Board of Governors, the Director General, or Member States. In September 1998 the General Conference adopted resolution GC(42)/RES/13 on the Safety of Transport of Radioactive Materials. In adopting that resolution the General Conference recognized that compliance with regulations that take account of the IAEA Regulations for the Safe Transport of Radioactive Material (the IAEA Transport Regulations) is providing a high level of safety during the transport of radioactive material. Good compliance requires that the regulations are implemented effectively. The General Conference therefore requested the IAEA Secretariat to provide a service for carrying out, at the request of any State, an appraisal of the implementation of the Transport Regulations by that State. In response to this request the Director General of the IAEA offered such an appraisal service to all States in letter J1.01.Circ, dated 10 December 1998. The first Transport Safety Appraisal Service (TranSAS) was undertaken and completed at the request of Slovenia in 1999. A report on the results of that appraisal was published and released for general distribution in the early fall of 1999. In each of the General Conferences since 1998, resolutions focused on transport safety have commended the Secretariat for establishing the TranSAS, commended those States that have requested the appraisal service and encouraged other States to avail themselves of this service see GC(43)/RES/11, GC(44)/RES/17, GC(45)/RES/10, GC(46)/RES/9 and GC(47)/RES/7. Six appraisals have been carried out to date as follows: Slovenia, Brazil, United Kingdom, Turkey, Panama and France. This presentation provides an overview of the Transport Safety Appraisal Service and summarizes the major findings from the

  13. The IAEA Transport Safety Appraisal Service (TranSAS)

    Energy Technology Data Exchange (ETDEWEB)

    Dicke, G.J. [International Atomic Energy Agency, Vienna (Austria)

    2004-07-01

    Representatives of all Member States of the IAEA meet once a year in September at the General Conference in Vienna, Austria, to consider and approve the Agency's programme and budget and to address matters brought before it by the Board of Governors, the Director General, or Member States. In September 1998 the General Conference adopted resolution GC(42)/RES/13 on the Safety of Transport of Radioactive Materials. In adopting that resolution the General Conference recognized that compliance with regulations that take account of the IAEA Regulations for the Safe Transport of Radioactive Material (the IAEA Transport Regulations) is providing a high level of safety during the transport of radioactive material. Good compliance requires that the regulations are implemented effectively. The General Conference therefore requested the IAEA Secretariat to provide a service for carrying out, at the request of any State, an appraisal of the implementation of the Transport Regulations by that State. In response to this request the Director General of the IAEA offered such an appraisal service to all States in letter J1.01.Circ, dated 10 December 1998. The first Transport Safety Appraisal Service (TranSAS) was undertaken and completed at the request of Slovenia in 1999. A report on the results of that appraisal was published and released for general distribution in the early fall of 1999. In each of the General Conferences since 1998, resolutions focused on transport safety have commended the Secretariat for establishing the TranSAS, commended those States that have requested the appraisal service and encouraged other States to avail themselves of this service see GC(43)/RES/11, GC(44)/RES/17, GC(45)/RES/10, GC(46)/RES/9 and GC(47)/RES/7. Six appraisals have been carried out to date as follows: Slovenia, Brazil, United Kingdom, Turkey, Panama and France. This presentation provides an overview of the Transport Safety Appraisal Service and summarizes the major findings from

  14. HBR guides

    CERN Document Server

    Duarte, Nancy; Dillon, Karen

    2015-01-01

    Master your most pressing professional challenges with this seven-volume set that collects the smartest best practices from leading experts all in one place. "HBR Guide to Better Business Writing" and "HBR Guide to Persuasive Presentations" help you perfect your communication skills; "HBR Guide to Managing Up and Across" and "HBR Guide to Office Politics" show you how to build the best professional relationships; "HBR Guide to Finance Basics for Managers" is the one book you'll ever need to teach you about the numbers; "HBR Guide to Project Management" addresses tough questions such as how to manage stakeholder expectations and how to manage uncertainty in a complex project; and "HBR Guide to Getting the Right Work Done" goes beyond basic productivity tips to teach you how to prioritize and focus on your work. This specially priced set of the most popular books in the series makes a perfect gift for aspiring leaders looking for trusted advice. Arm yourself with the advice you need to succeed on the job, from ...

  15. 76 FR 71577 - Guidance for Industry on Medication Guide Distribution Requirements and Inclusion of Medication...

    Science.gov (United States)

    2011-11-18

    ...] Guidance for Industry on Medication Guide Distribution Requirements and Inclusion of Medication Guides in... guidance for industry entitled ``Medication Guides-- Distribution Requirements and Inclusion in Risk... Requirements and Inclusion in Risk Evaluation and Mitigation Strategies (REMS).'' This guidance provides...

  16. The effects of conscientiousness on the appraisals of daily stressors.

    Science.gov (United States)

    Gartland, Nicola; O'Connor, Daryl B; Lawton, Rebecca

    2012-02-01

    Conscientiousness (C) is positively associated with health and longevity although the mechanisms underlying this relationship are not fully understood. Stress may play a role in explaining the C-longevity relationship. This study investigated whether C predicted the cognitive appraisals of daily stressors/hassles. Participants (N=102) completed measures of C and cognitive appraisal in relation to the most stressful hassle they had experienced in the last 7 days. Correlational analysis revealed that Total C, Order and Industriousness were positively correlated with primary appraisals, and Responsibility was positively correlated with secondary appraisals. The facets of C were then entered into hierarchical regression models, controlling for age and gender. This demonstrated that Order (β=0.27, paccounting for 15.8% of the variance. Responsibility significantly predicted secondary appraisals (β=0.44, paccounting for 16.3% of the variance. These findings indicate that higher Order and Industriousness are related to having a greater stake in daily stressors, whereas higher Responsibility is related to greater confidence in one's ability to deal with daily stressors. These results are the first demonstration that C is related to the appraisals of daily hassles and suggest that C may moderate the experience of stress in daily life. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Alienation appraisals distinguish adults diagnosed with DID from PTSD.

    Science.gov (United States)

    DePrince, Anne P; Huntjens, Rafaële J C; Dorahy, Martin J

    2015-11-01

    Studies are beginning to show the importance of appraisals to different types and severities of psychiatric disorders. Yet, little work in this area has assessed whether trauma-related appraisals can differentiate complex trauma-related disorders, such as posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). The current study evaluated whether any of 6 trauma-related appraisals distinguished adults diagnosed with DID from those diagnosed with PTSD. To accomplish this, we first examined the basic psychometric properties of a Dutch-translated short-form of the Trauma Appraisals Questionnaire (TAQ) in healthy control (n = 57), PTSD (n = 27) and DID (n = 12) samples. The short-form Dutch translation of the TAQ showed good internal reliability and criterion-related validity for all 6 subscales (betrayal, self-blame, fear, alienation, shame, anger). Of the 6 subscales, the alienation appraisal subscale specifically differentiated DID from PTSD, with the former group reporting more alienation. Abuse-related appraisals that emphasize disconnection from self and others may contribute to reported problems of memory and identity common in DID. The current findings suggest that addressing experiences of alienation may be particularly important in treatment for clients diagnosed with DID. (c) 2015 APA, all rights reserved).

  18. Scope of environmental risk management

    Energy Technology Data Exchange (ETDEWEB)

    O' Riordan, T

    1979-01-01

    Environmental risk management embraces three techniques for project appraisal: cost/benefit analysis, environmental impact analysis and risk assessment. It also explicitly relates scientific investigations to political judgments, sometimes so closely that the two cannot be separated. Indeed it is now apparent that environmental risk management encompasses procedures both to review the relative merits and priorities of policies as well as to appraise the environmental risks of particular schemes. Until recently this relationship has not been fully appreciated, so much imagination and innovation is still required to develop the most-suitable mechanisms for review.

  19. The Good Appraisal Toolkit for Primary Care Chambers Ruth et al The Good Appraisal Toolkit for Primary Care 189pp Radcliffe Publishing 9781857756029 1857756029.

    Science.gov (United States)

    2005-03-02

    The principles and frameworks demonstrated in this book could be used in many other healthcare settings. The text is divided neatly into nine chapters and addresses practical issues such as being an effective appraiser, developing and demonstrating competence, linking appraisal with career development, and evaluation of the appraisal process. The comprehensive approach to all aspects of appraisal makes this a must-have book for all health professionals and managers undertaking appraisals. It should also appeal to clinical governance leads and individuals being appraised. There are excellent tips on how to prepare for appraisals and how to link this with reflection, lifelong learning, career direction, and so on. The book is well referenced and contains an appendix with useful examples for the appraiser.

  20. Technical Safety Appraisal of the Pinellas Plant

    International Nuclear Information System (INIS)

    1991-01-01

    This report presents the Technical Safety Appraisal (TSA) of the Pinellas Plant in Pinellas County, Florida. The plant is owned and controlled by the US Department of Energy and operated by General Electric Neutron Devices (GEND). The TSA was performed during the period January 15--31, 1989, in support of a Tiger Team Assessment which occurred during the period January 15 to February 2, 1989. The TSA provided the Safety and Health Subteam input to the Tiger Team Assessment. The completion of the assessment process includes: (1) submission of the Team's preliminary findings and concerns, in a Draft Report, to the Manager, Albuquerque Operations Office and to the site contractors at the conclusion of the onsite assessment; (2) review of the Draft Report for technical and factual accuracy; incorporation of the appropriate review comments, suggested changes, and modifications, as well as input from all interested Program Secretarial Offices; preparation of a draft Action Plan by the Albuquerque Operations Office to address the Concerns, and submittal of that Action Plan through the Program Office to ES ampersand H for their review and comment. The Secretary approved the final Action Plan on December 16, 1990, and directed its implementation. The comments and suggestions of the Program Secretarial Offices, the Operations Office, and the site contractor have been incorporated, as appropriate, in this report prior to its publication

  1. Spent fuel storage options: a critical appraisal

    International Nuclear Information System (INIS)

    Singh, K.P.; Bale, M.G.

    1990-01-01

    The delayed decisions on nuclear fuel reprocessing strategies in the USA and other countries have forced the development of new long-term irradiated fuel storage techniques, to allow a larger volume of fuel to be held on the nuclear station site after removal from the reactor. The nuclear power industry has responded to the challenge by developing several viable options for long-term onsite storage, which can be employed individually or in tandem. They are: densification of storage in the existing spent fuel pool; building another fuel pool facility at the plant site; onsite cask park, and on site vault clusters. Desirable attributes of a storage option are: Safety: minimise the number of fuel handling steps; Economy: minimise total installed, and O and M cost; Security: protection from anti-nuclear protesters; Site adaptability: available site space, earthquake characteristics of the region and so on; Non-intrusiveness: minimise required modifications to existing plant systems; Modularisation: afford the option to adapt a modular approach for staged capital outlays; and Maturity: extent of industry experience with the technology. A critical appraisal is made of each of the four aforementioned storage options in the light of these criteria. (2 figures, 1 table, 4 references) (Author)

  2. An annual performance appraisal for CERN

    CERN Multimedia

    2012-01-01

    The March Council session is the occasion for CERN’s annual performance appraisal, but instead of the MARS form familiar to CERN staff, the lab’s working document is an Annual Progress Report, linked to the Medium-Term Plan, matching achievements to objectives. This year, I think it’s fair to say, we were firmly able to tick the ‘achieved’ box.   Top of the list of objectives was the LHC, which exceeded expectations in 2011 by delivering over five times the anticipated luminosity for protons while improving the lead-ion integrated luminosity by an order of magnitude compared to 2010.  As a result, the experiments published over 190 papers and made a staggering 1900 conference presentations. Underpinning this was the Worldwide LHC Computing Grid, which routinely performs so well that we hardly notice it's there. Non-LHC physics also had its day in the sun in 2011, with experiments at the PS, SPS, AD, n_TOF and ISOLDE, as well ...

  3. How to transform economics? A philosophical appraisal

    Directory of Open Access Journals (Sweden)

    Deniz Kellecioglu

    2017-11-01

    Full Text Available Ten years after the global financial crisis there is hardly any evidence that the theories, teaching and policies of mainstream economics have changed. This paper is an attempt to contribute to the greater understanding of this persistence, but also to the discussion on what the requirements are to materialise a transformation in economics, given the dismal outcomes in the world economy. The analytical approach of the paper is to utilise relevant philosophical accounts that point out attributes of dominant discourses, and methodological requirements to supersede an already dominant discourse. The objective is to contribute to an improved understanding of factors that obstruct or construct transformations in a knowledge field such as economics; and thereby contribute to transformation efforts, preferably for a more pluralist and emancipatory economics. Given the complexities and the tensions between different philosophical positions, the conclusions of this appraisal are summarised into five criteria that appear essential to realise a successful transformation in economics: critical juncture; dissimilarity; scholar validation; sensibility; and external power. It is suggested to revise efforts to fulfil these criteria as much, and as soon as possible, given the importance and urgency of changing the trajectory of our economies and societies.

  4. CEO performance appraisal: review and recommendations.

    Science.gov (United States)

    Newman, J F; Tyler, L; Dunbar, D M

    2001-01-01

    CEO performance appraisal (PA) is very valuable to an organization, but the chances of obtaining a PA of high quality decrease as executive responsibility increases. The realities of CEO PA are that it: (1) is inevitable; (2) is creative and complex; (3) involves politics; and (4) has a significant effect on the organization and the executive. PA is conducted for legal and social requirements, to enhance communication, to provide opportunities for improvement, and to relate performance to compensation. This article discusses several problems with chief executive officer (CEO) PA and the contemporary approaches that seek to improve it. Three fundamental areas for evaluation are identified: (1) organizational success; (2) areawide health status; and (3) professional role fulfillment. These provide an outline for successful healthcare PA. In addition to a discussion of the strategic considerations behind a successful CEO PA system, several recommendations are offered for the implementation of the annual evaluation process. The final goal of CEO PA is to link its results to CEO incentive compensation. It is strongly recommended that some portion of the CEO's salary directly hinge on his performance in two critical areas: organizational effectiveness and community health status.

  5. Seismic Safety Guide

    International Nuclear Information System (INIS)

    Eagling, D.G.

    1983-09-01

    This guide provides managers with practical guidelines for administering a comprehensive earthquake safety program. The Guide is comprehensive with respect to earthquakes in that it covers the most important aspects of natural hazards, site planning, evaluation and rehabilitation of existing buildings, design of new facilities, operational safety, emergency planning, special considerations related to shielding blocks, non-structural elements, lifelines, fire protection and emergency facilities. Management of risk and liabilities is also covered. Nuclear facilities per se are not dealt with specifically. The principles covered also apply generally to nuclear facilities but the design and construction of such structures are subject to special regulations and legal controls

  6. Seismic Safety Guide

    Energy Technology Data Exchange (ETDEWEB)

    Eagling, D.G. (ed.)

    1983-09-01

    This guide provides managers with practical guidelines for administering a comprehensive earthquake safety program. The Guide is comprehensive with respect to earthquakes in that it covers the most important aspects of natural hazards, site planning, evaluation and rehabilitation of existing buildings, design of new facilities, operational safety, emergency planning, special considerations related to shielding blocks, non-structural elements, lifelines, fire protection and emergency facilities. Management of risk and liabilities is also covered. Nuclear facilities per se are not dealt with specifically. The principles covered also apply generally to nuclear facilities but the design and construction of such structures are subject to special regulations and legal controls.

  7. Rapid urban malaria appraisal (RUMA in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Akogbeto Martin

    2005-09-01

    Full Text Available Abstract Background The rapid urban malaria appraisal (RUMA methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology. Methods This work was done in Yopougon municipality (Abidjan, Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1 a literature review, 2 the collection of available health statistics, 3 a risk mapping, 4 school parasitaemia surveys, 5 health facility-based surveys and 6 a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness. Results A substantial amount of literature (including unpublished theses and statistics was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500–13,000 USD for a six to ten-week period. Conclusion RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.

  8. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  9. A framework for assessing Health Economic Evaluation (HEE) quality appraisal instruments.

    Science.gov (United States)

    Langer, Astrid

    2012-08-16

    Health economic evaluations support the health care decision-making process by providing information on costs and consequences of health interventions. The quality of such studies is assessed by health economic evaluation (HEE) quality appraisal instruments. At present, there is no instrument for measuring and improving the quality of such HEE quality appraisal instruments. Therefore, the objectives of this study are to establish a framework for assessing the quality of HEE quality appraisal instruments to support and improve their quality, and to apply this framework to those HEE quality appraisal instruments which have been subject to more scrutiny than others, in order to test the framework and to demonstrate the shortcomings of existing HEE quality appraisal instruments. To develop the quality assessment framework for HEE quality appraisal instruments, the experiences of using appraisal tools for clinical guidelines are used. Based on a deductive iterative process, clinical guideline appraisal instruments identified through literature search are reviewed, consolidated, and adapted to produce the final quality assessment framework for HEE quality appraisal instruments. The final quality assessment framework for HEE quality appraisal instruments consists of 36 items organized within 7 dimensions, each of which captures a specific domain of quality. Applying the quality assessment framework to four existing HEE quality appraisal instruments, it is found that these four quality appraisal instruments are of variable quality. The framework described in this study should be regarded as a starting point for appraising the quality of HEE quality appraisal instruments. This framework can be used by HEE quality appraisal instrument producers to support and improve the quality and acceptance of existing and future HEE quality appraisal instruments. By applying this framework, users of HEE quality appraisal instruments can become aware of methodological deficiencies

  10. Influenza pandemic planning guide

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-11-15

    An influenza pandemic will have serious economic impacts on the natural gas industry due to absenteeism as well as downstream effects due to supply disruption.This guide was prepared to assist gas distribution companies in planning for an influenza epidemic. The guide aimed to minimize the risks that an influenza pandemic might pose to the health and safety of employees and the continuity of business operations. The guide discussed 5 critical aspects of emergency planning: (1) prevention and threat mitigation; (2) preparedness; (3) response; (4) business continuity; and (5) communication. The legal context of the emergency plans were discussed. The plans were also discussed to other essential infrastructure emergency response plans. Recommendations were presented for infection control, decentralization and access restriction. Outlines for pandemic response planning teams and training and exercise programs were provided. Issues related to alert, mobilization, and response procedures were also discussed. 10 refs., 3 tabs., 1 fig.

  11. 2013 MARS – Refresher presentation | General principles of the Merit, Appraisal and Recognition Scheme

    CERN Multimedia

    2013-01-01

    Staff members are invited to attend one of the three following information sessions that shall outline the general principles of the 2013 annual Merit, Appraisal and Recognition Scheme (MARS).   Monday 14 January at 10:00-11:30 – Filtration Plant (222-R-001) Thursday 17 January at 10:00-11:30 – Kjell Johnsen Auditorium (30-7-018) Monday 21 January at 10:00-11:30 - BE Amphitheatre Prévessin (864-1-D02)   General information on the MARS exercise may also be found in the CERN admin e-guide: https://admin-eguide.web.cern.ch/admin-eguide/mars/mars.asp. Human Resources Department Tel. 72728

  12. A Critical Appraisal of the "Day" Diagram

    Science.gov (United States)

    Roberts, Andrew P.; Tauxe, Lisa; Heslop, David; Zhao, Xiang; Jiang, Zhaoxia

    2018-04-01

    The "Day" diagram (Day et al., 1977, https://doi.org/10.1016/0031-9201(77)90108-X) is used widely to make inferences about the domain state of magnetic mineral assemblages. Based on theoretical and empirical arguments, the Day diagram is demarcated into stable "single domain" (SD), "pseudo single domain" ("PSD"), and "multidomain" (MD) zones. It is straightforward to make the necessary measurements for a sample and to plot results within the "domain state" framework based on the boundaries defined by Day et al. (1977, https://doi.org/10.1016/0031-9201(77)90108-X). We discuss 10 issues that limit Day diagram interpretation, including (1) magnetic mineralogy, (2) the associated magnetocrystalline anisotropy type, (3) mineral stoichiometry, (4) stress state, (5) surface oxidation, (6) magnetostatic interactions, (7) particle shape, (8) thermal relaxation, (9) magnetic particle mixtures, and (10) definitional/measurement issues. In most studies, these variables are unknowns and cannot be controlled for, so that hysteresis parameters for single bulk samples are nonunique and any data point in a Day diagram could result from infinite combinations of relevant variables. From this critical appraisal, we argue that the Day diagram is fundamentally ambiguous for domain state diagnosis. Widespread use of the Day diagram has also contributed significantly to prevalent but questionable views, including underrecognition of the importance of stable SD particles in the geological record and reinforcement of the unhelpful PSD concept and of its geological importance. Adoption of approaches that enable correct domain state diagnosis should be an urgent priority for component-specific understanding of magnetic mineral assemblages and for quantitative rock magnetic interpretation.

  13. An appraisal of the quality of published qualitative dental research.

    Science.gov (United States)

    Masood, Mohd; Thaliath, Ebin T; Bower, Elizabeth J; Newton, J Timothy

    2011-06-01

    To appraise the quality of published qualitative research in dentistry and identify aspects of quality, which require attention in future research. Qualitative research studies on dental topics were appraised using the critical appraisal skills programme (CASP) appraisal framework for qualitative research. The percentage of CASP criteria fully met during the assessment was used as an indication of the quality of each paper. Individual criteria were not weighted. Forty-three qualitative studies were identified for appraisal of which 48% had a dental public health focus. Deficiencies in detail of reporting, research design, methodological rigour, presentation of findings, reflexivity, credibility of findings and relevance of study were identified. Problems with quality were apparent irrespective of journal impact factor, although papers from low impact factor journals exhibited the most deficiencies. Journals with the highest impact factors published the least qualitative research. The quality of much of the qualitative research published on dental topics is mediocre. Qualitative methods are underutilized in oral health research. If quality guidelines such as the CASP framework are used in the context of a thorough understanding of qualitative research design and data analysis, they can promote good practice and the systematic assessment of qualitative research. © 2010 John Wiley & Sons A/S.

  14. Sex differences in the appraisal of traumatic events and psychopathology.

    Science.gov (United States)

    Kucharska, Justyna

    2017-09-01

    The current study is an investigation of the relationship between the appraisal of traumatic events and mental disorder symptoms: internalizing symptoms and externalizing/substance-abuse symptoms. Cumulative trauma over the lifetime was taken into account. Also, specific effects related to traumatic events of various types (i.e., betrayal trauma, accident involving a family member, physical violence, and natural disaster) were assessed. Participants, 190 young men and 277 young women, were asked to evaluate the strength with which the traumatic event impacted their lives. It was hypothesized that the relationship between traumatic experiences and mental disorder symptoms would be stronger in women than in men, and also that cognitive appraisal, in interaction with gender, would be related to the severity of the symptoms. Women showed higher levels of internalizing symptoms, but lower levels of externalizing/substance-abuse symptoms than men. Still, the correlation between cumulative trauma and both types of symptoms was stronger in women. For all types of trauma, women reported a stronger negative appraisal of the event than men. Interaction of sex and cognitive appraisal was demonstrated to be related to the severity of internalizing disorders. In the present study, women, as compared with men, evaluated traumatic events more negatively (for all types of trauma) and the relationship between trauma and mental disorder symptoms was also stronger in women. These results show the importance of the appraisal of trauma in the development of psychiatric symptoms in women and men following trauma. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Technical Safety Appraisal of the Rocky Flats Plant

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Blake P.

    1989-01-01

    This report provides the results of a Technical Safety Appraisal (TSA) of the Rocky Flats Plant (RFP) conducted November 14 to 18 and November 28 to December 9, 1988. This appraisal covered the effectiveness and improvements in the RFP safety program across the site, evaluating progress to date against standards of accepted practice. The appraisal included coverage of the timeliness and effectiveness of actions taken in response to the recommendations/concerns in three previous Technical Safety Appraisals (TSAs) of RFP Bldg. 707 conducted in July 1986, Bldgs. 771/774 conducted in October/November 1986, and Bldgs. 776/777 conducted in January/February 1988. Results of this appraisal are given in Section IV for each of 14 technical safety areas at RFP. These results include a discussion, conclusions and any new safety concerns for each technical safety area. Appendix A contains a description of the system for categorizing concerns, and the concerns are tabulated in Appendix B. Appendix C reports on the evaluation of the contractor's actions and the current status of each of the 230 recommendations and concerns contained in the three previous TSA reports.

  16. Dancing in pain: pain appraisal and coping in dancers.

    Science.gov (United States)

    Anderson, Ruth; Hanrahan, Stephanie J

    2008-01-01

    This study investigated the relationships between the type of pain experienced (performance pain and injury pain), the cognitive appraisal of pain and pain coping styles in dancers. Fifty-one professional ballet and contemporary dancers (17 males and 34 females), with the mean age of 25.9 years, completed a general pain questionnaire, the Pain Appraisal Inventory, the Survey of Pain Attitudes Control Subscale, and the Sports Inventory for Pain. Multivariate analyses of variance indicated that both the cognitive appraisal of the pain and pain coping styles did not differ according to the type of pain experienced or the pain severity. However, it was found that dancers with performance pain of either low or high severity were more likely to dance in pain than dancers experiencing injury pain. Multiple regression analyses indicated that the appraisal of pain as threatening was predictive of the use of avoidance and catastrophizing pain coping styles. Overall, results indicated that dancers may not differentiate between performance pain and injury pain, or modify their appraisal and coping strategies according to the characteristics of the pain experienced. The study highlighted an opportunity for increased education for dancers in recognizing the difference between pain considered to be a routine aspect of training and pain which is a signal of serious injury.

  17. Guide device

    International Nuclear Information System (INIS)

    Brammer, C.M. Jr.

    1977-01-01

    Disclosed is a fuel handling guide tube centering device for use in nuclear reactors during fuel assembly handling operations. The device comprises an outer ring secured to the flange of a nuclear reactor pressure vessel, a rotatable table rotatably coupled to the outer ring, and a plurality of openings through the table. Truncated locating cones are positioned in each of the openings in the table, and the locating cones center the guide tube during fuel handling operations. The openings in the table are located such that each fuel assembly in the nuclear core may be aligned with one of the openings by a suitable rotation of the table. The locating cones thereby provide alignment between the fuel handling mechanism located in the guide tube and the individual fuel assemblies of the cone. The need for a device to provide alignment is especially critical for floating nuclear power plants, where wave motion may exist during fuel handling operations. 5 claims, 4 figures

  18. Risk

    Science.gov (United States)

    Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

    2015-01-01

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  19. {sup 18}F-FDG PET/CT to assess response and guide risk-stratified follow-up after chemoradiotherapy for oropharyngeal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Thomas; Lei, Mary; Guerrero Urbano, Teresa [Guy' s and St Thomas' NHS Foundation Trust, Department of Clinical Oncology, London (United Kingdom); Barrington, Sally [King' s College, PET Imaging Centre at St Thomas' Hospital, London (United Kingdom); Thavaraj, Selvam [Guy' s and St Thomas' NHS Foundation Trust, Head and Neck Pathology Department, London (United Kingdom); Jeannon, Jean-Pierre; Lyons, Andrew; Oakley, Richard; Simo, Ricard [Guy' s and St Thomas' NHS Foundation Trust, Department of Head and Neck Surgery, London (United Kingdom)

    2016-07-15

    To evaluate the use of {sup 18}F-FDG PET/CT as the principal investigation to assess tumour response, to determine the need for further surgery and to guide follow-up following radical chemoradiotherapy for stage III/IV oropharyngeal squamous cell carcinoma (OPSCC). A retrospective analysis was undertaken in 146 patients treated at our centre with radical chemoradiotherapy for OPSCC and who had a PET/CT scan to assess response. According to the PET/CT findings, patients were divided into four groups and recommendations: (1) complete metabolic response (enter clinical follow-up); (2) low-level uptake only (follow-up PET/CT scan in 12 weeks); (3) residual uptake suspicious for residual disease (further investigation with or without neck dissection); and (4) new diagnosis of distant metastatic disease (palliative treatment options). The initial PET/CT scan was performed at a median of 12.4 weeks (range 4.3 - 21.7 weeks) following treatment. Overall sensitivity and specificity rates were 92.0 % (74.0 - 99.0 %) and 85 % (77.5 - 90.9 %). Of the 146 patients, 90 (62 %) had a complete response and had estimated 3-year overall and disease-free survival rates of 91.9 % (85.6 - 98.2 %) and 85.6 % (78.0 - 93.2 %), respectively, 17 (12 %) had residual low-level uptake only (with two having confirmed residual disease on subsequent PET/CT, both surgically salvaged), 30 (21 %) had suspicious residual uptake (12 proceeded to neck dissection; true positive rate at surgery 33 %). HPV-positive patients with reassuring PET/CT findings had an estimated 3-year progression-free survival rate of 91.7 % (85.2 - 98.2 %), compared with 66.2 % (41.5 - 90.9 %) of HPV-negative patients. A strategy of using PET/CT results alongside clinical examination to help select patients for salvage surgery appears successful. Despite a complete response on the 12-week PET/CT scan, HPV-negative patients have a significant risk of disease relapse in the following 2 years and further studies to assess whether

  20. A Critical Appraisal of the `Day' Diagram

    Science.gov (United States)

    Roberts, A. P.; Tauxe, L.; Heslop, D.

    2017-12-01

    The `Day' diagram [Day et al., 1977; doi:10.1016/0031-9201(77)90108-X] is used widely to infer the mean domain state of magnetic mineral assemblages. The Day plot coordinates are the ratios of the saturation remanent magnetization to saturation magnetization (Mrs/Ms) and the coercivity of remanence to coercivity (Bcr/Bc), as determined from a major hysteresis loop and a backfield demagnetization curve. Based on theoretical and empirical arguments, Day plots are typically demarcated into stable single domain (SD), `pseudosingle domain' (`PSD'), and multidomain (MD) zones. It is a simple task to determine Mrs/Ms and Bcr/Bc for a sample and to assign a mean domain state based on the boundaries defined by Day et al. [1977]. Many other parameters contribute to variability in a Day diagram, including surface oxidation, mineral stoichiometry, stress state, magnetostatic interactions, and mixtures of magnetic particles with different sizes and shapes. Bulk magnetic measurements usually lack detailed independent evidence to constrain each free parameter, which makes the Day diagram fundamentally ambiguous. This raises questions about its usefulness for diagnosing magnetic particle size variations. The Day diagram is also used to make inferences about binary mixing of magnetic particles, where, for example, mixtures of SD and MD particles give rise to a bulk `PSD' response even though the concentration of `PSD' grains could be zero. In our assessment of thousands of hysteresis measurements of geological samples, binary mixing occurs in a tiny number of cases. Ternary, quaternary, and higher order mixing are usually observed. Also, uniaxial SD and MD end-members are nearly always inappropriate for considering mixing because uniaxial SD particles are virtually non-existent in igneous rocks. Thus, use of mixing lines in Day diagrams routinely provides unsatisfactory representations of particle size variations. We critically appraise the Day diagram and argue that its many

  1. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients.

    Science.gov (United States)

    Nour-Eldin, Nour-Eldin A; Alsubhi, Mohammed; Emam, Ahmed; Lehnert, Thomas; Beeres, Martin; Jacobi, Volkmar; Gruber-Rouh, Tatjana; Scholtz, Jan-Erik; Vogl, Thomas J; Naguib, Nagy N

    2016-02-01

    To assess the scope and determining risk factors related to the development of pneumothorax throughout CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques and the outcome of its management. The study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD 5.2) from November 2008 to June 2013 in a retrospective design. Patients were classified according to lung biopsy technique into coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were lesions pneumothorax were classified into: (a) Technical risk factors, (b) patient-related risk factors, and (c) lesion-associated risk factors. Radiological assessments were performed by two radiologists in consensus. Mann-Whitney U test and Fisher's exact tests were used for statistical analysis. p values pneumothorax complicating CT-guided lung biopsy was less in the non-coaxial group (23.2 %, 77 out of 332) than the coaxial group (27 %, 86 out of 318). However, the difference in incidence between both groups was statistically insignificant (p = 0.14). Significant risk factors for the development of pneumothorax in both groups were emphysema (p pneumothorax in the non-coaxial group was significantly correlated to the number of specimens obtained (p = 0.006). This factor was statistically insignificant in the coaxial group (p = 0.45). The biopsy yield was more diagnostic and conclusive in the coaxial group in comparison to the non-coaxial group (p = 0.008). Simultaneous incidence of pneumothorax and pulmonary hemorrhage was 27.3 % (21/77) in non-coaxial group and in 30.2 % (26/86) in coaxial group. Conservative management was sufficient for treatment of 91 out of 101 patients of pneumothorax in both groups (90.1 %). Manual evacuation of pneumothorax was efficient in 44/51 patients (86.3 %) in both groups and intercostal chest tube was applied after failure of manual evacuation (7

  2. Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2011-11-03

    This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the \\'treat-to-target\\' paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and \\'real-world\\' populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

  3. The Efficacy of Performance Appraisal to Increase Employees’ Job Satisfaction

    Directory of Open Access Journals (Sweden)

    Iranita Hervi Mahardayani

    2016-08-01

    Full Text Available This research aims to find out the effectiveness of implementation performance appraisal toward job satisfaction of employees UMKM Bordir Dahlia in Kabupaten Kudus. Sampling was done by using population studies to 16 employees of UMKM embroidery Dahlia Kudus. The type of this research is quantitative with pra experiment approached by One group pre and posttest design method. Data analysis on this research using non parametric with different test techniques Wilcoxon t-tes. The analysis result of different test scale job satisfaction before and after handling obtained Z = - 1,268, with p = 0,205 (p>0,05, so that there is no differences on job satisfaction on employees of embroidery Dahlia before and after treatment by giving performance appraisal. It means treatment by giving performance appraisal unable to increase employees job satisfaction. Therefore, the hypothesis on this research is rejected.

  4. Why is discrimination stressful? The mediating role of cognitive appraisal.

    Science.gov (United States)

    King, Kimberly R

    2005-08-01

    This study attempts to shed light on past findings that experiences of racial and gender discrimination are associated with poor psychological and physical health outcomes by investigating the role of cognitive appraisal as a mediator of the relationship between experiences of discrimination and affective stress reactions. African American female college students (N = 115) imagined themselves in an audiotaped scenario in which they overheard 2 European American male classmates make negative evaluations of them. Participants then completed measures of causal attributions, cognitive appraisal, and affective stress reactions. Multiple regression analyses supported the hypotheses that attributions to racism and to discrimination that combines racism and sexism were associated with increased stress reactions. This relationship was mediated by cognitive appraisals of centrality. (c) 2005 APA

  5. COMMUNICATION OPENNESS IN PERFORMANCE APPRAISAL SYSTEMS ENHANCING JOB SATISFACTION

    Directory of Open Access Journals (Sweden)

    ISMAIL Azman

    2014-06-01

    Full Text Available The aim of this paper is to investigate the relationship between communication openness in performance appraisal systems and job satisfaction. A survey method was employed to gather data from employees who have worked in a privatized postal company in Sarawak, Malaysia. SmartPLS version 2.0 was used to determine the validity and reliability of instrument and test the research hypotheses. The outcomes of SmartPLS path model showed that explanation and feedback were positively and significantly related to job satisfaction. This result confirms that the ability of appraisers to clearly explain the performance appraisal practices and adequately provide feedback in determining performance scores have been important predictors of appraises’ job satisfaction in the studied organization. Further, this study provides discussion, implications and conclusion.

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

    Science.gov (United States)

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

    2007-01-01

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

  7. Artificial Neural Networks and the Mass Appraisal of Real Estate

    Directory of Open Access Journals (Sweden)

    Gang Zhou

    2018-03-01

    Full Text Available With the rapid development of computer, artificial intelligence and big data technology, artificial neural networks have become one of the most powerful machine learning algorithms. In the practice, most of the applications of artificial neural networks use back propagation neural network and its variation. Besides the back propagation neural network, various neural networks have been developing in order to improve the performance of standard models. Though neural networks are well known method in the research of real estate, there is enormous space for future research in order to enhance their function. Some scholars combine genetic algorithm, geospatial information, support vector machine model, particle swarm optimization with artificial neural networks to appraise the real estate, which is helpful for the existing appraisal technology. The mass appraisal of real estate in this paper includes the real estate valuation in the transaction and the tax base valuation in the real estate holding. In this study we focus on the theoretical development of artificial neural networks and mass appraisal of real estate, artificial neural networks model evolution and algorithm improvement, artificial neural networks practice and application, and review the existing literature about artificial neural networks and mass appraisal of real estate. Finally, we provide some suggestions for the mass appraisal of China's real estate.

  8. Importance of Change Appraisal for Employee Well-being during Organizational Restructuring: Findings from the Finnish Paper Industry’s Extensive Transition

    Science.gov (United States)

    PAHKIN, Krista; NIELSEN, Karina; VÄÄNÄNEN, Ari; MATTILA-HOLAPPA, Pauliina; LEPPÄNEN, Anneli; KOSKINEN, Aki

    2014-01-01

    The global recession has forced the Finnish forest industry to carry out major restructuring activities. Employees have faced different kinds of restructuring, mainly aimed at reducing staff and production. Many studies have shown the negative consequences of restructuring on employee well-being by using negative, ill-health indicators. Our aim is to examine the extent to which change appraisal influences both the negative and positive aspects of work-related well-being among employees who continue working in the organization after the restructuring process. We also examine the role of different actors (top management, immediate supervisor, employees themselves) in how the change is appraised. The study investigated blue-collar employees working in the Finnish forest industry during a period of extensive transition (2008–2009). All six participating factories underwent restructuring between baseline and the follow-up survey (n=369). After adjustment for gender, age and baseline well-being, negative change appraisal increased the risk of experiencing more stress and less work enjoyment. Negative change appraisals thus also damaged the positive, motivational aspects of employee well-being. The results showed the importance of offering employees the opportunity to participate in the planning of changes related to their work as regards positive change appraisal. PMID:24975107

  9. A cost-utility analysis of risk model-guided versus physician's choice antiemetic prophylaxis in patients receiving chemotherapy for early-stage breast cancer: a net benefit regression approach.

    Science.gov (United States)

    Thavorn, Kednapa; Coyle, Doug; Hoch, Jeffrey S; Vandermeer, Lisa; Mazzarello, Sasha; Wang, Zhou; Dranitsaris, George; Fergusson, Dean; Clemons, Mark

    2017-08-01

    We assessed the cost-effectiveness of a risk model-guided (RMG) antiemetic prophylaxis strategy compared with the physician's choice (PC) strategy in patients receiving chemotherapy for early-stage breast cancer. We conducted a cost-utility analysis based on a published randomized controlled trial of 324 patients with early-stage breast cancer undergoing chemotherapy at two Canadian cancer centers. Patients were randomized to receive their antiemetic treatments according to either predefined risk scores or the treating physician's preference. Effectiveness was measured as quality-adjusted life years (QALYs) gained. Cost and utility data were obtained from the Canadian published literature. We used generalized estimating equations to estimate the incremental cost-effectiveness ratios (ICERs) and 95% confidence intervals (CIs) over a range of willingness-to-pay values. The lower and upper bounds of the 95% CIs were used to characterize the statistical uncertainty for the cost-effectiveness estimates and construct cost-effectiveness acceptability curves. From the health care system's perspective, the RMG strategy was associated with greater QALYs gained (0.0016, 95% CI 0.0009, 0.0022) and higher cost ($49.19, 95% CI $24.87, $73.08) than the PC strategy, resulting in an ICER of $30,864.28 (95% CI $14,718.98, $62,789.04). At the commonly used threshold of $50,000/QALY, the probability that RMG prophylaxis is cost-effective was >94%; this probability increased with greater willingness-to-pay values. The risk-guided antiemetic prophylaxis is an economically attractive option for patients receiving chemotherapy for early-stage breast cancer. This information supports the implementation of risk prediction models to guide chemotherapy-induced nausea and vomiting prophylaxis in clinical practices.

  10. Homebuyer's Guide.

    Science.gov (United States)

    Sindt, Roger P.; Harris, Jack

    Designed to assist prospective buyers in making such important decisions as whether to buy a new or older home and within what price range, the guide provides information on the purchase process. Discussion of the purchase process covers the life-cycle costs (recurring homeownership costs that must be met every month); selection of a home;…

  11. Procedures for the systematic appraisal of operational radiation protection programmes

    International Nuclear Information System (INIS)

    1987-09-01

    The purpose of this document is to give guidance to management and regulators of organisations using ionizing radiations on a technique for systematically appraising their operational radiation protection programme in order that its adequacy and effectiveness can be objectively determined. The appraisal technique is based on analytical trees and can be used to examine either a whole programme, to determine its completion and adequacy or to examine one component of a programme in considerable detail. This document will not develop technical recommendations on particular radiation protection programmes. These will be found in the appropriate Safety Series document on operational radiation protection. 8 refs, figs

  12. FASP, an analytic resource appraisal program for petroleum play analysis

    Science.gov (United States)

    Crovelli, R.A.; Balay, R.H.

    1986-01-01

    An analytic probabilistic methodology for resource appraisal of undiscovered oil and gas resources in play analysis is presented in a FORTRAN program termed FASP. This play-analysis methodology is a geostochastic system for petroleum resource appraisal in explored as well as frontier areas. An established geologic model considers both the uncertainty of the presence of the assessed hydrocarbon and its amount if present. The program FASP produces resource estimates of crude oil, nonassociated gas, dissolved gas, and gas for a geologic play in terms of probability distributions. The analytic method is based upon conditional probability theory and many laws of expectation and variance. ?? 1986.

  13. APPRAISAL OF INDIGENOUS PIG PROCUTION AND ...

    African Journals Online (AJOL)

    Dr Adesope

    livelihood and a risk aversion strategy which did not involve conversion of whole ... and usage issues; policy issues and farmers' perception of the importance .... in clay mining and brick making as their primary occupation which is equally a ...

  14. FDG-PET/CT in a patient with poor-risk non-seminoma testis with mature teratoma and secondary gliosarcoma: Multimodality imaging for guiding multimodality treatment

    Energy Technology Data Exchange (ETDEWEB)

    Quak, Elske; Kovacs, Iringo; Oyen, Wim J. G.; Van der Graaf, Winette T. A. [Radboud University Nijmegen Medical Centre, Nijmegen (Nauru)

    2015-09-15

    The value of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in detecting viable tumours in patients with metastasised non-seminomatous testicular cancer and residual and new masses post chemotherapy remains to be determined. We describe the case of a 41-year-old patient with metastasised non-seminomatous testicular cancer, with both retroperitoneal and extra-retroperitoneal residual masses post chemotherapy, for whom FDG-PET/CT guided major treatment decisions. FDG-PET/CT correctly identified the locations of viable tumour, as was proved by histology, and successfully guided surgery. In conclusion, in selected cases surveillance of patients with non-seminomatous testicular cancer with FDG-PET/CT can guide major treatment decisions when considering surgery for metastatic disease.

  15. Risk

    Science.gov (United States)

    Barshi, Immanuel

    2016-01-01

    Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

  16. DMPD: Toll like receptors and autoimmunity: a critical appraisal. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 17959357 Toll like receptors and autoimmunity: a critical appraisal. Papadimitraki ...ml) Show Toll like receptors and autoimmunity: a critical appraisal. PubmedID 17959357 Title Toll like receptors and auto

  17. Effects of School-Based Educational Interventions for Enhancing Adolescents Abilities in Critical Appraisal of Health Claims: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Lena V Nordheim

    Full Text Available Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims.We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation to assess the certainty of the evidence.Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low.Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health

  18. Effects of School-Based Educational Interventions for Enhancing Adolescents Abilities in Critical Appraisal of Health Claims: A Systematic Review.

    Science.gov (United States)

    Nordheim, Lena V; Gundersen, Malene W; Espehaug, Birgitte; Guttersrud, Øystein; Flottorp, Signe

    2016-01-01

    Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims. We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) to assess the certainty of the evidence. Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low. Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health claims. The small

  19. A New Appraisal- Lessons from the History of Efforts to Value Green and High-Performance Home Attributes in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-10-21

    Rigorous consideration of green and high-performance (“green/HP”) features is rarely included in the property valuation process._ To help illuminate why this is the case, this report takes stock of the history of efforts to improve practices, and identifies barriers that have emerged and opportunities for overcoming them. Particular emphasis is placed on what energy and environmental policymakers and other stakeholders outside the appraisal community can contribute to the broader effort to advance professional practices. The history has unfolded in parallel with turbulent periods in the housing market for which appraisers and their customers are deemed to share responsibility, followed by cycles of regulations, siloing of appraisers in the name of professional integrity, and commoditization of the valuation process itself. This pattern has important ramifications for aspirations that appraisers engage more fully in identifying and valuing the green/HP characteristics of homes. On the one hand, it is legally and ethically incumbent on appraisers to do so, yet on the other hand it is perceived as a risky avenue to follow. Risks arise where findings can be challenged as either over- or under-stating value, together with a market environment in which the complexity of their assignments increases despite downward pressure on appraiser fees. While efforts to address green/HP considerations date back to the early 1980s, the vast majority of activity has taken place within the past five years. Many players have engaged in the efforts to promote improved valuation practices. These include the Appraisal Foundation, The Appraisal Institute, Colorado Energy Office, Earth Advantage, EcoBroker, Elevate Energy, Fannie Mae, Federal Housing Administration, Home Innovation Research Labs, The Institute for Market Transformation, Northwest Energy Efficiency Alliance, National Association of Homebuilders, National Association of State Energy Officials, National Association of

  20. Nonlinear Appraisal Modeling: An Application of Machine Learning to the Study of Emotion Production

    OpenAIRE

    Meuleman, Ben; Scherer, Klaus R.

    2013-01-01

    Appraisal theory of emotion claims that emotions are not caused by "raw" stimuli, as such, but by the subjective evaluation (appraisal) of those stimuli. Studies that analyzed this relation have been dominated by linear models of analysis. These methods are not ideally suited to examine a basic assumption of many appraisal theories, which is that appraisal criteria interact to differentiate emotions, and hence show nonlinear effects. Studies that did model interactions were either l...

  1. Learning to Appraise the Quality of Qualitative Research Articles: A Contextualized Learning Object for Constructing Knowledge

    Science.gov (United States)

    Chenail, Ronald J.

    2011-01-01

    Helping beginning qualitative researchers critically appraise qualitative research articles is a common learning objective for introductory methodology courses. To aid students in achieving competency in appraising the quality of qualitative research articles, a multi-part activity incorporating the Critical Appraisal Skills Programme's (CASP)…

  2. 12 CFR 564.8 - Appraisal policies and practices of savings associations and subsidiaries.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appraisal policies and practices of savings associations and subsidiaries. 564.8 Section 564.8 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.8 Appraisal policies and practices of savings associations and...

  3. A Field Study of Discrete Emotions: Athletes' Cognitive Appraisals during Competition

    Science.gov (United States)

    Martinent, Guillaume; Ferrand, Claude

    2015-01-01

    Purpose: Cognitive-motivational-relational theory (CMRT) emphasizes that cognitive appraisal components and core relational themes (in which the 6 separate appraisal judgments are brought together as 1) are the proximal determinants of athletes' emotions. This study aimed to explore appraisals associated with discrete emotions experienced by…

  4. (Un)ethical behavior and performance appraisal: the role of affect, support, and organizational justice

    NARCIS (Netherlands)

    Jacobs, G.; Belschak, F.D.; den Hartog, D.N.

    2014-01-01

    Performance appraisals are widely used as an HR instrument. This study among 332 police officers examines the effects of performance appraisals from a behavioral ethics perspective. A mediation model relating justice perceptions of police officers’ last performance appraisal to their work affect,

  5. 5 CFR 430.405 - Procedures for certifying agency appraisal systems.

    Science.gov (United States)

    2010-01-01

    ... SERVICE REGULATIONS PERFORMANCE MANAGEMENT Performance Appraisal Certification for Pay Purposes § 430.405... appraisals of their relative performance against performance expectations in any given appraisal period..., requirements, or expectations for the employees they supervise to ensure that they clearly link to...

  6. Automatic Affective Appraisal of Sexual Penetration Stimuli in Women with Vaginismus or Dyspareunia

    NARCIS (Netherlands)

    Huijding, Jorg; Borg, Charmaine; Weijmar-Schultz, Willibrord; de Jong, Peter J.

    Introduction. Current psychological views are that negative appraisals of sexual stimuli lie at the core of sexual dysfunctions. It is important to differentiate between deliberate appraisals and more automatic appraisals, as research has shown that the former are most relevant to controllable

  7. Evidence-based review and appraisal of the use of droperidol in the emergency department

    Directory of Open Access Journals (Sweden)

    Pei-Chun Lai

    2018-01-01

    Full Text Available Droperidol is a short-acting, potent dopamine D2 antagonist that can pass through the blood–brain barrier. A black box warning was issued for droperidol by the United States Food and Drug Administration in 2001 because of a risk of development of torsades de pointes induced by QT prolongation. Many experts feel that the incidence of arrhythmia is overestimated, and low-dose droperidol is almost always used by anesthesiologists for postoperative nausea and vomiting. In this review, we used evidence-based analysis to appraise high-quality studies with a low risk of bias published after 2001 on the use of droperidol in the emergency department (ED. Droperidol appears not only efficacious but also safe to treat patients with nausea/vomiting, acute psychosis, and migraine in the ED. For these conditions, droperidol may be an option for shared decision-making.

  8. Technical appraisal of the current situation in the field of radioactive waste management

    International Nuclear Information System (INIS)

    1985-01-01

    Industrial activities are regarded as safe even though a small risk always exists. The philosophy of radiation protection accepts this and recognises that some level of risk will also be associated with safe radioactive waste management. Therefore the objective of radioactive waste management is to look for a strategy which, taken as a whole, is considered safe and provides an acceptable balance of all the radiological, technical, social, political and economic considerations. The RWMC's appraisal underlines the need for such a balance while concentrating on radiological and technical factors, particularly on the long term safety aspects of radioactive waste management. The fundamental conclusion is that detailed short and long term safety assessments can now be made which give confidence that radiation protection objectives can be met with currently available technology for most waste types, and at a cost which is only a small fraction of the overall cost of nuclear-generated power

  9. An Appraisal of the DEXA Wave Energy Converter

    DEFF Research Database (Denmark)

    Pecher, Arthur; Kofoed, Jens Peter

    This report has been requested by VækstFonden and aims at giving an overview of the experimental tests and a general appraisal of the DEXA wave energy converter (WEC). The reported results and findings were obtained during previously performed experimental tests by the Wave Energy Research Group...

  10. 9 CFR 53.3 - Appraisal of animals or materials.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Appraisal of animals or materials. 53.3 Section 53.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF... animals or materials. (a) Animals affected by or exposed to disease, and materials required to be...

  11. An appraisal of undergraduate curriculum of technical education in ...

    African Journals Online (AJOL)

    The purpose of this study was to appraise the curriculum of technical teacher education in terms of its compatibility to the goals of the programme. A sample of three Universities offering technical teacher programme was used for the study. Components of the technical teacher education curriculum in each institution were ...

  12. 49 CFR 24.103 - Criteria for appraisals.

    Science.gov (United States)

    2010-10-01

    ...-year sales history of the property. (See appendix A, § 24.103(a)(1).) (ii) All relevant and reliable..., § 24.103(a).) (iii) A description of comparable sales, including a description of all relevant physical..., signature, and certification of the appraiser. (b) Influence of the project on just compensation. The...

  13. Quantum theories of the early universe - a critical appraisal

    International Nuclear Information System (INIS)

    Hu, B.L.

    1988-01-01

    A critical appraisal of certain general problems in the study of quantum processes in curved space as applied to the construction of theories of the early universe is presented. Outstanding issues in different cosmological models and the degree of success of different quantum processes in addressing these issues are summarized. (author)

  14. MAPS evaluation report and procedures governing interviews and performance appraisals

    CERN Multimedia

    HR Department

    2006-01-01

    Following various improvements to the MAPS report and to the procedures governing interviews and performance appraisals (announced in the CERN Bulletin 48-49/2005), a third information session has been organized for all staff members on Tuesday, 31 January at 10 a.m.: AB Auditorium P (864-1-D02), Human Resources Department Tel. 73566

  15. Dimensions in Appraising Fatigue in Relation to Performance

    NARCIS (Netherlands)

    Dam, A. van; Keijsers, G.P.J.; Eling, P.A.T.M.

    2011-01-01

    Studies on the relation between fatigue and performance often fail to find a strong and direct link, implying that multiple factors may be involved. A literature search on the fatigue-performance relationship suggests that two different conceptual frameworks are employed concerning the appraisal of

  16. Performance appraisal: carrot or stick? | Quinn | South African ...

    African Journals Online (AJOL)

    To be critically reflective, practitioners need to gather feedback about their performance so that they can reflect on it and develop themselves in those areas in which weaknesses are recognised. The Academic Development Centre staff agreed to participate in a departmental Performance Appraisal process in order to ...

  17. Investment Appraisal Process in the Banking & Finance Industry

    NARCIS (Netherlands)

    M.M. Akalu; J.R. Turner (Rodney)

    2002-01-01

    textabstractWe have studied how the banking and finance industry performs investment appraisal, measures subsequent follow-up and designates project success or failure. Furthermore, the authors looked into the extent of use of the new generation value management models. The result shows that firms

  18. An Appraisal of the Axiological Dimension of Sexual Relationships ...

    African Journals Online (AJOL)

    In other words, one could say that the attitudes of adolescents towards dating, masturbation or even sexual intercourse are rather negative. Significantly, however, the crux of this article is to establish and appraise the axiological dimension of the permissive sexual relationship with affection, thereafter, suggests ways of ...

  19. Internet Use for Prediagnosis Symptom Appraisal by Colorectal Cancer Patients

    Science.gov (United States)

    Thomson, Maria D.; Siminoff, Laura A.; Longo, Daniel R.

    2012-01-01

    Background: This study explored the characteristics of colorectal cancer (CRC) patients who accessed Internet-based health information as part of their symptom appraisal process prior to consulting a health care provider. Method: Newly diagnosed CRC patients who experienced symptoms prior to diagnosis were interviewed. Brief COPE was used to…

  20. Taking a Second Look at Economic Stabilization Policy: Appraisal ...

    African Journals Online (AJOL)

    Taking a Second Look at Economic Stabilization Policy: Appraisal and issues. ... International Journal of Development and Management Review ... It draws from a background of arguments of different schools of thought on which of the two approaches is better suited for controlling the economy of nations in order to achieve ...