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

Science.gov (United States)

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

2017-11-01

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

Engineering design guidelines for nuclear criticality safety

International Nuclear Information System (INIS)

Waltz, W.R.

1988-08-01

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

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

Directory of Open Access Journals (Sweden)

Johnson Lorraine

2010-06-01

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

Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline

Science.gov (United States)

Nieman, Lynnette K.; Biller, Beverly M. K.; Findling, James W.; Murad, M. Hassan; Newell-Price, John; Savage, Martin O.; Tabarin, Antoine

2015-01-01

Objective: The objective is to formulate clinical practice guidelines for treating Cushing's syndrome. Participants: Participants include an Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. The European Society for Endocrinology co-sponsored the guideline. Evidence: The Task Force used the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews and used the best available evidence from other published systematic reviews and individual studies. Consensus Process: The Task Force achieved consensus through one group meeting, several conference calls, and numerous e-mail communications. Committees and members of The Endocrine Society and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines. Conclusions: Treatment of Cushing's syndrome is essential to reduce mortality and associated comorbidities. Effective treatment includes the normalization of cortisol levels or action. It also includes the normalization of comorbidities via directly treating the cause of Cushing's syndrome and by adjunctive treatments (eg, antihypertensives). Surgical resection of the causal lesion(s) is generally the first-line approach. The choice of second-line treatments, including medication, bilateral adrenalectomy, and radiation therapy (for corticotrope tumors), must be individualized to each patient. PMID:26222757

Comparison of British Thoracic Society and American Thoracic Society reintroduction guidelines for anti-tuberculous therapy induced liver injury

International Nuclear Information System (INIS)

Zuberi, B. F.; Alvi, H.; Zuberi, F. F.; Salahuddin, J.

2014-01-01

Objective: To compare the efficacy of British Thoracic Society and American Thoracic Society guidelines for re-introduction of anti-tuberculous therapy after drug-induced liver injury, and to assess the ease of administration of each guideline on a scale of 1-10. Methods: The randomised prospective interventional study was conducted at the Department of Medicine and Pulmonology, Dow University of Health Sciences, Karachi, from December 2011 to November 2013. Patients with anti-tuberculous therapy drug-induced liver injury were selected. Hepatotoxic anti-tuberculous therapy was stopped and modified anti-tuberculous therapy was started. Patients were followed weekly till clinical and biochemical parameters got stabilised. After stabilisation, the patients were randomised to one of the two groups to receive re-introduction of anti-tuberculous therapy under the guidelines of British Thoracic Society (Group I) or those of American Thoracic Society (Group II). Means of the groups were analysed by Student's t test and proportions were compared by chi-square test. Multivariate analysis was done for age, body mass index and serum albumin for recurrence of drug-induced liver injury after the re-introduction. P value <0.05 was taken as significant. Results: Of the total 325 patients, 163(50.15%) were in Group I, while 162(49.84%) were in Group II. The frequency of recurrence of drug-induced liver injury in Group I was 16 (9.8%) and in Group II it was 18 (11.1%). There was no statistically significant difference between the two groups (p<0.7). Age was positively related with drug-induced liver injury, while body mass index and serum albumin were negatively associated. Conclusion: There was no significant difference between the two major guidelines though the American Thoracic Society guideline was easier to follow. (author)

Evaluation and treatment of hypertriglyceridemia: an endocrine society clinical practice guideline.

NARCIS (Netherlands)

Berglund, L.; Brunzell, J.D.; Goldberg, A.C.; Goldberg, I.J.; Sacks, F.M.; Murad, M.H.; Stalenhoef, A.F.H.

2012-01-01

Objective: The aim was to develop clinical practice guidelines on hypertriglyceridemia. Participants: The Task Force included a chair selected by The Endocrine Society Clinical Guidelines Subcommittee (CGS), five additional experts in the field, and a methodologist. The authors received no corporate

Wound Healing Society (WHS) venous ulcer treatment guidelines: what's new in five years?

Science.gov (United States)

Tang, Jennifer C; Marston, William A; Kirsner, Robert S

2012-01-01

Since the establishment of the guidelines for the treatment of venous ulcers by the Wound Healing Society in 2006, there has been an abundance of new literature, both in accord and discord with the guidelines. The goal of this update is to highlight new findings since the publication of these guidelines to assist practitioner and patient in appropriate health care decisions, as well as to drive future research endeavors. © 2012 by the Wound Healing Society.

Guidelines on the safety of light-based home-use hair removal devices from the European Society for Laser Dermatology

DEFF Research Database (Denmark)

Town, Graham; Ash, C; Dierickx, C

2012-01-01

. These guidelines provide a definition of light-based home-use technology, to inform healthcare professionals about home-use light-based technology and encourage manufacturers wishing to sell in Europe to adopt 'best practice'. The review presents the current status on standards and regulation issues and considers...... home-use safety issues, encompassing human, device and electrical safety, given risks to the eyes and skin from optical radiation both to the consumer and persons in the vicinity. Proposed technical measurement methodology is considered with focus on recognized critical parameters for the safe use...... of light-based hair removal technology including recording the technical performance and safety claims of a range of home-use hair removal devices. The literature review emphasizes potential adverse incidents and safety aspects of treating cosmetic conditions, such as unwanted hair growth. Although some...

Radiation Safety Management Guidelines for PET-CT: Focus on Behavior and Environment

International Nuclear Information System (INIS)

Jung, Jin Wook; Han, Eun Ok

2011-01-01

Our purpose is to specify behavior and environmental factors aimed at reducing the exposed dosage caused by PET-CT and to develop radiation safety management guidelines adequate for domestic circumstances. We have used a multistep-multimethod as the methodological approach to design and to carry out the research both in quality and quantity, including an analysis on previous studies, professional consultations and a survey. The survey includes responses from 139 practitioners in charged of 109 PET-CTs installed throughout Korea(reported by the Korean Society of Nuclear Medicine, 2010). The research use 156 questions using Cronbach's α (alpha) coefficients which were: 0.818 for 'the necessity of setting and installing the radiation protective environment'; 0.916 for 'the necessity of radiation protection', 'setting and installing the radiation protective environment'; and 0.885 for 'radiation protection'. The check list, derived from the radiation safety management guidelines focused on behavior and environment, was composed of 20 items for the radiation protective environment: including 5 items for the patient; 4 items for the guardian; 3 items for the radiologist; and 8 items applied to everyone involved; for a total of 26 items for the radiation protective behavior including: 12 items for the patient; 1 item for the guardian, 7 items for the radiologist; and 6 items applied to everyone involved. The specific check list is shown in (Table 5-6). Since our country has no safety management guidelines of its own to reduce the exposed dosage caused by PET-CTs, we believe the guidelines developed through this study means great deal to the field as it is not only appropriate for domestic circumstances, but also contains specific check lists for each target who may be exposed to radiation in regards to behavior and environment.

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

International Nuclear Information System (INIS)

Erickson, Beth A.; Demanes, D. Jeffrey; Ibbott, Geoffrey S.; Hayes, John K.; Hsu, I-Chow J.; Morris, David E.; Rabinovitch, Rachel A.; Tward, Jonathan D.; Rosenthal, Seth A.

2011-01-01

High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal, breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.

Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline

OpenAIRE

McKim, Douglas A; Road, Jeremy; Avendano, Monica; Abdool, Steve; Côté, Fabien; Duguid, Nigel; Fraser, Janet; Maltais, François; Morrison, Debra L; O’Connell, Colleen; Petrof, Basil J; Rimmer, Karen; Skomro, Robert

2011-01-01

Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee ha...

European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery

NARCIS (Netherlands)

Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Christiana; van der Zee, Ate; Vergote, Ignace; duBois, Andreas

Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecological cancers across Europe. Methods The European Society of Gynaecological Oncology

Korean Society of Cardiovascular Imaging Guidelines for Cardiac Computed Tomography

International Nuclear Information System (INIS)

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

2011-01-01

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

Safety culture enhancement through the implementation of IAEA guidelines

International Nuclear Information System (INIS)

Mengolini, A.; Debarberis, L.

2007-01-01

This paper presents the methodology applied and the results achieved in adapting and implementing the IAEA guidelines on safety culture to a research reactor as a step towards supporting its Life Management Program. The background is presented together with the effort undertaken to develop awareness on safety culture and the enhancement programme hereafter developed. The present study shows how issues of safety culture, management awareness and commitment deserve attention and can be of fundamental relevance also for research reactors. The study presents how guidelines developed specifically for nuclear power installations (NPPs) can be adapted to meet the needs and peculiarities of other nuclear installations. Moreover, the difficulties met during the implementation of the guidelines are discussed and important information and lessons can be learnt for the nuclear industry in general

The European Society of Human Reproduction and Embryology guideline for the diagnosis and treatment of endometriosis : an electronic guideline implementability appraisal

NARCIS (Netherlands)

van Dijk, Lotte J. E. W.; Nelen, Willianne L. D. M.; D'Hooghe, Thomas M.; Dunselman, Gerard A. J.; Hermens, Rosella P. M. G.; Bergh, Christina; Nygren, Karl G.; Simons, Arnold H. M.; de Sutter, Petra; Marshall, Catherine; Burgers, Jako S.; Kremer, Jan A. M.

2011-01-01

Background: Clinical guidelines are intended to improve healthcare. However, even if guidelines are excellent, their implementation is not assured. In subfertility care, the European Society of Human Reproduction and Embryology (ESHRE) guidelines have been inventoried, and their methodological

Assessment of safety regulation using an artificial society

International Nuclear Information System (INIS)

Furuta, Kazuo; Nagase, Masaya

2005-01-01

This study proposes using an artificial society to assess impacts of safety regulation on the society. The artificial society used in this study is a multi-agent system, which consists of many agents representing companies. The agents cannot survive unless they get profits by producing some products. Safety regulation functions as the business environment, which the agents will evolve to fit to. We modeled this process of survival and adaptation by the genetic algorithm. Using the proposed model, case simulations were performed to compare various regulation styles, and some interesting insights were obtained how regulation style influences behavior of the agents and then productivity and safety level of the industry. In conclusion, an effective method for assessment of safety regulation has been developed, and then several insights were shown in this study

Management of patients with refractory angina: Canadian Cardiovascular Society/Canadian Pain Society joint guidelines.

Science.gov (United States)

McGillion, Michael; Arthur, Heather M; Cook, Allison; Carroll, Sandra L; Victor, J Charles; L'allier, Philippe L; Jolicoeur, E Marc; Svorkdal, Nelson; Niznick, Joel; Teoh, Kevin; Cosman, Tammy; Sessle, Barry; Watt-Watson, Judy; Clark, Alexander; Taenzer, Paul; Coyte, Peter; Malysh, Louise; Galte, Carol; Stone, James

2012-01-01

Refractory angina (RFA) is a debilitating disease characterized by cardiac pain resistant to conventional treatments for coronary artery disease including nitrates, calcium-channel and β-adrenoceptor blockade, vasculoprotective agents, percutaneous coronary interventions, and coronary artery bypass grafting. The mortality rate of patients living with RFA is not known but is thought to be in the range of approximately 3%. These individuals suffer severely impaired health-related quality of life with recurrent and sustained pain, poor general health status, psychological distress, impaired role functioning, and activity restriction. Effective care for RFA sufferers in Canada is critically underdeveloped. These guidelines are predicated upon a 2009 Canadian Cardiovascular Society (CCS) Position Statement which identified that underlying the problem of RFA management is the lack of a formalized, coordinated, interprofessional strategy between the cardiovascular and pain science/clinical communities. The guidelines are therefore a joint initiative of the CCS and the Canadian Pain Society (CPS) and make practice recommendations about treatment options for RFA that are based on the best available evidence. Concluding summary recommendations are also made, giving direction to future clinical practice and research on RFA management in Canada. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Nuclear criticality safety training: guidelines for DOE contractors

International Nuclear Information System (INIS)

Crowell, M.R.

1983-09-01

The DOE Order 5480.1A, Chapter V, Safety of Nuclear Facilities, establishes safety procedures and requirements for DOE nuclear facilities. This guide has been developed as an aid to implementing the Chapter V requirements pertaining to nuclear criticality safety training. The guide outlines relevant conceptual knowledge and demonstrated good practices in job performance. It addresses training program operations requirements in the areas of employee evaluations, employee training records, training program evaluations, and training program records. It also suggests appropriate feedback mechanisms for criticality safety training program improvement. The emphasis is on academic rather than hands-on training. This allows a decoupling of these guidelines from specific facilities. It would be unrealistic to dictate a universal program of training because of the wide variation of operations, levels of experience, and work environments among DOE contractors and facilities. Hence, these guidelines do not address the actual implementation of a nuclear criticality safety training program, but rather they outline the general characteristics that should be included

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Transperineal Permanent Brachytherapy of Prostate Cancer

International Nuclear Information System (INIS)

Rosenthal, Seth A.; Bittner, Nathan H.J.; Beyer, David C.; Demanes, D. Jeffrey; Goldsmith, Brian J.; Horwitz, Eric M.; Ibbott, Geoffrey S.; Lee, W. Robert; Nag, Subir; Suh, W. Warren; Potters, Louis

2011-01-01

Transperineal permanent prostate brachytherapy is a safe and efficacious treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for permanent prostate brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrist. Factors with respect to patient selection and appropriate use of supplemental treatment modalities such as external beam radiation and androgen suppression therapy are discussed. Logistics with respect to the brachtherapy implant procedure, the importance of dosimetric parameters, and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful prostate brachytherapy program.

International Continence Society supported pelvic physiotherapy education guideline.

Science.gov (United States)

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

2018-02-01

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

European Hernia Society guidelines on prevention and treatment of parastomal hernias.

Science.gov (United States)

Antoniou, S A; Agresta, F; Garcia Alamino, J M; Berger, D; Berrevoet, F; Brandsma, H-T; Bury, K; Conze, J; Cuccurullo, D; Dietz, U A; Fortelny, R H; Frei-Lanter, C; Hansson, B; Helgstrand, F; Hotouras, A; Jänes, A; Kroese, L F; Lambrecht, J R; Kyle-Leinhase, I; López-Cano, M; Maggiori, L; Mandalà, V; Miserez, M; Montgomery, A; Morales-Conde, S; Prudhomme, M; Rautio, T; Smart, N; Śmietański, M; Szczepkowski, M; Stabilini, C; Muysoms, F E

2018-02-01

International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched. Quality assessment was performed using Scottish Intercollegiate Guidelines Network checklists. The guidelines were presented at the 38th European Hernia Society Congress and each key question was evaluated in a consensus voting of congress participants. End colostomy is associated with a higher incidence of parastomal hernia, compared to other types of stomas. Clinical examination is necessary for the diagnosis of parastomal hernia, whereas computed tomography scan or ultrasonography may be performed in cases of diagnostic uncertainty. Currently available classifications are not validated; however, we suggest the use of the European Hernia Society classification for uniform research reporting. There is insufficient evidence on the policy of watchful waiting, the route and location of stoma construction, and the size of the aperture. The use of a prophylactic synthetic non-absorbable mesh upon construction of an end colostomy is strongly recommended. No such recommendation can be made for other types of stomas at present. It is strongly recommended to avoid performing a suture repair for elective parastomal hernia. So far, there is no sufficient comparative evidence on specific techniques, open or laparoscopic surgery and specific mesh types. However, a mesh without a hole is suggested in preference to a keyhole mesh when laparoscopic repair is performed. An evidence-based approach to the diagnosis and management of parastomal hernias reveals the lack of

Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline

Science.gov (United States)

Berglund, Lars; Brunzell, John D.; Goldberg, Anne C.; Goldberg, Ira J.; Sacks, Frank; Murad, Mohammad Hassan; Stalenhoef, Anton F. H.

2012-01-01

Objective: The aim was to develop clinical practice guidelines on hypertriglyceridemia. Participants: The Task Force included a chair selected by The Endocrine Society Clinical Guidelines Subcommittee (CGS), five additional experts in the field, and a methodologist. The authors received no corporate funding or remuneration. Consensus Process: Consensus was guided by systematic reviews of evidence, e-mail discussion, conference calls, and one in-person meeting. The guidelines were reviewed and approved sequentially by The Endocrine Society's CGS and Clinical Affairs Core Committee, members responding to a web posting, and The Endocrine Society Council. At each stage, the Task Force incorporated changes in response to written comments. Conclusions: The Task Force recommends that the diagnosis of hypertriglyceridemia be based on fasting levels, that mild and moderate hypertriglyceridemia (triglycerides of 150–999 mg/dl) be diagnosed to aid in the evaluation of cardiovascular risk, and that severe and very severe hypertriglyceridemia (triglycerides of > 1000 mg/dl) be considered a risk for pancreatitis. The Task Force also recommends that patients with hypertriglyceridemia be evaluated for secondary causes of hyperlipidemia and that subjects with primary hypertriglyceridemia be evaluated for family history of dyslipidemia and cardiovascular disease. The Task Force recommends that the treatment goal in patients with moderate hypertriglyceridemia be a non-high-density lipoprotein cholesterol level in agreement with National Cholesterol Education Program Adult Treatment Panel guidelines. The initial treatment should be lifestyle therapy; a combination of diet modification and drug therapy may also be considered. In patients with severe or very severe hypertriglyceridemia, a fibrate should be used as a first-line agent. PMID:22962670

Development of safety evaluation guidelines for base-isolated buildings in Japan

International Nuclear Information System (INIS)

Aoyama, Hiroyuki

1989-01-01

This paper describes the safety evaluation guidelines and the review process for non-nuclear base-isolated buildings proposed for construction in Japan. The paper discusses the guidelines application for two types of soil: hard soil and intermediate soil (soft soil was excluded.); safety evaluation items included in the level C design review; and safety margin of base isolation. Lessons learned through these design review efforts have potential applicability to design of seismic base isolation for nuclear power plants

OSART Independent Safety Culture Assessment (ISCA) Guidelines

International Nuclear Information System (INIS)

2016-01-01

Safety culture is understood as an important part of nuclear safety performance. This has been demonstrated by the analysis of significant events such as Chernobyl, Davis Besse, Vandellos II, Asco, Paks, Mihamma and Forsmark, among others. In order to enhance safety culture, one essential activity is to perform assessments. IAEA Safety Standard Series No. GS-R-3, The Management System for Facilitites and Activities, states requirements for continuous improvement of safety culture, of which self, peer and independent safety culture assessments constitute an essential part. In line with this requirement, the Independent Safety Culture Assessment (ISCA) module is offered as an add-on module to the IAEA Operational Safety Review Team (OSART) programme. The OSART programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. By including the ISCA module in an OSART mission, the receiving organization benefits from the synergy between the technical and the safety culture aspects of the safety review. The joint operational safety and safety culture assessment provides the organization with the opportunity to better understand the interactions between technical, human, organizational and cultural aspects, helping the organization to take a systemic approach to safety through identifying actions that fully address the root causes of any identified issue. Safety culture assessments provide insight into the fundamental drivers that shape organizational patterns of behaviour, safety consciousness and safety performance. The complex nature of safety culture means that the analysis of the results of such assessments is not as straightforward as for other types of assessment. The benefits of the results of nuclear safety culture assessments are maximized only if appropriate tools and guidance for these assessments is used; hence, this comprehensive guideline has been developed. The methodology explained

EM Health and Safety Plan Guidelines

Energy Technology Data Exchange (ETDEWEB)

1994-12-01

This document contains information about the Health and Safety Plan Guidelines. Topics discussed include: Regulatory framework; key personnel; hazard assessment; training requirements; personal protective equipment; extreme temperature disorders or conditions; medical surveillance; exposure monitoring/air sampling; site control; decontamination; emergency response/contingency plan; emergency action plan; confined space entry; and spill containment.

Home mechanical ventilation: a Canadian Thoracic Society clinical practice guideline.

Science.gov (United States)

McKim, Douglas A; Road, Jeremy; Avendano, Monica; Abdool, Steve; Cote, Fabien; Duguid, Nigel; Fraser, Janet; Maltais, Fracois; Morrison, Debra L; O'Connell, Colleen; Petrof, Basil J; Rimmer, Karen; Skomro, Robert

2011-01-01

Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of userfriendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.

Esophageal stenting for benign and malignant disease : European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

NARCIS (Netherlands)

Spaander, Manon C W; Baron, Todd H; Siersema, Peter D; Fuccio, Lorenzo; Schumacher, Brigitte; Escorsell, Àngels; Garcia-Pagán, Juan-Carlos; Dumonceau, Jean-Marc; Conio, Massimo; de Ceglie, Antonella; Skowronek, Janusz; Nordsmark, Marianne; Seufferlein, Thomas; Van Gossum, André; Hassan, Cesare; Repici, Alessandro; Bruno, Marco J

2016-01-01

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN).

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines-Anticoagulation During Cardiopulmonary Bypass.

Science.gov (United States)

Shore-Lesserson, Linda; Baker, Robert A; Ferraris, Victor A; Greilich, Philip E; Fitzgerald, David; Roman, Philip; Hammon, John W

2018-02-01

Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup. This was a group of interdisciplinary professionals gathered to summarize the evidence and create practice recommendations for various aspects of CPB. To date, anticoagulation practices in CPB have not been standardized in accordance with the evidence base. This clinical practice guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation therapy for CPB using the available evidence. To identify relevant evidence, a systematic review was outlined and literature searches were conducted in PubMed using standardized medical subject heading (MeSH) terms from the National Library of Medicine list of search terms. Search dates were inclusive of January 2000 to December 2015. The search yielded 833 abstracts, which were reviewed by two independent reviewers. Once accepted into the full manuscript review stage, two members of the writing group evaluated each of 286 full papers for inclusion eligibility into the guideline document. Ninety-six manuscripts were included in the final review. In addition, 17 manuscripts published before 2000 were included to provide method, context, or additional supporting evidence for the recommendations as these papers were considered sentinel publications. Members of the writing group wrote and developed recommendations based on review of the articles obtained and achieved

Infectious Diseases Society of America (IDSA) POSITION STATEMENT: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines.

Science.gov (United States)

2018-05-02

IDSA did not endorse the 2016 Surviving Sepsis Campaign Guidelines despite being represented in the working group that drafted the guidelines document. Leadership from the IDSA, the Surviving Sepsis Campaign Guidelines, and the Society of Critical Care Medicine had numerous amicable discussions primarily regarding the bolded, rated guidelines recommendations. Our societies had different perspectives, however, regarding the interpretation of the major studies that informed the guidelines' recommendations, thus leading us to different conclusions and different perspectives on the recommendations. IDSA consequently elected not to endorse the guidelines. IDSA nonetheless hopes to be able to continue collaborating with the Surviving Sepsis Campaign and the Society of Critical Care Medicine to resolve our differences and to develop further strategies together to prevent sepsis and septic shock as well as reduce death and disability from these conditions both nationally and globally.

Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline

Directory of Open Access Journals (Sweden)

Douglas A McKim

2011-01-01

Full Text Available Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.

Mexican Asthma Guidelines: GUIMA 2017

Directory of Open Access Journals (Sweden)

Désirée Larenas-Linnemann

2017-04-01

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

Usability and Safety in Electronic Medical Records Interface Design: A Review of Recent Literature and Guideline Formulation.

Science.gov (United States)

Zahabi, Maryam; Kaber, David B; Swangnetr, Manida

2015-08-01

The objectives of this study were to (a) review electronic medical record (EMR) and related electronic health record (EHR) interface usability issues, (b) review how EMRs have been evaluated with safety analysis techniques along with any hazard recognition, and (c) formulate design guidelines and a concept for enhanced EMR interfaces with a focus on diagnosis and documentation processes. A major impact of information technology in health care has been the introduction of EMRs. Although numerous studies indicate use of EMRs to increase health care quality, there remain concerns with usability issues and safety. A literature search was conducted using Compendex, PubMed, CINAHL, and Web of Science databases to find EMR research published since 2000. Inclusion criteria included relevant English-language papers with subsets of keywords and any studies (manually) identified with a focus on EMR usability. Fifty studies met the inclusion criteria. Results revealed EMR and EHR usability problems to include violations of natural dialog, control consistency, effective use of language, effective information presentation, and customization principles as well as a lack of error prevention, minimization of cognitive load, and feedback. Studies focusing on EMR system safety made no objective assessments and applied only inductive reasoning methods for hazard recognition. On the basis of the identified usability problems and structure of safety analysis techniques, we provide EMR design guidelines and a design concept focused on the diagnosis process and documentation. The design guidelines and new interface concept can be used for prototyping and testing enhanced EMRs. © 2015, Human Factors and Ergonomics Society.

2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines.

Science.gov (United States)

Ferraris, Victor A; Brown, Jeremiah R; Despotis, George J; Hammon, John W; Reece, T Brett; Saha, Sibu P; Song, Howard K; Clough, Ellen R; Shore-Lesserson, Linda J; Goodnough, Lawrence T; Mazer, C David; Shander, Aryeh; Stafford-Smith, Mark; Waters, Jonathan; Baker, Robert A; Dickinson, Timothy A; FitzGerald, Daniel J; Likosky, Donald S; Shann, Kenneth G

2011-03-01

Practice guidelines reflect published literature. Because of the ever changing literature base, it is necessary to update and revise guideline recommendations from time to time. The Society of Thoracic Surgeons recommends review and possible update of previously published guidelines at least every three years. This summary is an update of the blood conservation guideline published in 2007. The search methods used in the current version differ compared to the previously published guideline. Literature searches were conducted using standardized MeSH terms from the National Library of Medicine PUBMED database list of search terms. The following terms comprised the standard baseline search terms for all topics and were connected with the logical 'OR' connector--Extracorporeal circulation (MeSH number E04.292), cardiovascular surgical procedures (MeSH number E04.100), and vascular diseases (MeSH number C14.907). Use of these broad search terms allowed specific topics to be added to the search with the logical 'AND' connector. In this 2011 guideline update, areas of major revision include: 1) management of dual anti-platelet therapy before operation, 2) use of drugs that augment red blood cell volume or limit blood loss, 3) use of blood derivatives including fresh frozen plasma, Factor XIII, leukoreduced red blood cells, platelet plasmapheresis, recombinant Factor VII, antithrombin III, and Factor IX concentrates, 4) changes in management of blood salvage, 5) use of minimally invasive procedures to limit perioperative bleeding and blood transfusion, 6) recommendations for blood conservation related to extracorporeal membrane oxygenation and cardiopulmonary perfusion, 7) use of topical hemostatic agents, and 8) new insights into the value of team interventions in blood management. Much has changed since the previously published 2007 STS blood management guidelines and this document contains new and revised recommendations. Copyright © 2011 The Society of Thoracic

Report from AmSECT's International Consortium for Evidence-Based Perfusion: American Society of Extracorporeal Technology Standards and Guidelines for Perfusion Practice: 2013.

Science.gov (United States)

Baker, Robert A; Bronson, Shahna L; Dickinson, Timothy A; Fitzgerald, David C; Likosky, Donald S; Mellas, Nicholas B; Shann, Kenneth G

2013-09-01

One of the roles of a professional society is to develop standards and guidelines of practice as an instrument to guide safe and effective patient care. The American Society of Extracorporeal Technology (AmSECT) first published its Essentials for Perfusion Practice, Clinical Function: Conduct of Extracorporeal Circulation in 1993. The International Consortium for Evidence-Based Perfusion (ICEBP), a committee within AmSECT, was tasked with updating this document in 2010. The aim of this report is to describe the method of development and content of AmSECT's new professional standards and guidelines. The ICEBP committee independently evaluated and provided input regarding the current "Essentials and Guidelines." Structural changes were made to the entire document, and a draft document was developed, presented, and circulated to the AmSECT Board of Directors and broader membership for comment. Informed by these reviews, a revised document was then presented to the Society for a membership vote. The final document consists of 15 areas of practice covered by 50 Standards and 38 Guidelines (see Appendix 1) with the first standard focusing on the development of institutional protocols to support their implementation and use. A majority of the membership voted to accept the document (81.2% of the voting membership accepting, 18.8% rejecting). After an audit of the balloting process by AmSECT's Ethics Committee, the results were reported to the membership and the document was officially adopted on July 24, 2013. The Standards and Guidelines will serve as a useful guide for cardiac surgical teams that wish to develop institution-specific standards and guidelines to improve the reliability, safety, and effectiveness of adult cardiopulmonary bypass. The ICEBP recognizes that the development of a Standards and Guidelines statement alone will not change care. Safe, reliable, and effective care will be best served through the development and implementation of institutional

Review of the International Society for Heart and Lung Transplantation Practice guidelines for management of heart failure in children.

Science.gov (United States)

Colan, Steven D

2015-08-01

In 2004, practice guidelines for the management of heart failure in children by Rosenthal and colleagues were published in conjunction with the International Society for Heart and Lung Transplantation. These guidelines have not been updated or reviewed since that time. In general, there has been considerable controversy as to the utility and purpose of clinical practice guidelines, but there is general recognition that the relentless progress of medicine leads to the progressive irrelevance of clinical practice guidelines that do not undergo periodic review and updating. Paediatrics and paediatric cardiology, in particular, have had comparatively minimal participation in the clinical practice guidelines realm. As a result, most clinical practice guidelines either specifically exclude paediatrics from consideration, as has been the case for the guidelines related to cardiac failure in adults, or else involve clinical practice guidelines committees that include one or two paediatric cardiologists and produce guidelines that cannot reasonably be considered a consensus paediatric opinion. These circumstances raise a legitimate question as to whether the International Society for Heart and Lung Transplantation paediatric heart failure guidelines should be re-reviewed. The time, effort, and expense involved in producing clinical practice guidelines should be considered before recommending an update to the International Society for Heart and Lung Transplantation Paediatric Heart Failure guidelines. There are specific areas of rapid change in the evaluation and management of heart failure in children that are undoubtedly worthy of updating. These domains include areas such as use of serum and imaging biomarkers, wearable and implantable monitoring devices, and acute heart failure management and mechanical circulatory support. At the time the International Society for Heart and Lung Transplantation guidelines were published, echocardiographic tissue Doppler, 3 dimensional

Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

NARCIS (Netherlands)

van Hooft, Jeanin E.; van Halsema, Emo E.; Vanbiervliet, Geoffroy; Beets-Tan, Regina G. H.; Dewitt, John M.; Donnellan, Fergal; Dumonceau, Jean-Marc; Glynne-Jones, Robert G. T.; Hassan, Cesare; Jiménez-Perez, Javier; Meisner, Søren; Muthusamy, V. Raman; Parker, Michael C.; Regimbeau, Jean-Marc; Sabbagh, Charles; Sagar, Jayesh; Tanis, Pieter J.; Vandervoort, Jo; Webster, George J.; Manes, Gianpiero; Barthet, Marc A.; Repici, Alessandro

2014-01-01

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). The Grading of Recommendations Assessment, Development, and

Self-Expandable Metal Stents for Obstructing Colonic and Extracolonic Cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

NARCIS (Netherlands)

van Hooft, J. E.; van Halsema, E. E.; Vanbiervliet, G.; Beets-Tan, R. G. H.; DeWitt, J. M.; Donnellan, F.; Dumonceau, J. M.; Glynne-Jones, R. G. T.; Hassan, C.; Jimenez-Perez, J.; Meisner, S.; Muthusamy, V. Raman; Parker, M. C.; Regimbeau, J. M.; Sabbagh, C.; Sagar, J.; Tanis, P. J.; Vandervoort, J.; Webster, G. J.; Manes, G.; Barthet, M. A.; Repici, A.

2014-01-01

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). The Grading of Recommendations Assessment, Development, and

Development of Manitoba Hydro's public water safety around dams management guidelines

Energy Technology Data Exchange (ETDEWEB)

Bonin, Dave; McPhail, Gord; Murphy, Shayla; Schellenberg, Gord [KGS Acres, Winnipeg, (Canada); Read, Nick [Manitoba Hydro, Winnipeg, (Canada)

2010-07-01

Several drowning fatalities and safety incidents have occurred around dams in Ontario, Manitoba and other jurisdictions in Canada. Following these incidents, Manitoba Hydro implemented several measures to improve public safety around its dams with the development of a warning signs manual. Manitoba Hydro found that a standard centralized approach to the process of improving public safety is better for ensuring compliance and consistency, even though they have safety measures in place. This paper described the process that Manitoba Hydro has followed in developing a formal set of public water safety around dams (PWSD) guidelines and a program for implementing these guidelines. This program was developed with the intent of providing a high standard of public protection and continuous improvement and monitoring on par with the effect spent on similar dam safety type programs. This paper focused on the development of the pilot PWSD management plan for Pine Falls generating station in order to test the effectiveness and usability of the guidelines.

SALTO Peer Review Guidelines. Guidelines for Peer Review of Safety Aspects of Long Term Operation of Nuclear Power Plants

International Nuclear Information System (INIS)

2014-01-01

International peer review is a useful tool for Member States to exchange experiences, learn from each other and apply good practices in the long term operation (LTO) of nuclear power plants (NPPs). The peer review is also an important mechanism through which the IAEA supports Member States in enhancing the safety of NPPs. The IAEA has conducted various types of safety review that indirectly address aspects of LTO, including safety reviews for design, engineering, operation and external hazards. Operational Safety Review Team (OSART) services include review of ageing management programmes. In addition, several Member States have requested Ageing Management Assessment Team (AMAT) missions. Through these experiences, it was recognized that a comprehensive peer review on LTO would be very useful to Member States. The Safety Aspects of Long Term Operation (SALTO) peer review addresses strategy and key elements for the safe LTO of NPPs, which includes AMAT objectives and complements OSART reviews. The SALTO peer review is designed to assist operating organizations in adopting a proper approach to LTP including implementing appropriate activities to ensure that plant safety will be maintained during the LTO period. The SALTO peer review can be tailored to focus on ageing management programmes (AMPs) or on other activities related to LTO to support the Member State in enhancing the safety of its NPPs. The SALTO peer review can also support regulators in establishing or improving regulatory and licensing strategies for the LTO of NPPs. The guidelines in this publication are primarily intended for members of a SALTO review team and provide a basic structure and common reference for peer reviews of LTO. Additionally, the guidelines also provide useful information to the operating organizations of NPPs (or technical support organizations) for carrying out their own self-assessments or comprehensive programme reviews. The guidelines are intended to be generic, as there are

Advancement on safety management system of nuclear power for safety and non-anxiety of society

International Nuclear Information System (INIS)

Yoshikawa, Hidekazu

2004-01-01

Advancement on safety management system is investigated to improve safety and non-anxiety of society for nuclear power, from the standpoint of human machine system research. First, the recent progress of R and D works of human machine interface technologies since 1980 s are reviewed and then the necessity of introducing a new approach to promote technical risk communication activity to foster safety culture in nuclear industries. Finally, a new concept of Offsite Operation and Maintenance Support Center (OMSC) is proposed as the core facility to assemble human resources and their expertise in all organizations of nuclear power, for enhancing safety and non-anxiety of society for nuclear power. (author)

Safety investigation of 'Mutsu', the first nuclear ship in Japan (the correspondence to the guideline of safety design examination, etc.)

International Nuclear Information System (INIS)

1981-01-01

Japan Nuclear Ship Development Agency had made previously application for the permission of the alteration of the reactor installation in the nuclear ship Mutsu (the first of this kind in Japan), based on the overall safety investigation of the ship made by JNDA. Taking the opportunity of the governmental safety examination concerning the permission, the correspondence of the safety aspects of the n.s. Mutsu to the existing guidelines for the safety of nuclear reactor facilities was examined. These results to further enhance the safety of the n.s. Mutsu are described concerning the following matters: the safety design examination guideline for power-generating LWR facilities (58 items); the safety evaluation guideline for power-generating LWR facilities (the analysis of abnormal transients during operation and accidents); the safety countermeasures to be adopted in the reactor plant of the n.s. Mutsu from the situation of the TMI nuclear accident in U.S. (7 in design and 10 in operation management); the analysis simulating the TMI accident. (J.P.N.)

Operational safety review programmes for nuclear power plants. Guidelines for assessment

International Nuclear Information System (INIS)

2002-01-01

The IAEA has been offering the Operational Safety Review Team (OSART) programme to provide advice and assistance to Member States in enhancing the operational safety of nuclear power plants (NPPs). Simultaneously, the IAEA has encouraged self-assessment and review by Member States of their own nuclear power plants to continuously improve nuclear safety. Currently, some utilities have been implementing safety review programmes to independently review their own plants. Corporate or national operational safety review programmes may be compliance or performance based. Successful utilities have found that both techniques are necessary to provide assurance that (i) as a minimum the NPP meets specific corporate and legal requirements and (ii) management at the NPP is encouraged to pursue continuous improvement principles. These programmes can bring nuclear safety benefits to the plants and utilities. The IAEA has conducted two pilot missions to assess the effectiveness of the operational review programme. Based on these missions and on the experience gained during OSART missions, this document has been developed to provide guidance on and broaden national/corporate safety review programmes in Member States, and to assist in maximizing their benefits. These guidelines are intended primarily for the IAEA team to conduct assessment of a national/corporate safety review programme. However, this report may also be used by a country or utility to establish its own national/corporate safety review programme. The guidelines may likewise be used for self-assessment or for establishing a baseline when benchmarking other safety review programmes. This report consists of four parts. Section 2 addresses the planning and preparation of an IAEA assessment mission and Sections 3 and 4 deal with specific guidelines for conducting the assessment mission itself

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

NARCIS (Netherlands)

Oonk, Maaike H. M.; Planchamp, Francois; Baldwin, Peter; Bidzinski, Mariusz; Brannstrom, Mats; Landoni, Fabio; Mahner, Sven; Mahantshetty, Umesh; Mirza, Mansoor; Petersen, Cordula; Querleu, Denis; Regauer, Sigrid; Rob, Lukas; Rouzier, Roman; Ulrikh, Elena; van der Velden, Jacobus; Vergote, Ignace; Woelber, Linn; van der Zee, Ate G. J.

Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. Methods The European Society of Gynaecological Oncology

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

NARCIS (Netherlands)

Oonk, Maaike H. M.; Planchamp, François; Baldwin, Peter; Bidzinski, Mariusz; Brännström, Mats; Landoni, Fabio; Mahner, Sven; Mahantshetty, Umesh; Mirza, Mansoor; Petersen, Cordula; Querleu, Denis; Regauer, Sigrid; Rob, Lukas; Rouzier, Roman; Ulrikh, Elena; van der Velden, Jacobus; Vergote, Ignace; Woelber, Linn; van der Zee, Ate G. J.

2017-01-01

The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. The European Society of Gynaecological Oncology Council nominated

Guidelines for preparing criticality safety evaluations at Department of Energy non-reactor nuclear facilities

International Nuclear Information System (INIS)

1993-11-01

This document contains guidelines that should be followed when preparing Criticality Safety Evaluations that will be used to demonstrate the safety of operations performed at DOE non-reactor nuclear facilities. Adherence to these guidelines will provide consistency and uniformity in criticality safety evaluations (CSEs) across the complex and will document compliance with the requirements of DOE Order 5480.24

2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: A joint report of the Korean Society of Cardiology and the Korean Society of Radiology

Energy Technology Data Exchange (ETDEWEB)

Yoon, Yeon Yee E. [Dept. of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul (Korea, Republic of); Hong, Yoo Jin; Choi, Eui Young [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others

2015-04-15

The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

Energy Technology Data Exchange (ETDEWEB)

Yoon, Yeonyee E. [Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Hong, Yoo Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Kim, Hyung-Kwan [Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Kim, Jeong A [Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 411-706 (Korea, Republic of); Na, Jin Oh [Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703 (Korea, Republic of); Yang, Dong Hyun [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736 (Korea, Republic of); Kim, Young Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Choi, Eui-Young [Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of)

2014-07-01

Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: A joint report of the Korean Society of Cardiology and the Korean Society of Radiology

International Nuclear Information System (INIS)

Yoon, Yeon Yee E.; Hong, Yoo Jin; Choi, Eui Young

2015-01-01

The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

Japanese Society of Medical Oncology Clinical Guidelines: Molecular Testing for Colorectal Cancer Treatment, Third Edition.

Science.gov (United States)

Yamazaki, Kentaro; Taniguchi, Hiroya; Yoshino, Takayuki; Akagi, Kiwamu; Ishida, Hideyuki; Ebi, Hiromichi; Nakatani, Kaname; Muro, Kei; Yatabe, Yasushi; Yamaguchi, Kensei; Tsuchihara, Katsuya

2018-06-01

The Japanese Society of Medical Oncology (JSMO) previously published 2 editions of the clinical guidelines: "Japanese guidelines for testing of KRAS gene mutation in colorectal cancer" in 2008 and "Japanese Society of Medical Oncology Clinical Guidelines: RAS (KRAS/NRAS) mutation testing in colorectal cancer patients" in 2014. These guidelines have contributed to the proper use of KRAS and RAS mutation testing, respectively. Recently, clinical utility, particularly for colorectal cancer (CRC) patients with BRAF V600E mutation or DNA mismatch-repair (MMR) deficiency, has been established. Therefore, the guideline members decided these genetic alterations should also be involved. The aim of this revision is to properly carry out testing for BRAF V600E mutation and MMR deficiency in addition to RAS mutation. The revised guidelines include the basic requirements for testing for these genetic alterations based on recent scientific evidence. Furthermore, because clinical utility of comprehensive genetic testing using next-generation sequencing and somatic gene testing of analyzing circulating tumor DNA has increasingly evolved with recent advancements in testing technology, we noted the current situation and prospects for these testing technologies and their clinical implementation in the revised guidelines. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America.

NARCIS (Netherlands)

Pappas, P.G.; Kauffman, C.A.; Andes, D.; Benjamin Jr., D.K.; Calandra, T; Edwards, J.E.; Filler, S.G.; Fisher, J.F.; Kullberg, B.J.; Ostrosky-Zeichner, L.; Reboli, A.C.; Rex, J.H.; Walsh, T.J.; Sobel, J.D.

2009-01-01

Guidelines for the management of patients with invasive candidiasis and mucosal candidiasis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous guidelines published in the 15 January 2004 issue of Clinical Infectious Diseases

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

Science.gov (United States)

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

2017-08-01

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

WOCN Society Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy-An Executive Summary.

Science.gov (United States)

This article provides an executive summary of the recommendations from the Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy, published by the Wound, Ostomy and Continence Nurses Society (WOCN Society). It presents an overview of the process used to update and develop the guideline and lists specific recommendations from the guideline. We provide recommendations that include the following topics: stoma construction, preoperative education, stoma site marking, selection of an ostomy pouching system, postoperative education, postoperative management issues, follow-up care after discharge from the acute care setting, health-related quality of life, and stomal and peristomal complications. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patient outcomes. The full text of the published guideline, which includes available evidence supporting the recommendations and a complete reference list, is available in print and as a mobile application from the WOCN Society's online bookstore (http://www.wocn.org). Refer to Supplemental Digital Content 1 (available at: http://links.lww.com/JWOCN/A40) associated with this article for a complete reference list for the guideline.

Measure Guideline: Combustion Safety for Natural Draft Appliances Using Indoor Air

Energy Technology Data Exchange (ETDEWEB)

Brand, L.

2014-04-01

This measure guideline covers how to assess and carry out the combustion safety procedures for appliances and heating equipment that uses indoor air for combustion in low-rise residential buildings. Only appliances installed in the living space, or in an area freely communicating with the living space, vented alone or in tandem with another appliance are considered here. A separate measure guideline addresses combustion appliances located either within the living space in enclosed closets or side rooms or outside the living space in an adjacent area like an attic or garage that use outdoor air for combustion. This document is for inspectors, auditors, and technicians working in homes where energy upgrades are being conducted whether or not air infiltration control is included in the package of measures being applied. In the indoor combustion air case, guidelines summarized here are based on language provided in several of the codes to establish minimum requirements for the space using simplified prescriptive measures. In addition, building performance testing procedures are provided by testing agencies. The codes in combination with the test procedures offer comprehensive combustion safety coverage to address safety concerns, allowing inexperienced residential energy retrofit inspectors to effectively address combustion safety issues and allow energy retrofits to proceed.

Guidelines for preparing criticality safety evaluations at Department of Energy non-reactor nuclear facilities

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-09-01

This Department of Energy (DOE) is approved for use by all components of DOE. It contains guidelines that should be followed when preparing Criticality Safety Evaluations that will be used to demonstrate the safety of operations performed at DOE Non-Reactor Nuclear Facilities. Adherence with these guidelines will provide consistency and uniformity in Criticality Safety Evaluations (CSEs) across the complex and will document compliance with DOE Order 5480.24 requirements as they pertain to CSEs.

Guidelines for preparing criticality safety evaluations at Department of Energy non-reactor nuclear facilities

International Nuclear Information System (INIS)

1998-09-01

This Department of Energy (DOE) is approved for use by all components of DOE. It contains guidelines that should be followed when preparing Criticality Safety Evaluations that will be used to demonstrate the safety of operations performed at DOE Non-Reactor Nuclear Facilities. Adherence with these guidelines will provide consistency and uniformity in Criticality Safety Evaluations (CSEs) across the complex and will document compliance with DOE Order 5480.24 requirements as they pertain to CSEs

Guidelines for implementation of RCM on safety systems

International Nuclear Information System (INIS)

Kim, Tae Woon; Brijendra Singh.

1996-04-01

Reliability Centered Maintenance (RCM) methodology was originally developed by the commercial airlines industry in the early 1960s for identifying applicable and effective preventive maintenance tasks and as currently used in nuclear power industry. Effective maintenance of the systems at a nuclear power plant (NPP) is essential for its safe and reliable operation. Reliability Centered Maintenance at NPP is the program to assure that plant systems remain within an original design criteria and are not adversely affected during the plant life time. The aim of this report is to provide the guidelines to implement the RCM approach on NPP safety systems. Safety systems are usually standby and therefore, we need to periodically detect and repair failures that may have occurred since the previous activation or inspection the equipment. The RCM guidelines are intended to help identify the failure modes and related root causes and then decide the maintenance policies to achieve the high level of safety and reliability. The RCM is intended to improve or maintain high levels of system reliability and plant availability. Since the reliability of plant systems will be improved, the plant safety correspondingly will be increased. Another goal of RCM is to optimize the maintenance and surveillance tasks such that the overall level of resources required to accomplish essential tasks is kept to minimum. RCM also strives to eliminate unnecessary corrective maintenance and to select yet most cost-effective approach to maintenance, testing and inspection for system components. 9 refs. (Author) .new

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2

DEFF Research Database (Denmark)

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas

2013-01-01

These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in 2006. For this 2012 revision, all available publications pertaining to the biological treatment of schizoph...

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, part 1

DEFF Research Database (Denmark)

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas

2012-01-01

These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry Guidelines for Biological Treatment of Schizophrenia published in 2005. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia we...

Mandatory criteria for cardiac rehabilitation programs: 2018 guidelines from the Portuguese Society of Cardiology.

Science.gov (United States)

Abreu, Ana; Mendes, Miguel; Dores, Hélder; Silveira, Conceição; Fontes, Paulo; Teixeira, Madalena; Santa Clara, Helena; Morais, João

2018-04-30

Cardiac rehabilitation (CR) is a multidisciplinary process for patients recovering after an acute cardiac event or with chronic cardiovascular disease that reduces mortality and morbidity and improves quality of life. It is considered a cost-effective intervention and is expressly indicated in the guidelines of the major medical societies. In Portugal, only 8% of patients discharged from hospital after myocardial infarction are included in CR programs. In Europe overall, the percentage admitted to CR programs is 30%, while in the USA it is 20-30%. In view of the underuse of CR in Portugal, we call the attention of the health authorities to the need to increase the number and national coverage of CR programs, while maintaining high quality standards. The aim is for all patients resident in Portugal who are eligible for CR programs to have the same opportunities for access and attendance. In order to preserve the benefits and safety of this intervention, CR needs to be performed according to international guidelines. The fact that various initiatives in this field have been developed by different professional groups, some of them non-medical, that do not follow the European guidelines, has prompted us to prepare a series of norms defining mandatory criteria for CR, based on current knowledge and evidence. In this way we aim to ensure that the required increase in the number of CR programs, linked in a national network of CR centers, does not detract from the need to maintain their efficacy and quality. These criteria should serve as the basis for the future accreditation of CR centers in Portugal. Copyright © 2018. Publicado por Elsevier España, S.L.U.

The Safety Pharmacology Society salary survey.

Science.gov (United States)

Pugsley, Michael K; Authier, Simon; Brabham, Tiffini; Soloviev, Maxim; Markgraf, Carrie G; Correll, Krystle; Traebert, Martin; Greiter-Wilke, Andrea; Valentin, Jean-Pierre; Vargas, Hugo; Botchway, Alfred; Leishman, Derek J; Curtis, Michael J

2017-11-01

Safety pharmacology is a growing discipline with scientists broadly distributed across international geographical regions. This electronic salary survey is the first to be distributed amongst the entire Safety Pharmacology Society (SPS) membership. An electronic survey was sent to all members of the Society. Categorical survey questions assessed membership employment types, annual incomes, and professional certifications, along with other associated career attributes. This survey was distributed to the SPS membership that is comprised of safety pharmacologists, toxicologists and pharmacologists working globally in the pharmaceutical industry, at contract research organizations (CRO), regulatory agencies, and academia or within the technology provider industry. The survey was open for responses from December 2015 to March 2016. The survey response rate was 28% (129/453). North America (68%) was the region with the largest number of respondents followed by Europe (28%). A preponderance of respondents (77%) had 12years of industry experience or more. 52% of responders earned annually between $40,000 and $120,000. As expected, salary was generally positively correlated with the number of years of experience in the industry or the educational background but there was no correlation between salary and the number of employee's directly supervised. The median salary was higher for male vs female respondents, but so was median age, indicative of no gender 'salary gap'. Our 2016 SPS salary survey results showcased significant diversity regarding factors that can influence salary compensation within this discipline. These data provided insights into the complex global job market trends. They also revealed the level of scientific specialization embedded within the organization, presently uniquely positioned to support the dynamic career paths of current and future safety pharmacologists. Copyright © 2017 Elsevier Inc. All rights reserved.

Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline

Science.gov (United States)

Legro, Richard S.; Arslanian, Silva A.; Ehrmann, David A.; Hoeger, Kathleen M.; Murad, M. Hassan; Pasquali, Renato; Welt, Corrine K.

2013-01-01

Objective: The aim was to formulate practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS). Participants: An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer developed the guideline. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. Consensus Process: One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of The Endocrine Society and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines. Two systematic reviews were conducted to summarize supporting evidence. Conclusions: We suggest using the Rotterdam criteria for diagnosing PCOS (presence of two of the following criteria: androgen excess, ovulatory dysfunction, or polycystic ovaries). Establishing a diagnosis of PCOS is problematic in adolescents and menopausal women. Hyperandrogenism is central to the presentation in adolescents, whereas there is no consistent phenotype in postmenopausal women. Evaluation of women with PCOS should exclude alternate androgen-excess disorders and risk factors for endometrial cancer, mood disorders, obstructive sleep apnea, diabetes, and cardiovascular disease. Hormonal contraceptives are the first-line management for menstrual abnormalities and hirsutism/acne in PCOS. Clomiphene is currently the first-line therapy for infertility; metformin is beneficial for metabolic/glycemic abnormalities and for improving menstrual irregularities, but it has limited or no benefit in treating hirsutism, acne, or infertility. Hormonal contraceptives and metformin are the treatment options in adolescents with PCOS. The role of weight loss in improving PCOS status per se is uncertain, but lifestyle intervention is beneficial in overweight

Validation of the American Society for Reproductive Medicine guidelines/recommendations in white European men presenting for couple's infertility.

Science.gov (United States)

Ventimiglia, Eugenio; Capogrosso, Paolo; Boeri, Luca; Ippolito, Silvia; Scano, Roberta; Moschini, Marco; Gandaglia, Giorgio; Papaleo, Enrico; Montorsi, Francesco; Salonia, Andrea

2016-10-01

To retrospectively validate the American Society for Reproductive Medicine (ASRM) guidelines/recommendations concerning endocrine evaluation in a cohort of white European men presenting for couple's infertility. Retrospective study. Academic reproductive medicine outpatient clinic. Cohort of 1,056 consecutive infertile men (noninterracial infertile couples). Testicular volume was assessed with a Prader orchidometer. Serum hormones were measured (8-10 a.m.) in all cases. Hypogonadism was defined as total T Society definition. Semen analysis values were assessed based on the 2010 World Health Organisation reference criteria. ASRM indications for endocrine assessment in infertile men (sperm concentration Society classification criteria. Conversely, 37 (23.7%) out of 156 patients with biochemical hypogonadism would have been overlooked. The overall predictive accuracy, sensitivity, and specificity of the ASRM guidelines was 58%, 76%, and 39%, respectively. Our nomogram was not reliable enough to predict hypogonadism, despite demonstrating a significantly higher predictive accuracy (68%) than the ASRM guidelines. The current findings show that the ASRM guidelines/recommendations for male infertility workup may not be suitable for application in white European infertile men. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Canadian Thoracic Society 2011 Guideline Update: Diagnosis and Treatment of Sleep Disordered Breathing

Directory of Open Access Journals (Sweden)

John Fleetham

2011-01-01

Full Text Available The Canadian Thoracic Society (CTS published an executive summary of guidelines for the diagnosis and treatment of sleep disordered breathing in 2006/2007. These guidelines were developed during several meetings by a group of experts with evidence grading based on committee consensus. These guidelines were well received and the majority of the recommendations remain unchanged. The CTS embarked on a more rigorous process for the 2011 guideline update, and addressed eight areas that were believed to be controversial or in which new data emerged. The CTS Sleep Disordered Breathing Committee posed specific questions for each area. The recommendations regarding maximum assessment wait times, portable monitoring, treatment of asymptomatic adult obstructive sleep apnea patients, treatment with conventional continuous positive airway pressure compared with automatic continuous positive airway pressure, and treatment of central sleep apnea syndrome in heart failure patients replace the recommendations in the 2006/2007 guidelines. The recommendations on bariatric surgery, complex sleep apnea and optimum positive airway pressure technologies are new topics, which were not covered in the 2006/2007 guidelines.

An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline

DEFF Research Database (Denmark)

Girard, Timothy D; Alhazzani, Waleed; Kress, John P

2017-01-01

BACKGROUND: Interventions that lead to earlier liberation from mechanical ventilation can improve patient outcomes. This guideline, a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST), provides evidence-based recommendations to o...

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

International Nuclear Information System (INIS)

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

1996-06-01

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

Executive Summary of the American College of Surgeons/Surgical Infection Society Surgical Site Infection Guidelines-2016 Update.

Science.gov (United States)

Ban, Kristen A; Minei, Joseph P; Laronga, Christine; Harbrecht, Brian G; Jensen, Eric H; Fry, Donald E; Itani, Kamal M F; Dellinger, E Patchen; Ko, Clifford Y; Duane, Therese M

Guidelines regarding the prevention, detection, and management of surgical site infections (SSIs) have been published previously by a variety of organizations. The American College of Surgeons (ACS)/Surgical Infection Society (SIS) Surgical Site Infection (SSI) Guidelines 2016 Update is intended to update these guidelines based on the current literature and to provide a concise summary of relevant topics.

An overview of review guidelines for HDL programmable devices in nuclear safety systems

International Nuclear Information System (INIS)

Komanduri, Raghavan; Srivani, L.; Thirugnana Murthy, D.

2013-01-01

HDL programmable devices viz. CPLDs and FPGAs are increasingly being used to implement digital designs in the I and C systems performing safety functions of nuclear power plants. Synthesizable RTL descriptions manually written in HDLs are the first step in developing industry standard large scale digital designs. The reliability of the implementation is determined by the methodologies followed by the designer during development. Very few guidelines on HPD design practices, specific to nuclear industry are available. This paper presents an overview of the existing guidelines such as IEC 62566 and U.S. NRC's 'Review guidelines for FPGAs in nuclear power plant safety systems'. (author)

Monitoring and evaluation of Blyth Offshore wind farm: Health and Safety guidelines

Energy Technology Data Exchange (ETDEWEB)

Pepper, L

2002-07-01

Experiences during the construction, operation and maintenance of the wind farm off the coast of Blyth in Northumberland are used to assess the practicality of implementing existing draft British Wind Energy Association (BWEA) guidelines. These best practice guidelines, which were drawn up in consultation with the Health and Safety Executive (HSE) offer advice on health and safety issues specific to the wind industry in the UK. The guidelines are intended to cover both onshore and offshore sites; common advice is followed by advice specific to offshore sites. The Blyth Offshore project, the first offshore wind farm in the UK, features two 2 MW turbines installed on a submerged rocky outcrop about 1 km from the coast in a depth of about 6 m at low tide and a tidal range of about 5 m. The report concluded that, from the experience at Blyth, the draft guidelines will provide a useful tool for those involved in all stages of a wind farm project.

Essentials from the 2015 European AIDS Clinical Society (EACS) guidelines for the treatment of adult HIV-positive persons

DEFF Research Database (Denmark)

Nielsen, Lene Ryom; Boesecke, C; Gisler, V

2016-01-01

BACKGROUND: The European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android. GUIDELINE HIGHLIGHTS: The 2015 version of the EACS guidelines...

Essentials from the 2015 European AIDS Clinical Society (EACS) guidelines for the treatment of adult HIV-positive persons

NARCIS (Netherlands)

Ryom, L.; Boesecke, C.; Gisler, V.; Manzardo, C.; Rockstroh, J. K.; Puoti, M.; Furrer, H.; Miro, J. M.; Gatell, J. M.; Pozniak, A.; Behrens, G.; Battegay, M.; Lundgren, J. D.; Lundgren, Jens D.; Ryom, Lene; Gatell, José M.; Pozniak, Anton; Manzardo, Christian; Monforte, Antonella d'Arminio; Arribas, José; Battegay, Manuel; Clumeck, Nathan; Dedes, Nikos; Geretti, Anna Maria; Horban, Andrzej; Katlama, Christina; McCormack, Sheena; Molina, Jean-Michel; Mussini, Cristina; Raffi, François; Reiss, Peter; Stellbrink, Hans-Jürgen; Behrens, Georg; Bower, Mark; Cinque, Paola; Collins, Simon; Compston, Juliet; Deray, Gilbert; de Wit, Stéphane; Fux, Christoph A.; Guraldi, Giovanni; Mallon, Patrick; Martinez, Esteban; Marzolini, Catia; Papapoulos, Socrates; Du Pasquier, Renaud; Poulter, Neil; Williams, Ian; Winston, Alan; Rockstroh, Jürgen K.

2016-01-01

BackgroundThe European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android. Guideline highlightsThe 2015 version of the EACS guidelines contains

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines-Anticoagulation During Cardiopulmonary Bypass.

Science.gov (United States)

Shore-Lesserson, Linda; Baker, Robert A; Ferraris, Victor A; Greilich, Philip E; Fitzgerald, David; Roman, Philip; Hammon, John W

2018-02-01

Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup. This was a group of interdisciplinary professionals gathered to summarize the evidence and create practice recommendations for various aspects of CPB. To date, anticoagulation practices in CPB have not been standardized in accordance with the evidence base. This clinical practice guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation therapy for CPB using the available evidence. To identify relevant evidence, a systematic review was outlined and literature searches were conducted in PubMed using standardized medical subject heading (MeSH) terms from the National Library of Medicine list of search terms. Search dates were inclusive of January 2000 to December 2015. The search yielded 833 abstracts, which were reviewed by two independent reviewers. Once accepted into the full manuscript review stage, two members of the writing group evaluated each of 286 full papers for inclusion eligibility into the guideline document. Ninety-six manuscripts were included in the final review. In addition, 17 manuscripts published before 2000 were included to provide method, context, or additional supporting evidence for the recommendations as these papers were considered sentinel publications. Members of the writing group wrote and developed recommendations based on review of the articles obtained and achieved

ASCOT guidelines revised 1996 edition. Guidelines for organizational self-assessment of safety culture and for reviews by the assessment of safety culture in organizations team

International Nuclear Information System (INIS)

1996-01-01

In order to properly assess safety culture, it is necessary to consider the contribution of all organizations which have an impact on it. Therefore, while assessing the safety culture in an operating organization it is necessary to address at least its interfaces with the local regulatory agency, utility corporate headquarters and supporting organizations. These guidelines are primarily intended for use by any organization wishing to conduct a self-assessment of safety culture. They should also serve as a basis for conducting an international peer review of the organization's self-assessment carried out by an ASCOT (Assessment of Safety Culture in Organizations Team) mission

Guidelines for Percutaneous Dilatational Tracheostomy (PDT) from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM)

DEFF Research Database (Denmark)

Madsen, Kristian Rørbæk; Guldager, Henrik; Rewers, Mikael

2011-01-01

Percutaneous dilatational tracheostomy is a common procedure in intensive care. This guideline from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM) describes indications and contraindications, timing, complications...

Proceedings of the 5th annual meeting of Japanese Society of Radiation Safety Management 2006 Nagoya

International Nuclear Information System (INIS)

2006-01-01

This is the program and the proceedings of the 5th annual meeting of Japanese Society of Radiation Safety Management held from November 29th through December 1st of 2006. The sessions held are: (1) Radiation Measurement 1, (2) Education Method, (3) Radiation Control, (4) Waste Handling, Contamination Inspection, and Renewal, (5) Exposure Reduction, Radiation Evaluation, and Radioactivity Control (6) Radiation Measurement 2, (7) Operation Environment, (8) Medical Exposure, (9) Radiation Measurement 3, (10) Software, IT Technology, and Data Processing, (11) Emission and Drainage Handling, and (12) Radiation Effect and Contamination Countermeasure. The poster sessions held are: (1) Radiation Measurement, (2) Environmental Radiation, (3) Scattering Rate, Penetration Rate, and Contamination Inspection, (4) Education Method, (5) Medical Exposure, (6) Access Control and Software, and (7) Radiation Control Method and Monitoring. The symposia held are: (1) 'Toward Establishment of Guideline for Safe X-ray Handling Education' and 'International Situation of Radiation Safety'. 2 keynote lectures were also held. (S.K.)

Guideline for examination concerning the evaluation of safety in light water power reactor installations

International Nuclear Information System (INIS)

1978-01-01

This guideline was drawn up as the guide for examination when the safety evaluation of nuclear reactors is carried out at the time of approving the installation of light water power reactors. Accordingly in case of the examination of safety, it must be confirmed that the contents of application are in conformity with this guideline. If they are in conformity, it is judged that the safety evaluation of the policy in the basic design of a reactor facility is adequate, and also that the evaluation concerning the separation from the public in surroundings is adequate as the condition of location of the reactor facility. This guideline is concerned with light water power reactors now in use, but the basic concept may be the reference for the examination of the other types of reactors. If such a case occurs that the safety evaluation does not conform to this guideline, it is not excluded when the appropriate reason is clarified. The purpose of safety evaluation, the scope to be evaluated, the selection of the events to be evaluated, the criteria for judgement, the matters taken into consideration at the time of analysis, the concrete events of abnormal transient change and accident in operation, and the concrete events of serious accident and hypothetic accident are stipulated. The explanation and two appendices are attached. (Kako, I.)

[Endoprosthesis Infections - Guidelines for Antibiotic Therapy Common Guidelines of the Czech Society for Orthopaedics and Traumatology and the Society for Infectious Diseases of the Czech Medical Association of J. E. Purkyně].

Science.gov (United States)

Musil, D; Balejová, M; Horníková, M; Chrdle, A; Mallátová, N; Nyč, O; Chmelík, V; Gallo, J; Jahoda, D; Stehlík, J

2017-01-01

PURPOSE OF THE STUDY This study aims to articulate regional guidelines for curative and suppressive antibiotic therapy of total joint replacement infections. MATERIAL AND METHODS When developing the standard, used as source materials were the published foreign guidelines for antibiotic therapy of prosthetic joint infections, the analysis of resistance of bacterial strains conducted in the Hospital in České Budějovice, a.s. and the assessment of strain resistance for the Czech Republic published by the European Antimicrobial Resistance Surveillance Network (EARS-Net). Considered was also the availability of individual antibiotics in the Czech Republic and restricted prescription according to the Summary of Product Characteristics as specified in the State Institute for Drug Control marketing authorisation. The expert group composed of orthopaedists, microbiologists and infectious disease specialists elaborated the basic antibiotic guideline for choosing an appropriate antibiotic/antifungal drug based on the usual susceptibility, its dose and dosage interval for initial and continuation therapy. The comments of individual specialists were gradually incorporated therein and in case of doubts majority rule was applied. The drafted document was sent for peer reviews to clinical orthopaedic, infectious disease and microbiological centres, whose comments were also incorporated and the finalised document was submitted for evaluation to specialised medical societies. RESULTS The outcome is the submitted guideline for antibiotic curative and suppressive therapy suitable for managing the prosthetic joint infections, which was approved by the committee of the Czech Society for Orthopaedics and Traumatology andthe Society for Infectious Diseases of the Czech Medical Association of J. E. Purkyně. DISCUSION Curative therapy of total joint replacement infections consists primarily in surgical treatment and has to be accompanied by adequate antibiotic therapy administered

Diabetes Technology-Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline.

Science.gov (United States)

Peters, Anne L; Ahmann, Andrew J; Battelino, Tadej; Evert, Alison; Hirsch, Irl B; Murad, M Hassan; Winter, William E; Wolpert, Howard

2016-11-01

To formulate clinical practice guidelines for the use of continuous glucose monitoring and continuous subcutaneous insulin infusion in adults with diabetes. The participants include an Endocrine Society-appointed Task Force of seven experts, a methodologist, and a medical writer. The American Association for Clinical Chemistry, the American Association of Diabetes Educators, and the European Society of Endocrinology co-sponsored this guideline. The Task Force developed this evidence-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned one systematic review and used the best available evidence from other published systematic reviews and individual studies. One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the American Association for Clinical Chemistry, the American Association of Diabetes Educators, and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines. Continuous subcutaneous insulin infusion and continuous glucose monitoring have an important role in the treatment of diabetes. Data from randomized controlled trials are limited on the use of medical devices, but existing studies support the use of diabetes technology for a wide variety of indications. This guideline presents a review of the literature and practice recommendations for appropriate device use.

Research oil guidelines for safety review of category 2 waste disposal

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-08-15

Safety confirmation items and monitoring items for engineered barriers were compiled, considering the current technical status and monitoring plan for the simulated subsurface disposal and its test facilities. In order to develop the guidelines of the safety review for the disposal of LLW generated from RI facilities and research facilities, technical issues relating toxic substances were surveyed. (author)

LMFBR safety criteria and guidelines for consideration in the design of future plants

International Nuclear Information System (INIS)

1990-01-01

For many years the Commission of the European Communities has been conducting activities aimed at the progressive harmonization of safety requirements and criteria applied to nuclear installations in the Community. These activities cover thermal and fast reactors. This publication represents a major achievement in reaching this goal. The document, which has been prepared in the framework of activities of the CEC fast-reactor safety working group (SWG), consists of safety criteria and guidelines for fast reactors. It represents the common view of all EC Member States which have a fast-reactor programme or are interested in fast-reactor development. The criteria and guidelines are structured according to different types of possible faults, such as core reactivity faults, general cooling faults, subassembly faults, faults outside the core and causes external to the station. Only those events are considered which are in the design basis of current fast-reactor projects. Proposed measures or guidelines to satisfy the criteria are based on the present knowledge and proven technology

Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for prostate cancer 2017.

Science.gov (United States)

Aljubran, Ali; Abusamra, Ashraf; Alkhateeb, Sultan; Alotaibi, Mohammed; Rabah, Danny; Bazarbashi, Shouki; Alkushi, Hussain; Al-Mansour, Mubarak; Alharbi, Hulayel; Eltijani, Amin; Alghamdi, Abdullah; Alsharm, Abdullah; Ahmad, Imran; Murshid, Esam

2018-01-01

This is an update to the previously published Saudi guidelines for the evaluation and medical and surgical management of patients diagnosed with prostate cancer. Prostate cancer is categorized according to the stage of the disease using the tumor node metastasis staging system 7 th edition. The guidelines are presented with supporting evidence levels based on a comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors) who were selected by the Saudi Oncology Society and Saudi Urological Association. Local factors, such as availability, logistic feasibility, and familiarity of various treatment modalities, have been taken into consideration. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health-care policymakers in the management of patients diagnosed with adenocarcinoma of the prostate.

Introducing the Canadian Thoracic Society Framework for Guideline Dissemination and Implementation, with Concurrent Evaluation

Directory of Open Access Journals (Sweden)

Samir Gupta

2013-01-01

Full Text Available The Canadian Thoracic Society (CTS is leveraging its strengths in guideline production to enable respiratory guideline implementation in Canada. The authors describe the new CTS Framework for Guideline Dissemination and Implementation, with Concurrent Evaluation, which has three spheres of action: guideline production, implementation infrastructure and knowledge translation (KT methodological support. The Canadian Institutes of Health Research ‘Knowledge-to-Action’ process was adopted as the model of choice for conceptualizing KT interventions. Within the framework, new evidence for formatting guideline recommendations to enhance the intrinsic implementability of future guidelines were applied. Clinical assemblies will consider implementability early in the guideline production cycle when selecting clinical questions, and new practice guidelines will include a section dedicated to KT. The framework describes the development of a web-based repository and communication forum to inventory existing KT resources and to facilitate collaboration and communication among implementation stakeholders through an online discussion board. A national forum for presentation and peer-review of proposed KT projects is described. The framework outlines expert methodological support for KT planning, development and evaluation including a practical guide for implementers and a novel ‘Clinical Assembly – KT Action Team’, and in-kind logistical support and assistance in securing peer-reviewed funding.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Colon Cancer.

Science.gov (United States)

Vogel, Jon D; Eskicioglu, Cagla; Weiser, Martin R; Feingold, Daniel L; Steele, Scott R

2017-10-01

The American Society of Colon and Rectal Surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Clinical Practice Guidelines Committee is composed of society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than to dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances presented by the individual patient.

In honor of the Teratology Society's 50th anniversary: The role of Teratology Society members in the development and evolution of in vivo developmental toxicity test guidelines.

Science.gov (United States)

Tyl, Rochelle W

2010-06-01

Members of the Teratology Society (established in 1960) were involved in the first governmental developmental and reproductive toxicity testing guidelines (1966) by FDA following the thalidomide epidemic, followed by other national and international governmental testing guidelines. The Segment II (developmental toxicity) study design, described in rodents and rabbits, has evolved with additional enhanced endpoints and better descriptions, mechanistic insights, range-finding studies, and toxico/pharmacokinetic ADME information (especially for pharmaceuticals). Society members were also involved in the development of the current screening assays and tests for endocrine disruptors (beginning in 1996) and are now involved with developing new testing guidelines (e.g., the extended one-generation protocol), and evaluating the current test guidelines and new initiatives under ILSI/HESI sponsorship. New initiatives include ToxCast from the U.S. EPA to screen, prioritize, and predict toxic chemicals by high throughput and high-content in vitro assays, bioinformation, and modeling to reduce (or eliminate) in vivo whole animal studies. Our Society and its journal have played vital roles in the scientific and regulatory accomplishments in birth defects research over the past 50 years and will continue to do so in the future. Happy 50th anniversary! (c) 2010 Wiley-Liss, Inc.

KAERI software verification and validation guideline for developing safety-critical software in digital I and C system of NPP

Energy Technology Data Exchange (ETDEWEB)

Kim, Jang Yeol; Lee, Jang Soo; Eom, Heung Seop

1997-07-01

This technical report is to present V and V guideline development methodology for safety-critical software in NPP safety system. Therefore it is to present V and V guideline of planning phase for the NPP safety system in addition to critical safety items, for example, independence philosophy, software safety analysis concept, commercial off the shelf (COTS) software evaluation criteria, inter-relationships between other safety assurance organizations, including the concepts of existing industrial standard, IEEE Std-1012, IEEE Std-1059. This technical report includes scope of V and V guideline, guideline framework as part of acceptance criteria, V and V activities and task entrance as part of V and V activity and exit criteria, review and audit, testing and QA records of V and V material and configuration management, software verification and validation plan production etc., and safety-critical software V and V methodology. (author). 11 refs.

KAERI software verification and validation guideline for developing safety-critical software in digital I and C system of NPP

International Nuclear Information System (INIS)

Kim, Jang Yeol; Lee, Jang Soo; Eom, Heung Seop.

1997-07-01

This technical report is to present V and V guideline development methodology for safety-critical software in NPP safety system. Therefore it is to present V and V guideline of planning phase for the NPP safety system in addition to critical safety items, for example, independence philosophy, software safety analysis concept, commercial off the shelf (COTS) software evaluation criteria, inter-relationships between other safety assurance organizations, including the concepts of existing industrial standard, IEEE Std-1012, IEEE Std-1059. This technical report includes scope of V and V guideline, guideline framework as part of acceptance criteria, V and V activities and task entrance as part of V and V activity and exit criteria, review and audit, testing and QA records of V and V material and configuration management, software verification and validation plan production etc., and safety-critical software V and V methodology. (author). 11 refs

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. Part 3

DEFF Research Database (Denmark)

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas

2015-01-01

These updated guidelines are based on the first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in the years 2005 and 2006. For this 2015 revision, all available publications pertaining to the biological...... treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations which are clinically and scientifically relevant. They are intended to be used by all physicians diagnosing and treating patients with schizophrenia...

Nutraceuticals in Migraine: A Summary of Existing Guidelines for Use.

Science.gov (United States)

Rajapakse, Thilinie; Pringsheim, Tamara

2016-04-01

The use of nutraceuticals or food/herbal products for health benefits is expanding in adults with migraine as they seek relief from pain in an effective and tolerable manner not always afforded by current conventional pharmacologic therapies. Guidelines from the American Academy of Neurology/American Headache Society, Canadian Headache Society, and European Federation of Neurological Societies have discussed nutraceuticals in varying degrees of detail with at times conflicting recommendations. This review serves to provide a summary of existing guidelines for the use of certain nutraceuticals including riboflavin, coenzyme Q10, magnesium, butterbur, feverfew, and omega-3 polyunsaturated fatty acids. The review will also discuss the regulation of nutraceuticals in North America and the current controversy regarding butterbur and its safety. © 2016 American Headache Society.

Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain.

Science.gov (United States)

Narouze, Samer; Benzon, Honorio T; Provenzano, David A; Buvanendran, Asokumar; De Andres, José; Deer, Timothy R; Rauck, Richard; Huntoon, Marc A

2015-01-01

Interventional spine and pain procedures cover a far broader spectrum than those for regional anesthesia, reflecting diverse targets and goals. When surveyed, interventional pain and spine physicians attending the American Society of Regional Anesthesia and Pain Medicine (ASRA) 11th Annual Pain Medicine Meeting exhorted that existing ASRA guidelines for regional anesthesia in patients on antiplatelet and anticoagulant medications were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors necessitated separate guidelines for pain and spine procedures. In response, ASRA formed a guidelines committee. After preliminary review of published complication reports and studies, committee members stratified interventional spine and pain procedures according to potential bleeding risk as low-, intermediate-, and high-risk procedures. The ASRA guidelines were deemed largely appropriate for the low- and intermediate-risk categories, but it was agreed that the high-risk targets required an intensive look at issues specific to patient safety and optimal outcomes in pain medicine. The latest evidence was sought through extensive database search strategies and the recommendations were evidence-based when available and pharmacology-driven otherwise. We could not provide strength and grading of these recommendations as there are not enough well-designed large studies concerning interventional pain procedures to support such grading. Although the guidelines could not always be based on randomized studies or on large numbers of patients from pooled databases, it is hoped that they will provide sound recommendations and the evidentiary basis for such recommendations.

Safety of MR liver specific contrast media

Energy Technology Data Exchange (ETDEWEB)

Bellin, Marie-France [Hopital Paul Brousse, Universite Paris 11, Villejuif Cedex (France); Webb, Judith A.W. [St. Bartholomew' s Hospital, Department of Diagnostic Imaging, London (United Kingdom); Molen, Aart J. van der [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Thomsen, Henrik S. [Copenhagen University Hospital at Herlev, Department of Diagnostic Radiology 54E2, Herlev (Denmark); Morcos, Sameh K. [Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Department of Diagnostic Imaging, Sheffield (United Kingdom)

2005-08-01

Over the past few years a number of magnetic resonance (MR) liver specific contrast agents have been introduced. In this report the safety issues of these agents are addressed. A literature search was carried out. Based on the available information, simple guidelines on the safety issue of liver specific contrast agents have been produced by the Contrast Media Safety Committee of the European Society of Urogenital Radiology. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela. Liver specific contrast agents appear in general to be safe and well tolerated. However, the incidence of adverse reactions with iron oxides and the intravenous manganese based agent seems to be slightly higher than with gadolinium based agents. However, no safety information from comparative clinical trials has been published. Guidelines on the safety aspects are presented. (orig.)

Safety of MR liver specific contrast media

International Nuclear Information System (INIS)

Bellin, Marie-France; Webb, Judith A.W.; Molen, Aart J. van der; Thomsen, Henrik S.; Morcos, Sameh K.

2005-01-01

Over the past few years a number of magnetic resonance (MR) liver specific contrast agents have been introduced. In this report the safety issues of these agents are addressed. A literature search was carried out. Based on the available information, simple guidelines on the safety issue of liver specific contrast agents have been produced by the Contrast Media Safety Committee of the European Society of Urogenital Radiology. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela. Liver specific contrast agents appear in general to be safe and well tolerated. However, the incidence of adverse reactions with iron oxides and the intravenous manganese based agent seems to be slightly higher than with gadolinium based agents. However, no safety information from comparative clinical trials has been published. Guidelines on the safety aspects are presented. (orig.)

Guidelines for the Review of Research Reactor Safety: Revised Edition. Reference Document for IAEA Integrated Safety Assessment of Research Reactors (INSARR)

International Nuclear Information System (INIS)

2013-01-01

The Integrated Safety Assessment of Research Reactors (INSARR) is an IAEA safety review service available to Member States with the objective of supporting them in ensuring and enhancing the safety of their research reactors. This service consists of performing a comprehensive peer review and an assessment of the safety of the respective research reactor. The reviews are based on IAEA safety standards and on the provisions of the Code of Conduct on the Safety of Research Reactors. The INSARR can benefit both the operating organizations and the regulatory bodies of the requesting Member States, and can include new research reactors under design or operating research reactors, including those which are under a Project and Supply Agreement with the IAEA. The first IAEA safety evaluation of a research reactor operated by a Member State was completed in October 1959 and involved the Swiss 20 MW DIORIT research reactor. Since then, and in accordance with its programme on research reactor safety, the IAEA has conducted safety review missions in its Member States to enhance the safety of their research reactor facilities through the application of the Code of Conduct on the Safety of Research Reactors and the relevant IAEA safety standards. About 320 missions in 51 Member States were undertaken between 1972 and 2012. The INSARR missions and other limited scope safety review missions are conducted following the guidelines presented in this publication, which is a revision of Guidelines for the Review of Research Reactor Safety (IAEA Services Series No. 1), published in December 1997. This publication details those IAEA safety standards and guidance publications relevant to the safety of research reactors that have been revised or published since 1997. The purpose of this publication is to give guidance on the preparation, implementation, reporting and follow-up of safety review missions. It is also intended to be of assistance to operators and regulators in conducting

The Italian National Guidelines for the fire safety of facades

Directory of Open Access Journals (Sweden)

Lamberto Mazziotti

2013-11-01

Full Text Available Traditionally, the facades' design buildings where once only focused on architectural or aesthetic purposes (in addition, of course, of whether protective issues. Nowadays, thanks to the technological development of the construction works and the use of new types of materials, the facades' design should also address fire safety related aspects. In Europe and especially in Italy – where the types of building façades are built with windows of small surface and natural stone coverings – the green building/sustainability movement has resulted in the development of new concepts in facade or curtain wall design that intended to enhance the energy efficiency of building façades. These new building surfaces are covered by extensive panelling fitted with insulating materials or by wide glass surfaces, capable of carry out the most diverse purposes including, just to name a few: energy reduction, climate comfort, recovery of electricity through photovoltaic panels that convert sunlight into electricity, large space for advertising purpose. One of the main fire safety goal for a building design is to restrict the vertical fire spread so that the smoke and flames are limited to the fire origin floor. The new building façade and curtain wall topologies could overwhelms concerns for fire safety, therefore the Italian National fire service has released a Fire Code Guideline in order to address the fire safety design for an high rise building façade. This paper aims to show the guideline contents and the related fire safety façades concerns.

A guideline for comprehensive evaluation of a licensee's effort to cultivate safety culture

International Nuclear Information System (INIS)

Makino, Maomi; Ishii, Yoichi

2009-01-01

The nuclear industry in Japan had held excellent performance in safety in the world during 90's. However recent events stem from organizational factors and defects of safety culture are pointed out in their contexts. In order to reduce accidents caused by organizational factors, the Japanese Regulatory body NISA (Nuclear and Industrial Safety Agency) decided to evaluate a licensee's effort for the cultivation of safety culture, and to order all licensses to add the provision of cultivating safety culture to their safety preservation rules. The inspection for the new safety preservation rules started in December, 2007. For a measure of evaluation by resident inspectors, NISA and the Japan Nuclear Energy Safety Organization (JNES) prepared a guideline for the prevention of degradation of safety culture and organizational climate. In this guideline, 14 items were defined as the components of the safety culture or as the viewpoints to evaluate the effort made to prevent any degradation of safety culture and organizational climate in the daily safety preservation activities. The 14 items are also used to establish the method to comprehensively evaluate the effort to prevent degradation of safety culture and organizational climate. This method consists of 10 steps: two steps to taken prior to start of the evaluation, two steps to be taken during the evaluation period, 5 steps to be taken during a comprehensive evaluation period and a final step to be taken for comprehensive findings for safety culture. This paper mainly describes the viewpoints to evaluate comprehensively a licensee's effort for cultivation of safety culture. (author)

Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline

Directory of Open Access Journals (Sweden)

Silvina Arrossi

2017-10-01

Full Text Available Purpose: To provide resource-stratified (four tiers, evidence-based recommendations on the primary prevention of cervical cancer globally. Methods: The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group for one round of formal ratings. Results: Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. Recommendations: In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus–related cancers and diseases. Basic settings: vaccinating boys is not recommended

Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline.

Science.gov (United States)

Arrossi, Silvina; Temin, Sarah; Garland, Suzanne; Eckert, Linda O'Neal; Bhatla, Neerja; Castellsagué, Xavier; Alkaff, Sharifa Ezat; Felder, Tamika; Hammouda, Doudja; Konno, Ryo; Lopes, Gilberto; Mugisha, Emmanuel; Murillo, Rául; Scarinci, Isabel C; Stanley, Margaret; Tsu, Vivien; Wheeler, Cosette M; Adewole, Isaac Folorunso; de Sanjosé, Silvia

2017-10-01

To provide resource-stratified (four tiers), evidence-based recommendations on the primary prevention of cervical cancer globally. The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group) for one round of formal ratings. Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus-related cancers and diseases. Basic settings: vaccinating boys is not recommended. It is the view of the American Society of Clinical Oncology that

Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines.

Science.gov (United States)

Binda, G A; Cuomo, R; Laghi, A; Nascimbeni, R; Serventi, A; Bellini, D; Gervaz, P; Annibale, B

2015-10-01

The mission of the Italian Society of Colorectal Surgery (SICCR) is to optimize patient care. Providing evidence-based practice guidelines is therefore of key importance. About the present report it concernes the SICCR practice guidelines for the diagnosis and treatment of diverticular disease of the colon. The guidelines are not intended to define the sole standard of care but to provide evidence-based recommendations regarding the available therapeutic options.

Guidelines for pressure vessel safety assessment

Science.gov (United States)

Yukawa, S.

1990-04-01

A technical overview and information on metallic pressure containment vessels and tanks is given. The intent is to provide Occupational Safety and Health Administration (OSHA) personnel and other persons with information to assist in the evaluation of the safety of operating pressure vessels and low pressure storage tanks. The scope is limited to general industrial application vessels and tanks constructed of carbon or low alloy steels and used at temperatures between -75 and 315 C (-100 and 600 F). Information on design codes, materials, fabrication processes, inspection and testing applicable to the vessels and tanks are presented. The majority of the vessels and tanks are made to the rules and requirements of ASME Code Section VIII or API Standard 620. The causes of deterioration and damage in operation are described and methods and capabilities of detecting serious damage and cracking are discussed. Guidelines and recommendations formulated by various groups to inspect for the damages being found and to mitigate the causes and effects of the problems are presented.

European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

DEFF Research Database (Denmark)

Oonk, Maaike H M; Planchamp, François; Baldwin, Peter

2017-01-01

OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological...... Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe). To ensure that the statements are evidence...

European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults.

Science.gov (United States)

Bollerslev, Jens; Rejnmark, Lars; Marcocci, Claudio; Shoback, Dolores M; Sitges-Serra, Antonio; van Biesen, Wim; Dekkers, Olaf M

2015-08-01

Hypoparathyroidism (HypoPT) is a rare (orphan) endocrine disease with low calcium and inappropriately low (insufficient) circulating parathyroid hormone levels, most often in adults secondary to thyroid surgery. Standard treatment is activated vitamin D analogues and calcium supplementation and not replacement of the lacking hormone, as in other hormonal deficiency states. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of chronic HypoPT in adults who do not have end-stage renal disease. We intend to draft a practical guideline, focusing on operationalized recommendations deemed to be useful in the daily management of patients. This guideline was developed and solely sponsored by The European Society of Endocrinology, supported by CBO (Dutch Institute for Health Care Improvement) and based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles as a methodological base. The clinical question on which the systematic literature search was based and for which available evidence was synthesized was: what is the best treatment for adult patients with chronic HypoPT? This systematic search found 1100 articles, which was reduced to 312 based on title and abstract. The working group assessed these for eligibility in more detail, and 32 full-text articles were assessed. For the final recommendations, other literature was also taken into account. Little evidence is available on how best to treat HypoPT. Data on quality of life and the risk of complications have just started to emerge, and clinical trials on how to optimize therapy are essentially non-existent. Most studies are of limited sample size, hampering firm conclusions. No studies are available relating target calcium levels with clinically relevant endpoints. Hence it is not possible to formulate recommendations based on strict evidence. This guideline is therefore mainly based on how patients are managed in clinical practice

Highlights of the 2017 European AIDS Clinical Society (EACS) Guidelines for the treatment of adult HIV-positive persons version 9.0

DEFF Research Database (Denmark)

Ryom, L; Boesecke, C; Bracchi, M

2018-01-01

BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. GUIDELINE HIGHLIGHTS: Major revisions have been made in all sections of the 2017 Guidelines: antiretrov...

Technical guidelines for the seismic safety re-evaluation at Eastern European NPPs

International Nuclear Information System (INIS)

Godoy, A.R.; Guerpinar, A.

2001-01-01

The paper describes one of the outcomes of the Engineering Safety Review Services (ESRS) that the IAEA provides as an element of the Agency's national, regional and interregional technical assistance and co-operation programmes and other extrabudgetary programmes to assess the safety of nuclear facilities. This refers to the establishment of detailed guidelines for conducting the seismic safety re-evaluation of existing nuclear power plants in Eastern European countries in line with updated criteria and current international practice. (author)

Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis.

Science.gov (United States)

Korbel, Krzysztof; Kozinoga, Mateusz; Stoliński, Łukasz; Kotwicki, Tomasz

2014-07-28

According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated. Based on the natural history of idiopathic scoliosis, SRS criteria, SOSORT 2008 experts' opinion and the knowledge of the possibilities of psychological assessment of conservative IS treatment, rules were proposed regarding nonsurgical IS therapy procedures, with special consideration being paid to the proper treatment start time (age, Risser test, biological maturity, Cobb angle), possibility of curvature progression, the importance of physiotherapy and psychological assessment. The knowledge of SRS criteria and SOSORT guidelines regarding the conservative treatment of IS are essential for proper treatment (the right time to start treatment), and supports establishment of interdisciplinary treatment teams, consisting of a physician, a physiotherapist, an orthopedic technician and a psychologist.

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

Energy Technology Data Exchange (ETDEWEB)

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

1997-10-01

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

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

International Nuclear Information System (INIS)

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

1997-10-01

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

75 FR 15485 - Pipeline Safety: Workshop on Guidelines for Integrity Assessment of Cased Pipe

Science.gov (United States)

2010-03-29

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket ID...: Pipeline and Hazardous Materials Safety Administration (PHMSA), DOT. ACTION: Notice of workshop. SUMMARY... ``Guidelines for Integrity Assessment of Cased Pipe in Gas Transmission Pipelines'' and related Frequently...

Guideline for dialysate quality of Spanish Society of Nephrology (second edition, 2015).

Science.gov (United States)

Pérez-García, Rafael; García Maset, Rafael; Gonzalez Parra, Emilio; Solozábal Campos, Carlos; Ramírez Chamond, Rafael; Martín-Rabadán, Pablo; Sobrino Pérez, Pedro Enrique; Gallego Pereira, Ovidio; Dominguez, Jon; de la Cueva Matute, Enrique; Ferllen, Ricardo

2016-01-01

A Best Practice Guideline about Dialysis fluid purity was developed under the leadership of the Spanish Society of Nephrology in 2004. The second edition revised Guideline considered new evidences and International Standard. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. This Guideline is based on the ISO13959, European Pharmacopoeia, the Real Farmacopea Española, the AAMI Standards and Recommended Practices, European Best Practice Guidelines for Haemodialysis, literature reviews, according to their level of evidence, and the opinion of the expert Spanish group. Two levels of quality of water were defined: purified water and high purified water (ultra pure) and for dialysate: ultra pure dialysate. Regular use of ultra pure dialysate is recommended for all type of hemodialysis to prevent and delay the occurrence of complications: inflammation, malnutrition, anaemia and amiloidosis. Water, concentrates and dialysate quality requirements are defined as maximum allowable contaminant levels: chemicals (4.1.2), conductivity, microbial and endotoxins (4.1.1): Monitoring frequency, maintenance and corrective actions were specified. Methods of sampling and analysis were described in appendix (anexos). For microbiological monitoring, R2A medium is recommended, incubated during 7-14 days at a temperature of 17-23°C. The dialysate quality assurance process involves all dialysis staff members and requires strict protocols. The physician in charge of hemodialysis has the ultimate responsibility for dialysate quality. All suggestions and questions about this Guideline are wellcome to www.senefro.org. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases

Directory of Open Access Journals (Sweden)

J. Scott Weese

2011-01-01

Full Text Available Urinary tract disease is a common reason for use (and likely misuse, improper use, and overuse of antimicrobials in dogs and cats. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, guidelines for diagnosis and management of urinary tract infections were created by a Working Group of the International Society for Companion Animal Infectious Diseases. While objective data are currently limited, these guidelines provide information to assist in the diagnosis and management of upper and lower urinary tract infections in dogs and cats.

Adherence to the European Society of Cardiology guidelines for the treatment of chronic heart failure

Science.gov (United States)

Sitepu, A.; Hamdani, K.

2018-03-01

Heart failure is a tremendous health problem with significant morbidity and mortality. The treatment of heart failure should be applied appropriately to improve the successful management of patients. This study aims to evaluate the adherence to European Society of Cardiology (ESC) guidelines for the treatment of chronic heart failure and to determine factors associated with guideline adherence. This study is an observational study comprising 97 patients with chronic heart failure with reduced ejection fraction. The guideline adherence was assessed the by the use of guideline adherence indicator (GAI), which consider GAI-3 or GAI-5, by calculating the proportion of recommended drugs was prescribed divided by a number of drugs indicated according to the ESC guidelines, in the absence of contraindications. The results showed the use of each indicated drugs were angiotensin- converting enzyme inhibitors or angiotensin receptor blockers (78.4%), beta-blockers (61.9%), mineralocorticoid receptor antagonists (61.9%), diuretics (89.7%), and digitalis (26.8%). Furthermore, the predominant categories of GAI-3 and GAI-5 were moderate. This study demonstrates that the adherence to ESC guidelines for the treatment of chronic heart failure still needs to be improved compared to recent studies. Also, age, etiology of heart failure and comorbidity were associated factors that influence the implementation of ESC guidelines.

Guidelines for the Layout and Contents of Safety Reports for Stationary Nuclear Power Plants

International Nuclear Information System (INIS)

1970-01-01

The purpose of the present document is to suggest guidelines for the organization and contents of the Safety Reports which support the request for authorization to construct and operate a nuclear power plant incorporating one or more reactors. Safety Reports represent the principal communication between the applicant and the Regulatory Body, as outlined in the Code of Practice for the Safe Operation of Nuclear Power Plants. It should be understood that these Safety Reports will be a valuable document for the applicant. They should contain, therefore, precise information on the plant and its operating conditions. The writing of Safety Reports should be considered an opportunity to enhance the safety of the plant and its operating conditions. Their main purpose is to provide information to permit the assessment of the nuclear safety implications which may arise from the establishment of the plant at the chosen site with due consideration to the health and safety of the general public and the operating personnel. Safety Reports should include information such as design bases, site and plant characteristics, limits and conditions, conduct of operation and safety analyses, in such way that the Regulatory Body may be able to evaluate the safety of the plant. The applicant should consider the present guidelines as a series of recommendations to be interpreted according to each specific case.

2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Treatment of Coccidioidomycosis.

Science.gov (United States)

Galgiani, John N; Ampel, Neil M; Blair, Janis E; Catanzaro, Antonino; Geertsma, Francesca; Hoover, Susan E; Johnson, Royce H; Kusne, Shimon; Lisse, Jeffrey; MacDonald, Joel D; Meyerson, Shari L; Raksin, Patricia B; Siever, John; Stevens, David A; Sunenshine, Rebecca; Theodore, Nicholas

2016-09-15

It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.Coccidioidomycosis, also known as San Joaquin Valley fever, is a systemic infection endemic to parts of the southwestern United States and elsewhere in the Western Hemisphere. Residence in and recent travel to these areas are critical elements for the accurate recognition of patients who develop this infection. In this practice guideline, we have organized our recommendations to address actionable questions concerning the entire spectrum of clinical syndromes. These can range from initial pulmonary infection, which eventually resolves whether or not antifungal therapy is administered, to a variety of pulmonary and extrapulmonary complications. Additional recommendations address management of coccidioidomycosis occurring for special at-risk populations. Finally, preemptive management strategies are outlined in certain at-risk populations and after unintentional laboratory exposure. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Attorney General forces Infectious Diseases Society of America to redo Lyme guidelines due to flawed development process.

Science.gov (United States)

Johnson, L; Stricker, R B

2009-05-01

Lyme disease is one of the most controversial illnesses in the history of medicine. In 2006 the Connecticut Attorney General launched an antitrust investigation into the Lyme guidelines development process of the Infectious Diseases Society of America (IDSA). In a recent settlement with IDSA, the Attorney General noted important commercial conflicts of interest and suppression of scientific evidence that had tainted the guidelines process. This paper explores two broad ethical themes that influenced the IDSA investigation. The first is the growing problem of conflicts of interest among guidelines developers, and the second is the increasing centralisation of medical decisions by insurance companies, which use treatment guidelines as a means of controlling the practices of individual doctors and denying treatment for patients. The implications of the first-ever antitrust investigation of medical guidelines and the proposed model to remediate the tainted IDSA guidelines process are also discussed.

Activities of ARCAL XX for the development of guidelines for the safety of radiation sources

International Nuclear Information System (INIS)

Velasques de Oliveira, S.M.; Betancourt, L.A.

2001-01-01

This report presents the contribution of the ARCAL XX project 'Guidelines for the Control of Radiation Sources' for the development and harmonization of the safety of radiation sources in Latin America. The project began in 1997 with the participation of nine countries. The methodology adopted has enabled all experts from the nine countries involved in the project to participate in discussions on the development of guidelines based on regional experience. Three common documents for all practices and six safety guides for the main practices have been revised for publication. For the next two years, the project co-ordinators are proposing regional and national workshops for the application of the safety guides approved by the ARCAL programme. (author)

Report on the International Society for Laboratory Hematology Survey on guidelines to support clinical hematology laboratory practice.

Science.gov (United States)

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

2016-05-01

Given the importance of evidence-based guidelines in health care, we surveyed the laboratory hematology community to determine their opinions on guideline development and their experience and interest in developing clinical hematology laboratory practice guidelines. The study was conducted using an online survey, distributed to members of the International Society for Laboratory Hematology (ISLH) in 2015, with analysis of collected, anonymized responses. A total of 245 individuals participated. Most worked in clinical and/or research laboratories (83%) or industry (11%). 42% felt there were gaps in current guidelines. The majority (58%) recommended that ISLH engages its membership in guideline development. Participants differed in their familiarity with, and use of, different organizations' guidelines. Participants felt it was important to follow best practice recommendations on guideline development, including engagement of experts, statement about conflict of interests and how they were managed, systematic review and grading evidence for recommendations, identifying recommendations lacking evidence or consensus, and public input and peer review of the guideline. Moreover, it was considered important to provide guidelines free of charge. Industry involvement in guidelines was considered less important. The clinical laboratory hematology community has high expectations of laboratory practice guidelines that are consistent with recent recommendations on evidence-based guideline development. © 2016 John Wiley & Sons Ltd.

Radiation safety for the emergency situation of the power plant accident. Radiation safety in society and its education

International Nuclear Information System (INIS)

Kosako, Toshiso

2012-01-01

Great East Japan Earthquake and Tsunamis, and following Fukushima Daiichi Nuclear Power Accident brought about great impact on society in Japan. Accident analysis of inside reactor was studied by reactor physics or reactor engineering knowledge, while dissipation of a large amount of radioactive materials outside reactor facilities, and radiation and radioactivity effects on people by way of atmosphere, water and soil were dealt with radiation safety or radiation protection. Due to extremely low frequency and experience of an emergency, there occurred a great confusion in the response of electric power company concerned, relevant regulating competent authorities, local government and media, and related scholars and researchers, which caused great anxieties amount affected residents and people. This article described radiation safety in the society and its education. Referring to actual examples, how radiation safety or radiation protection knowledge should be dealt with emergency risk management in the society was discussed as well as problem of education related with nuclear power, radiation and prevention of disaster and fostering of personnel for relevant people. (T. Tanaka)

Methodology for calculating guideline concentrations for safety shot sites

International Nuclear Information System (INIS)

1997-06-01

Residual plutonium (Pu), with trace quantities of depleted uranium (DU) or weapons grade uranium (WU), exists in surficial soils at the Nevada Test Site (NTS), Nellis Air Force Range (NAFR), and the Tonopah Test Range (TTR) as the result of the above-ground testing of nuclear weapons and special experiments involving the detonation of plutonium-bearing devices. The special experiments (referred to as safety shots) involving plutonium-bearing devices were conducted to study the behavior of Pu as it was being explosively compressed; ensure that the accidental detonation of the chemical explosive in a production weapon would not result in criticality; evaluate the ability of personnel to manage large-scale Pu dispersal accidents; and develop criteria for transportation and storage of nuclear weapons. These sites do not pose a health threat to either workers or the general public because they are under active institutional control. The DOE is committed to remediating the safety shot sites so that radiation exposure to the public, both now and in the future, will be maintained within the established limits and be as low as reasonably achievable. Remediation requires calculation of a guideline concentration for the Pu, U, and their decay products that are present in the surface soil. This document presents the methodology for calculating guideline concentrations of weapons grade plutonium, weapons grade uranium, and depleted uranium in surface soils at the safety shot sites. Emphasis is placed on obtaining site-specific data for use in calculating dose to potential residents from the residual soil contamination

Methodology for calculating guideline concentrations for safety shot sites

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-06-01

Residual plutonium (Pu), with trace quantities of depleted uranium (DU) or weapons grade uranium (WU), exists in surficial soils at the Nevada Test Site (NTS), Nellis Air Force Range (NAFR), and the Tonopah Test Range (TTR) as the result of the above-ground testing of nuclear weapons and special experiments involving the detonation of plutonium-bearing devices. The special experiments (referred to as safety shots) involving plutonium-bearing devices were conducted to study the behavior of Pu as it was being explosively compressed; ensure that the accidental detonation of the chemical explosive in a production weapon would not result in criticality; evaluate the ability of personnel to manage large-scale Pu dispersal accidents; and develop criteria for transportation and storage of nuclear weapons. These sites do not pose a health threat to either workers or the general public because they are under active institutional control. The DOE is committed to remediating the safety shot sites so that radiation exposure to the public, both now and in the future, will be maintained within the established limits and be as low as reasonably achievable. Remediation requires calculation of a guideline concentration for the Pu, U, and their decay products that are present in the surface soil. This document presents the methodology for calculating guideline concentrations of weapons grade plutonium, weapons grade uranium, and depleted uranium in surface soils at the safety shot sites. Emphasis is placed on obtaining site-specific data for use in calculating dose to potential residents from the residual soil contamination.

Review of the American Physical Society light water reactor safety study

International Nuclear Information System (INIS)

Budnitz, R.J.

1975-11-01

The issue of light-water reactor (LWR) safety has been the subject of a part-time, year-long study sponsored by the American Physical Society and supported by the National Science Foundation and the former Atomic Energy Commission. The 1974-1975 study produced a Report by the Study Group to the Society. The Report's ''Summary of Conclusions and Major Recommendations'' section is presented

Summary of Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia: An Evidence-Based Update by the Canadian Infectious Disease Society and the Canadian Thoracic Society

Directory of Open Access Journals (Sweden)

Lionel A Mandell

2000-01-01

Full Text Available Community-acquired pneumonia (CAP is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in the knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity against Streptococcus pneumoniae has been important as well. It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Diseases Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.

Guidelines for transoesophageal echocardiographic probe cleaning and disinfection from the British Society of Echocardiography.

Science.gov (United States)

Kanagala, P; Bradley, C; Hoffman, P; Steeds, R P

2011-10-01

The clinical utility of transoesophageal echocardiography (TOE) is well established. Being a semi-invasive procedure, however, the potential for transmission of infection between sequential patients exists. This has implications for the protection of both patients and medical staff. Guidelines for disinfection during gastrointestinal endoscopy (GIE) have been in place for many years.(1,2) Unfortunately, similar guidance is lacking with respect to TOE. Although traversing the same body cavities and sharing many similarities with upper GIE, there are fundamental structural and procedural differences with TOE which merit special consideration in establishing a decontamination protocol. This document provides recommendations for TOE probe decontamination based on the available evidence, expert opinion, and modification of the current British Society of Gastroenterology guidelines.

Annual report 1986 of Society for Reactor Safety (GRS)

International Nuclear Information System (INIS)

1987-01-01

The overall development of Society for Reactor Safety (GRS) is indicated by its annual volume of achievement. After initially high growth rates that achievement has come to stand at some 62 million marks or so over the last years. GRS today employs some 450 staff, of which 325 are scientific-technical experts representing altogether nearly 4000 man-years of experience in nuclear technology. The report presents essential results from the main points of activity of GRS over 10 years. In accordance with the aim of the institution they primarily cover projects in the sectors safety and radiation protection for nuclear facilities. Since 1985, since the extension of its contract of associates, GRS has also increasingly been concerned with safety questions in non-nuclear technology, concentrating mainly on the transfer of existing methods. (orig./DG) [de

Official Executive Summary of an American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline

DEFF Research Database (Denmark)

Schmidt, Gregory A; Girard, Timothy D; Kress, John P

2017-01-01

BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A mult...

New guidelines for dam safety classification

International Nuclear Information System (INIS)

Dascal, O.

1999-01-01

Elements are outlined of recommended new guidelines for safety classification of dams. Arguments are provided for the view that dam classification systems should require more than one system as follows: (a) classification for selection of design criteria, operation procedures and emergency measures plans, based on potential consequences of a dam failure - the hazard classification of water retaining structures; (b) classification for establishment of surveillance activities and for safety evaluation of dams, based on the probability and consequences of failure - the risk classification of water retaining structures; and (c) classification for establishment of water management plans, for safety evaluation of the entire project, for preparation of emergency measures plans, for definition of the frequency and extent of maintenance operations, and for evaluation of changes and modifications required - the hazard classification of the project. The hazard classification of the dam considers, as consequence, mainly the loss of lives or persons in jeopardy and the property damages to third parties. Difficulties in determining the risk classification of the dam lie in the fact that no tool exists to evaluate the probability of the dam's failure. To overcome this, the probability of failure can be substituted for by a set of dam characteristics that express the failure potential of the dam and its foundation. The hazard classification of the entire project is based on the probable consequences of dam failure influencing: loss of life, persons in jeopardy, property and environmental damage. The classification scheme is illustrated for dam threatening events such as earthquakes and floods. 17 refs., 5 tabs

Measure Guideline: Combustion Safety for Natural Draft Appliances Through Appliance Zone Isolation

Energy Technology Data Exchange (ETDEWEB)

Fitzgerald, J. [Center for Energy and Environment, Minneapolis, MN (United States); Bohac, D. [Center for Energy and Environment, Minneapolis, MN (United States)

2014-04-01

This measure guideline covers how to assess and carry out the isolation of natural draft combustion appliances from the conditioned space of low-rise residential buildings. It deals with combustion appliances located either within the living space in enclosed closets or side rooms or outside the living space in an adjacent area like an attic or garage. This subset of houses does not require comprehensive combustion safety tests and simplified prescriptive procedures can be used to address safety concerns. This allows residential energy retrofit contractors inexperienced in advanced combustion safety testing to effectively address combustion safety issues and allow energy retrofits including tightening and changes to distribution and ventilation systems to proceed.

European AIDS Clinical Society (EACS) guidelines for the clinical management and treatment of HIV-infected adults

DEFF Research Database (Denmark)

Clumeck, N; Pozniak, A; Raffi, F

2008-01-01

A working group of the European AIDS Clinical Society (EACS) have developed these guidelines for European clinicians to help them in the treatment of adults with HIV infection. This third version of the guidelines includes, as new topics, the assessment of patients at initial and subsequent clinic...... virological failure and the treatment of HIV during pregnancy. In Europe, there is a wide range of clinical practices in antiretroviral therapy depending on various factors such as drug registration, national policies, local availability, reimbursement and access to treatment. These can vary greatly from one...

Highlights of the 2017 European AIDS Clinical Society (EACS) Guidelines for the treatment of adult HIV-positive persons version 9.0

NARCIS (Netherlands)

Ryom, L.; Boesecke, C.; Bracchi, M.; Ambrosioni, J.; Pozniak, A.; Arribas, J.; Behrens, G.; Mallon, P. G. M.; Puoti, M.; Rauch, A.; Miro, J. M.; Kirk, O.; Marzolini, C.; Lundgren, J. D.; Battegay, M.; D'Arminio Monforte, Antonella; Clumeck, Nathan; Dedes, Nikos; Gatell, José M.; Horban, Andrzej; Katlama, Christine; McCormack, Sheena; Molina, Jean-Michel; Mussini, Cristina; Raffi, François; Reiss, Peter; Stellbrink, Hans-Jürgen; Bower, Mark; Cinque, Paola; Collins, Simon; Compston, Juliet; de Wit, Stéphane; Fabbri, Leonardo M.; Fux, Christoph A.; Guaraldi, Giovanni; Martínez, Esteban; Papapoulos, Socrates; Du Pasquier, Renaud; Poulter, Neil; Williams, Ian; Winston, Alan; Berenguer, Juan; Bhagani, Sanjay; Bruno, Raffaele; Konov, Svilen; Lacombe, Karine; Mauss, Stefan; Mendão, Luís; Peters, Lars; Rockstroh, Jürgen K.

2018-01-01

The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities,

Keeping Up with the Diabetes Technology: 2016 Endocrine Society Guidelines of Insulin Pump Therapy and Continuous Glucose Monitor Management of Diabetes.

Science.gov (United States)

Galderisi, Alfonso; Schlissel, Elise; Cengiz, Eda

2017-09-23

Decades after the invention of insulin pump, diabetes management has encountered a technology revolution with the introduction of continuous glucose monitoring, sensor-augmented insulin pump therapy and closed-loop/artificial pancreas systems. In this review, we discuss the significance of the 2016 Endocrine Society Guidelines for insulin pump therapy and continuous glucose monitoring and summarize findings from relevant diabetes technology studies that were conducted after the publication of the 2016 Endocrine Society Guidelines. The 2016 Endocrine Society Guidelines have been a great resource for clinicians managing diabetes in this new era of diabetes technology. There is good body of evidence indicating that using diabetes technology systems safely tightens glycemic control while managing both type 1 and type 2 diabetes. The first-generation diabetes technology systems will evolve as we gain more experience and collaboratively work to improve them with an ultimate goal of keeping people with diabetes complication and burden-free until the cure for diabetes becomes a reality.

Insights from the Society of Infectious Diseases Pharmacists on antimicrobial stewardship guidelines from the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

Science.gov (United States)

Drew, Richard H; White, Roger; MacDougall, Conan; Hermsen, Elizabeth D; Owens, Robert C

2009-05-01

In 2007, the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America published a document that addressed the major considerations for the justification, description, and conduct of antimicrobial stewardship programs. Our document is intended to continue the dialogue of these formalized programmatic strategies. We briefly review the guidelines, including the two primary strategies (prospective auditing with feedback, and preauthorization), and the supplemental strategies (education, information technology, transitional therapy, de-escalation or streamlining, and dose optimization). Discussions are introduced or furthered in the areas of program goals, barriers and solutions, and outcome measures. Definition and training of infectious diseases pharmacists are presented in detail. We offer keys to future success, which include continued collaboration and expanded use of information technology.

Guideline on evaluation and acceptance of commercial grade digital equipment for nuclear safety applications

International Nuclear Information System (INIS)

1996-10-01

Nuclear power plants are increasingly upgrading their instrumentation and control (I ampersand C) systems with commercial digital equipment, which allows them to continue meeting safety and reliability requirements while controlling operating costs. However, the use of commercial software-based devices for safety related applications has raised new issues that impact design, procurement, and licensing activities. This guideline describes a consistent, comprehensive approach for the evaluation and acceptance of commercial digital equipment for nuclear safety systems

Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults: Executive Summary

Directory of Open Access Journals (Sweden)

M Diane Lougheed

2012-01-01

Full Text Available BACKGROUND: In 2010, the Canadian Thoracic Society (CTS published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines.

Methodology for clinical trials involving patients with cancer who have febrile neutropenia: updated guidelines of the Immunocompromised Host Society/Multinational Association for Supportive Care in Cancer, with emphasis on outpatient studies.

Science.gov (United States)

Feld, Ronald; Paesmans, Marianne; Freifeld, Alison G; Klastersky, Jean; Pizzo, Philip A; Rolston, Kenneth V I; Rubenstein, Edward; Talcott, James A; Walsh, Thomas J

2002-12-15

Two multinational organizations, the Immunocompromised Host Society and the Multinational Association for Supportive Care in Cancer, have produced for investigators and regulatory bodies a set of guidelines on methodology for clinical trials involving patients with febrile neutropenia. The guidelines suggest that response (i.e., success of initial empirical antibiotic therapy without any modification) be determined at 72 h and again on day 5, and the reasons for modification should be stated. Blinding and stratification are to be encouraged, as should statistical consideration of trials specifically designed for showing equivalence. Patients enrolled in outpatient studies should be selected by use of a validated risk model, and patients should be carefully monitored after discharge from the hospital. Response and safety parameters should be recorded along with readmission rates. If studies use these guidelines, comparisons between studies will be simpler and will lead to further improvements in patient therapy.

Implication of human factors in terms of safety

International Nuclear Information System (INIS)

Furuta, Kazuo

2001-01-01

A critical accident of JCO occurred on September 30, 1999 gave a large impact not only to common society but also to nuclear energy field. This accident occurred by direct reason perfectly out of forecasting of the participants of nuclear energy, where a company made up a guideline violating from business allowance and safety rule and workmen also operated under a procedure out of the guideline. After the accident, a number of countermeasures on equipments, rules, and regulations were carried out, but discussion on software such as their operating methods, concrete regulation on business and authority of operators, and training of specialists seems to be much late. Safety is a problem on a complex system, containing not only hardware but also software such as human, organization, society, and so on. Then, here was discussed on a problem directly faced by conventional safety, engineering centering at hardware through thinking of a problem on human factors. (G.K.)

Management of spontaneous pneumothorax compared to British Thoracic Society (BTS) 2003 guidelines: a district general hospital audit.

Science.gov (United States)

Medford, Andrew Rl; Pepperell, Justin Ct

2007-10-01

In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. To determine adherence to the 2003 BTS SP guidelines in a district general hospital. An initial retrospective audit of 52 episodes of acute SP was performed. Subsequent intervention involved a junior doctor educational update on both the 2003 BTS guidelines and the initial audit results, and the setting up of an online guideline hyperlink. After the educational intervention a further prospective re-audit of 28 SP episodes was performed. Management of SP deviated considerably from the 2003 BTS guidelines in the initial audit - deviation rate 26.9%. After the intervention, a number of clinical management deviations persisted (32.1% deviation rate); these included failure to insert a chest drain despite unsuccessful aspiration, and attempting aspiration of symptomatic secondary SPs. Specific tools to improve standards might include a pneumothorax proforma to improve record keeping and a pneumothorax care pathway to reduce management deviations compared to BTS guidelines. Successful change also requires identification of the total target audience for any educational intervention.

A guide to guidelines for professional societies and other developers of recommendations: introduction to integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

Science.gov (United States)

Schünemann, Holger J; Woodhead, Mark; Anzueto, Antonio; Buist, A Sonia; Macnee, William; Rabe, Klaus F; Heffner, John

2012-12-01

Organizations around the world are recognizing that guidelines should be based on the best available evidence, that the development of recommendations needs to be transparent, and that appropriate processes should be followed. In June 2007, we convened an American Thoracic Society (ATS)/European Respiratory Society (ERS)-sponsored workshop with over 60 representatives from 36 international organizations to provide advice to guideline developers about the required steps and processes for guideline development using the management of chronic obstructive pulmonary disease (COPD) as an example. Following the workshop, participants completed a series of 14 review articles that underwent peer review and incorporated key new literature until June 2011 for most articles in this series. The review articles evaluate the guideline cycle including: priority setting, question formulation, managing conflict of interest, defining appropriate outcomes, stakeholder involvement, grading the quality of evidence and strength of recommendations, integration of values and preferences, considering resource use, reporting of guidelines, implementation, and adaptation. In this Introduction we frame the background and methods of these reviews and provide the key conclusions of the workshop. A summary of the workshop's conclusions and recommendations was published in The Lancet. Given the enormous resources that are spent on research and the importance of providing the best guidance to healthcare decision makers, attributing appropriate funds to research syntheses and transparent, independent guidance for the development of evidence-based guidelines is justified. Furthermore, given the immense amount of work that is required, individuals and organizations need to collaborate to achieve the best possible and cost-effective coordination of these efforts.

Safety of transcranial magnetic stimulation: review of international guidelines and new findings

Directory of Open Access Journals (Sweden)

N. A. Suponeva

2017-01-01

Full Text Available Transcranial magnetic stimulation (TMS is a rapidly developing method of neuromodulation. The use of TMS has increased significantly in both research and clinical practice. This allows not only to better understand this method, but also assess possible risks and consequences for both healthy individuals and patients. In 1998 and 2009 safety, ethical considerations, and application guidelines for the use of TMS in clinical practice and research were published. These recommendations are now the basis for safe application of the method in clinical practice and research. Safety of brain stimulation includes several aspects: the prevention and treatment of adverse effects, the strategy of patient and stimulation protocols selection, as well as safety and monitoring procedures. The most common adverse effects of TMS include headache and neck pain, syncope, transient hearing impairment. The risk of epileptic seizureis extremely low and can be minimized by careful selection of patients and the use of safe stimulation protocols. Careful selection of patients is important, taking into account a large number of factors that influence the risk of adverse effects. These factors are considered in the questionnaires to identify limitations and absolute or relative contraindications to TMS. Another important part of TMS safety is the choice of the stimulation protocol and parameters such as intensity, frequency, duration of one train of stimuli, and the interstimulus interval. Currently, the recommended limits of stimulation parameters are covered in the safety guidelines. It is also necessary to follow the procedure, including the monitoring the patient's condition during TMS and the providing qualified assistance in case of adverse effects.

Tracheotomy in the intensive care unit: Guidelines from a French expert panel: The French Intensive Care Society and the French Society of Anaesthesia and Intensive Care Medicine.

Science.gov (United States)

Trouillet, Jean-Louis; Collange, Olivier; Belafia, Fouad; Blot, François; Capellier, Gilles; Cesareo, Eric; Constantin, Jean-Michel; Demoule, Alexandre; Diehl, Jean-Luc; Guinot, Pierre-Grégoire; Jegoux, Franck; L'Her, Erwan; Luyt, Charles-Edouard; Mahjoub, Yazine; Mayaux, Julien; Quintard, Hervé; Ravat, François; Vergez, Sébastien; Amour, Julien; Guillot, Max

2018-06-01

Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Société de réanimation de langue française) and the French Society of Anesthesia and Intensive Care Medicine (Société francaise d'anesthésie réanimation) with the participation of the French Emergency Medicine Association (Société française de médecine d'urgence), the French Society of Otorhinolaryngology. Sixteen experts and two coordinators agreed to consider questions concerning tracheotomy and its practical implementation. Five topics were defined: indications and contraindications for tracheotomy in intensive care, tracheotomy techniques in intensive care, modalities of tracheotomy in intensive care, management of patients undergoing tracheotomy in intensive care, and decannulation in intensive care. The summary made by the experts and the application of GRADE methodology led to the drawing up of 8 formal guidelines, 10 recommendations, and 3 treatment protocols. Among the 8 formal guidelines, 2 have a high level of proof (Grade 1±) and 6 a low level of proof (Grade 2±). For the 10 recommendations, GRADE methodology was not applicable and instead 10 expert opinions were produced. Copyright © 2018 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Japan Society of Gynecologic Oncology guidelines 2013 for the treatment of uterine body neoplasms.

Science.gov (United States)

Ebina, Yasuhiko; Katabuchi, Hidetaka; Mikami, Mikio; Nagase, Satoru; Yaegashi, Nobuo; Udagawa, Yasuhiro; Kato, Hidenori; Kubushiro, Kaneyuki; Takamatsu, Kiyoshi; Ino, Kazuhiko; Yoshikawa, Hiroyuki

2016-06-01

The third version of the Japan Society of Gynecologic Oncology guidelines for the treatment of uterine body neoplasms was published in 2013. The guidelines comprise nine chapters and nine algorithms. Each chapter includes a clinical question, recommendations, background, objectives, explanations, and references. This revision was intended to collect up-to-date international evidence. The highlights of this revision are to (1) newly specify costs and conflicts of interest; (2) describe the clinical significance of pelvic lymph node dissection and para-aortic lymphadenectomy, including variant histologic types; (3) describe more clearly the indications for laparoscopic surgery as the standard treatment; (4) provide guidelines for post-treatment hormone replacement therapy; (5) clearly differentiate treatment of advanced or recurrent cancer between the initial treatment and the treatment carried out after the primary operation; (6) collectively describe fertility-sparing therapy for both atypical endometrial hyperplasia and endometrioid adenocarcinoma (corresponding to G1) and newly describe relapse therapy after fertility-preserving treatment; and (7) newly describe the treatment of trophoblastic disease. Overall, the objective of these guidelines is to clearly delineate the standard of care for uterine body neoplasms in Japan with the goal of ensuring a high standard of care for all Japanese women diagnosed with uterine body neoplasms.

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas.

Science.gov (United States)

Kubik-Huch, Rahel A; Weston, Michael; Nougaret, Stephanie; Leonhardt, Henrik; Thomassin-Naggara, Isabelle; Horta, Mariana; Cunha, Teresa Margarida; Maciel, Cristina; Rockall, Andrea; Forstner, Rosemarie

2018-02-28

The aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging guidelines for MR work-up in patients with known or suspected uterine leiomyomas. Guidelines for imaging uterine leiomyomas were defined based on a survey distributed to all members of the working group, an expert consensus meeting at European Congress of Radiology (ECR) 2017 and a critical review of the literature. The 25 returned questionnaires as well as the expert consensus meeting have shown reasonable homogeneity of practice among institutions. Expert consensus and literature review lead to an optimized MRI protocol to image uterine leiomyomas. Recommendations include indications for imaging, patient preparation, MR protocols and reporting criteria. The incremental value of functional imaging (DWI, DCE) is highlighted and the role of MR angiography discussed. MRI offers an outstanding and reproducible map of the size, site and distribution of leiomyomas. A standardised imaging protocol and method of reporting ensures that the salient features are recognised. These imaging guidelines are based on the current practice among expert radiologists in the field of female pelvic imaging and also incorporate essentials of the current published MR literature of uterine leiomyomas. • MRI allows comprehensive mapping of size and distribution of leiomyomas. • Basic MRI comprise T2W and T1W sequences centered to the uterus. • Standardized reporting ensures pivotal information on leiomyomas, the uterus and differential diagnosis. • MRI aids in differentiation of leiomyomas from other benign and malignant entities, including leiomyosarcoma.

Issues in the management of acute agitation: how much current guidelines consider safety?

Directory of Open Access Journals (Sweden)

Bruno ePacciardi

2013-05-01

Full Text Available Agitated behavior constitutes up to 10% of emergency psychiatric interventions. Pharmacological tranquilization is often used as a valid treatment for agitation but a strong evidence base does not underpin it. Available literature shows different recommendations, supported by research data, theoretical considerations or clinical experience. Rapid tranquilization is mainly based on parenteral drug treatment and the few existing guidelines on this topic, when suggesting the use of first generation antipsychotics and benzodiazepines, include drugs with questionable tolerability profile such as chlorpromazine, haloperidol, midazolam and lorazepam. In order to systematically evaluate safety concerns related to the adoption of such guidelines, we reviewed them independently from principal diagnosis while examining tolerability data for suggested treatments. There is a growing evidence about safety profile of second generation antipsychotics for rapid tranquilization but further controlled studies providing definitive data in this area are urgently needed.

Seismic PSA implementation standards by AESJ and the utilization of the advanced safety examination guideline for seismic design for nuclear power plant

International Nuclear Information System (INIS)

Ebisawa, Katsumi; Hibino, Kenta

2008-01-01

The Advanced Safety Examination Guideline for Seismic Design for Nuclear Power Plant (the advanced safety examination guideline) was worked out on September 19, 2006. In this paper, a summary of the method of probability theory in the advanced safety examination guideline and the Seismic PSA Implementation Standards is stated. On utilization of the probability theory for the advanced safety examination guideline, the uncertainty resulting from the process of the decision of the basic design earthquake ground motion (Ss) is stated to be considered using the proper method. The references of the extra probability for evaluation of earthquake hazard and combination of the working load and the earthquake load are stated. Definition, evaluation method and effort to lower the 'residual risks', and relation between the residual risks and the extra probability of Ss are described. A summary of the earthquake-resistant design for nuclear power facilities is explained by the old guideline. (S.Y.)

OSART guidelines

International Nuclear Information System (INIS)

1988-02-01

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

ASCI 2010 contrast media guideline for cardiac imaging: a report of the Asian Society of Cardiovascular Imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group

Science.gov (United States)

Kitagawa, Kakuya; Tsai, I-Chen; Chan, Carmen; Yu, Wei; Yong, Hwan Seok; Choi, Byoung Wook

2010-01-01

The use of contrast media for cardiac imaging becomes increasing as the widespread of cardiac CT and cardiac MR. A radiologist needs to carefully consider the indication and the injection protocol of contrast media to be used as well as the possibility of adverse effect. There are several guidelines for contrast media in western countries. However, these are focusing the adverse effect of contrast media. The Asian Society of Cardiovascular Imaging, the only society dedicated to cardiovascular imaging in Asia, formed a Working Group and created a guideline, which summarizes the integrated knowledge of contrast media for cardiac imaging. In cardiac imaging, coronary artery evaluation is feasible by non-contrast MR angiography, which can be an alternative examination in high risk patients for the use of iodine contrast media. Furthermore, the body habitus of Asian patients is usually smaller than that of their western counterparts. This necessitates modifications in the injection protocol and in the formula for calculation of estimated glomerular filtration rate. This guideline provided fundamental information for the use of contrast media for Asian patients in cardiac imaging. PMID:20931289

General Guidelines for Remote Operation and Maintenance of Pyroprocess Equipment

Energy Technology Data Exchange (ETDEWEB)

Kim, S. H.; Park, B. S.; Park, H. S.; Lee, H. J.; Choi, C. W.; Lee, J. K

2007-12-15

As the pyroprocess handle the high radioactive materials, a high radioactive material handling facility required high safety, radioactive shielding, strict quality control, and the remote handling equipment of high technology. This report describes the guidelines of for pyroprocess based the design guides for radioactive material handling facility and equipment from American Nuclear Society(ANS), design guidelines for remotely maintained equipment from Oak Ridge National Laboratory(ORNL), and the experience of design for ACP equipment installed at the ACPF(Advanced Conditioning Process Facility). The General guidelines in this report are as follows. The General guidelines for remote operation and maintenance of pyroprocess equipment: Pyroprocess, Remote handling equipment for pyroprocess, General guide for remote operation and maintenance, general guidelines for the design of remotely operated and maintained equipment, Estimation and analysis for remote maintenance.

Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.

Science.gov (United States)

Pappas, Peter G; Kauffman, Carol A; Andes, David R; Clancy, Cornelius J; Marr, Kieren A; Ostrosky-Zeichner, Luis; Reboli, Annette C; Schuster, Mindy G; Vazquez, Jose A; Walsh, Thomas J; Zaoutis, Theoklis E; Sobel, Jack D

2016-02-15

It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

System Guidelines for EMC Safety-Critical Circuits: Design, Selection, and Margin Demonstration

Science.gov (United States)

Lawton, R. M.

1996-01-01

Demonstration of safety margins for critical points (circuits) has traditionally been required since it first became a part of systems-level Electromagnetic Compatibility (EMC) requirements of MIL-E-6051C. The goal of this document is to present cost-effective guidelines for ensuring adequate Electromagnetic Effects (EME) safety margins on spacecraft critical circuits. It is for the use of NASA and other government agencies and their contractors to prevent loss of life, loss of spacecraft, or unacceptable degradation. This document provides practical definition and treatment guidance to contain costs within affordable limits.

Guidelines of the French Society of Otorhinolaryngology (SFORL). Epistaxis and high blood pressure.

Science.gov (United States)

Michel, J; Prulière Escabasse, V; Bequignon, E; Vérillaud, B; Robard, L; Crampette, L; Malard, O

2017-02-01

The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) on epistaxis in high blood pressure. A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. It is recommended to measure the blood pressure of patients in acute-phase epistaxis (Grade A); to control high blood pressure medically in the acute phase of bleeding, to reduce its duration; to monitor blood pressure at the waning of nosebleed; and to control high blood pressure medically in the waning phase to reduce the risk of recurrence. In case of persistent high blood pressure on waning of severe epistaxis, it is recommended to prescribe cardiovascular evaluation to screen for underlying hypertensive disease (Grade B). Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Executive Summary: 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Treatment of Coccidioidomycosis.

Science.gov (United States)

Galgiani, John N; Ampel, Neil M; Blair, Janis E; Catanzaro, Antonino; Geertsma, Francesca; Hoover, Susan E; Johnson, Royce H; Kusne, Shimon; Lisse, Jeffrey; MacDonald, Joel D; Meyerson, Shari L; Raksin, Patricia B; Siever, John; Stevens, David A; Sunenshine, Rebecca; Theodore, Nicholas

2016-09-15

It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.Coccidioidomycosis, also known as San Joaquin Valley fever, is a systemic infection endemic to parts of the southwestern United States and elsewhere in the Western Hemisphere. Residence in and recent travel to these areas are critical elements for the accurate recognition of patients who develop this infection. In this practice guideline, we have organized our recommendations to address actionable questions concerning the entire spectrum of clinical syndromes. These can range from initial pulmonary infection, which eventually resolves whether or not antifungal therapy is administered, to a variety of pulmonary and extrapulmonary complications. Additional recommendations address management of coccidioidomycosis occurring for special at-risk populations. Finally, preemptive management strategies are outlined in certain at-risk populations and after unintentional laboratory exposure. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Guidelines for confirmatory inplant tests of safety-relief valve discharges for BWR plants

International Nuclear Information System (INIS)

Su, T.M.

1981-05-01

Inplant tests of safety/relief valve (SRV) discharges may be required to confirm generically established specifications for SRV loads and the maximum suppression pool temperature, and to evaluate possible effects of plant-unique parameters. These tests are required in those plants which have features that differ substantially from those previously tested. Guidelines for formulating appropriate test matrices, establishing test procedures, selecting necessary instrumentation, and reporting the test results are provided in this report. Guidelines to determine if inplant tests are required on the basis of the plant unique parameters are also included in the report

OSART Guidelines. 2015 Edition. Reference Report for IAEA Operational Safety Review Teams (OSARTs)

International Nuclear Information System (INIS)

2016-01-01

The IAEA works to provide a global nuclear safety and security framework for the protection of people and the environment from the effects of ionizing radiation, the minimization of the likelihood of accidents that could endanger life and property, and effective mitigation of the effects of any such events, should they occur. The strategic approach to achieving such a framework involves continual improvement in four areas: national and international safety infrastructures; the establishment and global acceptance of IAEA safety standards; an integrated approach to the provision for the application of the safety standards; and a global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. Conservative design, careful manufacture and sound construction are all prerequisites for the safe operation of nuclear power plants. However, the safety of the plant also depends ultimately on: sound management, policies, procedures, processes and practices; the capability and reliability of commissioning and operating personnel; comprehensive instructions; sound accident management and emergency preparedness; and adequate resources. Finally, a positive attitude and conscientiousness on the part of all staff in discharging their responsibilities is important to safety. The OSART programme is based on the safety standards applicable to nuclear power plants. IAEA safety standards reflect the consensus of Member States on nuclear safety matters. The reports of the International Nuclear Safety Group identify important current nuclear safety issues and also serve as references during an OSART review. The publication OSART Guidelines provides overall guidance on the conduct of OSART

Updating Human Factors Engineering Guidelines for Conducting Safety Reviews of Nuclear Power Plants

International Nuclear Information System (INIS)

O'Hara, J.M.; Higgins, J.; Fleger, Stephen

2011-01-01

The U.S. Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) programs of applicants for nuclear power plant construction permits, operating licenses, standard design certifications, and combined operating licenses. The purpose of these safety reviews is to help ensure that personnel performance and reliability are appropriately supported. Detailed design review procedures and guidance for the evaluations is provided in three key documents: the Standard Review Plan (NUREG-0800), the HFE Program Review Model (NUREG-0711), and the Human-System Interface Design Review Guidelines (NUREG-0700). These documents were last revised in 2007, 2004 and 2002, respectively. The NRC is committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool. To this end, the NRC is updating its guidance to stay current with recent research on human performance, advances in HFE methods and tools, and new technology being employed in plant and control room design. This paper describes the role of HFE guidelines in the safety review process and the content of the key HFE guidelines used. Then we will present the methodology used to develop HFE guidance and update these documents, and describe the current status of the update program.

Guidelines regarding National Reports under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2011-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention on Nuclear Safety (hereinafter called the Convention), are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material that it may be useful to include in the National Reports required under Article 5 and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention [es

Guidelines regarding National Reports under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2013-01-01

These Guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention on Nuclear Safety (hereinafter called the Convention), are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material that may be useful to include in the National Reports required under Article 5 of the Convention and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention.

Guidelines regarding National Reports under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2011-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention on Nuclear Safety (hereinafter called the Convention), are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material that it may be useful to include in the National Reports required under Article 5 and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention

IAEA/NEA incident reporting system (IRS). Reporting guidelines. Feedback from safety related operating experience for nuclear power plants

International Nuclear Information System (INIS)

1998-01-01

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

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

Science.gov (United States)

Waldfahrer, F

2016-04-01

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

Comments from the Behavioral Teratology Committee of the Japanese Teratology Society on OECD guideline for the testing of chemicals, proposal for a new guideline 426, developmental neurotoxicity study, draft document (September 2003).

Science.gov (United States)

Fukui, Yoshihiro; Ema, Makoto; Fujiwara, Michio; Higuchi, Hashihiro; Inouye, Minoru; Iwase, Takayuki; Kihara, Takahide; Nishimura, Tatsuya; Oi, Akihide; Ooshima, Yojiro; Otani, Hiroki; Shinomiya, Mitsuhiro; Sugioka, Kozo; Yamano, Tsunekazu; Yamashita, Keisuke H; Tanimura, Takashi

2004-09-01

In September 2003, a new revision of the draft guideline (Organization for Economic Co-operation and Development [OECD] Guideline for the Testing of Chemicals, Proposal for a New Guideline 426, Developmental Neurotoxicity Study) was distributed. The draft guideline consists of 51 paragraphs and an appendix. The National Coordinators were requested to arrange national expert reviews of the guideline proposal in their member countries. The member of the Behavioral Teratology (BT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed and commented on the draft Test Guideline proposal. The BT Committee of the JTS also commented that the International Collaborative Study to validate this protocol should be definitely performed. These comments were sent to the OECD Secretariat. The BT Committee of the JTS expects that the comments are useful for further discussion.

Dam safety operating guidelines

International Nuclear Information System (INIS)

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

1990-01-01

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

Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

Directory of Open Access Journals (Sweden)

David Armstrong

2012-01-01

Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

Biological effects of electromagnetic fields and recently updated safety guidelines for strong static magnetic fields

International Nuclear Information System (INIS)

Yamaguchi-Sekino, Sachiko; Sekino, Masaki; Ueno, Shoogo

2011-01-01

Humans are exposed daily to artificial and naturally occurring magnetic fields that originate from many different sources. We review recent studies that examine the biological effects of and medical applications involving electromagnetic fields, review the properties of static and pulsed electromagnetic fields that affect biological systems, describe the use of a pulsed electromagnetic field in combination with an anticancer agent as an example of a medical application that incorporates an electromagnetic field, and discuss the recently updated safety guidelines for static electromagnetic fields. The most notable modifications to the 2009 International Commission on Non-Ionizing Radiation Protection guidelines are the increased exposure limits, especially for those who work with or near electromagnetic fields (occupational exposure limits). The recommended increases in exposure were determined using recent scientific evidence obtained from animal and human studies. Several studies since the 1994 publication of the guidelines have examined the effects on humans after exposure to high static electromagnetic fields (up to 9.4 tesla), but additional research is needed to ascertain further the safety of strong electromagnetic fields. (author)

The South African Society of Psychiatrists/Psychiatry Management Group management guidelines for adult attention-deficit/hyperactivity disorder

Directory of Open Access Journals (Sweden)

Renata Schoeman

2017-04-01

Full Text Available Disclaimer: These guidelines do not aim to provide a comprehensive review of all the pertinent literature comprising the evidence base and, as such, should be utilised in conjunction with other guidelines as well as the responsibility of practitioners to maintain a high level of personal knowledge and expertise. Despite the known efficacy of treatment and the substantial costs of untreated attention-deficit/hyperactivity disorder (ADHD, access to healthcare and treatment is not a given for many patients in South Africa (SA. In SA, there is poor identification and treatment of common mental disorders at primary healthcare level and limited access to specialist resources with a service delivery and treatment gap of up to 75%. Medication options are also often limited in emerging markets and in SA psychiatrists, and patients do not have access to the medication armamentarium available in established markets. Furthermore, the majority of South Africans currently utilise the public healthcare sector and may not have access to treatment options referred to in these guidelines. These guidelines should therefore not be seen as a policy document. The process: The South African Society of Psychiatrists’ Special Interest Group (SIG for adult ADHD was launched on 25 September 2015, with doctors Rykie Liebenberg and Renata Schoeman as convenor and co-convenor, respectively. The overall objective of the ADHD SIG is to improve the basket of care available to patients with ADHD. This is only possible through a combined and concerted effort of individuals with a special interest in and passion for ADHD to improve knowledge about and funding for the care of individuals with the disorder. One of the specific aims of the ADHD SIG was to develop South African guidelines for the diagnosis and treatment of adult ADHD specifically and update guidelines for the treatment of child, adolescent and adult ADHD. Dr Schoeman has recently completed her MBA at the University

Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for urothelial cell carcinoma of the urinary bladder 2017

Directory of Open Access Journals (Sweden)

Hulayel Alharbi

2018-01-01

Full Text Available This is an update to the previously published Saudi guidelines for the evaluation and medical/surgical management of patients diagnosed with urothelial cell carcinoma of the urinary bladder. It is categorized according to the stage of the disease using the tumor node metastasis staging system, 7th edition. The guidelines are presented with their accompanying supporting evidence level, which is based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors who were selected by the Saudi Oncology Society and Saudi Urological Association. Considerations to the local availability of drugs, technology, and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health-care policymakers in the management of patients diagnosed with urothelial cell carcinoma of the urinary bladder.

Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for urothelial cell carcinoma of the urinary bladder 2017.

Science.gov (United States)

Alharbi, Hulayel; Alkhateeb, Sultan; Murshid, Esam; Alotaibi, Mohammed; Abusamra, Ashraf; Rabah, Danny; Almansour, Mubarak; Alghamdi, Abdullah; Aljubran, Ali; Eltigani, Amin; Alkushi, Hussein; Ahmed, Imran; Alsharm, Abdullah; Bazarbashi, Shouki

2018-01-01

This is an update to the previously published Saudi guidelines for the evaluation and medical/surgical management of patients diagnosed with urothelial cell carcinoma of the urinary bladder. It is categorized according to the stage of the disease using the tumor node metastasis staging system, 7 th edition. The guidelines are presented with their accompanying supporting evidence level, which is based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors) who were selected by the Saudi Oncology Society and Saudi Urological Association. Considerations to the local availability of drugs, technology, and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health-care policymakers in the management of patients diagnosed with urothelial cell carcinoma of the urinary bladder.

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Substance Use and Related Disorders. Part 2: Opioid dependence

NARCIS (Netherlands)

Soyka, Michael; Kranzler, Henry R.; van den Brink, Wim; Krystal, John; Möller, Hans-Jürgen; Kasper, Siegfried

2011-01-01

Objectives. To develop evidence-based practice guidelines for the pharmacological treatment of opioid abuse and dependence. Methods. An international task force of the World Federation of Societies of Biological Psychiatry (WFSBP) developed these practice guidelines after a systematic review of the

Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

NARCIS (Netherlands)

Hooton, Thomas M.; Bradley, Suzanne F.; Cardenas, Diana D.; Colgan, Richard; Geerlings, Suzanne E.; Rice, James C.; Saint, Sanjay; Schaeffer, Anthony J.; Tambayh, Paul A.; Tenke, Peter; Nicolle, Lindsay E.

2010-01-01

Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer.

Science.gov (United States)

Watanabe, Toshiaki; Muro, Kei; Ajioka, Yoichi; Hashiguchi, Yojiro; Ito, Yoshinori; Saito, Yutaka; Hamaguchi, Tetsuya; Ishida, Hideyuki; Ishiguro, Megumi; Ishihara, Soichiro; Kanemitsu, Yukihide; Kawano, Hiroshi; Kinugasa, Yusuke; Kokudo, Norihiro; Murofushi, Keiko; Nakajima, Takako; Oka, Shiro; Sakai, Yoshiharu; Tsuji, Akihito; Uehara, Keisuke; Ueno, Hideki; Yamazaki, Kentaro; Yoshida, Masahiro; Yoshino, Takayuki; Boku, Narikazu; Fujimori, Takahiro; Itabashi, Michio; Koinuma, Nobuo; Morita, Takayuki; Nishimura, Genichi; Sakata, Yuh; Shimada, Yasuhiro; Takahashi, Keiichi; Tanaka, Shinji; Tsuruta, Osamu; Yamaguchi, Toshiharu; Yamaguchi, Naohiko; Tanaka, Toshiaki; Kotake, Kenjiro; Sugihara, Kenichi

2018-02-01

Japanese mortality due to colorectal cancer is on the rise, surpassing 49,000 in 2015. Many new treatment methods have been developed during recent decades. The Japanese Society for Cancer of the Colon and Rectum Guidelines 2016 for the treatment of colorectal cancer (JSCCR Guidelines 2016) were prepared to show standard treatment strategies for colorectal cancer, to eliminate disparities among institutions in terms of treatment, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding between health-care professionals and patients by making these Guidelines available to the general public. These Guidelines were prepared by consensus reached by the JSCCR Guideline Committee, based on a careful review of the evidence retrieved by literature searches, and in view of the medical health insurance system and actual clinical practice settings in Japan. Therefore, these Guidelines can be used as a tool for treating colorectal cancer in actual clinical practice settings. More specifically, they can be used as a guide to obtaining informed consent from patients and choosing the method of treatment for each patient. As a result of the discussions held by the Guideline Committee, controversial issues were selected as Clinical Questions, and recommendations were made. Each recommendation is accompanied by a classification of the evidence and a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here we present the English version of the JSCCR Guidelines 2016.

Radiological risk comparison guidelines

International Nuclear Information System (INIS)

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

1992-01-01

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

The role of probabilistic safety assessment and probabilistic safety criteria in nuclear power plant safety

International Nuclear Information System (INIS)

1992-01-01

The purpose of this Safety Report is to provide guidelines on the role of probabilistic safety assessment (PSA) and a range of associated reference points, collectively referred to as probabilistic safety criteria (PSC), in nuclear safety. The application of this Safety Report and the supporting Safety Practice publication should help to ensure that PSA methodology is used appropriately to assess and enhance the safety of nuclear power plants. The guidelines are intended for use by nuclear power plant designers, operators and regulators. While these guidelines have been prepared with nuclear power plants in mind, the principles involved have wide application to other nuclear and non-nuclear facilities. In Section 2 of this Safety Report guidelines are established on the role PSA can play as part of an overall safety assurance programme. Section 3 summarizes guidelines for the conduct of PSAs, and in Section 4 a PSC framework is recommended and guidance is provided for the establishment of PSC values

[Austrian guideline for palliative sedation therapy (long version) : Results of a Delphi process of the Austrian Palliative Society (OPG)].

Science.gov (United States)

Weixler, Dietmar; Roider-Schur, Sophie; Likar, Rudolf; Bozzaro, Claudia; Daniczek, Thomas; Feichtner, Angelika; Gabl, Christoph; Hammerl-Ferrari, Bernhard; Kletecka-Pulker, Maria; Körtner, Ulrich H J; Kössler, Hilde; Meran, Johannes G; Miksovsky, Aurelia; Pusswald, Bettina; Wienerroither, Thomas; Watzke, Herbert

2017-02-01

Palliative sedation therapy (PST) is an important and ethically accepted therapy in the care of selected palliative care patients with otherwise unbearable suffering from refractory distress. PST is increasingly used in end-of-life care. Austria does not have a standardized ethical guideline for this exceptional practice near end of life, but there is evidence that practice varies throughout the country. The Austrian Palliative Society (OPG) nominated a multidisciplinary working group of 16 palliative care experts and ethicists who established the national guideline on the basis of recent review work with the aim to adhere to the Europeans Association of Palliative Care's (EAPC) framework on palliative sedation therapy respecting Austrians legal, structural and cultural background. Consensus was achieved by a four-step sequential Delphi process. The Delphi-process was strictly orientated to the recently published EUROIMPACT-sedation-study-checklist and to the AGREE-2-tool. Additionally national stakeholders participated in the reflection of the results. As a result of a rigorous consensus process the long version of the Austrian National Palliative Sedation Guideline contains 112 statements within eleven domains and is supplemented by a philosophers excursus on suffering. By establishing a national guideline for palliative sedation therapy using the Delphi technique for consensus and stakeholder involvement the Austrian Palliative Society aims to ensure nationwide good practice of palliative sedation therapy. Screening for the practicability and efficacy of this guideline will be a future task.

Guidelines regarding the Review Process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2011-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing National Reports submitted in accordance with Article 5 and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of National Reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views [fr

Guidelines regarding the review process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2002-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing National Reports submitted in accordance with Article 5 and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of National Reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views

Guidelines regarding the review process under the convention on nuclear safety

International Nuclear Information System (INIS)

1998-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing national reports submitted in accordance with Article 5 and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of national reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views

Guidelines regarding the Review Process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2011-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing National Reports submitted in accordance with Article 5 and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of National Reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views

Guidelines regarding the review process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

1999-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing national reports submitted in accordance with Article 5 and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of national reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views

Guidelines regarding the Review Process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2011-01-01

These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing National Reports submitted in accordance with Article 5 and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of National Reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views [es

An evaluation of the guidelines of the Society of Obstetricians and Gynaecologists of Canada.

Science.gov (United States)

Ghui, Roslyn; Bansal, Jassimran Kaur; McLaughlin, Catarina; Kotaska, Andrew; Lokugamage, Amali

2016-07-01

Clinical practice guidelines hope to offer unbiased, evidence-based guidance for clinicians. This paper examines levels of evidence contained within the guidelines of the Society of Obstetricians and Gynaecologists of Canada and compares classification of the recommendation (CoR) A/B/C/D/E/L (derived from evidence and consensus) versus quality of evidence assessment (QoEA) I-III. 1250 recommendations were analysed and 43% of recommendations were graded as "good" evidence, the highest grade of CoR, while just 24.6% of recommendations were based on the highest level of QoEA (level I). The paper discusses possible reasons for this discrepancy. The authors hope that this analysis promotes greater transparency in evidence-based medicine ultimately leading to using the best quality of evidence available yet taking into account any areas of scientific uncertainty. This will enhance respectful care of patients, while taking into account their autonomy and furthering the cause of patient centre care.

OSART guidelines - 2005 edition. Reference report for IAEA Operational Safety Review Teams (OSARTs)

International Nuclear Information System (INIS)

2005-01-01

when exchanging ideas, at the working level, for enhancing safety. The OSART programme is based on the IAEA's Nuclear Safety Standard Series (Fundamentals, Requirements and Safety Guides) for nuclear power plants and the Basic Safety Standards for Radiation Protection. The Nuclear Safety Standards reflect the consensus of Member States on nuclear safety matters. The reports of the International Nuclear Safety Advisory Group, identifying important current nuclear safety issues also serve as references during an OSART review. The OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Additional guidance and reference material prepared by the IAEA and the expertise of the OSART members contribute to the bases of the review. OSART reviews are performance oriented in that they accept different approaches to commissioning and operational safety that represent good practices and may contribute to ensuring a good safety record on the part of the operating organization. Recommendations are made on items of direct relevance to safety, whereas suggestions made might enhance plant safety indirectly but would certainly improve performance. Commendable good practices identified at plants are communicated to other plants where relevant in order to effect improvements. This revision of the OSART guidelines supersedes the 1994 Edition (IAEA-TECDOC-744)

OSART guidelines - 2005 edition. Reference report for IAEA Operational Safety Review Teams (OSARTs)

International Nuclear Information System (INIS)

2007-01-01

when exchanging ideas, at the working level, for enhancing safety. The OSART programme is based on the IAEA's Nuclear Safety Standard Series (Fundamentals, Requirements and Safety Guides) for nuclear power plants and the Basic Safety Standards for Radiation Protection. The Nuclear Safety Standards reflect the consensus of Member States on nuclear safety matters. The reports of the International Nuclear Safety Advisory Group, identifying important current nuclear safety issues also serve as references during an OSART review. The OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Additional guidance and reference material prepared by the IAEA and the expertise of the OSART members contribute to the bases of the review. OSART reviews are performance oriented in that they accept different approaches to commissioning and operational safety that represent good practices and may contribute to ensuring a good safety record on the part of the operating organization. Recommendations are made on items of direct relevance to safety, whereas suggestions made might enhance plant safety indirectly but would certainly improve performance. Commendable good practices identified at plants are communicated to other plants where relevant in order to effect improvements. This revision of the OSART guidelines supersedes the 1994 Edition (IAEA-TECDOC-744)

OSART guidelines - 2005 edition. Reference report for IAEA Operational Safety Review Teams (OSARTs)

International Nuclear Information System (INIS)

2008-01-01

when exchanging ideas, at the working level, for enhancing safety. The OSART programme is based on the IAEA's Nuclear Safety Standard Series (Fundamentals, Requirements and Safety Guides) for nuclear power plants and the Basic Safety Standards for Radiation Protection. The Nuclear Safety Standards reflect the consensus of Member States on nuclear safety matters. The reports of the International Nuclear Safety Advisory Group, identifying important current nuclear safety issues also serve as references during an OSART review. The OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Additional guidance and reference material prepared by the IAEA and the expertise of the OSART members contribute to the bases of the review. OSART reviews are performance oriented in that they accept different approaches to commissioning and operational safety that represent good practices and may contribute to ensuring a good safety record on the part of the operating organization. Recommendations are made on items of direct relevance to safety, whereas suggestions made might enhance plant safety indirectly but would certainly improve performance. Commendable good practices identified at plants are communicated to other plants where relevant in order to effect improvements. This revision of the OSART guidelines supersedes the 1994 Edition (IAEA-TECDOC-744)

2011 Annual Meeting of the Safety Pharmacology Society: an overview.

Science.gov (United States)

Cavero, Icilio

2012-03-01

The keynote address of 2011 Annual Meeting of the Safety Pharmacology Society examined the known and the still to be known on drug-induced nephrotoxicity. The nominee of the Distinguished Service Award Lecture gave an account of his career achievements particularly on the domain of chronically instrumented animals for assessing cardiovascular safety. The value of Safety Pharmacology resides in the benefits delivered to Pharma organizations, regulators, payers and patients. Meticulous due diligence concerning compliance of Safety Pharmacology studies to best practices is an effective means to ensure that equally stringent safety criteria are applied to both in-licensed and in-house compounds. Innovative technologies of great potential for Safety Pharmacology presented at the meeting are organs on chips (lung, heart, intestine) displaying mechanical and biochemical features of native organs, electrical field potential (MEA) or impedance (xCELLigence Cardio) measurements in human induced pluripotent stem cell-derived cardiomyocytes for unveiling cardiac electrophysiological and mechanical liabilities, functional human airway epithelium (MucilAir™) preparations with unique 1-year shelf-life for acute and chronic in vitro evaluation of drug efficacy and toxicity. Custom-designed in silico and in vitro assay platforms defining the receptorome space occupied by chemical entities facilitate, throughout the drug discovery phase, the selection of candidates with optimized safety profile on organ function. These approaches can now be complemented by advanced computational analysis allowing the identification of compounds with receptorome, or clinically adverse effect profiles, similar to those of the drug candidate under scrutiny for extending the safety assessment to potential liability targets not captured by classical approaches. Nonclinical data supporting safety can be quite reassuring for drugs with a discovered signal of risk. However, for marketing authorization

Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy.

Science.gov (United States)

Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dube, Catherine; Enns, Robert; Hollingworth, Roger; Macintosh, Donald; Borgaonkar, Mark; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Kuipers, Ernst J

2012-01-01

Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. The consensus process identified a clear need for high-quality clinical and outcomes research to support quality improvement in the delivery of endoscopy services. The

Atopic Dermatitis Guideline. Position Paper from the Latin American Society of Allergy, Asthma and Immunology

Directory of Open Access Journals (Sweden)

Jorge Sánchez

2014-06-01

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

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

Science.gov (United States)

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

2014-01-01

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

An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE)

NARCIS (Netherlands)

Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564; Serefoglu, Ege Can; Shindel, Alan W; Adaikan, P Ganesan; Becher, Edgardo; Dean, John; Giuliano, Francois; Hellstrom, Wayne J G; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

INTRODUCTION: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and

The Society for Industrial and Organizational Psychology's guidelines for education and training: An executive summary of the 2016/2017 revision.

Science.gov (United States)

Gibson, Jennifer Lee; Payne, Stephanie C; Morgan, Whitney Botsford; Allen, Joseph A

2018-05-24

The Society for Industrial and Organizational Psychology (SIOP, Division 14 of the American Psychological Association [APA]) maintains Guidelines for Education and Training to provide guidance for the training of industrial-organizational (I-O) psychologists. The 2016/2017 revision combines separate documents for master's- and doctoral-level training into one document, because the competencies required for each degree are not very different. Instead, the degrees differ in breadth and depth. The updated Guidelines were approved as APA policy in August 2017. In this article, we briefly review the revision process and highlight the updates made in the latest version of the Guidelines. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Guidelines for Safety Evaluation of a Potential for PWR Steam Generator Tube Failure due to Fluid elastic Instability

Energy Technology Data Exchange (ETDEWEB)

Jo, Jong Chull; Do, Kyu Sik; Sheen, Cheol [Nuclear System Evaluation Dept., Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2013-05-15

It was found that both SG tube rupture events occurred at North Anna Unit 1 in 1987 and at Mihama Unit 2 in 1991 were caused by a high cycle fatigue due to fluid elastic instability. Therefore, with regard to nuclear safety it is important to design the SG properly in a conservative manner so that the potential for SG U-tube failures due to fluid elastic instability can be minimized. This article provides guidelines for assessing the potential for SG U-tube damage due to fluid elastic instability. This article described guidelines for safety evaluation of a potential for PWR steam generator tube failure due to fluid elastic instability. The guidelines address the requirements for realistically performing the SG thermal-hydraulic analysis and the modal analysis of tubes as well as the criteria for conservatively determining the added mass, the damping ratio and the fluid elastic instability coefficient. The guidelines can be used to predict the potential SG tubes which are susceptible to failure due to fluid elastic instability at operating nuclear power plants and also to evaluate the safety and structural integrity of new SG designs at the licensing review stage. Failure of a pressurized water reactor (PWR) steam generator (SG) tube leads to a leakage of contaminated primary coolant to the secondary system, which has serious safety implications such as the potential for direct release of radioactive fission products to the environment and the loss of coolant. Excessive tube vibration excited by dynamic forces of internal or external fluid flow is called flow-induced vibration (FIV). Among the FIV mechanisms, the so-called fluid elastic instability of SG tubes in cross flow is the most important safety issue in the design of SGs because it may cause severe tube failure in a very short time.

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

Science.gov (United States)

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

2016-08-01

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

The Lebanese Society for Infectious Diseases and Clinical Microbiology (LSIDCM) guidelines for adult community-acquired pneumonia (Cap) in Lebanon.

Science.gov (United States)

Moghnieh, Rima; Yared Sakr, Nadine; Kanj, Souha S; Musharrafieh, Umayya; Husni, Rula; Jradeh, Mona; Al-Awar, Ghassan; Matar, Madona; Jureij, Wafa; Antoine, Saad; Azar, Eid; Abi Hanna, Pierre; Minari, Afaf; Hammoud, Jamale; Kfoury, Joumana; Mahfouz, Tahsin; Abou Chakra, Diaa; Zaatari, Mohamad; Tabbarah, Zuhayr A

2014-01-01

Adult community-acquired pneumonia (CAP) is a common cause of morbidity and mortality which is managed by different disciplines in a heterogeneous fashion. Development of consensus guidelines to standardize these wide variations in care has become a prime objective. The Lebanese Society of Infectious Diseases and Clinical Microbiology (LSIDCM) convened to set Lebanese national guidelines for the management of CAP since it is a major and a prevalent disease affecting the Lebanese population. These guidelines, besides being helpful in direct clinical practice, play a major role in establishing stewardship programs in hospitals in an effort to contain antimicrobial resistance on the national level. These guidelines are intended for primary care practitioners and emergency medicine physicians. They constitute an appropriate starting point for specialists' consultation being based on the available local epidemiological and resistance data. This document includes the following: 1/ Rationale and scope of the guidelines; 2/ Microbiology of CAP based on Lebanese data; 3/ Clinical presentation and diagnostic workup of CAP; 4/ Management and prevention strategies based on the IDSA/ATS Consensus Guidelines, 2007, and the ESCMID Guidelines, 2011, and tailored to the microbiological data in Lebanon; 5/ Comparison to regional guidelines. The recommendations made in this document were graded based on the strength of the evidence as in the 2007 IDSA/ATS Consensus Guidelines. Hopefully, these guidelines will be an important step towards standardization of CAP care in Lebanon and set the agenda for further research in this area.

The Saudi Thoracic Society pneumococcal vaccination guidelines-2016

Science.gov (United States)

Alharbi, N. S.; Al-Barrak, A. M.; Al-Moamary, M. S.; Zeitouni, M. O.; Idrees, M. M.; Al-Ghobain, M. O.; Al-Shimemeri, A. A.; Al-Hajjaj, Mohamed S.

2016-01-01

Streptococcus pneumoniae (pneumococcus) is the leading cause of morbidity and mortality worldwide. Saudi Arabia is a host to millions of pilgrims who travel annually from all over the world for Umrah and the Hajj pilgrimages and are at risk of developing pneumococcal pneumonia or invasive pneumococcal disease (IPD). There is also the risk of transmission of S. pneumoniae including antibiotic resistant strains between pilgrims and their potential global spread upon their return. The country also has unique challenges posed by susceptible population to IPD due to people with hemoglobinopathies, younger age groups with chronic conditions, and growing problem of antibiotic resistance. Since the epidemiology of pneumococcal disease is constantly changing, with an increase in nonvaccine pneumococcal serotypes, vaccination policies on the effectiveness and usefulness of vaccines require regular revision. As part of the Saudi Thoracic Society (STS) commitment to promote the best practices in the field of respiratory diseases, we conducted a review of S. pneumoniae infections and the best evidence base available in the literature. The aim of the present study is to develop the STS pneumococcal vaccination guidelines for healthcare workers in Saudi Arabia. We recommend vaccination against pneumococcal infections for all children Saudi Arabia population <50 years of age, many of whom have risk factors for contracting pneumococcal infections. A section for pneumococcal vaccination before the Umrah and Hajj pilgrimages is included as well. PMID:27168856

State of the art of probabilistic safety analysis (PSA) in the FRG, and principles of a PSA-guideline

International Nuclear Information System (INIS)

Balfanz, H.P.

1987-01-01

Contents of the articles: Survey of PSA performed during licensing procedures of an NPP; German Nuclear Standards' requirements on the reliability of safety systems; PSA-guideline for NPP: Principles and suggestions; Motivation and tasks of PSA; Aspects of the methodology of safety analyses; Structure of event tree and fault tree analyses; Extent of safety analyses; Performance and limits of PSA. (orig./HSCH)

Workplace health and safety during pandemic influenza : CAGC guideline

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-11-15

Pandemic influenza is a possible biological hazard that employers must take into account during hazard assessment and emergency planning. This report presented a guideline to all workplaces in Alberta and provided information on legislated requirements, best practices, guidelines and strategies in workplace health and safety and employment standards in the event of a pandemic influenza. The report explained the difference between a pandemic and a pandemic influenza, and why scientists expect another pandemic influenza. Pandemic influenza was described as being different from seasonal influenza. This document also explained how pandemic influenza relates to the worker and the workplace, and how the workplace can prepare for and respond to pandemic influenza. Pandemic influenza hazard categories were also listed along with steps in the hazard assessment and control of pandemic influenza. The steps involve listing the types of work and work-related activities; identifying the hazard; assessing the hazards; implementing controls; communicating the information to workers and providing training; and evaluating the effectiveness of controls. The guide also addressed emergency response plan development for pandemic influenza; first aid; and employment standards during pandemic influenza. refs., tabs.

Guidelines regarding the Review Process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2013-01-01

These Guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing National Reports submitted in accordance with Article 5 of the Convention and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of National Reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views. [fr

Guidelines regarding the Review Process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2013-01-01

These Guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing National Reports submitted in accordance with Article 5 of the Convention and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of National Reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views.

Guidelines regarding the Review Process under the Convention on Nuclear Safety

International Nuclear Information System (INIS)

2013-01-01

These Guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties on the process for reviewing National Reports submitted in accordance with Article 5 of the Convention and thereby to facilitate the efficient review of implementation by the Contracting Parties of their obligations under the Convention. The aim of the review process should be to achieve a thorough examination of National Reports submitted in accordance with Article 5 of the Convention, so that Contracting Parties can learn from each other's solutions to common and individual nuclear safety problems and, above all, contribute to improving nuclear safety worldwide through a constructive exchange of views. [es

Are the American Society for Radiation Oncology Guidelines Accurate Predictors of Recurrence in Early Stage Breast Cancer Patients Treated with Balloon-Based Brachytherapy?

Directory of Open Access Journals (Sweden)

Moira K. Christoudias

2013-01-01

Full Text Available The American Society for Radiation Oncology (ASTRO consensus statement (CS provides guidelines for patient selection for accelerated partial breast irradiation (APBI following breast conserving surgery. The purpose of this study was to evaluate recurrence rates based on ASTRO CS groupings. A single institution review of 238 early stage breast cancer patients treated with balloon-based APBI via balloon based brachytherapy demonstrated a 4-year actuarial ipsilateral breast tumor recurrence (IBTR rate of 5.1%. There were no significant differences in the 4-year actuarial IBTR rates between the “suitable,” “cautionary,” and “unsuitable” ASTRO categories (0%, 7.2%, and 4.3%, resp., P=0.28. ER negative tumors had higher rates of IBTR than ER positive tumors. The ASTRO groupings are poor predictors of patient outcomes. Further studies evaluating individual clinicopathologic features are needed to determine the safety of APBI in higher risk patients.

Validation of the 2014 European Society of Cardiology guidelines risk prediction model for the primary prevention of sudden cardiac death in hypertrophic cardiomyopathy.

Science.gov (United States)

Vriesendorp, Pieter A; Schinkel, Arend F L; Liebregts, Max; Theuns, Dominic A M J; van Cleemput, Johan; Ten Cate, Folkert J; Willems, Rik; Michels, Michelle

2015-08-01

The recently released 2014 European Society of Cardiology guidelines of hypertrophic cardiomyopathy (HCM) use a new clinical risk prediction model for sudden cardiac death (SCD), based on the HCM Risk-SCD study. Our study is the first external and independent validation of this new risk prediction model. The study population consisted of a consecutive cohort of 706 patients with HCM without prior SCD event, from 2 tertiary referral centers. The primary end point was a composite of SCD and appropriate implantable cardioverter-defibrillator therapy, identical to the HCM Risk-SCD end point. The 5-year SCD risk was calculated using the HCM Risk-SCD formula. Receiver operating characteristic curves and C-statistics were calculated for the 2014 European Society of Cardiology guidelines, and risk stratification methods of the 2003 American College of Cardiology/European Society of Cardiology guidelines and 2011 American College of Cardiology Foundation/American Heart Association guidelines. During follow-up of 7.7±5.3 years, SCD occurred in 42 (5.9%) of 706 patients (ages 49±16 years; 34% women). The C-statistic of the new model was 0.69 (95% CI, 0.57-0.82; P=0.008), which performed significantly better than the conventional risk factor models based on the 2003 guidelines (C-statistic of 0.55: 95% CI, 0.47-0.63; P=0.3), and 2011 guidelines (C-statistic of 0.60: 95% CI, 0.50-0.70; P=0.07). The HCM Risk-SCD model improves the risk stratification of patients with HCM for primary prevention of SCD, and calculating an individual risk estimate contributes to the clinical decision-making process. Improved risk stratification is important for the decision making before implantable cardioverter-defibrillator implantation for the primary prevention of SCD. © 2015 American Heart Association, Inc.

A study on the establishment of safety assessment guidelines of commercial grade item dedication in digitalized safety systems

International Nuclear Information System (INIS)

Hwang, H. S.; Kim, B. R.; Oh, S. H.

1999-01-01

Because of obsolescing the components used in safety related systems of nuclear power plants, decreasing the number of suppliers qualified for the nuclear QA program and increasing maintenance costs of them, utilities have been considering to use commercial grade digital computers as an alternative for resolving such issues. However, commercial digital computers use the embedded pre-existing software, including operating system software, which are not developed by using nuclear grade QA program. Thus, it is necessary for utilities to establish processes for dedicating digital commercial grade items. A regulatory body also needs guidance to evaluate the digital commercial products properly. This paper surveyed the regulations and their regulatory guides, which establish the requirements for commercial grade items dedication, industry standards and guidances applicable to safety related systems. This paper provides some guidelines to be applied in evaluating the safety of digital upgrades and new digital plant protection systems in Korea

Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE).

Science.gov (United States)

Sandoe, Jonathan A T; Barlow, Gavin; Chambers, John B; Gammage, Michael; Guleri, Achyut; Howard, Philip; Olson, Ewan; Perry, John D; Prendergast, Bernard D; Spry, Michael J; Steeds, Richard P; Tayebjee, Muzahir H; Watkin, Richard

2015-02-01

Infections related to implantable cardiac electronic devices (ICEDs), including pacemakers, implantable cardiac defibrillators and cardiac resynchronization therapy devices, are increasing in incidence in the USA and are likely to increase in the UK, because more devices are being implanted. These devices have both intravascular and extravascular components and infection can involve the generator, device leads and native cardiac structures or various combinations. ICED infections can be life-threatening, particularly when associated with endocardial infection, and all-cause mortality of up to 35% has been reported. Like infective endocarditis, ICED infections can be difficult to diagnose and manage. This guideline aims to (i) improve the quality of care provided to patients with ICEDs, (ii) provide an educational resource for all relevant healthcare professionals, (iii) encourage a multidisciplinary approach to ICED infection management, (iv) promote a standardized approach to the diagnosis, management, surveillance and prevention of ICED infection through pragmatic evidence-rated recommendations, and (v) advise on future research projects/audit. The guideline is intended to assist in the clinical care of patients with suspected or confirmed ICED infection in the UK, to inform local infection prevention and treatment policies and guidelines and to be used in the development of educational and training material by the relevant professional societies. The questions covered by the guideline are presented at the beginning of each section. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A Handbook for Public Playground Safety. Volume II: Technical Guidelines for Equipment and Surfacing.

Science.gov (United States)

Consumer Product Safety Commission, Washington, DC.

This handbook suggests safety guidelines for public playground equipment and describes various surfaces used under the equipment and possible injuries resulting from falls. The handbook is intended for use mainly by manufacturers, installers, school and park officials, and others interested in technical criteria for public playground equipment.…

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

Science.gov (United States)

Palta, Manisha; Lee, W Robert

2011-01-01

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

SU-E-P-43: A Knowledge Based Approach to Guidelines for Software Safety

International Nuclear Information System (INIS)

Salomons, G; Kelly, D

2015-01-01

Purpose: In the fall of 2012, a survey was distributed to medical physicists across Canada. The survey asked the respondents to comment on various aspects of software development and use in their clinic. The survey revealed that most centers employ locally produced (in-house) software of some kind. The respondents also indicated an interest in having software guidelines, but cautioned that the realities of cancer clinics include variations, that preclude a simple solution. Traditional guidelines typically involve periodically repeating a set of prescribed tests with defined tolerance limits. However, applying a similar formula to software is problematic since it assumes that the users have a perfect knowledge of how and when to apply the software and that if the software operates correctly under one set of conditions it will operate correctly under all conditions Methods: In the approach presented here the personnel involved with the software are included as an integral part of the system. Activities performed to improve the safety of the software are done with both software and people in mind. A learning oriented approach is taken, following the premise that the best approach to safety is increasing the understanding of those associated with the use or development of the software. Results: The software guidance document is organized by areas of knowledge related to use and development of software. The categories include: knowledge of the underlying algorithm and its limitations; knowledge of the operation of the software, such as input values, parameters, error messages, and interpretation of output; and knowledge of the environment for the software including both data and users. Conclusion: We propose a new approach to developing guidelines which is based on acquiring knowledge-rather than performing tests. The ultimate goal is to provide robust software guidelines which will be practical and effective

SU-E-P-43: A Knowledge Based Approach to Guidelines for Software Safety

Energy Technology Data Exchange (ETDEWEB)

Salomons, G [Cancer Center of Southeastern Ontario & Queen’s University, Kingston, ON (Canada); Kelly, D [Royal Military College of Canada, Kingston, ON, CA (Canada)

2015-06-15

Purpose: In the fall of 2012, a survey was distributed to medical physicists across Canada. The survey asked the respondents to comment on various aspects of software development and use in their clinic. The survey revealed that most centers employ locally produced (in-house) software of some kind. The respondents also indicated an interest in having software guidelines, but cautioned that the realities of cancer clinics include variations, that preclude a simple solution. Traditional guidelines typically involve periodically repeating a set of prescribed tests with defined tolerance limits. However, applying a similar formula to software is problematic since it assumes that the users have a perfect knowledge of how and when to apply the software and that if the software operates correctly under one set of conditions it will operate correctly under all conditions Methods: In the approach presented here the personnel involved with the software are included as an integral part of the system. Activities performed to improve the safety of the software are done with both software and people in mind. A learning oriented approach is taken, following the premise that the best approach to safety is increasing the understanding of those associated with the use or development of the software. Results: The software guidance document is organized by areas of knowledge related to use and development of software. The categories include: knowledge of the underlying algorithm and its limitations; knowledge of the operation of the software, such as input values, parameters, error messages, and interpretation of output; and knowledge of the environment for the software including both data and users. Conclusion: We propose a new approach to developing guidelines which is based on acquiring knowledge-rather than performing tests. The ultimate goal is to provide robust software guidelines which will be practical and effective.

UPSAT guidelines. 1996 edition. Reference document for IAEA Uranium Productions Safety Assessment Teams (UPSATs)

International Nuclear Information System (INIS)

1996-05-01

The IAEA Uranium Production Safety Assessment Team (UPSAT) programme provides advice and assistance to Member States to enhance the safety and environmental performance of uranium production facilities during construction, commissioning and operation. Sound design and construction are prerequisite for the safe and environmentally responsible operation of uranium mines and mills. However, the safety of the facility depends ultimately on sound policies, procedures and practices; on the capability and reliability of the construction, commissioning and operating personnel; on comprehensive instructions; and on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. The UPSAT guidelines have been developed in the following areas: (1) management, organization and administration; (2) training and qualification; (3) operation (4) maintenance; (5) safety, fire protection, emergency planning, and preparedness; (6) radiation protection; (7) environmental monitoring programme; (8) construction management; (9) commissioning and decommissioning

Overview of IAEA guidelines for fire safety inspection and operation in nuclear power plants

International Nuclear Information System (INIS)

Mowrer, D.S.

1998-01-01

In 1992, the International Atomic Energy Agency began an ambitious project on fire safety in nuclear power plants. The purpose of this ongoing project is to provide specific guidance on compliance with the requirements set forth through the IAEA Nuclear Safety Standards program established in 1974. The scope of the Fire Safety project encompasses several tasks, including the development of new standards and guidelines to assist Member States in assessing the level of fire safety in existing plants. Five new Safety Practices, one new Safety Guide and a Technical Document have been developed for use by the fire safety community. The primary intent of these new documents is to provide detailed guidance and a consistent format for the assessment of the overall level of fire safety being provided in existing nuclear power plants around the world and especially in developing countries. Sufficient detail is provided in the Safety Guide and Safety Practices to allow technically knowledgeable plant personnel, outside consultants or other technical experts to assess the adequacy of fire safety within the plant facilities. This paper describes topics addressed by each of the IAEA Fire Safety documents and discussed the relationship of each document to others in the series. (author)

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder.

Science.gov (United States)

Yatham, Lakshmi N; Kennedy, Sidney H; Parikh, Sagar V; Schaffer, Ayal; Bond, David J; Frey, Benicio N; Sharma, Verinder; Goldstein, Benjamin I; Rej, Soham; Beaulieu, Serge; Alda, Martin; MacQueen, Glenda; Milev, Roumen V; Ravindran, Arun; O'Donovan, Claire; McIntosh, Diane; Lam, Raymond W; Vazquez, Gustavo; Kapczinski, Flavio; McIntyre, Roger S; Kozicky, Jan; Kanba, Shigenobu; Lafer, Beny; Suppes, Trisha; Calabrese, Joseph R; Vieta, Eduard; Malhi, Gin; Post, Robert M; Berk, Michael

2018-03-01

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third- line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment-emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second- line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence-based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first-line treatments for acute mania. First-line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be

RSK-guidelines for PWR reactors

International Nuclear Information System (INIS)

1979-01-01

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

IRIS guidelines. 2014 ed. Integrated Review of Infrastructure for Safety (IRIS) for self-assessment when establishing the safety infrastructure for a nuclear power programme

International Nuclear Information System (INIS)

2014-01-01

The IAEA safety standards reflect an international consensus on what constitutes a high level of safety for protecting people and the environment, and therefore represent what all Member States should achieve, whilst recognizing the ultimate responsibility of each State to ensure safety when implementing a nuclear power programme. IAEA Safety Standards Series No. SSG-16, entitled Establishing the Safety Infrastructure for a Nuclear Power Programme was published in order to provide recommendations, presented in the form of sequential actions, on meeting safety requirements progressively during the initial three phases of the development of safety, as described in INSAG-22, Nuclear Safety Infrastructure for a National Nuclear Power Programme Supported by the IAEA Fundamental Safety Principles. To that end, the 200 safety related actions, which are proposed by SSG-16, constitute a roadmap to establish a foundation for promoting a high level of safety over the entire lifetime of the nuclear power plant. These actions reflect international consensus on good practice in order to achieve full implementation of IAEA safety standards. The IAEA has developed a methodology and tool, the Integrated Review of Infrastructure for Safety (IRIS), to assist States in undertaking self-assessment with respect to SSG-16 recommendations when establishing the safety infrastructure for a nuclear power programme, and to develop an action plan for improvement. The IRIS methodology and the associated tool are fully compatible with the IAEA safety standards and are also used, when appropriate, in the preparation of review missions, such as the Integrated Regulatory Review Service and advisory missions. The present guidelines describe the IRIS methodology for self-assessment against SSG-16 recommendations. Through IRIS implementation, every organization concerned with nuclear safety may gain proper awareness and engage in a continuous progressive process to develop the effective national

Development of safety and regulatory requirements for Korean next generation reactor - Development of human factors design review guidelines (II)

Energy Technology Data Exchange (ETDEWEB)

Lee, Jung Woon; Oh, In Suk; Lee, Hyun Chul; Cheon, Se Woo [Korea Atomic Energy Research Institute, Taejon (Korea)

1999-02-01

The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25. Human Factors Engineering Program Review Model' and '26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation', which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and the characteristics of the KNGR design, and reviewing the reference documents of NURGE-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides at KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system design review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we updated the guidelines by reviewing the literature related to alarm design that published after 1994. 12 refs., 11 figs., 2 tabs. (Author)

Development of safety and regulatory requirements for Korean next generation reactor - Development of human factors design review guidelines (II)

Energy Technology Data Exchange (ETDEWEB)

Lee, Jung Woon; Oh, In Suk; Lee, Hyun Chul; Cheon, Se Woo [Korea Atomic Energy Research Institute, Taejon (Korea)

1999-02-01

The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25. Human Factors Engineering Program Review Model' and '26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation', which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and the characteristics of the KNGR design, and reviewing the reference documents of NURGE-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides at KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system design review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we updated the guidelines by reviewing the literature related to alarm design that published after 1994. 12 refs., 11 figs., 2 tabs. (Author)

European Society of Veterinary Cardiology screening guidelines for dilated cardiomyopathy in Doberman Pinschers.

Science.gov (United States)

Wess, G; Domenech, O; Dukes-McEwan, J; Häggström, J; Gordon, S

2017-10-01

Dilated cardiomyopathy (DCM) is the most common cardiac disease in large breed dogs and is inherited in Doberman Pinschers with a high prevalence (58%). The European Society for Veterinary Cardiology convened a task force to formulate screening guidelines for DCM in Dobermans. Screening for occult DCM in Dobermans should start at three years of age and use both Holter monitoring and echocardiography. Yearly screening over the life of the dog is recommended, as a one-time screening is not sufficient to rule out future development of DCM. The preferred echocardiographic method is the measurement of the left ventricular volume by Simpson's method of discs (SMOD). Less than 50 single ventricular premature complexes (VPCs) in 24 h are considered to be normal in Dobermans, although detection of any number of VPCs is cause for concern. Greater than 300 VPCs in 24 h or two subsequent recordings within a year showing between 50 and 300 VPCs in 24 h is considered diagnostic of occult DCM in Dobermans regardless of the concurrent echocardiographic findings. The guidelines also provide recommendations concerning ancillary tests, that are not included in the standard screening protocol, but which may have some utility when recommended tests are not available or financially untenable on an annual basis. These tests include assay of cardiac biomarkers (Troponin I and N-Terminal pro-B-type Natriuretic Peptide) as well as a 5-min resting electrocardiogram (ECG). The current guidelines should help to establish an early diagnosis of DCM in Dobermans. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Radiation safety in nuclear medicine procedures

International Nuclear Information System (INIS)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun

2017-01-01

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed

Radiation safety in nuclear medicine procedures

Energy Technology Data Exchange (ETDEWEB)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun [Dept. of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, Gwangju (Korea, Republic of)

2017-03-15

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE

Directory of Open Access Journals (Sweden)

Stanley E. Althof, PhD

2014-06-01

Conclusion: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE. Sex Med 2014;2:60–90.

Medical Physics Practice Guideline 4.a: Development, implementation, use and maintenance of safety checklists.

Science.gov (United States)

Fong de Los Santos, Luis E; Evans, Suzanne; Ford, Eric C; Gaiser, James E; Hayden, Sandra E; Huffman, Kristina E; Johnson, Jennifer L; Mechalakos, James G; Stern, Robin L; Terezakis, Stephanie; Thomadsen, Bruce R; Pronovost, Peter J; Fairobent, Lynne A

2015-05-08

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

Commentary on the "Evidence- and Consensus-Based (S3) Guidelines for the Treatment of Actinic Keratosis" Published by the International League of Dermatological Societies in Cooperation with the European Dermatology Forum.

Science.gov (United States)

Diepgen, Thomas L; Kresken, Joachim; Krutmann, Jean; Merk, Hans F; Senger, Erik; Surber, Christian; Szeimies, Rolf-Markus

2018-04-03

In 2015, the International League of Dermatological Societies and the European Dermatology Forum published a guideline for the treatment of actinic keratosis, which is classified as an evidence- and consensus-based S3 guideline. From the point of view of the GD Task Force "Licht.Hautkrebs.Prävention," an interdisciplinary expert panel of the Society for Dermopharmacy for the prevention and treatment of skin cancer, this guideline reveals strengths and weaknesses but, in summary, does not meet the claim for an evidence- and consensus-based S3 guideline. © 2018 S. Karger AG, Basel.

The ASM Curriculum Guidelines for Undergraduate Microbiology: A Case Study of the Advocacy Role of Societies in Reform Efforts.

Science.gov (United States)

Horak, Rachel E A; Merkel, Susan; Chang, Amy

2015-05-01

A number of national reports, including Vision and Change in Undergraduate Biology Education: A Call to Action, have called for drastic changes in how undergraduate biology is taught. To that end, the American Society for Microbiology (ASM) has developed new Curriculum Guidelines for undergraduate microbiology that outline a comprehensive curriculum for any undergraduate introductory microbiology course or program of study. Designed to foster enduring understanding of core microbiology concepts, the Guidelines work synergistically with backwards course design to focus teaching on student-centered goals and priorities. In order to qualitatively assess how the ASM Curriculum Guidelines are used by educators and learn more about the needs of microbiology educators, the ASM Education Board distributed two surveys to the ASM education community. In this report, we discuss the results of these surveys (353 responses). We found that the ASM Curriculum Guidelines are being implemented in many different types of courses at all undergraduate levels. Educators indicated that the ASM Curriculum Guidelines were very helpful when planning courses and assessments. We discuss some specific ways in which the ASM Curriculum Guidelines have been used in undergraduate classrooms. The survey identified some barriers that microbiology educators faced when trying to adopt the ASM Curriculum Guidelines, including lack of time, lack of financial resources, and lack of supporting resources. Given the self-reported challenges to implementing the ASM Curriculum Guidelines in undergraduate classrooms, we identify here some activities related to the ASM Curriculum Guidelines that the ASM Education Board has initiated to assist educators in the implementation process.

The ASM Curriculum Guidelines for Undergraduate Microbiology: A Case Study of the Advocacy Role of Societies in Reform Efforts

Directory of Open Access Journals (Sweden)

Rachel E.A. Horak

2015-03-01

Full Text Available A number of national reports, including Vision and Change in Undergraduate Biology Education: A Call to Action, have called for drastic changes in how undergraduate biology is taught. To that end, the American Society for Microbiology (ASM developed new Curriculum Guidelines for undergraduate microbiology that outline a comprehensive curriculum for any undergraduate introductory microbiology course or program of study. Designed to foster enduring understanding of core microbiology concepts, the Guidelines work synergistically with backwards course design to focus teaching on student-centered goals and priorities.  In order to qualitatively assess how the ASM Curriculum Guidelines are used by educators and learn more about the needs of microbiology educators, the ASM Education Board distributed two surveys to the ASM education community. In this report, we discuss results of these surveys (353 responses. We found that the ASM Curriculum Guidelines are being implemented in many different types of courses at all undergraduate levels. Educators indicated that the ASM Curriculum Guidelines were very helpful when planning courses and assessments. We discuss some specific ways in which the ASM Curriculum Guidelines have been used in undergraduate classrooms. The survey identified some barriers that microbiology educators faced when trying to adopt the ASM Curriculum Guidelines, including lack of time, lack of financial resources, and lack of supporting resources. Given the self-reported challenges to implementing the ASM Curriculum Guidelines in undergraduate classrooms, we identify here some activities related to the ASM Curriculum Guidelines that the ASM Education Board has initiated to assist educators in the implementation process.

2014 Guidelines of Taiwan Society of Cardiology (TSOC) for the Management of Pulmonary Arterial Hypertension

Science.gov (United States)

Hsu, Chih-Hsin; Ho, Wan-Jing; Huang, Wei-Chun; Chiu, Yu-Wei; Hsu, Tsu-Shiu; Kuo, Ping-Hung; Hsu, Hsao-Hsun; Chang, Jia-Kan; Cheng, Chin-Chang; Lai, Chao-Lun; Liang, Kae-Woei; Lin, Shoa-Lin; Sung, Hsao-Hsun; Tsai, Wei-Chuan; Weng, Ken-Pen; Hsieh, Kai-Sheng; Yin, Wei-Hsian; Lin, Shing-Jong; Wang, Kuo-Yang

2014-01-01

Pulmonary hypertension (PH) is a hemodynamic and pathophysiologic condition, defined as a mean pulmonary arterial pressure exceeding 25 mmHg at rest. According to the recent classifications, it is grouped into pulmonary arterial hypertension (PAH), heart-related, lung-related, thromboembolic, and miscellaneous PH. In the past two decades, tremendous advances have occurred in the field of PH. These include (1) development of clinical diagnostic algorithm and a monitoring strategy dedicated to PAH, (2) defining strong rationales for screening at-risk populations, (3) advent of pulmonary specific drugs which makes PAH manageable, (4) recognition of needs of having proper strategy of combining existing pulmonary specific drugs, and/or potential novel drugs, (5) pursuit of clinical trials with optimal surrogate endpoints and study durations, (6) recognition of critical roles of PH/right ventricular function, as well as interdependence of ventricles in different conditions, especially those with various phenotypes of heart failure, and (7) for rare diseases, putting equal importance on carefully designed observation studies, various registries, etc., besides double blind randomized studies. In addition, ongoing basic and clinical research has led to further understanding of relevant physiology, pathophysiology, epidemiology and genetics of PH/PAH. This guidelines from the working group of Pulmonary Hypertension of the Taiwan Society of Cardiology is to provide updated guidelines based on the most recent international guidelines as well as Taiwan’s domestic research on PH. The guidelines are mainly for the management of PAH (Group 1) ; however the majority of content can be helpful for managing other types of PH. PMID:27122817

Executive summary of the Clinical Guidelines of Pharmacotherapy for Neuropathic Pain: second edition by the Japanese Society of Pain Clinicians.

Science.gov (United States)

Sumitani, Masahiko; Sakai, Tetsuya; Matsuda, Yoichi; Abe, Hiroaki; Yamaguchi, Shigeki; Hosokawa, Toyoshi; Fukui, Sei

2018-06-01

Neuropathic pain has a substantial effect on quality of life (QOL). The Japanese Society of Pain Clinicians (JSPC) has developed clinical guidelines of pharmacotherapy for neuropathic pain. These guidelines offer clarity on recommendations based on both the most recent scientific evidence and expert opinions. Understanding the concept, disease entity, and burden of neuropathic pain, as well as its screening and diagnosis are important steps before starting pharmacotherapy. As well as other guidelines, the guidelines propose several lines of pharmacotherapies in a step-wise manner. To name a few different points, our guidelines propose an extract from inflamed cutaneous tissue of rabbits inoculated with vaccinia virus, which has been found to be effective for post-herpetic neuralgia in Japan, as one of the second-line drugs. When prescribing opioid analgesics, proposed as the third-line drugs, for neuropathic pain, the guidelines recommend physicians continue evaluations on either abuse or addiction. The guidelines do not recommend concomitant use of nonsteroidal anti-inflammatory drugs and acetaminophen because of lack of clinical evidence of their efficacy. If patients do not respond well to pharmacotherapy, which is prescribed in a step-wise manner, other treatment strategies should be considered to improve patients' activities of daily living and QOL.

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).

Science.gov (United States)

Galiè, Nazzareno; Humbert, Marc; Vachiery, Jean-Luc; Gibbs, Simon; Lang, Irene; Torbicki, Adam; Simonneau, Gérald; Peacock, Andrew; Vonk Noordegraaf, Anton; Beghetti, Maurice; Ghofrani, Ardeschir; Gomez Sanchez, Miguel Angel; Hansmann, Georg; Klepetko, Walter; Lancellotti, Patrizio; Matucci, Marco; McDonagh, Theresa; Pierard, Luc A; Trindade, Pedro T; Zompatori, Maurizio; Hoeper, Marius

2015-10-01

Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk-benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. Published on behalf of the European Society of Cardiology and European Respiratory Society. All rights reserved. © 2015 European Society of Cardiology & European Respiratory Society.

IAEA guidance on ageing management for nuclear power plants. Guidance on effective management of the physical ageing of systems, structures and components important to safety for nuclear power plants. Overview. Programmatic guidelines. Component specific guidelines. Review guidelines. Version 1, 2002

International Nuclear Information System (INIS)

2002-01-01

Operational experience shows that excellent plant safety and excellent performance go hand in hand, and that they are achieved by effective leadership and management that includes a unified approach to safety and production. This is also applicable to ageing management. Effective ageing management leads to both enhanced plant safety and enhanced performance and is a prerequisite for long service life. The IAEA project on Safety Aspects of NPP Ageing has produced since 1990 a comprehensive set of programmatic and component specific guidelines on managing ageing, while providing an interactive environment for information exchange and co-operation among practitioners, and has assisted Member States in the application of the guidelines through the provision of training and advice. The objective of the CD-ROM is to preserve the IAEA's guidance on ageing management and to facilitate its retrieval, updating, extension and dissemination in order to help increase the effectiveness of ageing management at nuclear power plants

An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE)

DEFF Research Database (Denmark)

Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D

2014-01-01

INTRODUCTION: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient...... for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. METHOD: A comprehensive literature review was performed. RESULTS: This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous...... of their patients. CONCLUSION: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual...

Adherence to the European Society of Cardiology (ESC) guidelines for chronic heart failure - A national survey of the cardiologists in Pakistan

Science.gov (United States)

2011-01-01

Background The aims of this study were to evaluate the awareness of and attitudes towards the 2005 European Society of Cardiology (ESC) guidelines for Heart Failure (HF) of the cardiologists in Pakistan and assess barriers to adherence to guidelines. Methods A cross-sectional survey was conducted in person from March to July 2009 to all cardiologists practicing in 4 major cities in Pakistan (Karachi, Lahore, Quetta and Peshawar). A validated, semi-structured questionnaire assessing ESC 2005 Guidelines for HF was used to obtain information from cardiologists. It included questions about awareness and relevance of HF guidelines (See Additional File 1). Respondents' management choices were compared with those of an expert panel based on the guidelines for three fictitious patient cases. Cardiologists were also asked about major barriers to adherence to guidelines. Results A total of 372 cardiologists were approached; 305 consented to participate (overall response rate, 82.0%). The survey showed a very high awareness of CHF guidelines; 97.4% aware of any guideline. About 13.8% considered ESC guidelines as relevant or very relevant for guiding treatment decisions while 92.8% chose AHA guidelines in relevance. 87.2% of respondents perceived that they adhered to the HF guidelines. For the patient cases, the proportions of respondents who made recommendations that completely matched those of the guidelines were 7% (Scenario 1), 0% (Scenario 2) and 20% (Scenario 3). Respondents considered patient compliance (59%) and cost/health economics (50%) as major barriers to guideline implementation. Conclusion We found important self reported departures from recommended HF management guidelines among cardiologists of Pakistan. PMID:22093082

Brazilian guidelines on prevention of cardiovascular disease in patients with diabetes: a position statement from the Brazilian Diabetes Society (SBD), the Brazilian Cardiology Society (SBC) and the Brazilian Endocrinology and Metabolism Society (SBEM).

Science.gov (United States)

Bertoluci, Marcello Casaccia; Moreira, Rodrigo Oliveira; Faludi, André; Izar, Maria Cristina; Schaan, Beatriz D; Valerio, Cynthia Melissa; Bertolami, Marcelo Chiara; Chacra, Ana Paula; Malachias, Marcus Vinicius Bolivar; Vencio, Sérgio; Saraiva, José Francisco Kerr; Betti, Roberto; Turatti, Luiz; Fonseca, Francisco Antonio Helfenstein; Bianco, Henrique Tria; Sulzbach, Marta; Bertolami, Adriana; Salles, João Eduardo Nunes; Hohl, Alexandre; Trujilho, Fábio; Lima, Eduardo Gomes; Miname, Marcio Hiroshi; Zanella, Maria Teresa; Lamounier, Rodrigo; Sá, João Roberto; Amodeo, Celso; Pires, Antonio Carlos; Santos, Raul D

2017-01-01

Since the first position statement on diabetes and cardiovascular prevention published in 2014 by the Brazilian Diabetes Society, the current view on primary and secondary prevention in diabetes has evolved as a result of new approaches on cardiovascular risk stratification, new cholesterol lowering drugs, and new anti-hyperglycemic drugs. Importantly, a pattern of risk heterogeneity has emerged, showing that not all diabetic patients are at high or very high risk. In fact, most younger patients who have no overt cardiovascular risk factors may be more adequately classified as being at intermediate or even low cardiovascular risk. Thus, there is a need for cardiovascular risk stratification in patients with diabetes. The present panel reviews the best current evidence and proposes a practical risk-based approach on treatment for patients with diabetes. The Brazilian Diabetes Society, the Brazilian Society of Cardiology, and the Brazilian Endocrinology and Metabolism Society gathered to form an expert panel including 28 cardiologists and endocrinologists to review the best available evidence and to draft up-to-date an evidence-based guideline with practical recommendations for risk stratification and prevention of cardiovascular disease in diabetes. The guideline includes 59 recommendations covering: (1) the impact of new anti-hyperglycemic drugs and new lipid lowering drugs on cardiovascular risk; (2) a guide to statin use, including new definitions of LDL-cholesterol and in non-HDL-cholesterol targets; (3) evaluation of silent myocardial ischemia and subclinical atherosclerosis in patients with diabetes; (4) hypertension treatment; and (5) the use of antiplatelet therapy. Diabetes is a heterogeneous disease. Although cardiovascular risk is increased in most patients, those without risk factors or evidence of sub-clinical atherosclerosis are at a lower risk. Optimal management must rely on an approach that will cover both cardiovascular disease prevention in

[Communication on health and safety risk control in contemporary society: an interdisciplinary approach].

Science.gov (United States)

Rangel-S, Maria Ligia

2007-01-01

This paper discusses communication as a technology for risk control with health and safety protection and promotion, within the context of a "risk society". As a component of Risk Analysis, risk communication is a technology that appears in risk literature, with well defined objectives, principles and models. These aspects are described and the difficulties are stressed, taking into consideration the multiple rationales related to risks in the culture and the many different aspects of risk regulation and control in the so-called "late modernity". Consideration is also given to the complexity of the communications process, guided by theoretical and methodological discussions in the field. In order to understand the true value of the communications field for risk control with health and safety protection and promotion, this paper also offers an overview of communication theories that support discussions of this matter, proposing a critical approach to models that include the dimensions of power and culture in the context of a capitalist society.

International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT).

Science.gov (United States)

Torres, Antoni; Niederman, Michael S; Chastre, Jean; Ewig, Santiago; Fernandez-Vandellos, Patricia; Hanberger, Hakan; Kollef, Marin; Li Bassi, Gianluigi; Luna, Carlos M; Martin-Loeches, Ignacio; Paiva, J Artur; Read, Robert C; Rigau, David; Timsit, Jean François; Welte, Tobias; Wunderink, Richard

2017-09-01

The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population-intervention-comparison-outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention. Copyright ©ERS 2017.

Implementation guidelines for seismic PSA

International Nuclear Information System (INIS)

Coman, Ovidiu; Samaddar, Sujit; Hibino, Kenta; )

2014-01-01

The presentation was devoted to development of guidelines for implementation of a seismic PSA. If successful, these guidelines can close an important gap. ASME/ANS PRA standards and the related IAEA Safety Guide (IAEA NS-G-2.13) describe capability requirements for seismic PSA in order to support risk-informed applications. However, practical guidance on how to meet these requirements is limited. Such guidelines could significantly contribute to improving risk-informed safety demonstration, safety management and decision making. Extensions of this effort to further PSA areas, particularly to PSA for other external hazards, can enhance risk-informed applications

2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

Science.gov (United States)

Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

2016-12-01

Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

Environmental Sustainability of Gm Crops for Food Safety on Risk Society

Directory of Open Access Journals (Sweden)

Gil Ramos de Carvalho Neto

2016-10-01

Full Text Available GM crops are presented as an alternative to the erradication of hunger. The risk society, however, considering the brazilian environmental law - specially the brazilian legislation on biosafety - the food safety and nutritional law and the economic and social data on the subject, it appears that the environmental sustainability of these crops is not yet complete. Producers should adopt additional safeguards if they wish a sustainable agriculture with effective food security.

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

Science.gov (United States)

Léger, Juliane; Olivieri, Antonella; Donaldson, Malcolm; Torresani, Toni; Krude, Heiko; van Vliet, Guy; Polak, Michel

2014-01-01

Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T4 supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy. PMID:24446653

Recommendations for the follow-up care of female breast cancer survivors: a guideline of the Spanish Society of Medical Oncology (SEOM), Spanish Society of General Medicine (SEMERGEN), Spanish Society for Family and Community Medicine (SEMFYC), Spanish Society for General and Family Physicians (SEMG), Spanish Society of Obstetrics and Gynecology (SEGO), Spanish Society of Radiation Oncology (SEOR), Spanish Society of Senology and Breast Pathology (SESPM), and Spanish Society of Cardiology (SEC).

Science.gov (United States)

Barnadas, A; Algara, M; Cordoba, O; Casas, A; Gonzalez, M; Marzo, M; Montero, A; Muñoz, M; Ruiz, A; Santolaya, F; Fernandez, T

2018-06-01

The increased incidence and decreased mortality of breast cancer have produced an increased number of breast cancer survivors. The type of sequelae and comorbidities that these patients present call for a collaborative follow-up by hospital-based specialized care and primary care. In this document, we present a guideline drafted and agreed among scientific societies whose members care for breast cancer survivors. The purpose of this guideline is to achieve the shared and coordinated follow-up of these patients by specialized care and primary care professionals. In it, we review the health issues derived from the treatments performed, with recommendations about the therapeutic approach to each of them, as well as a proposal for joint follow-up by primary and specialized care.

Management of Thyroid Peroxidase Antibody Euthyroid Women in Pregnancy: Comparison of the American Thyroid Association and the Endocrine Society Guidelines

Directory of Open Access Journals (Sweden)

L. Mehran

2013-01-01

Full Text Available The presence of thyroid autoantibodies is relatively high in women of childbearing age. There is evidence that positive thyroperoxidase antibody even in euthyroid women may increase the risk of spontaneous and recurrent pregnancy loss and preterm delivery. However, the evidence is not enough to justify recommendation on the screening of pregnant women for thyroid autoantibodies or LT4 supplementation for reducing maternal or fetal complications. In this paper we reviewed the related evidence and compared the new guidelines of the American Thyroid Association and Endocrine Society with respect to the screening and management of positive thyroperoxidase antibody in euthyroid pregnant women. As there was no major contradiction or disagreement between the two guidelines, either one of two guidelines may be used by clinicians for the appropriate management of thyroid autoimmunity during pregnancy.

American brachytherapy society (ABS) consensus guidelines for brachytherapy of esophageal cancer

International Nuclear Information System (INIS)

Gaspar, Laurie E.; Nag, Subir; Herskovic, Arnold; Mantravadi, Rao; Speiser, Burton

1997-01-01

Introduction: There is wide variation in the indications, treatment regimens, and dosimetry for brachytherapy in the treatment of cancer of the esophagus. No guidelines for optimal therapy currently exist. Methods and Materials: Utilizing published reports and clinical experience, representatives of the Clinical Research Committee of the American Brachytherapy Society (ABS) formulated guidelines for brachytherapy in esophageal cancer. Results: Recommendations were made for brachytherapy in the definitive and palliative treatment of esophageal cancer. (A) Definitive treatment: Good candidates for brachytherapy include patients with unifocal thoracic adeno- or squamous cancers ≤ 10 cm in length, with no evidence of intra-abdominal or metastatic disease. Contraindications include tracheal or bronchial involvement, cervical esophagus location, or stenosis that cannot be bypassed. The esophageal brachytherapy applicator should have an external diameter of 6-10 mm. If 5FU-based chemotherapy and 45-50-Gy external beam are used, recommended brachytherapy is either: (i) HDR 10 Gy in two weekly fractions of 5 Gy each; or (ii) LDR 20 Gy in a single course at 0.4-1 Gy/hr. All doses are specified 1 cm from the midsource or middwell position. Brachytherapy should follow external beam radiation therapy and should not be given concurrently with chemotherapy. (B) Palliative treatment: Patients with adeno- or squamous cancers of the thoracic esophagus with distant metastases or unresectable local disease progression/recurrence after definitive radiation treatment should be considered for brachytherapy with palliative intent. After limited dose (30 Gy) EBRT, the recommended brachytherapy is either: (i) HDR 10-14 Gy in one or two fractions; or (ii) LDR 20-25 Gy in a single course at 0.4-1 Gy/hr. The need for external beam radiation in newly diagnosed patients with a life expectancy of less than 3 months is controversial. In these cases, HDR of 15-20 Gy in two to four fractions or

OSART guidelines. 1992 edition

International Nuclear Information System (INIS)

1992-01-01

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

An official American thoracic society workshop report: developing performance measures from clinical practice guidelines.

Science.gov (United States)

Kahn, Jeremy M; Gould, Michael K; Krishnan, Jerry A; Wilson, Kevin C; Au, David H; Cooke, Colin R; Douglas, Ivor S; Feemster, Laura C; Mularski, Richard A; Slatore, Christopher G; Wiener, Renda Soylemez

2014-05-01

Many health care performance measures are either not based on high-quality clinical evidence or not tightly linked to patient-centered outcomes, limiting their usefulness in quality improvement. In this report we summarize the proceedings of an American Thoracic Society workshop convened to address this problem by reviewing current approaches to performance measure development and creating a framework for developing high-quality performance measures by basing them directly on recommendations from well-constructed clinical practice guidelines. Workshop participants concluded that ideally performance measures addressing care processes should be linked to clinical practice guidelines that explicitly rate the quality of evidence and the strength of recommendations, such as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. Under this framework, process-based performance measures would only be developed from strong recommendations based on high- or moderate-quality evidence. This approach would help ensure that clinical processes specified in performance measures are both of clear benefit to patients and supported by strong evidence. Although this approach may result in fewer performance measures, it would substantially increase the likelihood that quality-improvement programs based on these measures actually improve patient care.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-12-01

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

A framework for the development of patient safety education and training guidelines.

Science.gov (United States)

Zikos, Dimitrios; Diomidous, Marianna; Mantas, John

2010-01-01

Patient Safety (PS) is a major concern that involves a wide range of roles in healthcare, including those who are directly and indirectly involved, and patients as well. In order to succeed into developing a safety culture among healthcare providers, carers and patients, there should be given great attention into building appropriate education and training tools, especially addressing those who plan patient safety activities. The framework described in this policy paper is based on the results of the European Network for Patient Safety (EUNetPaS) project and analyses the principles and elements of the guidance that should be provided to those who design and implement Patient Safety Education and training activities. The main principles that it should be based on and the core teaching objectives-expected outcomes are addressed. Once the main context and considerations are properly set, the guidance should define the general schema of the content that should be included in the Education and Training activities, as well as how these activities would be delivered. It is also important that the different roles of the recipients are clearly distinguished and linked to their role-specific methods, proper delivery platforms and success stories. Setting these principles into practice when planning and implementing interventions, primarily aims to enlighten and support those who are enrolled to design and implement Patient Safety education and training teaching activities. This is achieved by providing them with a framework to build upon, succeeding to build a collaborative, safety conscious and competent environment, in terms of PS. A guidelines web platform has been developed to support this process.

Adherence to the European Society of Cardiology (ESC guidelines for chronic heart failure - A national survey of the cardiologists in Pakistan

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Shoukat Sana

2011-11-01

Full Text Available Abstract Background The aims of this study were to evaluate the awareness of and attitudes towards the 2005 European Society of Cardiology (ESC guidelines for Heart Failure (HF of the cardiologists in Pakistan and assess barriers to adherence to guidelines. Methods A cross-sectional survey was conducted in person from March to July 2009 to all cardiologists practicing in 4 major cities in Pakistan (Karachi, Lahore, Quetta and Peshawar. A validated, semi-structured questionnaire assessing ESC 2005 Guidelines for HF was used to obtain information from cardiologists. It included questions about awareness and relevance of HF guidelines (See Additional File 1. Respondents' management choices were compared with those of an expert panel based on the guidelines for three fictitious patient cases. Cardiologists were also asked about major barriers to adherence to guidelines. Additional file 1 Questionnaire. Description: Questionnaire that was administered to participants. Click here for file Results A total of 372 cardiologists were approached; 305 consented to participate (overall response rate, 82.0%. The survey showed a very high awareness of CHF guidelines; 97.4% aware of any guideline. About 13.8% considered ESC guidelines as relevant or very relevant for guiding treatment decisions while 92.8% chose AHA guidelines in relevance. 87.2% of respondents perceived that they adhered to the HF guidelines. For the patient cases, the proportions of respondents who made recommendations that completely matched those of the guidelines were 7% (Scenario 1, 0% (Scenario 2 and 20% (Scenario 3. Respondents considered patient compliance (59% and cost/health economics (50% as major barriers to guideline implementation. Conclusion We found important self reported departures from recommended HF management guidelines among cardiologists of Pakistan.

Radiotherapy procedures quality control program: Guidelines established by the Spanish Society of Radiotherapy and Oncology

International Nuclear Information System (INIS)

Palacios, A.; Pardo, J.; Valls, A.; Petschen, I.; Castell, A.; Villar, A.; Pedro Olive, B.A.; Munoz, V.; Fernandez, J.; Rodriguez, R.; Oton, C.

2001-01-01

The main purpose of the Royal Decree 1566/1998 of July 17 th , is to establish the quality criteria in radiation therapy in order to assure the optimisation of both radiation oncology treatments and radiation protection of the patients. According to this decree, the implementation of a quality control program in the radiation oncology departments is imperative. This program must be in writing and always available for supervision of health authorities. When necessary, modifications to improve non-optimal procedures or equipment will be made. The Spanish Society of Radiotherapy and Oncology, in order to co-operate and facilitate to all its members, set up a task force focussing on elaborating a set of guidelines that every single Radiation Oncology Department could use to develop its own quality control program. No agreements regarding equipment quality control were made by the Commission, in spite they are a part of the quality control program in radiotherapy, because it is considered that they correspond to members of other scientific societies. (author)

The Helsinki Declaration on Patient Safety in Anesthesiology: a way forward with the European Board and the European Society of Anesthesiology.

Science.gov (United States)

Petrini, F; Solca, M; De Robertis, E; Peduto, V A; Pasetto, A; Conti, G; Antonelli, M; Pelosi, P

2010-11-01

Anesthesiology, which includes anaesthesia, perioperative care, intensive care medicine, emergency medicine and pain therapy, is acknowledged as the leading medical specialty in addressing issues of patient safety, but there is still a long way to go. Several factors pose hazards in Anesthesiology, like increasingly older and sicker patients, more complex surgical interventions, more pressure on throughput, as well as new drugs and devices. To better design educational and research strategies to improve patient safety, the European Board of Anesthesiology (EBA) and the European Society of Anesthesiology (ESA) have produced a blueprint for patient safety in Anesthesiology. This document, to be known as the Helsinki Declaration on Patient Safety in Anesthesiology, was endorsed together with the World Health Organization (WHO), the World Federation of Societies of Anesthesiologists (WFSA), and the European Patients' Federation (EPF) at the Euroanaesthesia meeting in Helsinki in June 2010. It was signed by several Presidents of National Anesthesiology Societies as well as other stakeholders. The Helsinki Declaration on Patient Safety in Anesthesiology represents a shared European view of what is necessary to improve patient safety, recommending practical steps that all anesthesiologists can include in their own clinical practice. The Italian Society of Anaesthesia, Analgesia, Reanimation and Intensive Care (SIAARTI) is looking forward to continuing work on "patient safety" issues in Europe, and to cooperating with the ESA in the best interest of European patients.

European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis

International Nuclear Information System (INIS)

Bazot, M.; Thomassin-Naggara, I.; Bharwani, N.; Huchon, C.; Kinkel, K.; Cunha, T.M.; Guerra, A.; Manganaro, L.; Bunesch, L.; Kido, A.; Togashi, K.; Rockall, A.G.

2017-01-01

Endometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging (MRI) is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion. This work was performed by a group of radiologists from the European Society of Urogenital Radiology (ESUR), experts in gynaecological imaging and a gynaecologist expert in methodology. The group discussed indications for MRI, technical requirements, patient preparation, MRI protocols and criteria for the diagnosis of pelvic endometriosis on MRI. The expert panel proposed a final recommendation for each criterion using Oxford Centre for Evidence Based Medicine (OCEBM) 2011 levels of evidence. (orig.)

European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis

Energy Technology Data Exchange (ETDEWEB)

Bazot, M.; Thomassin-Naggara, I. [Tenon Hospital, Department of Radiology, Paris (France); Bharwani, N. [Imperial College Healthcare NHS Trust, Department of Radiology, St Mary' s Hospital, London (United Kingdom); Huchon, C. [CHI Poissy Saint-Germain en Laye, Versailles University France, Department of Obtetrics and Gynaecology, Poissy (France); Kinkel, K. [Institut de Radiologie, Chene-Bougeries (Switzerland); Cunha, T.M. [Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Servico de Radiologia, Lisboa (Portugal); Guerra, A. [Hospital da Luz, Department of Radiology, Lisbon (Portugal); Manganaro, L. [Sapienza University of Rome, Department of Radiological Sciences, Rome (Italy); Bunesch, L. [Hospital Clinic Barcelona, Department of Radiology (Urogenital Section), Barcelona (Spain); Kido, A.; Togashi, K. [Kyoto University Hospital, Department of Diagnostic Radiology, Kyoto (Japan); Rockall, A.G. [The Royal Marsden Hospital, Department of Radiology, London (United Kingdom)

2017-07-15

Endometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging (MRI) is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion. This work was performed by a group of radiologists from the European Society of Urogenital Radiology (ESUR), experts in gynaecological imaging and a gynaecologist expert in methodology. The group discussed indications for MRI, technical requirements, patient preparation, MRI protocols and criteria for the diagnosis of pelvic endometriosis on MRI. The expert panel proposed a final recommendation for each criterion using Oxford Centre for Evidence Based Medicine (OCEBM) 2011 levels of evidence. (orig.)

General safety guidelines for looking for a low mass activity-long life waste storage site

International Nuclear Information System (INIS)

2008-01-01

The objective of this document is to define general guidelines which must be followed during the stages of search for a site and stages of design of a storage facility for low activity-long life radioactive wastes, in order to ensure its safety after closure. After having specified the considered wastes, geological shapes, and situations, this document defines the fundamental objective and the associated criteria (protection against chemical risk, radioprotection). It presents the design aspects related to safety (safety principles and functions, waste packages, public works engineering, geological environment, storage concepts). The last part deals with the safety demonstration after site closure which includes the control of some components, the assessment of disturbances in the storage facility or due to its presence, the taking of uncertainty and sensitivity studies into account, the influence of natural events

Implications of the 2014 Androgen Excess and Polycystic Ovary Syndrome Society guidelines on polycystic ovarian morphology for polycystic ovary syndrome diagnosis

NARCIS (Netherlands)

Christ, J. P.; Gunning, M. N.; Fauser, B. C.J.M.

2017-01-01

The Androgen Excess and Polycystic Ovary Syndrome Society (AEPCOS) has recommended an updated threshold for polycystic ovarian morphology (PCOM) of 25 follicles or more, 10 ml or more of ovarian volume, or both. We describe the effect of these guidelines on reproductive and metabolic characteristics

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass--Temperature Management During Cardiopulmonary Bypass.

Science.gov (United States)

Engelman, Richard; Baker, Robert A; Likosky, Donald S; Grigore, Alina; Dickinson, Timothy A; Shore-Lesserson, Linda; Hammon, John W

2015-08-01

In order to improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including: 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate. Authors adopted the American College of Cardiology/American Heart Association method for development clinical practice guidelines, and arrived at the following recommendations: CLASS I RECOMMENDATIONS: a)The oxygenator arterial outlet blood temperature is recommended to be utilized as a surrogate for cerebral temperature measurement during CPB. (Class I, Level C) b)To monitor cerebral perfusate temperature during warming, it should be assumed that the oxygenator arterial outlet blood temperature under-estimates cerebral perfusate temperature. (Class I, Level C) c)Surgical teams should limit arterial outlet blood temperature to<37°C to avoid cerebral hyperthermia. (Class 1, Level C) d)Temperature gradients between the arterial outlet and venous inflow on the oxygenator during CPB cooling should not exceed 10°C to avoid generation of gaseous emboli. (Class 1, Level C) e)Temperature gradients between the arterial outlet and venous inflow on the oxygenator during CPB rewarming should not exceed 10°C to avoid out-gassing when blood is returned to the patient. (Class 1, Level C) CLASS IIa a)Pulmonary artery or nasopharyngeal temperature recording is reasonable for weaning and immediate post-bypass temperature measurement. (Class IIa, Level C)b)Rewarming when arterial blood outlet temperature ≥30° C: i.To achieve the desired temperature for separation from bypass, it is reasonable to maintain a temperature gradient between

Guideline for collection, analysis and presentation of safety data in clinical trials of vaccines in pregnant women

Science.gov (United States)

Jones, Christine E.; Munoz, Flor M.; Spiegel, Hans M.L.; Heininger, Ulrich; Zuber, Patrick L.F.; Edwards, Kathryn M.; Lambach, Philipp; Neels, Pieter; Kohl, Katrin S.; Gidudu, Jane; Hirschfeld, Steven; Oleske, James M.; Khuri-Bulos, Najwa; Bauwens, Jorgen; Eckert, Linda O.; Kochhar, Sonali; Bonhoeffer, Jan; Heath, Paul T.

2017-01-01

Vaccination during pregnancy is increasingly being used as an effective approach for protecting both young infants and their mothers from serious infections. Drawing conclusions from published studies in this area can be difficult because of the inability to compare vaccine trial results across different studies and settings due to the heterogeneity in the definitions of terms used to assess the safety of vaccines in pregnancy and the data collected in such studies. The guidelines proposed in this document have been developed to harmonize safety data collection in all phases of clinical trials of vaccines in pregnant women and apply to data from the mother, fetus and infant. Guidelines on the prioritization of the data to be collected is also provided to allow applicability in various geographic, cultural and resource settings, including high, middle and low-income countries. PMID:27481360

Closed medical negligence claims can drive patient safety and reduce litigation.

Science.gov (United States)

Pegalis, Steven E; Bal, B Sonny

2012-05-01

Medical liability reform is viewed by many physician groups as a means of reducing medical malpractice litigation and lowering healthcare costs. However, alternative approaches such as closed medical negligence claims data may also achieve these goals. We asked whether information gleaned from closed claims related to medical negligence could promote patient safety and reduce costs related to medical liability. Specifically, we investigated whether physician groups have examined such data to identify error patterns and to then institute specific patient treatment protocols. We searched for medical societies that have systematically examined closed medical negligence claims in their specialty to develop specific standards of physician conduct. We then searched the medical literature for published evidence of the efficacy, if any, related to the patient safety measures thus developed. Anesthesia and obstetric physician societies have successfully targeted costs and related concerns arising from medical malpractice lawsuits by using data from closed claims to develop patient safety and treatment guidelines. In both specialties, after institution of safety measures derived from closed medical negligence claims, the incidence and costs related to medical malpractice decreased and physician satisfaction improved. Tort reform, in the form of legislatively prescribed limits on damages arising from lawsuits, is not the only means of addressing the incidence and costs related to medical malpractice litigation. As the experience of anesthesia and obstetric physicians has demonstrated, safety guidelines derived from analyzing past medical malpractice litigation can achieve the same goals while also promoting patient safety.

Nuclear space power safety and facility guidelines study

International Nuclear Information System (INIS)

Mehlman, W.F.

1995-01-01

This report addresses safety guidelines for space nuclear reactor power missions and was prepared by The Johns Hopkins University Applied Physics Laboratory (JHU/APL) under a Department of Energy grant, DE-FG01-94NE32180 dated 27 September 1994. This grant was based on a proposal submitted by the JHU/APL in response to an open-quotes Invitation for Proposals Designed to Support Federal Agencies and Commercial Interests in Meeting Special Power and Propulsion Needs for Future Space Missionsclose quotes. The United States has not launched a nuclear reactor since SNAP 10A in April 1965 although many Radioisotope Thermoelectric Generators (RTGs) have been launched. An RTG powered system is planned for launch as part of the Cassini mission to Saturn in 1997. Recently the Ballistic Missile Defense Office (BMDO) sponsored the Nuclear Electric Propulsion Space Test Program (NEPSTP) which was to demonstrate and evaluate the Russian-built TOPAZ II nuclear reactor as a power source in space. As of late 1993 the flight portion of this program was canceled but work to investigate the attributes of the reactor were continued but at a reduced level. While the future of space nuclear power systems is uncertain there are potential space missions which would require space nuclear power systems. The differences between space nuclear power systems and RTG devices are sufficient that safety and facility requirements warrant a review in the context of the unique features of a space nuclear reactor power system

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-01-15

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

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

International Nuclear Information System (INIS)

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

2017-01-01

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

Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines

Energy Technology Data Exchange (ETDEWEB)

Valicenti, Richard K., E-mail: Richard.valicenti@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis School of Medicine, Davis, California (United States); Thompson, Ian [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States); Albertsen, Peter [Division of Urology, University of Connecticut Health Center, Farmington, Connecticut (United States); Davis, Brian J. [Department of Radiation Oncology, Mayo Medical School, Rochester, Minnesota (United States); Goldenberg, S. Larry [Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia (Canada); Wolf, J. Stuart [Department of Urology, University of Michigan, Ann Arbor, Michigan (United States); Sartor, Oliver [Department of Medicine and Urology, Tulane Medical School, New Orleans, Louisiana (United States); Klein, Eric [Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio (United States); Hahn, Carol [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Roach, Mack [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Faraday, Martha M. [Four Oaks, Inc (United States)

2013-08-01

Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review.

Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines

International Nuclear Information System (INIS)

Valicenti, Richard K.; Thompson, Ian; Albertsen, Peter; Davis, Brian J.; Goldenberg, S. Larry; Wolf, J. Stuart; Sartor, Oliver; Klein, Eric; Hahn, Carol; Michalski, Jeff; Roach, Mack; Faraday, Martha M.

2013-01-01

Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review

American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.

Science.gov (United States)

Kampman, Kyle; Jarvis, Margaret

2015-01-01

The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This "Practice Guideline" was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) - a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of the

Guidelines for safety related telecommunications systems on normally unattended fixed offshore installations

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-12-01

Guidance is given on the design of telecommunications systems required for safety purposes on normally unattended offshore installations associated with oil and gas production on the United Kingdom continental shelf. The guidelines are mainly concerned with ensuring that: while the installation is unattended, its operation can be remotely monitored and controlled effectively to prevent the escalation of any abnormal situation; the installation can be safely approached when it is necessary to transfer personnel on board; persons on board, for example for inspection or maintenance activities, are safe. (UK)

Proceedings of the 7th National Congress of the Mexican Society of Radiological Safety C.A

International Nuclear Information System (INIS)

1997-01-01

The Mexican Society of Radiological Safety, celebrates on this time the 100 Anniversary of the radioactivity discovery, phenomenon coined by Marie Curie in 1898 and discover by Henry Beckerel in March 1896, when both were working with natural radioactive isotopes. Subsequently, on the new age of Physics, the use of radioactive isotopes was impulse by the invention of Cyclotron made by Dr. Ernest Orland Lawrence in the United States, which permits the manufacturing of tens of artificial radioactive isotopes which convert its in an indispensable tool in Medicine, Industry, Research, Agriculture and other disciplines, by its wide variety of applications, creating the radiological safety culture by the implicit risk in the use of these materials. From its creation in 1976, our society was removing to promote the radiological safety and two years each celebrates its National Congress removing specialists in this discipline and invite new generations to awake their interest by this useful field. (Author)

Contemporaneous International Asthma Guidelines Present Differing Recommendations: An Analysis

Directory of Open Access Journals (Sweden)

Samir Gupta

2016-01-01

Full Text Available Background. Several international groups develop asthma guidelines. Conflicting recommendations across guidelines have been described in several disease areas and may contribute to practice variability. Accordingly, we compared the latest Canadian Thoracic Society (CTS asthma guideline with contemporaneous international asthma guidelines to evaluate conflicting recommendations and their causes. Methods. We identified the latest CTS asthma guideline update (2012 and the following societies which also updated their guidelines in 2012: the British Thoracic Society and Scottish Intercollegiate Guidelines Network and the Global Initiative for Asthma. We compared these three guidelines on (1 key methodological factors and (2 adult pharmacotherapy recommendations. Results. Methods used and documentation provided for literature search strategy and dates, evidence synthesis, outcomes considered, evidence appraisal, and recommendation formulation varied between guidelines. Criteria used to define suboptimal asthma control varied widely between guidelines. Inhaled corticosteroid dosing recommendations diverged, as did recommendations surrounding use of budesonide/formoterol as a reliever and controller and recommendations in the subsequent step. Conclusions. There are important differences between recommendations provided in contemporaneous asthma guidelines. Causes include differences in methods used for interpreting evidence and formulating recommendations. Adopting a common set of valid and explicit methods across international societies could harmonize recommendations and facilitate guideline implementation.

Fatal Exertional Heat Stroke and American Football Players: The Need for Regional Heat-Safety Guidelines.

Science.gov (United States)

Grundstein, Andrew J; Hosokawa, Yuri; Casa, Douglas J

2018-01-01

  Weather-based activity modification in athletics is an important way to minimize heat illnesses. However, many commonly used heat-safety guidelines include a uniform set of heat-stress thresholds that do not account for geographic differences in acclimatization.   To determine if heat-related fatalities among American football players occurred on days with unusually stressful weather conditions based on the local climate and to assess the need for regional heat-safety guidelines.   Cross-sectional study.   Data from incidents of fatal exertional heat stroke (EHS) in American football players were obtained from the National Center for Catastrophic Sport Injury Research and the Korey Stringer Institute.   Sixty-one American football players at all levels of competition with fatal EHSs from 1980 to 2014.   We used the wet bulb globe temperature (WBGT) and a z-score WBGT standardized to local climate conditions from 1991 to 2010 to assess the absolute and relative magnitudes of heat stress, respectively.   We observed a poleward decrease in exposure WBGTs during fatal EHSs. In milder climates, 80% of cases occurred at above-average WBGTs, and 50% occurred at WBGTs greater than 1 standard deviation from the long-term mean; however, in hotter climates, half of the cases occurred at near average or below average WBGTs.   The combination of lower exposure WBGTs and frequent extreme climatic values in milder climates during fatal EHSs indicates the need for regional activity-modification guidelines with lower, climatically appropriate weather-based thresholds. Established activity-modification guidelines, such as those from the American College of Sports Medicine, work well in the hotter climates, such as the southern United States, where hot and humid weather conditions are common.

Methodological quality of guidelines in gastroenterology.

Science.gov (United States)

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

2014-06-01

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

Activity of the Atomic Energy Society of Japan for compiling the consensus standard on nuclear criticality safety control

International Nuclear Information System (INIS)

Yamane, Yoshihiro; Matsumoto, Tadakuni

2003-01-01

Activity of the Atomic Energy Society of Japan for compiling the consensus standard on nuclear criticality safety control is presented. The standard recommends an enhancement of nuclear criticality safety throughout a life cycle of facility in terms of a concept of 'barriers against criticality'. (author)

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

NARCIS (Netherlands)

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

2010-01-01

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

Surgical Safety Training of World Health Organization Initiatives.

Science.gov (United States)

Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael

2014-01-01

Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended. © 2013 by the American College of Medical Quality.

American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer.

NARCIS (Netherlands)

Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.

2010-01-01

PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer.

NARCIS (Netherlands)

Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.

2010-01-01

PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

Japanese Guideline for Atopic Dermatitis

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2011-01-01

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

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.

Science.gov (United States)

Mehta, Nilesh M; Skillman, Heather E; Irving, Sharon Y; Coss-Bu, Jorge A; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M; Goday, Praveen S; Braunschweig, Carol

2017-07-01

This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and 2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The

Best Practice Guidelines for the use of CFD in Nuclear Reactor Safety Applications

International Nuclear Information System (INIS)

Mahaffy, J.; Chung, B.; Song, C.; Dubois, F.; Graffard, E.; Ducros, F.; Heitsch, M.; Scheuerer, M.; Henriksson, M.; Komen, E.; Moretti, F.; Morii, T.; Muehlbauer, P.; Rohde, U.; Smith, B. L.; Watanabe, T.; Zigh, G.

2007-01-01

In May 2002, an 'Exploratory Meeting of Experts to Define an Action Plan on the Application of Computational Fluid Dynamics (CFD) Codes to Nuclear Reactor Safety Problems' was held at Aix-en-Provence, France. One of three recommended actions was the formation of this writing group to report on the need for guidelines for use of CFD in single phase Nuclear Reactor Safety (NRS) applications. CSNI approved this writing group at the end of 2002, and work began in March 2003. A final report was submitted to GAMA in September 2004, summarizing existing Best Practice Guidelines (BPG) for CFD, and recommending creation of a BPG document for Nuclear Reactor Safety (NRS) applications. The present document is intended to provide an internally complete set of guidelines for a range of single phase applications of CFD to NRS problems. However, it is not meant to be comprehensive; it is recognized that for any specific application a higher level of specificity is possible on questions of nodalization, model selection, and validation. This document should provide direct guidance on the key considerations in known single phase applications, and general directions for resolving remaining details. The intent is that it will serve as a template for further application specific (e.g. PTS, induced break) BPG documents that will provide much more detailed information and examples. The document begins with a summary of NRS related CFD analysis in countries represented by the authors. Chapter 3 deals with definition of the problem and its solution approach. This includes isolation of the portion of the NRS problem most in need of CFD, and use of a classic thermal hydraulic (TH) safety code to provide boundary conditions for the CFD based upon less detailed simulation of the balance of plant. Chapter 4 provides guidance in choosing between various options, and also discusses use of a transient calculation with tightly coupled CFD and TH codes. Chapter 5 discusses selection of physical

A benchmarking project on the quality of previous guidelines about the management of malignant pleural effusion from the European Society of Thoracic Surgeons (ESTS) Pleural Diseases Working Group.

Science.gov (United States)

Bertolaccini, Luca; Bedetti, Benedetta; Brunelli, Alessandro; Marinova, Katerina; Raveglia, Federico; Rocco, Gaetano; Shargall, Yaron; Solli, Piergiorgio; Varela, Gonzalo; Papagiannopoulos, Kostas; Kuzdzal, Jaroslaw; Massard, Gilbert; Ruffini, Enrico; Falcoz, Pierre-Emmanuel; Martinez-Barenys, Carlos; Opitz, Isabelle; Batirel, Hasan F; Toker, Alper; Scarci, Marco

2017-08-01

In the European Society of Thoracic Surgeons (ESTS) survey about management of malignant pleural effusions (MPE), 56% of respondents are not informed of any relevant clinical guidelines and 52%, who are aware of the existence of guidelines, declared that they are in need of updating or revision. The ESTS Pleural Diseases Working Group developed a benchmarking project on quality of previous guidelines on the management of MPE. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used to assess each guideline. Each item was scored on a 7-point scale. Scores for each domain were calculated. Economic data for the nations which have issued the guidelines were collected from the Organisation for Economic Cooperation and Development health statistics database. Six guidelines fitted the inclusion criteria and were assessed. Five out of 6 guidelines were produced by a multinational collaboration. Observers would recommend only 2 guidelines with minimal modification. Two areas that received the best score were clarity of presentation and scope and purpose (objectives and health questions target population). The applicability of guideline domain had the lowest score. Multivariate analysis demonstrated that clarity of presentation, international guidelines and publication through medical journal were related to improved scores. A strong correlation was observed between the measures of economic status. The quality of guidelines assessed by the AGREE II criteria was found to be extremely variable. Guidelines achieving higher AGREE II scores were more likely to come from the European Union with the direct involvement of scientific societies in their development. It was also recognized that some fundamental unanswered questions remain about the management of MPE. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Guideline from Japanese Society of Echocardiography: 2018 focused update incorporated into Guidance for the Management and Maintenance of Echocardiography Equipment.

Science.gov (United States)

Daimon, Masao; Akaishi, Makoto; Asanuma, Toshihiko; Hashimoto, Shuji; Izumi, Chisato; Iwanaga, Shiro; Kawai, Hiroya; Toide, Hiroyuki; Hayashida, Akihiro; Yamada, Hirotsugu; Murata, Mitsushige; Hirano, Yutaka; Suzuki, Kengo; Nakatani, Satoshi

2018-03-01

Echocardiography plays a pivotal role as an imaging modality in the modern cardiology practice. Information derived from echocardiography is definitely helpful for a patient care. The Japanese Society of Echocardiography has promoted echocardiography for a routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure it, we believe equipment in good conditions and a comfortable environment are important for both a patient and an examiner. Thus, the Committee for Guideline Writing, the Japanese Society of Echocardiography published brief guidance for the routine use of echocardiography equipment in 2015. Recently, the importance of international standardization has been emphasized in the medical laboratories. Accordingly, the committee has revised and updated our guidance for the routine use of echocardiography equipment.

Indian Society of Neuro-Oncology consensus guidelines for the contemporary management of medulloblastoma.

Science.gov (United States)

Gupta, Tejpal; Sarkar, Chitra; Rajshekhar, Vedantam; Chatterjee, Sandip; Shirsat, Neelam; Muzumdar, Dattatreya; Pungavkar, Sona; Chinnaswamy, Girish; Jalali, Rakesh

2017-01-01

The high success rate in the management medulloblastoma achieved in the western world is not exactly mirrored in developing countries including India. Socio-demographic differences, health-care disparity, and lack in uniformity of care with resultant widespread variations in the clinical practice are some of the reasons that may partly explain this difference in outcomes. Patients with medulloblastoma require a multi-disciplinary team approach involving but not limited to neuro-radiology, neurosurgery; neuropathology, molecular biology, radiation oncology, pediatric medical oncology and rehabilitative services for optimizing outcomes. The Indian Society of Neuro-Oncology (ISNO) constituted an expert multi-disciplinary panel with adequate representation from all stakeholders to prepare national consensus guidelines for the contemporary management of medulloblastoma. Minimum desirable, as well as preferable though optional recommendations (as appropriate), were developed and adopted for the pre-surgical work-up including neuroimaging; neurosurgical management including surgical principles, techniques, and complications; neuropathology reporting and molecular testing; contemporary risk-stratification in the molecular era; appropriate adjuvant therapy (radiotherapy and chemotherapy); and follow-up schedule in medulloblastoma. The current document represents a broad consensus reached amongst various stakeholders within the neuro-oncology community involved in the contemporary curative-intent management of children with medulloblastoma. It provides both general as well as specific guidelines and recommendations to be adopted by physicians and health care providers across India to achieve uniformity of care, improve disease-related outcomes, and compare results between institutions within the country.

American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer

NARCIS (Netherlands)

Wolff, Antonio C.; Hammond, M. Elizabeth H.; Schwartz, Jared N.; Hagerty, Karen L.; Allred, D. Craig; Cote, Richard J.; Dowsett, Mitchell; Fitzgibbons, Patrick L.; Hanna, Wedad M.; Langer, Amy; McShane, Lisa M.; Paik, Soonmyung; Pegram, Mark D.; Perez, Edith A.; Press, Michael F.; Rhodes, Anthony; Sturgeon, Catharine; Taube, Sheila E.; Tubbs, Raymond; Vance, Gail H.; van de Vijver, Marc; Wheeler, Thomas M.; Hayes, Daniel F.

2007-01-01

PURPOSE: To develop a guideline to improve the accuracy of human epidermal growth factor receptor 2 (HER2) testing in invasive breast cancer and its utility as a predictive marker. METHODS: The American Society of Clinical Oncology and the College of American Pathologists convened an expert panel,

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics*

OpenAIRE

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-01-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent ...

Guidelines of the French Society of Otorhinolaryngology (SFORL). Managing epistaxis under coagulation disorder due to antithrombotic therapy.

Science.gov (United States)

Escabasse, V; Bequignon, E; Vérillaud, B; Robard, L; Michel, J; Malard, O; Crampette, L

2017-05-01

The authors present the guidelines of the French Society of Otorhinolaryngology concerning the management of epistaxis during antithrombotic therapy. A review of the literature was performed by a multidisciplinary work group. Guidelines were drafted, then re-edited by a reading group independent of the work group to produce the final text. The proposed recommendations were graded A, B, C or expert opinion, on decreasing levels of evidence. Before any decision to modify antithrombotic treatment, it is recommended to screen for overdose and assess the risk of thrombosis. In stented patients, dual antiplatelet therapy must be maintained during the month following stenting and, if possible, for 3 months. In epistaxis with antivitamin K (AVK) overdose controlled by packing, corrective measures are based on the International Normalized Ratio (INR). In uncontrolled epistaxis, it is recommended to stop AVK, administer antidotes and regularly monitor INR. In case of intravascular embolization, it is not recommended to alter anticoagulant treatment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Safety of treatments for inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).

Science.gov (United States)

Biancone, Livia; Annese, Vito; Ardizzone, Sandro; Armuzzi, Alessandro; Calabrese, Emma; Caprioli, Flavio; Castiglione, Fabiana; Comberlato, Michele; Cottone, Mario; Danese, Silvio; Daperno, Marco; D'Incà, Renata; Frieri, Giuseppe; Fries, Walter; Gionchetti, Paolo; Kohn, Anna; Latella, Giovanni; Milla, Monica; Orlando, Ambrogio; Papi, Claudio; Petruzziello, Carmelina; Riegler, Gabriele; Rizzello, Fernando; Saibeni, Simone; Scribano, Maria Lia; Vecchi, Maurizio; Vernia, Piero; Meucci, Gianmichele

2017-04-01

Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs. These observations prompted the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) to establish Italian guidelines on the safety of currently available treatments for Crohn's disease and ulcerative colitis. These guidelines discuss the use of aminosalicylates, systemic and low bioavailability corticosteroids, antibiotics (metronidazole, ciprofloxacin, rifaximin), thiopurines, methotrexate, cyclosporine A, TNFα antagonists, vedolizumab, and combination therapies. These guidelines are based on current knowledge derived from evidence-based medicine coupled with clinical experience of a national working group. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

SCART guidelines. Reference report for IAEA Safety Culture Assessment Review Team (SCART)

International Nuclear Information System (INIS)

2008-01-01

on the SCART Guidelines, which provide overall guidance to ensure the consistency and comprehensiveness of the safety culture review. At the same time, SCART missions are designed to be able to respond to more specific or detailed requirements in accordance with national or regional culture. SCART missions are conducted with the aim to develop recommendations and suggestions in areas of direct relevance to the safety culture of the reviewed nuclear organizations. Commendable good safety culture practices are identified and communicated to other nuclear organizations in order to effect improvements worldwide. SCART is available to all Member States, and to all kinds of organizations, using or regulating the use of nuclear materials (e.g. nuclear facilities, regulatory bodies, nuclear design organizations)

[Preoperative fasting guidelines: an update].

Science.gov (United States)

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

2015-03-01

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

Pediatric parenteral nutrition: clinical practice guidelines from the Spanish Society of Parenteral and Enteral Nutrition (SENPE), the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH)

Science.gov (United States)

Pedrón Giner, Consuelo; Cuervas-Mons Vendrell, Margarita; Galera Martínez, Rafael; Gómez López, Lilianne; Gomis Muñoz, Pilar; Irastorza Terradillos, Iñaki; Martínez Costa, Cecilia; Moreno Villares, José Manuel; Pérez-Portabella Maristany, Cleofé; Pozas Del Río, M ª Teresa; Redecillas Ferreiro, Susana E; Prieto Bozano, Gerardo; Grupo de Estandarización de la Senpe, Senpe

2017-06-05

Introduction:Parenteral nutrition (PN) in childhood is a treatment whose characteristics are highly variable depending on the age and pathology of the patient. Material and methods: The Standardization and Protocols Group of the Spanish Society for Parenteral and Enteral Nutrition (SENPE) is an interdisciplinary group formed by members of the SENPE, the Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH) that intends to update this issue. For this, a detailed review of the literature has been carried out, looking for the evidences that allow us to elaborate a Clinical Practice Guide following the criteria of the Oxford Center for Evidence-Based Medicine. Results: This manuscript summarizes the recommendations regarding indications, access routes, requirements, modifi cations in special situations, components of the mixtures, prescription and standardization, preparation, administration, monitoring, complications and home NP. The complete document is published as a monographic number. Conclusions: This guide is intended to support the prescription of pediatric PN. It provides the basis for rational decisions in the context of the existing evidence. No guidelines can take into account all of the often compelling individual clinical circumstances.

January 2014 pulmonary journal club: interventional guidelines

Directory of Open Access Journals (Sweden)

Mathew M

2014-01-01

Full Text Available No abstract available. Article truncated after 150 words. A few years ago a colleague and I were discussing the shape of healthcare in the USA. One of the comments that was made was "that despite the high costs within our system, that at least there was some standardization in the treatment of certain diseases, for example, receiving Aspirin for an acute myocardial infarction". Guidelines exist to ensure that for certain conditions a standard of care is practiced. When guidelines start to become a measuring stick for what is now considered best practice…..then it our responsibility to ensure that guidelines are rooted on high quality evidence. This paper reviewed the validity of guidelines published and practiced by several of the interventional medical societies including the American Association for Bronchology and Interventional Pulmonology (AABIP, American Society of Diagnostic and Interventional Nephrology (ASDIN, American Society For Gastrointestinal Endoscopy (ASGE and the Society for Cardiovascular Angiography and Interventions (SCAI. A total of ...

Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology.

Science.gov (United States)

Smith, Ian; Kranke, Peter; Murat, Isabelle; Smith, Andrew; O'Sullivan, Geraldine; Søreide, Eldar; Spies, Claudia; in't Veld, Bas

2011-08-01

caesarean section, supplemented with 30 ml of 0.3 mol l(-1) sodium citrate if general anaesthesia is planned. Infants should be fed before elective surgery. Breast milk is safe up to 4 h and other milks up to 6 h. Thereafter, clear fluids should be given as in adults. The guidelines also consider the safety and possible benefits of preoperative carbohydrates and offer advice on the postoperative resumption of oral intake.

Management and follow-up of gallbladder polyps : Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE).

Science.gov (United States)

Wiles, Rebecca; Thoeni, Ruedi F; Barbu, Sorin Traian; Vashist, Yogesh K; Rafaelsen, Søren Rafael; Dewhurst, Catherine; Arvanitakis, Marianna; Lahaye, Max; Soltes, Marek; Perinel, Julie; Roberts, Stuart Ashley

2017-09-01

The management of incidentally detected gallbladder polyps on radiological examinations is contentious. The incidental radiological finding of a gallbladder polyp can therefore be problematic for the radiologist and the clinician who referred the patient for the radiological examination. To address this a joint guideline was created by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE). A targeted literature search was performed and consensus guidelines were created using a series of Delphi questionnaires and a seven-point Likert scale. A total of three Delphi rounds were performed. Consensus regarding which patients should have cholecystectomy, which patients should have ultrasound follow-up and the nature and duration of that follow-up was established. The full recommendations as well as a summary algorithm are provided. These expert consensus recommendations can be used as guidance when a gallbladder polyp is encountered in clinical practice. • Management of gallbladder polyps is contentious • Cholecystectomy is recommended for gallbladder polyps >10 mm • Management of polyps <10 mm depends on patient and polyp characteristics • Further research is required to determine optimal management of gallbladder polyps.

Quality of evidence-based pediatric guidelines

NARCIS (Netherlands)

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

2005-01-01

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

Guidelines for radiation safety in interventional cardiology (JCS 2006)

International Nuclear Information System (INIS)

Nagai, Ryozo; Awai, Kazuo; Iesaka, Yoshihito

2006-01-01

The guidelines are made for physicians in cardiovascular field who may be unfamiliar to radiation safety, to understand and know it easily. The introductory chapter describes the basic knowledge for management of radiation exposure and clinical feature of radiation-induced dermal damages like classification, clinical progress and case presentation. Following chapter is itemized, explained in a style of Q and A, and contains sections of; the fundamental knowledge's of radiation exposure management and of radiation skin damage, informed consent and measures for excessive exposure and skin damage crisis, factors influencing the exposure dose, contrivances to reduce the dose in patients, additional factors affecting the crisis of skin damage, contrivances to reduce the dose in medical personnel exposure, management of imaging instruments, methods to measure the exposure dose in patients, intervention in vessels other than the coronary artery, electro-physiological examinations and treatments, nuclear medical diagnoses, CT examinations, diagnosis and treatment of pregnant women, and present states in other countries. (T.I.)

[How practical guidelines can be applied in poor countries? Example of the introduction of a bronchoscopy unit in Cambodia].

Science.gov (United States)

Couraud, S; Chan, S; Avrillon, V; Horn, K; Try, S; Gérinière, L; Perrot, É; Guichon, C; Souquet, P-J; Ny, C

2013-10-01

According to UN, Cambodia is one of the poorest countries in the World. Respiratory diseases are current public health priorities. In this context, a new bronchoscopy unit (BSU) was created in the respiratory medicine department of Preah Kossamak hospital (PKH) thanks to a tight cooperation between a French and a Cambodian team. Aim of this study was to describe conditions of introduction of this equipment. Two guidelines for practice are available. They are respectively edited by the French and British societies of pulmonology. These guidelines were reviewed and compared to the conditions in which BS was introduced in PKH. Each item from guidelines was combined to a categorical value: "applied", "adapted" or "not applied". In 2009, 54 bronchoscopies were performed in PKH, mainly for suspicion of infectious or tumour disease. In total, 52% and 46% of the French and British guideline items respectively were followed in this Cambodian unit. Patient safety items are those highly followed. By contrast "staff safety" items were those weakly applied. Implementation of EBS in developing countries seems feasible in good conditions of quality and safety for patients. However, some recommendations cannot be applied due to local conditions. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

S3-Guideline on allergy prevention: 2014 update: Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Society for Pediatric and Adolescent Medicine (DGKJ).

Science.gov (United States)

Schäfer, Torsten; Bauer, Carl-Peter; Beyer, Kirsten; Bufe, Albrecht; Friedrichs, Frank; Gieler, Uwe; Gronke, Gerald; Hamelmann, Eckard; Hellermann, Mechthild; Kleinheinz, Andreas; Klimek, Ludger; Koletzko, Sibylle; Kopp, Matthias; Lau, Susanne; Müsken, Horst; Reese, Imke; Schmidt, Sabine; Schnadt, Sabine; Sitter, Helmut; Strömer, Klaus; Vagts, Jennifer; Vogelberg, Christian; Wahn, Ulrich; Werfel, Thomas; Worm, Margitta; Muche-Borowski, Cathleen

The continued high prevalence of allergic diseases in Western industrialized nations combined with the limited options for causal therapy make evidence-based primary prevention necessary. The recommendations last published in the S3-guideline on allergy prevention in 2009 have been revised and a consensus reached on the basis of an up-to-date systematic literature search. Evidence was sought for the period between May 2008 and May 2013 in the Cochrane and MEDLINE electronic databases, as well as in the reference lists of recent review articles. In addition, experts were surveyed for their opinions. The relevance of retrieved literature was checked by means of two filter processes: firstly according to title and abstract, and secondly based on the full text of the articles. Included studies were given an evidence grade, and a bias potential (low/high) was specified for study quality. A formal consensus on the revised recommendations was reached by representatives of the relevant specialist societies and (self-help) organizations (nominal group process). Of 3,284 hits, 165 studies (one meta-analysis, 15 systematic reviews, 31 randomized controlled trials, 65 cohort studies, 12 case-control studies and 41 cross-sectional studies) were included and evaluated. Recommendations on the following remain largely unaltered: full breastfeeding for 4 months as a means of allergy prevention (hypoallergenic infant formula in the case of infants at risk); avoidance of overweight; fish consumption (during pregnancy/lactation and in the introduction of solid foods for infants); vaccination according to the recommendations of the German Standing Committee on Vaccination (Ständige Impfkommission, STIKO); avoidance of air pollutants and tobacco exposure and avoidance of indoor conditions conducive to the development of mold. The assertion that a reduction in house-dust mite allergen content as a primary preventive measure is not recommended also remains unchanged. The introduction of

2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology.

Science.gov (United States)

Green, Martin S; Guerra, Peter G; Krahn, Andrew D

2011-01-01

The last guidelines on training for adult cardiac electrophysiology (EP) were published by the Canadian Cardiovascular Society in 1996. Since then, substantial changes in the knowledge and practice of EP have mandated a review of the previous guidelines by the Canadian Heart Rhythm Society, an affiliate of the Canadian Cardiovascular Society. Novel tools and techniques also now allow electrophysiologists to map and ablate increasingly complex arrhythmias previously managed with pharmacologic or device therapy. Furthermore, no formal attempt had previously been made to standardize EP training across the country. The 2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology represent a consensus arrived at by panel members from both societies, as well as EP program directors across Canada and other select contributors. In describing program requirements, the technical and cognitive skills that must be acquired to meet training standards, as well as the minimum number of procedures needed in order to acquire these skills, the new guidelines provide EP program directors and committee members with a template to develop an appropriate curriculum for EP training for cardiology fellows here in Canada. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

ESRS guidelines for software safety reviews. Reference document for the organization and conduct of Engineering Safety Review Services (ESRS) on software important to safety in nuclear power plants

International Nuclear Information System (INIS)

2000-01-01

The IAEA provides safety review services to assist Member States in the application of safety standards and, in particular, to evaluate and facilitate improvements in nuclear power plant safety performance. Complementary to the Operational Safety Review Team (OSART) and the International Regulatory Review Team (IRRT) services are the Engineering Safety Review Services (ESRS), which include reviews of siting, external events and structural safety, design safety, fire safety, ageing management and software safety. Software is of increasing importance to safety in nuclear power plants as the use of computer based equipment and systems, controlled by software, is increasing in new and older plants. Computer based devices are used in both safety related applications (such as process control and monitoring) and safety critical applications (such as reactor protection). Their dependability can only be ensured if a systematic, fully documented and reviewable engineering process is used. The ESRS on software safety are designed to assist a nuclear power plant or a regulatory body of a Member State in the review of documentation relating to the development, application and safety assessment of software embedded in computer based systems important to safety in nuclear power plants. The software safety reviews can be tailored to the specific needs of the requesting organization. Examples of such reviews are: project planning reviews, reviews of specific issues and reviews prior final acceptance. This report gives information on the possible scope of ESRS software safety reviews and guidance on the organization and conduct of the reviews. It is aimed at Member States considering these reviews and IAEA staff and external experts performing the reviews. The ESRS software safety reviews evaluate the degree to which software documents show that the development process and the final product conform to international standards, guidelines and current practices. Recommendations are

Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases: S2k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto- Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD).

Science.gov (United States)

Pfaar, Oliver; Bachert, Claus; Bufe, Albrecht; Buhl, Roland; Ebner, Christof; Eng, Peter; Friedrichs, Frank; Fuchs, Thomas; Hamelmann, Eckard; Hartwig-Bade, Doris; Hering, Thomas; Huttegger, Isidor; Jung, Kirsten; Klimek, Ludger; Kopp, Matthias Volkmar; Merk, Hans; Rabe, Uta; Saloga, Joachim; Schmid-Grendelmeier, Peter; Schuster, Antje; Schwerk, Nicolaus; Sitter, Helmut; Umpfenbach, Ulrich; Wedi, Bettina; Wöhrl, Stefan; Worm, Margitta; Kleine-Tebbe, Jörg; Kaul, Susanne; Schwalfenberg, Anja

The present guideline (S2k) on allergen-specific immunotherapy (AIT) was established by the German, Austrian and Swiss professional associations for allergy in consensus with the scientific specialist societies and professional associations in the fields of otolaryngology, dermatology and venereology, pediatric and adolescent medicine, pneumology as well as a German patient organization (German Allergy and Asthma Association; Deutscher Allergie- und Asthmabund, DAAB) according to the criteria of the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF). AIT is a therapy with disease-modifying effects. By administering allergen extracts, specific blocking antibodies, toler-ance-inducing cells and mediators are activated. These prevent further exacerbation of the allergen-triggered immune response, block the specific immune response and attenuate the inflammatory response in tissue. Products for SCIT or SLIT cannot be compared at present due to their heterogeneous composition, nor can allergen concentrations given by different manufacturers be compared meaningfully due to the varying methods used to measure their active ingredients. Non-modified allergens are used for SCIT in the form of aqueous or physically adsorbed (depot) extracts, as well as chemically modified allergens (allergoids) as depot extracts. Allergen extracts for SLIT are used in the form of aqueous solutions or tablets. The clinical efficacy of AIT is measured using various scores as primary and secondary study endpoints. The EMA stipulates combined symptom and medication scores as primary endpoint. A harmonization of clinical endpoints, e. g., by using the combined symptom and medication scores (CSMS) recommended by the EAACI, is desirable in the future in order to permit the comparison of results from different studies. The current CONSORT recommendations from the ARIA/GA2LEN group specify standards for the

Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy

Directory of Open Access Journals (Sweden)

Graeme Meintjes

2015-12-01

Full Text Available The most recent version of the Southern African HIV Clinicians Society’s adult antiretroviral therapy (ART guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomised controlled trials that addressed the optimal timing of ART in HIV-infected patients with high CD4 counts were published: Strategic timing of antiretroviral therapy (START and TEMPRANO ANRS 12136 (Early antiretroviral treatment and/or early isoniazid prophylaxis against tuberculosis in HIV-infected adults. The findings of these two trials were consistent: there was significant individual clinical benefit from starting ART immediately in patients with CD4 counts higher than 500 cells/μL rather than deferring until a certain lower CD4 threshold or clinical indication was met. The findings add to prior evidence showing that ART reduces the risk of onward HIV transmission. Therefore, early ART initiation has the public health benefits of potentially reducing both HIV incidence and morbidity. Given this new and important evidence, the Society took the decision to provide a specific update on the section of the adult ART guidelines relating to when ART should be initiated.

Instructional Guidelines. Welding.

Science.gov (United States)

Fordyce, H. L.; Doshier, Dale

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

Guidelines of the French Society of Otorhinolaryngology (SFORL) (short version). Specific treatment of epistaxis in Rendu-Osler-Weber disease.

Science.gov (United States)

Robard, L; Michel, J; Prulière Escabasse, V; Bequignon, E; Vérillaud, B; Malard, O; Crampette, L

2017-02-01

The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) concerning specific treatment of epistaxis in Rendu-Osler-Weber disease. A multidisciplinary work-group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. Rendu-Osler-Weber disease is diagnosed from the presence of at least three of Curaçao's four criteria. In acute epistaxis, bidigital compression is recommended. Embolization is reserved for resistant epistaxis. Non-resorbable nasal packing and cauterization are contraindicated. Patient education is essential. Telangiectasia of the nasal mucosa can be treated by various local means. In the event of insufficient control, systemic administration of tranexamic acid is recommended. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

American Epilepsy Society

Science.gov (United States)

... for the AES Annual Meeting. More info here . Epilepsy Currents American Epilepsy Society Journal Impact Factor More ... P450 enzyme overexpression during spontaneous recurrent seizures More Epilepsy Professional News AES Status Epilepticus guideline for treatment ...

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

Energy Technology Data Exchange (ETDEWEB)

Spada, Cristiano; Barbaro, Federico; Petruzziello, Lucio [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Stoker, Jaap; Haan, Margriet C. de [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Alarcon, Onofre [Universidad de La Laguna, Department of Gastroenterology, Hospital Universitario de Canarias, Facultad de Medicina, La Laguna, Tenerife (Spain); Bellini, Davide; Laghi, Andrea [Sapienza University of Rome, I.C.O.T. Hospital, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Bretthauer, Michael [Oslo University Hospital, Department of Health Economy and Health Management, University of Oslo, and Department of Transplantation Medicine, Gastroenterology Unit, Oslo (Norway); Dumonceau, Jean-Marc [Gedyt Endoscopy Center, Buenos Aires (Argentina); Ferlitsch, Monika [Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna (Austria); Halligan, Steve; Helbren, Emma; Plumb, Andrew; Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); Hellstrom, Mikael [Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Department of Radiology, Gothenburg (Sweden); Kuipers, Ernst J. [Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam (Netherlands); Lefere, Philippe [Virtual Colonoscopy Teaching Centre, Hooglede (Belgium); AZ Delta, Roeselare (Belgium); Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Neri, Emanuele [University of Pisa, Diagnostic and Interventional Radiology, Pisa (Italy); Regge, Daniele [Institute for Cancer Research and Treatment, Candiolo-Torino (Italy); Hassan, Cesare [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Ospedale Nuovo Regina Margherita, Department of Gastroenterology, Rome (Italy)

2014-10-03

Colorectal cancer (CRC) is a major cause of morbidity and mortality [1, 2]. CRC screening by fecal occult blood testing (FOBT) has been shown to reduce CRC mortality [3, 4], and is currently used in several European countries. Colonoscopy is highly effective for detecting advanced neoplasia, and endoscopic polypectomy reduces subsequent CRCspecific incidence and mortality [5]. In Europe, colonoscopy is mainly used to investigate FOBT-positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk [6]. Computed tomographic colonography (CTC) is a minimally invasive imaging technique that is highly accurate for detecting colorectal cancer (CRC) and adenomatous polyps. The technique is standardized [7], and CTC is more easily performed than barium enema. Evidence-based data suggest that CTC is the natural replacement for barium enema and a complementary rather than an alternative examination to colonoscopy. However, the clinical scenarios for which CTC is indicated remain unclear. To address this uncertainty - 20 years after the first presentation of CTC at a radiological meeting [8] - the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) decided to produce a common guideline regarding indications for CTC in clinical practice. Technical and quality issues of CTC have been deliberately excluded from this work as these have already been discussed separately [7].

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

International Nuclear Information System (INIS)

Spada, Cristiano; Barbaro, Federico; Petruzziello, Lucio; Stoker, Jaap; Haan, Margriet C. de; Alarcon, Onofre; Bellini, Davide; Laghi, Andrea; Bretthauer, Michael; Dumonceau, Jean-Marc; Ferlitsch, Monika; Halligan, Steve; Helbren, Emma; Plumb, Andrew; Taylor, Stuart A.; Hellstrom, Mikael; Kuipers, Ernst J.; Lefere, Philippe; Mang, Thomas; Neri, Emanuele; Regge, Daniele; Hassan, Cesare

2015-01-01

Colorectal cancer (CRC) is a major cause of morbidity and mortality [1, 2]. CRC screening by fecal occult blood testing (FOBT) has been shown to reduce CRC mortality [3, 4], and is currently used in several European countries. Colonoscopy is highly effective for detecting advanced neoplasia, and endoscopic polypectomy reduces subsequent CRCspecific incidence and mortality [5]. In Europe, colonoscopy is mainly used to investigate FOBT-positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk [6]. Computed tomographic colonography (CTC) is a minimally invasive imaging technique that is highly accurate for detecting colorectal cancer (CRC) and adenomatous polyps. The technique is standardized [7], and CTC is more easily performed than barium enema. Evidence-based data suggest that CTC is the natural replacement for barium enema and a complementary rather than an alternative examination to colonoscopy. However, the clinical scenarios for which CTC is indicated remain unclear. To address this uncertainty - 20 years after the first presentation of CTC at a radiological meeting [8] - the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) decided to produce a common guideline regarding indications for CTC in clinical practice. Technical and quality issues of CTC have been deliberately excluded from this work as these have already been discussed separately [7].

American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version).

NARCIS (Netherlands)

Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.

2010-01-01

PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition): Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain.

Science.gov (United States)

Narouze, Samer; Benzon, Honorio T; Provenzano, David; Buvanendran, Asokumar; De Andres, José; Deer, Timothy; Rauck, Richard; Huntoon, Marc A

2018-04-01

The American Society of Regional Anesthesia and Pain Medicine (ASRA) 2012 survey of meeting attendees showed that existing ASRA anticoagulation guidelines for regional anesthesia were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors required separate guidelines for pain and spine procedures. In response, a guidelines committee was formed. After preliminary review of published complications reports and studies, the committee stratified interventional spine and pain procedures according to potential bleeding risk: low-, intermediate-, and high-risk procedures. The ASRA regional anesthesia anticoagulation guidelines were largely deemed appropriate for the low- and intermediate-risk categories, but the high-risk category required further investigation. The first guidelines specific to interventional spine and pain procedures were published in 2015. Recent reviews evaluating bleeding complications in patients undergoing specific interventional pain procedures, the development of new regional anesthesia and acute pain guidelines, and the development of new anticoagulants and antiplatelet medications necessitate complementary updated guidelines. The authors desired coordination with the authors of the recently updated regional and acute pain anticoagulation guidelines. The latest evidence was sought through extensive database search strategies and the recommendations were evidence based when available and pharmacology driven otherwise. We could not provide strength and grading of these recommendations because there are not enough well-designed large studies concerning interventional pain procedures to support such grading. Although the guidelines could not always be based on randomized studies or on large numbers of patients from pooled databases, it is hoped that they will provide sound recommendations and the evidentiary basis for such recommendations. This publication is intended as a living document to be updated

Pharmacological Management of Chronic Neuropathic Pain – Consensus Statement and Guidelines from the Canadian Pain Society

Directory of Open Access Journals (Sweden)

DE Moulin

2007-01-01

Full Text Available Neuropathic pain (NeP, generated by disorders of the peripheral and central nervous system, can be particularly severe and disabling. Prevalence estimates indicate that 2% to 3% of the population in the developed world suffer from NeP, which suggests that up to one million Canadians have this disabling condition. Evidence-based guidelines for the pharmacological management of NeP are therefore urgently needed. Randomized, controlled trials, systematic reviews and existing guidelines focusing on the pharmacological management of NeP were evaluated at a consensus meeting. Medications are recommended in the guidelines if their analgesic efficacy was supported by at least one methodologically sound, randomized, controlled trial showing significant benefit relative to placebo or another relevant control group. Recommendations for treatment are based on degree of evidence of analgesic efficacy, safety, ease of use and cost-effectiveness. Analgesic agents recommended for first-line treatments are certain antidepressants (tricyclics and anticonvulsants (gabapentin and pregabalin. Second-line treatments recommended are serotonin noradrenaline reuptake inhibitors and topical lidocaine. Tramadol and controlled-release opioid analgesics are recommended as third-line treatments for moderate to severe pain. Recommended fourth-line treatments include cannabinoids, methadone and anticonvulsants with lesser evidence of efficacy, such as lamotrigine, topiramate and valproic acid. Treatment must be individualized for each patient based on efficacy, side-effect profile and drug accessibility, including cost. Further studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics, long-term outcomes, and treatment of pediatric and central NeP.

Singapore Cancer Network (SCAN) Guidelines for Systemic Therapy of Pancreatic Adenocarcinoma.

Science.gov (United States)

2015-10-01

The SCAN pancreatic cancer workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for systemic therapy for pancreatic adenocarcinoma in Singapore. The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting. Five international guidelines were evaluated- those developed by the National Cancer Comprehensive Network (2014), the European Society of Medical Oncology (2012), Cancer Care Ontario (2013), the Japan Pancreas Society (2013) and the British Society of Gastroenterology, Pancreatic Society of Great Britain and Ireland, and the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (2005). Recommendations on the management of resected, borderline resectable, locally advanced and metastatic pancreatic adenocarcinoma were developed. These adapted guidelines form the SCAN Guidelines for systemic therapy for pancreatic adenocarcinoma in Singapore.

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

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

2017-04-15

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

Comparing the 2010 North American and European atrial fibrillation guidelines.

Science.gov (United States)

Gillis, Anne M; Skanes, Allan C

2011-01-01

This article compares the important differences in the American College of Cardiology Foundation (ACCF)/American Heart Association (AHA)/Heart Rhythm Society (HRS), Canadian Cardiovascular Society (CCS), and European Society of Cardiology (ESC) 2010 guidelines on atrial fibrillation (AF). All guidelines recommend more lenient targets for ventricular rate control although the CCS guidelines recommend a target heart rate at rest guidelines accept a target heart rate at rest guidelines recommend that the choice of antiarrhythmic drug for maintenance of sinus rhythm be based on the underlying cardiovascular disease state. However, the CCS guidelines do not recommend that the use of Class IC drugs or sotalol be restricted in the presence of left ventricular hypertrophy alone. All the guidelines have incorporated dronedarone into their recommendations of antiarrhythmic drug therapy for maintenance of sinus rhythm. However, the CCS guidelines do not make a specific recommendation that the use of dronedarone is reasonable to decrease the risk of hospitalization for cardiovascular causes in patients with AF. The ACCF/AHA/HRS update makes a strong recommendation for catheter ablation in patients with paroxysmal AF who have failed a single anti-arrhythmic drug whereas the CCS and ESC guidelines make this a conditional recommendation. The CCS guidelines are the only guidelines at present that recommend dabigitran for prevention of stroke in high risk patients and suggest that dabigatran is preferred to warfarin for stroke prevention in most patient groups. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Improving the implementation of perioperative safety guidelines using a multifaceted intervention approach: protocol of the IMPROVE study, a stepped wedge cluster randomized trial.

Science.gov (United States)

Emond, Yvette E J J M; Calsbeek, Hiske; Teerenstra, Steven; Bloo, Gerrit J A; Westert, Gert P; Damen, Johan; Wolff, André P; Wollersheim, Hub C

2015-01-08

This study is initiated to evaluate the effects, costs, and feasibility at the hospital and patient level of an evidence-based strategy to improve the use of Dutch perioperative safety guidelines. Based on current knowledge, expert opinions and expertise of the project team, a multifaceted implementation strategy has been developed. This is a stepped wedge cluster randomized trial including nine representative hospitals across The Netherlands. Hospitals are stratified into three groups according to hospital type and geographical location and randomized in terms of the period for receipt of the intervention. All adult surgical patients meeting the inclusion criteria are assessed for patient outcomes. The implementation strategy includes education, audit and feedback, organizational interventions (e.g., local embedding of the guidelines), team-directed interventions (e.g., multi-professional team training), reminders, as well as patient-mediated interventions (e.g., patient safety cards). To tailor the implementation activities, we developed a questionnaire to identify barriers for effective guideline adherence, based on (a) a theoretical framework for classifying barriers and facilitators, (b) an instrument for measuring determinants of innovations, and (c) 19 semi-structured interviews with perioperative key professionals. Primary outcome is guideline adherence measured at the hospital (i.e., cluster) and patient levels by a set of perioperative Patient Safety Indicators (PSIs), which was developed parallel to the perioperative guidelines. Secondary outcomes at the patient level are in-hospital complications, postoperative wound infections and mortality, length of hospital stay, and unscheduled transfer to the intensive care unit, non-elective readmission to the hospital and unplanned reoperation, all within 30 days after the initial surgery. Also, patient safety culture and team climate will be studied as potential determinants. Finally, a process evaluation is

Commentary on recent therapeutic guidelines for osteoarthritis.

Science.gov (United States)

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

2015-06-01

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

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

Energy Technology Data Exchange (ETDEWEB)

Balleyguier, Corinne [Radiology Department, Institut Gustave Roussy, Villejuif (France); Sala, E. [Radiology Department, Addenbrooke' s Hospital, Cambridge (United Kingdom); Cunha, T. da [Radiology Department, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisbon (Portugal); Bergman, A. [Department of Radiology, Uppsala University Hospital (Sweden); Brkljacic, B. [Department of Diagnostic and Interventional Radiology, University Hospital ' ' Dubrava' ' , Zagreb (Croatia); Danza, F. [Dipartimento di Bioimmaginie Scienze Radiologiche, Universita Cattolica del S. Cuore, Rome (Italy); Forstner, R. [Zentralroentgeninstitut, Landeskliniken Salzburg, Salzburg (Austria); Hamm, B. [Department of Radiology, Charite Humboldt Universitaet, Berlin (Germany); Kubik-Huch, R. [Institut Radiologie, Kantonsspital Baden, Baden (Switzerland); Lopez, C.; Manfredi, R. [Department of Radiology, ' ' A. Gemelli' ' University Hospital, Rome (Italy); McHugo, J. [Department of Radiology, Birmingham Women' s Hospital, Birmingham (United Kingdom); Oleaga, L. [Radiology Department, Hospital Clinic, Barcelona (Spain); Togashi, K. [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Graduate School of Medicine, Kyoto (Japan); Kinkel, K. [Institut de Radiologie, Clinique des Grangettes, Geneva (Switzerland)

2011-05-15

To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine cervix) of the pelvic content. Axial T1-weighted sequence is useful to detect suspicious pelvic and abdominal lymph nodes, and images from symphysis to the left renal vein are required. The intravenous administration of Gadolinium-chelates is optional but is often required for small lesions (<2 cm) and for follow-up after treatment. Diffusion-weighted sequences are optional but are recommended to help evaluate lymph nodes and to detect a residual lesion after chemoradiotherapy. Expert consensus and literature review lead to an optimized MRI protocol to stage uterine cervical cancer. MRI is the imaging modality of choice for preoperative staging and follow-up in patients with uterine cervical cancer. (orig.)

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

Science.gov (United States)

Dinis-Ribeiro, M.; Areia, M.; de Vries, A. C.; Marcos-Pinto, R.; Monteiro-Soares, M.; O'Connor, A.; Pereira, C.; Pimentel-Nunes, P.; Correia, R.; Ensari, A.; Dumonceau, J. M.; Machado, J. C.; Macedo, G.; Malfertheiner, P.; Matysiak-Budnik, T.; Megraud, F.; Miki, K.; O'Morain, C.; Peek, R. M.; Ponchon, T.; Ristimaki, A.; Rembacken, B.; Carneiro, F.; Kuipers, E. J.

2012-01-01

Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods. PMID:22198778

Guidelines of the French Speaking Society for Chest Medicine for management of malignant pleural mesothelioma.

Science.gov (United States)

Scherpereel, Arnaud

2007-06-01

Previously considered as a rare tumor, malignant pleural mesothelioma (MPM) has become a very important public health issue. In fact, MPM is a tumor with a poor survival, and its incidence is expected to continue to increase for at least the next 10 years. Asbestos exposure is the main factor involved in MPM pathogenesis. The diagnosis of MPM may be difficult because of differential diagnosis such as pleural benign disease induced by asbestos exposure or pleural metastasis of adenocarcinoma. Management of patients with MPM also remains complicated because they are often referred for evaluation late in the evolution of the disease. Moreover, MPM exhibits a high resistance to radiotherapy and chemotherapy; only few patients are candidates for radical surgery. New therapeutic strategies such as gene or cell therapy are still on clinical trial. Therefore, an optimal treatment of MPM is not clearly defined yet, despite the introduction of recent drugs. Between April 2005 and January 2006, the French Speaking Society for Chest Medicine (SPLF), in collaboration with other French scientific societies, brought together experts on mesothelioma to draw up recommendations in order to provide clinicians with clear, concise, up-to-date guidelines on management of MPM, presented in this report.

ASCOT guidelines

International Nuclear Information System (INIS)

1994-05-01

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

Japanese Guideline for Atopic Dermatitis 2014

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2014-01-01

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

[Recombinant human erythropoietin in neonates: guidelines for clinical practice from the French Society of Neonatology].

Science.gov (United States)

Lopez, E; Beuchée, A; Truffert, P; Pouvreau, N; Patkai, J; Baud, O; Boubred, F; Flamant, C; Jarreau, P-H

2015-10-01

1/To assess the effectiveness and safety of EPO in reducing red blood cell (RBC) transfusions in preterm infants. 2/To provide guidelines for clinical practice in France. 1/This systematic evidence review is based on PubMed search, Cochrane library. 2/Using French National Authority for Health methods concerning guidelines for clinical practice. Early EPO reduced the risk of RBC transfusions, donor exposure, and the number of transfusions in very preterm infants (LE2). Late EPO reduced the risk of RBC transfusions and the number of transfusions in very preterm infants (LE2). There is no difference between the effectiveness of early and late EPO (LE2). There is no difference between high-dose and low-dose EPO (LE2). The level of evidence is too low to recommend the intravenous route. EPO has no impact on the rate of bronchopulmonary dysplasia, necrotizing enterocolitis (LE3), and retinopathy of prematurity (LE2). The level of evidence is too low to recommend EPO for neuroprotection in very preterm or term infants. EPO to reduce RBC transfusion in very preterm infants is recommended (Level A). The optimal time to start therapy is unknown (Level B). The recommended dose is 750IU/kg/week via three subcutaneous injections for 6weeks (Level B). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The role of post-earthquake structural safety in pre-earthquake retrof in decision: guidelines and applications

International Nuclear Information System (INIS)

Bazzurro, P.; Telleen, K.; Maffei, J.; Yin, J.; Cornell, C.A.

2009-01-01

Critical structures such as hospitals, police stations, local administrative office buildings, and critical lifeline facilities, are expected to be operational immediately after earthquakes. Any rational decision about whether these structures are strong enough to meet this goal or whether pre-empitive retrofitting is needed cannot be made without an explicit consideration of post-earthquake safety and functionality with respect to aftershocks. Advanced Seismic Assessment Guidelines offer improvement over previous methods for seismic evaluation of buildings where post-earthquake safety and usability is a concern. This new method allows engineers to evaluate the like hood that a structure may have restricted access or no access after an earthquake. The building performance is measured in terms of the post-earthquake occupancy classifications Green Tag, Yellow Tag, and Red Tag, defining these performance levels quantitatively, based on the structure's remaining capacity to withstand aftershocks. These color-coded placards that constitute an established practice in US could be replaced by the standard results of inspections (A to E) performed by the Italian Dept. of Civil Protection after an event. The article also shows some applications of these Guidelines to buildings of the largest utility company in California, Pacific Gas and Electric Company (PGE). [it

American brachytherapy society (ABS) guidelines for brachytherapy of esophageal cancer

International Nuclear Information System (INIS)

Nag, Subir; Gaspar, Laurie; Herskovic, Arnold; Mantravadi, Prasad; Speiser, Burton

1996-01-01

Introduction: There is wide variation in the indications, techniques, treatment regimens and dosimetry being used to treat cancer of the esophagus and no guidelines exist for optimal therapy. Methods: The Clinical Research Committee of the ABS met to formulate consensus guidelines for brachytherapy in esophageal cancer. Results: Good candidates for brachytherapy include patients with unifocal disease, with thoracic tumor 10 cm primary regional lymph adenopathy or tumor located in the gastro-esophageal junction or cervical esophagus. Contraindications include tracheo-esophageal fistula or stenosis that cannot be by-passed. The esophageal or nasogastric tube inserted should have a diameter of 6-10 mm whenever possible. If 5FU-based chemotherapy and 50 Gy external beam (EBRT) are used, it is suggested that the low dose rate brachytherapy (LDR) dose be 20 Gy at 0.4-1 Gy/hr, prescribed at 1 cm from the source. If high dose rate (HDR) is used, the dose recommended is 10 Gy in 2 weekly fractions of 5 Gy each, given after EBRT. Chemotherapy is not usually given concurrently with brachytherapy, and when it is, the brachytherapy dose is reduced. The length of esophagus treated by brachytherapy includes the post-EBRT involved area and a 1-2 cm margin proximally and distally. Supportive care, given during EBRT includes an antifungal agent (e.g., diflucan) and carafate. Gradual dilatation of the esophagus is required post-treatment for esophageal strictures. Conclusion: Guidelines were developed for brachytherapy in esophageal cancer. As more clinical data becomes available, these guidelines will be updated by the ABS

Japanese guidelines for atopic dermatitis 2017

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2017-04-01

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

2015 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension

Directory of Open Access Journals (Sweden)

Chern-En Chiang

2015-01-01

The TSOC/THS hypertension guidelines provide the most updated information available in the management of hypertension. The guidelines are not mandatory, and members of the task force fully realize that treatment of hypertension should be individualized to address each patient's circumstances. Ultimately, the decision of the physician decision remains of the utmost importance in hypertension management.

[Consensus clinical practice guidelines of the Andalusian Epilepsy Society on prescribing generic antiepileptic drugs].

Science.gov (United States)

Cañadillas-Hidalgo, F M; Sánchez-Alvarez, J C; Serrano-Castro, P J; Mercadé-Cerdá, J M

Pharmaceutical spending in Spain accounts for 1.2-1.4% of the gross domestic product and is increasing by 5-12% per year. One of the measures adopted by the government to cut this spending is the possible substitution of original prescribed drugs by generics. In the case of antiepileptic drugs (AED), which are characterised by a scant therapeutic margin, these steps have sparked a scientific debate about their repercussion on the control of epileptic patients. We propose to draw up a set of implicit evidence-based consensus practice guidelines concerning issues related with this topic. A selective search for quality scientific information on the subject was conducted on PubMed-Medline, Tripdatabase and the Biblioteca Cochrane Plus. The selected references were analysed and discussed by the authors, and the recommendations deriving from them were collected. A total of 21 primary documents and 16 practice guidelines, protocols or experts' recommendations were identified. Our recommendations were explicitly included at the end of the text. The Andalusian Epilepsy Society makes the following recommendations: 1) not replacing an innovative AED by its generic in a controlled patient; 2) beginning treatment with a generic AED in monotherapy or in association is acceptable; 3) not exchanging generic AED from different pharmaceutical companies; 4) explaining to the patient the rules governing the authorization of generics and the importance of avoiding exchanges between different generic AED; and 5) if there is some worsening of the clinical condition or side effects appear following the introduction of a generic, the causes must be investigated and communicated to the bodies responsible for pharmacovigilance.

Diagnostic and therapeutic strategy in Menière's disease. Guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (SFORL).

Science.gov (United States)

Nevoux, J; Franco-Vidal, V; Bouccara, D; Parietti-Winkler, C; Uziel, A; Chays, A; Dubernard, X; Couloigner, V; Darrouzet, V; Mom, T

2017-12-01

The authors present the guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (Société française d'oto-rhino-laryngologie et de chirurgie de la face et du cou: SFORL) for diagnostic and therapeutic strategy in Menière's disease. A work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, then read over by an editorial group independent of the work group. The guidelines were graded according to the literature analysis and recommendations grading guide published by the French National Agency for Accreditation and Evaluation in Health (January 2000). Menière's disease is diagnosed in the presence of the association of four classical clinical items and after eliminating differential diagnoses on MRI. In case of partial presentation, objective audiovestibular tests are recommended. Therapy comprises medical treatment and surgery, either conservative or sacrificing vestibular function. Medical treatment is based on lifestyle improvement, betahistine, diuretics or transtympanic injection of corticosteroids or gentamicin. The main surgical treatments, in order of increasing aggressiveness, are endolymphatic sac surgery, vestibular neurotomy and labyrinthectomy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Current role of MDCT in the diagnosis of coronary artery disease (2011). A clinical guideline of the Austrian Societies of Cardiology and Radiology

International Nuclear Information System (INIS)

Hergan, K.; Globits, S.; Loewe, C.

2011-01-01

The clinical guideline of the Austrian Societies for Cardiology and Radiology on the actual role of MDCT in the diagnosis of coronary artery diseases includes the following issues: CT calcium scoring; CT angiography (CTA) of the coronaries; actually recommended application of MDCR; generally inappropriate use of the technique for specific patients; radiation exposure; structural and organizational framework.

Safety guidelines for magnetic resonance diagnostic facilities (1991)

International Nuclear Information System (INIS)

1992-01-01

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

Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology Position Statement on Dyslipidemia Management: differences between the European and American Guidelines.

Science.gov (United States)

Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

2015-01-01

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.

Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update.

Science.gov (United States)

Toner, James P; Coddington, Charles C; Doody, Kevin; Van Voorhis, Brad; Seifer, David B; Ball, G David; Luke, Barbara; Wantman, Ethan

2016-09-01

The Society for Assisted Reproductive Technology (SART) was established within a few years of assisted reproductive technology (ART) in the United States, and has not only reported on the evolution of infertility care, but also guided it toward improved success and safety. Moving beyond its initial role as a registry, SART has expanded its role to include quality assurance, data validation, practice and advertising guidelines, research, patient education and advocacy, and membership support. The success of ART in this country has greatly benefited from SART's role, as highlighted by a series of graphs. SART continues to set the standard and lead the way. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Nuclear safety policy working group recommendations on nuclear propulsion safety for the space exploration initiative

Science.gov (United States)

Marshall, Albert C.; Lee, James H.; Mcculloch, William H.; Sawyer, J. Charles, Jr.; Bari, Robert A.; Cullingford, Hatice S.; Hardy, Alva C.; Niederauer, George F.; Remp, Kerry; Rice, John W.

1993-01-01

An interagency Nuclear Safety Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative (SEI) nuclear propulsion program. These recommendations, which are contained in this report, should facilitate the implementation of mission planning and conceptual design studies. The NSPWG has recommended a top-level policy to provide the guiding principles for the development and implementation of the SEI nuclear propulsion safety program. In addition, the NSPWG has reviewed safety issues for nuclear propulsion and recommended top-level safety requirements and guidelines to address these issues. These recommendations should be useful for the development of the program's top-level requirements for safety functions (referred to as Safety Functional Requirements). The safety requirements and guidelines address the following topics: reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, safeguards, risk/reliability, operational safety, ground testing, and other considerations.

[The German guideline "legal evaluation after closed head injury"].

Science.gov (United States)

Wallesch, C W; Fries, W; Marx, P; du Mesnil de Rochemont, R; Roschmann, R; Schmidt, R; Schwerdtfeger, K; Tegenthoff, M; Widder, B

2013-09-01

In 2005, the "Deutsche Gesellschaft für Neurowissenschaftliche Begutachtung" (German Society for Neuroscientific Legal Evaluation) together with other Societies published a guideline for the legal evaluation of patients with closed head injuries. Meanwhile, not only scientific progress in imaging techniques but also in other fields such as neuropsychology has necessitated a revision, which is presented here. In the mean time, the handling of guidelines has been systematised in Germany so that a registration with the Cooperation of German Medical Learned Societies is applied for and publication in the German Guideline Registry is expected. © Georg Thieme Verlag KG Stuttgart · New York.

Guidelines for radiological interventions

International Nuclear Information System (INIS)

Kauffmann, G.W.

1998-01-01

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

APSIC guidelines for disinfection and sterilization of instruments in health care facilities

Directory of Open Access Journals (Sweden)

Moi Lin Ling

2018-02-01

Full Text Available Abstract Background The Asia Pacific Society of Infection Control launched its revised Guidelines for Disinfection and Sterilization of Instruments in Health Care Facilities in February 2017. This document describes the guidelines and recommendations for the reprocessing of instruments in healthcare setting. It aims to highlight practical recommendations in a concise format designed to assist healthcare facilities at Asia Pacific region in achieving high standards in sterilization and disinfection. Method The guidelines were revised by an appointed workgroup comprising experts in the Asia Pacific region, following reviews of previously published guidelines and recommendations relevant to each section. Results It recommends the centralization of reprocessing, training of all staff with annual competency assessment, verification of cleaning, continual monitoring of reprocessing procedures to ensure their quality and a corporate strategy for dealing with single-use and single-patient use medical equipment/devices. Detailed recommendations are also given with respect to reprocessing of endoscopes. Close working with the Infection Prevention & Control department is also recommended where decisions related to reprocessing medical equipment/devices are to be made. Conclusions Sterilization facilities should aim for excellence in practices as this is part of patient safety. The guidelines that come with a checklist help service providers identify gaps for improvement to reach this goal.

Follow-up of patients with adrenal incidentaloma, in accordance with the European society of endocrinology guidelines: Could we be safe?

Science.gov (United States)

Morelli, V; Scillitani, A; Arosio, M; Chiodini, I

2017-03-01

Recently, the European Society of Endocrinology (ESE) published new guidelines on the management of adrenal incidentalomas. At the same time Lopez and coworkers published on the Annals of Internal Medicine an important study showing that even patients with non-functioning adrenal tumors have an increased risk of incident diabetes. In consideration of previous data and of the results of the study of Lopez and coworkers, some points emerge from the ESE Guidelines that deserve attention. Firstly, it must be observed that the term "autonomous cortisol secretion," introduced by the ESE Panel in the place of the commonly used "subclinical hypercortisolism," seems questionable, since the guidelines do not suggest determining the adrenocorticotroph hormone levels that could give the certain proof of a truly autonomous cortisol secretion. Secondly, the ESE Guidelines suggest against repeated hormonal workup in AI patients with a normal hormonal secretion at initial evaluation, but also in those with a "possible autonomous cortisol secretion," if in the absence of comorbidities potentially related to hypercortisolism. Thirdly, the ESE Guidelines suggest against further imaging during follow-up in patients with an adrenal mass below 4 cm in size with clear benign features on imaging studies. Considering the available literature data that are briefly summarized in this comment, we believe that no sufficient evidence is available to date for giving sharp-cutting recommendations about the uselessness of a biochemical and morphological follow-up in AI patients, even in those with initially benign and not hypersecreting adrenal adenomas. However, if a recommendation has to be given on the basis of the present evidences, we should suggest to biochemically and morphologically follow-up AI patients for at least 5 years.

An audit of skeletal surveys for suspected non-accidental injury following publication of the British Society of Paediatric Radiology guidelines

International Nuclear Information System (INIS)

Swinson, S.; Tapp, M.; Brindley, R.; Chapman, S.; Offiah, A.; Johnson, K.

2008-01-01

Aim: To audit change in the content and standard of skeletal surveys in the UK following the publication of the British Society of Paediatric Radiology (BSPR) guidelines for skeletal surveys in suspected non-accidental injury. Materials and methods: One hundred skeletal surveys, which were performed throughout England and Wales between February 2004 and September 2006 and received for a second opinion at a single children's hospital, were reviewed. The views obtained were compared with the defined reference standard 20 views as recommended by the BSPR. Additionally, each view was assessed for technical quality out of a maximum score of 11. The results were compared with an earlier study published prior to the definitive guideline. Additional information included whether images were film or digital and whether a computed tomography examination of the head was documented. Results: A mean of 16.5 (range 5-20) of the 20 recommended views were covered per survey and 15% of surveys included all 20 recommended views (previously 0%). The mean technical score per film was 9.7/11 (88%). Sixty-two percent of the skeletal surveys were digitally acquired and 59% included a CT examination of the head. Conclusion: There is still considerable variation in skeletal surveys performed in the UK, but progress has been observed in all areas in the light of the BSPR guidelines. There remains room for improvement, and further publicity of the guidelines is recommended

An audit of skeletal surveys for suspected non-accidental injury following publication of the British Society of Paediatric Radiology guidelines

Energy Technology Data Exchange (ETDEWEB)

Swinson, S. [Birmingham Children' s Hospital, Birmingham (United Kingdom)], E-mail: sophieswinson@doctors.org.uk; Tapp, M.; Brindley, R.; Chapman, S. [Birmingham Children' s Hospital, Birmingham (United Kingdom); Offiah, A. [Great Ormond Street Hospital, London (United Kingdom); Johnson, K. [Birmingham Children' s Hospital, Birmingham (United Kingdom)

2008-06-15

Aim: To audit change in the content and standard of skeletal surveys in the UK following the publication of the British Society of Paediatric Radiology (BSPR) guidelines for skeletal surveys in suspected non-accidental injury. Materials and methods: One hundred skeletal surveys, which were performed throughout England and Wales between February 2004 and September 2006 and received for a second opinion at a single children's hospital, were reviewed. The views obtained were compared with the defined reference standard 20 views as recommended by the BSPR. Additionally, each view was assessed for technical quality out of a maximum score of 11. The results were compared with an earlier study published prior to the definitive guideline. Additional information included whether images were film or digital and whether a computed tomography examination of the head was documented. Results: A mean of 16.5 (range 5-20) of the 20 recommended views were covered per survey and 15% of surveys included all 20 recommended views (previously 0%). The mean technical score per film was 9.7/11 (88%). Sixty-two percent of the skeletal surveys were digitally acquired and 59% included a CT examination of the head. Conclusion: There is still considerable variation in skeletal surveys performed in the UK, but progress has been observed in all areas in the light of the BSPR guidelines. There remains room for improvement, and further publicity of the guidelines is recommended.

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

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika

2007-01-15

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

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

Science.gov (United States)

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

2007-06-01

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

The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer.

Science.gov (United States)

Brunelli, Alessandro; Charloux, Anne; Bolliger, Chris T; Rocco, Gaetano; Sculier, Jean-Paul; Varela, Gonzalo; Licker, Marc; Ferguson, Mark K; Faivre-Finn, Corinne; Huber, Rudolf Maria; Clini, Enrico M; Win, Thida; De Ruysscher, Dirk; Goldman, Lee

2009-07-01

The European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS) established a joint task force with the purpose to develop clinical evidence-based guidelines on evaluation of fitness for radical therapy in patients with lung cancer. The following topics were discussed, and are summarized in the final report along with graded recommendations: Cardiologic evaluation before lung resection; lung function tests and exercise tests (limitations of ppoFEV1; DLCO: systematic or selective?; split function studies; exercise tests: systematic; low-tech exercise tests; cardiopulmonary (high tech) exercise tests); future trends in preoperative work-up; physiotherapy/rehabilitation and smoking cessation; scoring systems; advanced care management (ICU/HDU); quality of life in patients submitted to radical treatment; combined cancer surgery and lung volume reduction surgery; compromised parenchymal sparing resections and minimally invasive techniques: the balance between oncological radicality and functional reserve; neoadjuvant chemotherapy and complications; definitive chemo and radiotherapy: functional selection criteria and definition of risk; should surgical criteria be re-calibrated for radiotherapy?; the patient at prohibitive surgical risk: alternatives to surgery; who should treat thoracic patients and where these patients should be treated?

April 2014 Arizona thoracic society notes

Directory of Open Access Journals (Sweden)

Robbins RA

2014-04-01

Full Text Available No abstract available. Article truncated at 150 words. The April 2014 Arizona Thoracic Society meeting was held on Wednesday, 4/23/2014 at Scottsdale Shea Hospital beginning at 6:30 PM. There were 15 in attendance representing the pulmonary, critical care, sleep, pathology and radiology communities. It was announced that there will be a wine tasting with the California, New Mexico and Colorado Thoracic Societies at the American Thoracic Society International Meeting. The tasting will be led by Peter Wagner and is scheduled for the Cobalt Room in the Hilton San Diego Bayfront on Tuesday, May 20, from 4-8 PM. Guideline development was again discussed. The consensus was to await publication of the IDSA Cocci Guidelines and respond appropriately. George Parides, Arizona Chapter Representative, gave a presentation on Hill Day. Representatives of the Arizona, New Mexico and Washington Thoracic Societies met with their Congressional delegations, including Rep. David Schweikert, to discuss the Cigar Bill, NIH funding, and the Medicare Sustainable Growth ...

Admission, discharge and triage guidelines for paediatric intensive care units in Spain.

Science.gov (United States)

de la Oliva, Pedro; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Rey-Galán, Corsino; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; de Carlos-Vicente, Juan Carlos; Hernández-Rastrollo, Ramón; Holanda-Peña, María Soledad; Pilar-Orive, Francisco Javier; Ocete-Hita, Esther; Rodríguez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis

2018-05-01

A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Swiss guideline: Protection objectives for the disposal of radioactive waste

International Nuclear Information System (INIS)

Zurkinden, A.

1994-01-01

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

Guideline for stress ulcer prophylaxis in the intensive care unit

DEFF Research Database (Denmark)

Madsen, Kristian Rørbaek; Lorentzen, Kristian; Clausen, Niels

2014-01-01

Stress ulcer prophylaxis (SUP) is commonly used in the intensive care unit (ICU), and is recommended in the Surviving Sepsis Campaign guidelines 2012. The present guideline from the Danish Society of Intensive Care Medicine and the Danish Society of Anesthesiology and Intensive Care Medicine sums...

ACC/AHA guidelines superior to ESC/EAS guidelines for primary prevention with statins in non-diabetic Europeans

DEFF Research Database (Denmark)

Mortensen, Martin Bødtker; Nordestgaard, Børge G; Afzal, Shoaib

2017-01-01

Aim We compared the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and the 2016 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines on prevention of atherosclerotic cardiovascular disease (ASCVD) using different risk prediction models [US......-calibrated around decision thresholds for statin therapy. For a Class I recommendation, 42% of individuals qualified for statins using the ACC/AHA guidelines vs. 6% with the ESC/EAS guidelines. Using ACC/AHA- vs. ESC/EAS-defined statin eligibility led to a substantial gain in sensitivity (+62% for any ASCVD and+76......% for fatal ASCVD) with a smaller loss in specificity (-35% for any ASCVD and -36% for fatal ASCVD). Similar differences between the ACC/AHA and ESC/EAS guidelines were found for men and women separately, and for Class IIa recommendations. The sensitivity and specificity of a US-PCE risk of 5% were similar...

Comparison of evaluation guidelines for life-safety seismic hazards

International Nuclear Information System (INIS)

Wyllie, L.A.; Love, R.J.

1989-01-01

The guidelines presented in Design Evaluation guidelines for Department of Energy Facilities Subjected to natural Phenomena Hazards (UCRL 15910 Draft; May 1989) include evaluation criteria for existing Department of Energy buildings subjected to earthquakes. These criteria were developed at the Lawrence Livermore National Laboratory for use in both the seismic design of new structures and the evaluation of existing structures. ATC-14: Evaluating The Seismic Resistance of Existing Buildings developed by the Applied Technology Council, consists of guidelines and criteria for identifying the buildings or building components that present unacceptable risk to human lives. This paper compares and contrasts the two evaluation guidelines for existing buildings using a prototype building as an example. The prototype building is a seven story, concrete shear wall building assuming a General Use Occupancy

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia - a short version for primary care.

Science.gov (United States)

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthøj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

2017-06-01

Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose of this publication is to offer relevant evidence-based recommendations for the biological treatment of schizophrenia in primary care. This publication is a short and practice-oriented summary of Parts I-III of the World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. The recommendations were developed by the authors and consented by a task force of international experts. Guideline recommendations are based on randomized-controlled trials and supplemented with non-randomized trials and meta-analyses where necessary. Antipsychotics of different chemical classes are the first-line pharmacological treatments for schizophrenia. Specific circumstances (e.g., suicidality, depression, substance dependence) may need additional treatment options. The pharmacological and non-pharmacological management of side effects is of crucial importance for the long-term treatment in all settings of the healthcare system. This summary of the three available evidence-based guidelines has the potential to support clinical decisions and can improve treatment of schizophrenia in primary care settings.

Efficacy and safety testing of mycotoxin-detoxifying agents in broilers following the European Food Safety Authority guidelines.

Science.gov (United States)

Osselaere, A; Devreese, M; Watteyn, A; Vandenbroucke, V; Goossens, J; Hautekiet, V; Eeckhout, M; De Saeger, S; De Baere, S; De Backer, P; Croubels, S

2012-08-01

Contamination of feeds with mycotoxins is a worldwide problem and mycotoxin-detoxifying agents are used to decrease their negative effect. The European Food Safety Authority recently stated guidelines and end-points for the efficacy testing of detoxifiers. Our study revealed that plasma concentrations of deoxynivalenol and deepoxy-deoxynivalenol were too low to assess efficacy of 2 commercially available mycotoxin-detoxifying agents against deoxynivalenol after 3 wk of continuous feeding of this mycotoxin at concentrations of 2.44±0.70 mg/kg of feed and 7.54±2.20 mg/kg of feed in broilers. This correlates with the poor absorption of deoxynivalenol in poultry. A safety study with 2 commercially available detoxifying agents and veterinary drugs showed innovative results with regard to the pharmacokinetics of 2 antibiotics after oral dosing in the drinking water. The plasma and kidney tissue concentrations of oxytetracycline were significantly higher in broilers receiving a biotransforming agent in the feed compared with control birds. For amoxicillin, the plasma concentrations were significantly higher for broilers receiving an adsorbing agent in comparison to birds receiving the biotransforming agent, but not to the control group. Mycotoxin-detoxifying agents can thus interact with the oral bioavailability of antibiotics depending on the antibiotic and detoxifying agent, with possible adverse effects on the health of animals and humans.

Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology position statement on dyslipidemia management. Differences between the European and American guidelines.

Science.gov (United States)

Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

2014-11-01

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

[Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology position statement on dyslipidemia management. Differences between the European and American guidelines].

Science.gov (United States)

Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

2015-01-01

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Full English text available from:www.revespcardiol.org/en. Copyright © 2014. Published by Elsevier España.

Management consensus guideline for hepatocellular carcinoma: 2016 updated by the Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan

Directory of Open Access Journals (Sweden)

Sheng-Nan Lu

2018-05-01

Full Text Available Background: Hepatocellular carcinoma (HCC is one of the leading causes of cancer-related mortality in Taiwan. To help clinical physicians to manage patients with HCC, the Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan produced the management consensus guideline for HCC. Methods: The recommendations focus on nine important issues on management of HCC, including surveillance, diagnosis, staging, surgery, local ablation, transarterial chemoembolization/transarterial radioembolization/hepatic arterial infusion chemotherapy, systemic therapy, radiotherapy, and prevention. Results: The consensus statements were discussed, debated and got consensus in each expert team. And then the statements were sent to all of the experts for further discussion and refinement. Finally, all of the experts were invited to vote for the statements, including the level of evidence and recommendation. Conclusion: With the development of the management consensus guideline, HCC patients could benefit from the optimal therapeutic modality. Keywords: Diagnosis, Hepatocellular carcinoma, Staging, Surveillance, Treatment

Testing post-editing guidelines

DEFF Research Database (Denmark)

Flanagan, Marian; Christensen, Tina Paulsen

2014-01-01

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

European Society of Endocrinology Clinical Practice Guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma.

Science.gov (United States)

Plouin, P F; Amar, L; Dekkers, O M; Fassnacht, M; Gimenez-Roqueplo, A P; Lenders, J W M; Lussey-Lepoutre, C; Steichen, O

2016-05-01

Phaeochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumours. Standard treatment is surgical resection. Following complete resection of the primary tumour, patients with PPGL are at risk of developing new tumoural events. The present guideline aims to propose standardised clinical care of long-term follow-up in patients operated on for a PPGL. The guideline has been developed by The European Society of Endocrinology and based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles. We performed a systematic review of the literature and analysed the European Network for the Study of Adrenal Tumours (ENS@T) database. The risk of new events persisted in the long term and was higher for patients with genetic or syndromic diseases. Follow-up in the published cohorts and in the ENS@T database was neither standardised nor exhaustive, resulting in a risk of follow-up bias and in low statistical power beyond 10 years after complete surgery. To inform patients and care providers in this context of low-quality evidence, the Guideline Working Group therefore prepared recommendations on the basis of expert consensus. Key recommendations are the following: we recommend that all patients with PPGL be considered for genetic testing; we recommend assaying plasma or urinary metanephrines every year to screen for local or metastatic recurrences or new tumours; and we suggest follow-up for at least 10 years in all patients operated on for a PPGL. High-risk patients (young patients and those with a genetic disease, a large tumour and/or a paraganglioma) should be offered lifelong annual follow-up. © 2016 European Society of Endocrinology.

Interaction of national and foreign safety guidelines

International Nuclear Information System (INIS)

Domaratzki, Z.

1991-01-01

A commercial contract for a nuclear power plant includes an agreement on the appropriate safety requirements with which the plant must conform. This may involve adopting the safety requirements of the exporting country, the importing country or a combination of the two sets of safety requirements. To ensure that a high level of safety is achieved it is appropriate that the regulatory authorities in the two countries should establish a co-operative arrangement which will extend for the life of the plant. The regulatory authority in the importing country will need to develop a good understanding of the design, safety analysis and operating history of the reactor type which is being purchased. The regulator in the exporting country can be of great assistance in this regard. The co-operative arrangement should extend into the commissioning and operating stage at which point there will be a two way flow of information. During the operating stage information exchange should include significant operating events, operating problems, new safety related research information, necessary design changes and the results of periodic updating of the safety analysis. In some cases the co-operation should extend to training of regulatory staff. The choice of national versus foreign safety requirements may be important. However, if the two regulatory authorities are to discharge their legal and moral safety responsibilities it is at least equally important to maintain a co-operative arrangement for the life of the plant. (author)

Wilderness Medical Society practice guidelines for the use of epinephrine in outdoor education and wilderness settings: 2014 update.

Science.gov (United States)

Gaudio, Flavio G; Lemery, Jay; Johnson, David E

2014-12-01

The Epinephrine Roundtable took place on July 27, 2008, during the 25th Annual Meeting of the Wilderness Medical Society (WMS) in Snowmass, CO. The WMS convened this roundtable to explore areas of consensus and uncertainty in the field treatment of anaphylaxis. Panelists were selected on the basis of their relevant academic or professional experience. There is a paucity of data that address the treatment of anaphylaxis in the wilderness. Anaphylaxis is a rare disease, with a sudden onset and drastic course that does not lend itself to study in randomized, controlled trials. Therefore, the panel endorsed the following position based on the limited available evidence and review of published articles, as well as expert consensus. The position represents the consensus of the panelists and is endorsed by the WMS. In 2014, the authors reviewed relevant articles published since the Epinephrine Roundtable. The following is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2010;21(4):185-187. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Methodological guidelines for developing accident modification functions

DEFF Research Database (Denmark)

Elvik, Rune

2015-01-01

This paper proposes methodological guidelines for developing accident modification functions. An accident modification function is a mathematical function describing systematic variation in the effects of road safety measures. The paper describes ten guidelines. An example is given of how to use...... limitations in developing accident modification functions are the small number of good evaluation studies and the often huge variation in estimates of effect. It is therefore still not possible to develop accident modification functions for very many road safety measures. © 2015 Elsevier Ltd. All rights...... the guidelines. The importance of exploratory analysis and an iterative approach in developing accident modification functions is stressed. The example shows that strict compliance with all the guidelines may be difficult, but represents a level of stringency that should be strived for. Currently the main...

The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the treatment of adolescent sexual offenders with paraphilic disorders

Science.gov (United States)

Thibaut, Florence; Bradford, John M. W.; Briken, Peer; De La Barra, Flora; Häßler, Frank; Cosyns, Paul

2016-01-01

Abstract The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults. In part, the challenge relates to adolescents being in various stages of puberty and development, which may limit the use of certain pharmacological agents due to their potential side effects. In addition, most of the published treatment programmes have used cognitive behavioural interventions, family therapies and psychoeducational interventions. Psychological treatment is predicated in adolescents on the notion that sexually deviant behaviour can be controlled by the offender, and that more adaptive behaviours can be learned. The main purposes of these guidelines are to improve the quality of care and to aid physicians in their clinical decisions. These guidelines brought together different expert views and involved an extensive literature research. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for efficacy, safety, tolerability and feasibility. An algorithm is proposed for the treatment of paraphilic disorders in adolescent sexual offenders or those who are at risk. PMID:26595752

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

Science.gov (United States)

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

2016-04-01

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

Comparison of Performance Characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association Guidelines.

Science.gov (United States)

Middleton, William D; Teefey, Sharlene A; Reading, Carl C; Langer, Jill E; Beland, Michael D; Szabunio, Margaret M; Desser, Terry S

2018-05-01

The American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) provides guidelines to practitioners who interpret sonographic examinations of thyroid nodules. The purpose of this study is to compare the ACR TI-RADS system with two other well-established guidelines. The ACR TI-RADS, the Korean Society of Thyroid Radiology (KSThR) Thyroid Imaging Reporting and Data System (TIRADS), and the American Thyroid Association guidelines were compared using 3422 thyroid nodules for which pathologic findings were available. The composition, echogenicity, margins, echogenic foci, and size of the nodules were assessed to determine whether a recommendation would be made for fine-needle aspiration or follow-up sonography when each system was used. The biopsy yield of malignant findings, the yield of follow-up, and the percentage of malignant and benign nodules that would be biopsied were determined for all nodules and for nodules 1 cm or larger. The percentage of nodules that could not be classified was 0%, 3.9%, and 13.9% for the ACR TI-RADS, KSThR TIRADS, and ATA guidelines, respectively. The biopsy yield of malignancy was 14.2%, 10.2%, and 10.0% for nodules assessed by the ACR TI-RADS, KSThR TIRADS, and ATA guidelines, respectively. The percentage of malignant nodules that were biopsied was 68.2%, 78.7%, and 75.9% for the ACR TI-RADS, the KSThR TIRADS, and the ATA guidelines, respectively, whereas the percentage of malignant nodules that would be either biopsied or followed was 89.2% for the ACR TI-RADS. The percentage of benign nodules that would be biopsied was 47.1%, 79.7%, and 78.1% for the ACR TI-RADS, the KSThR TIRADS, and the ATA guidelines, respectively. The percentage of benign nodules that would be either biopsied or followed was 65.2% for the ACR TI-RADS. The ACR TI-RADS performs well when compared with other well-established guidelines.

Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics.

Science.gov (United States)

Indinnimeo, Luciana; Chiappini, Elena; Miraglia Del Giudice, Michele

2018-04-06

Acute asthma attack is a frequent condition in children. It is one of the most common reasons for emergency department (ED) visit and hospitalization. Appropriate care is fundamental, considering both the high prevalence of asthma in children, and its life-threatening risks. Italian Society of Pediatrics recently issued a guideline on the management of acute asthma attack in children over age 2, in ambulatory and emergency department settings. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was adopted. A literature search was performed using the Cochrane Library and Medline/PubMed databases, retrieving studies in English or Italian and including children over age 2 year. Inhaled ß 2 agonists are the first line drugs for acute asthma attack in children. Ipratropium bromide should be added in moderate/severe attacks. Early use of systemic steroids is associated with reduced risk of ED visits and hospitalization. High doses of inhaled steroids should not replace systemic steroids. Aminophylline use should be avoided in mild/moderate attacks. Weak evidence supports its use in life-threatening attacks. Epinephrine should not be used in the treatment of acute asthma for its lower cost / benefit ratio, compared to β 2 agonists. Intravenous magnesium solphate could be used in children with severe attacks and/or forced expiratory volume1 (FEV1) lower than 60% predicted, unresponsive to initial inhaled therapy. Heliox could be administered in life-threatening attacks. Leukotriene receptor antagonists are not recommended. This Guideline is expected to be a useful resource in managing acute asthma attacks in children over age 2.

[Invasive candidiasis in non-neutropenic adults : Guideline-based management in the intensive care unit].

Science.gov (United States)

Glöckner, A; Cornely, O A

2013-12-01

Invasive Candida infections represent a diagnostic and therapeutic challenge for clinicians particularly in the intensive care unit (ICU). Despite substantial advances in antifungal agents and treatment strategies, invasive candidiasis remains associated with a high mortality. Recent guideline recommendations on the management of invasive candidiasis by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) from 2012, the German Speaking Mycological Society and the Paul Ehrlich Society for Chemotherapy (DMykG/PEG) from 2011 and the Infectious Diseases Society of America (IDSA) from 2009 provide valuable guidance for diagnostic procedures and treatment of these infections but need to be interpreted in the light of the individual situation of the patient and the local epidemiology of fungal pathogens. The following recommendations for management of candidemia are common to all three guidelines. Any positive blood culture for Candida indicates disseminated infection or deep organ infection and requires antifungal therapy. Treatment should be initiated as soon as possible. Removal or changing of central venous catheters or other foreign material in the bloodstream is recommended whenever possible. Ophthalmological examination for exclusion of endophthalmitis and follow-up blood cultures during therapy are also recommended. Duration of therapy should be 14 days after clearance of blood cultures and resolution of symptoms. Consideration of surgical options and a prolonged antifungal treatment (weeks to months) are required when there is organ involvement. During the last decade several new antifungal agents were introduced into clinical practice. These innovative drugs showed convincing efficacy and favorable safety in randomized clinical trials. Consequently, they were integrated in recent therapeutic guidelines, often replacing former standard drugs as first-line options. Echinocandins have emerged as the generally preferred primary treatment in

Canadian Headache Society guideline for migraine prophylaxis.

Science.gov (United States)

Pringsheim, Tamara; Davenport, W Jeptha; Mackie, Gordon; Worthington, Irene; Aubé, Michel; Christie, Suzanne N; Gladstone, Jonathan; Becker, Werner J

2012-03-01

The primary objective of this guideline is to assist the practitioner in choosing an appropriate prophylactic medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. This guideline is focused on patients with episodic migraine (headache on ≤ 14 days a month). Through a comprehensive search strategy, randomized, double blind, controlled trials of drug treatments for migraine prophylaxis and relevant Cochrane reviews were identified. Studies were graded according to criteria developed by the US Preventive Services Task Force. Recommendations were graded according to the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. In addition, a general literature review and expert consensus were used for aspects of prophylactic therapy for which randomized controlled trials are not available. Prophylactic drug choice should be based on evidence for efficacy, side-effect profile, migraine clinical features, and co-existing disorders. Based on our review, 11 prophylactic drugs received a strong recommendation for use (topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, butterbur, riboflavin, coenzyme Q10, and magnesium citrate) and 6 received a weak recommendation (divalproex sodium, flunarizine, pizotifen, venlafaxine, verapamil, and lisinopril). Quality of evidence for different medications varied from high to low. Prophylactic treatment strategies were developed to assist the practitioner in selecting a prophylactic drug for specific clinical situations. These strategies included: first time strategies for patients who have not had prophylaxis before (a beta-blocker and a tricyclic strategy), low side effect strategies (including both drug and herbal/vitamin/mineral strategies), a strategy for patients with high body mass index, strategies for patients with co-existent hypertension or with co-existent depression and /or

Comparison of Western and Asian Guidelines Concerning the Management of Colon Cancer.

Science.gov (United States)

Pellino, Gianluca; Warren, Oliver; Mills, Sarah; Rasheed, Shahnawaz; Tekkis, Paris P; Kontovounisios, Christos

2018-02-01

Guidelines are important to standardize treatments and optimize outcomes. Several societies have published authoritative guidelines for patients with colon cancer, and a certain degree of variation can be predicted. This study aims to compare Western and Asian guidelines for the management of colon cancer. A literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies published between 2010 and 2017 by the online resources from the official Web sites of the societies/panels. Sources included guidelines by European Society of Medical Oncology, the Japanese Society for Cancer of the Colon and Rectum, and the National Comprehensive Cancer Network. Only full-text studies and the latest guidelines dealing with colon cancer were included. Studies and guidelines were separately assessed by 2 authors, who independently identified discrepancies and areas for further research. These were discussed and agreed with by all the authors. The recommendations of the guidelines of each society were compared, seeking discrepancies and potential areas for improvement. Endoscopic techniques for the management of early colon cancer are discussed in detail in the Asian guidelines. Asian guidelines advocate extended (D3) lymphadenectomy on a routine basis in T3/T4 and in selected T2 patients, whereas such an approach is still under investigation in Western countries. Only US guidelines describe neoadjuvant chemotherapy and radiotherapy. All the guidelines recommend adjuvant treatment in selected stage II patients, but agreement exists that this is performed without solid evidence, because better outcomes are hypothesized based on studies including stage III or stage II/III patients. The role of cytoreductive surgery with intra-abdominal chemotherapy is dubious, and European guidelines only recommend it in the setting of trials. Asian guidelines endorse an aggressive surgical approach to peritoneal disease. Only US

SARIS Guidelines. 2014 Ed

International Nuclear Information System (INIS)

2014-01-01

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

Utilization of the American Telemedicine Association's Clinical Practice Guidelines

Science.gov (United States)

Antoniotti, Nina; Bernard, Jordana

2013-01-01

Abstract Background: The American Telemedicine Association (ATA) Standards and Guidelines Committee develops practice standards and guidelines. Key to the Committee's mission is dissemination so the standards can be used in the practice of telemedicine. Over a 2-year period, when a standards document was accessed from the ATA Web site, a short survey was completed, but it did not assess how the documents were used once downloaded. A more formal survey was conducted to determine the impact ATA standards and guidelines are having on healthcare delivery via telemedicine. Materials and Methods: A survey was developed and distributed via SurveyMonkey to 13,177 ATA members and nonmembers in November 2011. Results were compiled and analyzed after a 90-day open period for responses to be submitted. Results: The majority of respondents (96%) believe the practice of telemedicine/telehealth should have standards and guidelines and that the ATA and other professional societies/associations should be responsible for developing them. The top uses of guidelines include guidance for clinical practice, training, gaining reimbursement, and research. Respondents indicating a need for standards and guidelines said the ATA (78.7%) and other professional societies/associations (74.5%) should be responsible for development. When asked to list specific practice guidelines or standards they are using for telehealth, the majority (21.5%) are using in-house (e.g., hospital, company)-developed guidelines, followed by those from professional associations/societies (20.4%) and those developed by the ATA (18.2%). Conclusions: Overall, the survey results indicate guidelines documents developed by the ATA and other professional societies and those developed in-house are being regularly accessed and used in both public and private sectors. Practitioners of telemedicine believe that standards and guidelines are needed for guidance for clinical practice, training, gaining reimbursement, and research

Assessing the cost of implementing the 2011 Society of Obstetricians and Gynecologists of Canada and Canadian College of Medical Genetics practice guidelines on the detection of fetal aneuploidies.

Science.gov (United States)

Lilley, Margaret; Hume, Stacey; Karpoff, Nina; Maire, Georges; Taylor, Sherry; Tomaszewski, Robert; Yoshimoto, Maisa; Christian, Susan

2017-09-01

The Society of Obstetricians and Gynecologists of Canada and the Canadian College of Medical Genetics published guidelines, in 2011, recommending replacement of karyotype with quantitative fluorescent polymerase chain reaction when prenatal testing is performed because of an increased risk of a common aneuploidy. This study's objective is to perform a cost analysis following the implementation of quantitative fluorescent polymerase chain reaction as a stand-alone test. A total of 658 samples were received between 1 April 2014 and 31 August 2015: 576 amniocentesis samples and 82 chorionic villi sampling. A chromosome abnormality was identified in 14% (93/658) of the prenatal samples tested. The implementation of the 2011 Society of Obstetricians and Gynecologists of Canada and the Canadian College of Medical Genetics guidelines in Edmonton and Northern Alberta resulted in a cost savings of $46 295.80. The replacement of karyotype with chromosomal microarray for some indications would be associated with additional costs. The implementation of new test methods may provide cost savings or added costs. Cost analysis is important to consider during the implementation of new guidelines or technologies. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

European guidelines for the certification of professionals in sleep medicine: report of the task force of the European Sleep Research Society.

Science.gov (United States)

Pevernagie, Dirk; Stanley, Neil; Berg, Sören; Krieger, Jean; Amici, Roberto; Bassetti, Claudio; Billiard, Michel; Cirignotta, Fabio; Garcia-Borreguero, Diego; Tobler, Irene; Fischer, Jürgen

2009-03-01

In recent years, sleep medicine has evolved into a full-grown discipline, featuring a multidisciplinary approach to diagnosis and treatment of patients with sleep disorders. Sleep medicine cuts across the boundaries of different conventional disciplines and is therefore open to medical and non-medical professionals with different specialty backgrounds. The aim of the current paper is to introduce a qualification for those professionals whose main occupation is to practice sleep medicine in the setting of a sleep medicine centre. The drafting of guidelines dealing with requirements for such qualification was entrusted to a task force by the European Sleep Research Society. The guidelines are the result of a progressive consensus procedure in which standards were defined for education, training, and evaluation. The final step along this pathway is a theoretical and practical examination, providing proof of proficiency in the field of sleep medicine. This paper describes the object of specific competences, the scope of sleep medicine, and the qualification procedures that pertain to three professional categories: medical specialists, non-medical professionals with a university master degree (such as psychologists and biologists), and nurses and technologists. Indices of preceding practical experience and theoretical knowledge are presented in Appendices 1 and 2. These guidelines are a European standard. They may be adapted in the future according to new scientific insights. National certification programs that comply with these guidelines may be subject to homologation by the ESRS.

Guidelines on Building Regulations 2008

DEFF Research Database (Denmark)

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

7 CFR 1724.55 - Dam safety.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Dam safety. 1724.55 Section 1724.55 Agriculture... § 1724.55 Dam safety. (a) The provisions of this section apply only to RUS financed electric system... for Dam Safety,”(Guidelines), as applicable. A dam, as more fully defined in the Guidelines, is...

Adopting preoperative fasting guidelines.

Science.gov (United States)

Anderson, Megan; Comrie, Rhonda

2009-07-01

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

Persistent pain in the older adult: what should we do now in light of the 2009 American geriatrics society clinical practice guideline?

Science.gov (United States)

Katz, James D; Shah, Tina

2009-12-01

The recent publication of revised guidelines for the management of persistent pain in the older adult (American Geriatric Society, 2009) has posed a dilemma for clinicians. In essence, these revised guidelines now downplay the use of nonsteroidal anti-inflammatory drugs (NSAIDs) relative to prior year's recommendations. The strong recommendation for caution when employing NSAIDs is because of the numerous, well-documented, potential adverse effects including renal failure, stroke, hypertension, heart failure exacerbations, and gastrointestinal complications. Nevertheless, physicians still have a substantial arsenal for combating chronic pain due to such conditions as degenerative arthritis and back problems. Options for intervention include physical therapy, topical nonsteroidals, capsaicin, topical lidocaine, intra-articular therapies, and judicious use of narcotics. In the future, cyclooxygenase-inhibiting nitric oxide-donating drugs may represent a technical improvement in the toxicity profile of traditional NSAIDs.

49 CFR 350.339 - What are tolerance guidelines?

Science.gov (United States)

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false What are tolerance guidelines? 350.339 Section 350... MOTOR CARRIER SAFETY ASSISTANCE PROGRAM Funding § 350.339 What are tolerance guidelines? Tolerance guidelines set forth the limited deviations from the FMCSRs allowed in your State's laws and regulations...

Inspection, evaluation and maintenance guidelines for reactor vessel internals in JAPAN

International Nuclear Information System (INIS)

Sakashita, Akihiro; Goto, Tomoya; Hirano, Shinro; Dozaki, Koji

2010-01-01

Inspection and Evaluation Guidelines for reactor internals has been taken into the Rules on Fitness-for–Service for Nuclear Power Plants of The Japan Society of Mechanical Engineers. It is a base of the maintenance plan of each Nuclear Power Plant. A plant maintenance methodology will have more importance to maintain the plant safety and stable plant operation. This paper introduces the systematization of the maintenance such as repair, replacement, preventive maintenance in these guidelines. Maintenance methodologies are classified follows. Repair: methodology to reinforce degraded parts by some methods or prevent progress of degradation of without replacement of the existing structure when the degradation of structure is actualized. Replacement: methodology to replace the existing structure with new one when the degradation of structure is actualized. Preventive maintenance : methodology to mitigate the damaged condition. When the maintenance methodologies are implemented in the actual plant, we have to consider the feedback of the inspection program and plant life management. (author)

Alpha-1 Antitrypsin Deficiency Targeted Testing and Augmentation Therapy: A Canadian Thoracic Society Clinical Practice Guideline

Directory of Open Access Journals (Sweden)

DD Marciniuk

2012-01-01

Full Text Available Alpha-1 antitrypsin (A1AT functions primarily to inhibit neutrophil elastase, and deficiency predisposes individuals to the development of chronic obstructive pulmonary disease (COPD. Severe A1AT deficiency occurs in one in 5000 to one in 5500 of the North American population. While the exact prevalence of A1AT deficiency in patients with diagnosed COPD is not known, results from small studies provide estimates of 1% to 5%. The present document updates a previous Canadian Thoracic Society position statement from 2001, and was initiated because of lack of consensus and understanding of appropriate patients suitable for targeted testing for A1AT deficiency, and for the use of A1AT augmentation therapy. Using revised guideline development methodology, the present clinical practice guideline document systematically reviews the published literature and provides an evidence-based update. The evidence supports the practice that targeted testing for A1AT deficiency be considered in individuals with COPD diagnosed before 65 years of age or with a smoking history of <20 pack years. The evidence also supports consideration of A1AT augmentation therapy in nonsmoking or exsmoking patients with COPD (forced expiratory volume in 1 s of 25% to 80% predicted attributable to emphysema and documented A1AT deficiency (level ≤11 μmol/L who are receiving optimal pharmacological and nonpharmacological therapies (including comprehensive case management and pulmonary rehabilitation because of benefits in computed tomography scan lung density and mortality.

Value of American Thoracic Society guidelines in predicting infection or colonization with multidrug-resistant organisms in critically ill patients.

Directory of Open Access Journals (Sweden)

Jianfeng Xie

Full Text Available The incidence rate of infection by multidrug-resistant organisms (MDROs can affect the accuracy of etiological diagnosis when using American Thoracic Society (ATS guidelines. We determined the accuracy of the ATS guidelines in predicting infection or colonization by MDROs over 18 months at a single ICU in eastern China.This prospective observational study examined consecutive patients who were admitted to an intensive care unit (ICU in Nanjing, China. MDROs were defined as bacteria that were resistant to at least three antimicrobial classes, such as methicillin-resistant Staphylococcus aureus (MRSA, vancomycin-resistant enterococci (VRE, Pseudomonas aeruginosa, Acinetobacter baumannii. Screening for MDROs was performed at ICU admission and discharge. Risk factors for infection or colonization with MDROs were recorded, and the accuracy of the ATS guidelines in predicting infection or colonization with MDROs was documented.There were 610 patients, 225 (37% of whom were colonized or infected with MDROs at ICU admission, and this increased to 311 (51% at discharge. At admission, the sensitivity (70.0%, specificity (31.6%, positive predictive value (38.2%, and negative predictive value (63.5%, all based on ATS guidelines for infection or colonization with MDROs were low. The negative predictive value was greater in patients from departments with MDRO infection rates of 31-40% than in patients from departments with MDRO infection rates of 30% or less and from departments with MDRO infection rates more than 40%.ATS criteria were not reliable in predicting infection or colonization with MDROs in our ICU. The negative predictive value was greater in patients from departments with intermediate rates of MDRO infection than in patients from departments with low or high rates of MDRO infection.ClinicalTrials.gov NCT01667991.

Guidelines for gloveboxes. Section 5.14: Electrical

International Nuclear Information System (INIS)

Tollner, R.L.

1995-07-01

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

Car Seat Safety

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Car Seat Safety KidsHealth / For Parents / Car Seat Safety ... certified child passenger safety technician.) Guidelines for Choosing Car Seats Choose a seat with a label that ...

Probabilistic safety assessment goals in Canada

International Nuclear Information System (INIS)

Snell, V.G.

1986-01-01

CANDU safety philosphy, both in design and in licensing, has always had a strong bias towards quantitative probabilistically-based goals derived from comparative safety. Formal probabilistic safety assessment began in Canada as a design tool. The influence of this carried over later on into the definition of the deterministic safety guidelines used in CANDU licensing. Design goals were further developed which extended the consequence/frequency spectrum of 'acceptable' events, from the two points defined by the deterministic single/dual failure analysis, to a line passing through lower and higher frequencies. Since these were design tools, a complete risk summation was not necessary, allowing a cutoff at low event frequencies while preserving the identification of the most significant safety-related events. These goals gave a logical framework for making decisions on implementing design changes proposed as a result of the Probabilistic Safety Analysis. Performing this analysis became a regulatory requirement, and the design goals remained the framework under which this was submitted. Recently, there have been initiatives to incorporate more detailed probabilistic safety goals into the regulatory process in Canada. These range from far-reaching safety optimization across society, to initiatives aimed at the nuclear industry only. The effectiveness of the latter is minor at very low and very high event frequencies; at medium frequencies, a justification against expenditures per life saved in other industries should be part of the goal setting

ESUR prostate MR guidelines 2012

DEFF Research Database (Denmark)

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

2012-01-01

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

European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium

DEFF Research Database (Denmark)

Aldecoa, César; Bettelli, Gabriella; Bilotta, Federico

2017-01-01

The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care, postoper...

European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium

NARCIS (Netherlands)

Aldecoa, César; Bettelli, Gabriella; Bilotta, Federico; Sanders, Robert D.; Audisio, Riccardo; Borozdina, Anastasia; Cherubini, Antonio; Jones, Christina; Kehlet, Henrik; Maclullich, Alasdair; Radtke, Finn; Riese, Florian; Slooter, Arjen J C; Veyckemans, Francis; Kramer, Sylvia; Neuner, Bruno; Weiss, Bjoern; Spies, Claudia D.

2017-01-01

The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care,

Bathroom safety - children

Science.gov (United States)

Well child - bathroom safety ... be put in charge of a younger child's safety. There should be an adult in the bathroom ... sure grandparents, friends, and other caretakers follow bathroom safety guidelines. Make sure your child's daycare also follows ...

Integrated Safety in ''SARAF'

International Nuclear Information System (INIS)

Dickstein, P.; Grof, Y.; Machlev, M.; Pernick, A.

2004-01-01

As of the very early stages of the accelerator project at the Soreq Nuclear Research Center ''SARAF'' a safety group was established which has been an inseparable participant in the planning and design of the new facility. The safety group comprises of teams responsible for the shielding, radiation protection and general industrial safety aspects of ''SARAF''. The safety group prepared and documented the safety envelope for the accelerator, dealing with the safety requirements and guidelines for the first, pre-operational, stages of the project. The safety envelope, though based upon generic principles, took into account the accelerator features and the expected modes of operation. The safety envelope was prepared in a hierarchical structure, containing Basic Principles, Basic Guidelines, General Principles for Safety Implementation, Safety Requirements and Safety Underlining Issues. The above safety envelope applies to the entire facility, which entails the accelerator itself and the experimental areas and associated plant and equipment utilizing and supporting the production of the accelerated particle beams

2016 Guidelines of the American Society of Mammalogists for the use of wild mammals in research and education

Science.gov (United States)

Sikes, Robert S.

2016-01-01

Abstract Guidelines for use of wild mammal species in research are updated from Sikes et al. (2011) . These guidelines cover current professional techniques and regulations involving the use of mammals in research and teaching; they also incorporate new resources, procedural summaries, and reporting requirements. Included are details on capturing, marking, housing, and humanely killing wild mammals. It is recommended that Institutional Animal Care and Use Committees (IACUCs), regulatory agencies, and investigators use these guidelines as a resource for protocols involving wild mammals, whether studied in the field or in captivity. These guidelines were prepared and approved by the American Society of Mammalogists (ASM), in consultation with professional veterinarians experienced in wildlife research and IACUCs, whose collective expertise provides a broad and comprehensive understanding of the biology of nondomesticated mammals. The current version of these guidelines and any subsequent modifications are available online on the Animal Care and Use Committee page of the ASM website ( http://mammalogy.org/uploads/committee_files/CurrentGuidelines.pdf ). Additional resources pertaining to the use of wild animals in research are available at: http://www.mammalsociety.org/committees/animal-care-and-use#tab3 . R esumen Los lineamientos para el uso de especies de mamíferos de vida silvestre en la investigación con base en Sikes et al. (2011) se actualizaron. Dichos lineamientos cubren técnicas y regulaciones profesionales actuales que involucran el uso de mamíferos en la investigación y enseñanza; también incorporan recursos nuevos, resúmenes de procedimientos y requisitos para reportes. Se incluyen detalles acerca de captura, marcaje, manutención en cautiverio y eutanasia de mamíferos de vida silvestre. Se recomienda que los comités institucionales de uso y cuidado animal (cifras en inglés: IACUCs), las agencias reguladoras y los investigadores se adhieran a

2016 Guidelines of the American Society of Mammalogists for the use of wild mammals in research and education.

Science.gov (United States)

Sikes, Robert S

2016-06-09

Guidelines for use of wild mammal species in research are updated from Sikes et al. (2011) . These guidelines cover current professional techniques and regulations involving the use of mammals in research and teaching; they also incorporate new resources, procedural summaries, and reporting requirements. Included are details on capturing, marking, housing, and humanely killing wild mammals. It is recommended that Institutional Animal Care and Use Committees (IACUCs), regulatory agencies, and investigators use these guidelines as a resource for protocols involving wild mammals, whether studied in the field or in captivity. These guidelines were prepared and approved by the American Society of Mammalogists (ASM), in consultation with professional veterinarians experienced in wildlife research and IACUCs, whose collective expertise provides a broad and comprehensive understanding of the biology of nondomesticated mammals. The current version of these guidelines and any subsequent modifications are available online on the Animal Care and Use Committee page of the ASM website ( http://mammalogy.org/uploads/committee_files/CurrentGuidelines.pdf ). Additional resources pertaining to the use of wild animals in research are available at: http://www.mammalsociety.org/committees/animal-care-and-use#tab3 . Los lineamientos para el uso de especies de mamíferos de vida silvestre en la investigación con base en Sikes et al. (2011) se actualizaron. Dichos lineamientos cubren técnicas y regulaciones profesionales actuales que involucran el uso de mamíferos en la investigación y enseñanza; también incorporan recursos nuevos, resúmenes de procedimientos y requisitos para reportes. Se incluyen detalles acerca de captura, marcaje, manutención en cautiverio y eutanasia de mamíferos de vida silvestre. Se recomienda que los comités institucionales de uso y cuidado animal (cifras en inglés: IACUCs), las agencias reguladoras y los investigadores se adhieran a dichos lineamientos

A review of the safety implications of magnetic resonance imaging at field strengths of 3 Tesla and above

International Nuclear Information System (INIS)

Crook, Neil; Robinson, Leslie

2009-01-01

Rationale: Diagnostic imaging is being driven by technological developments particularly so in the field of Magnetic Resonance Imaging (MRI). Electromagnetic fields used to produce images are becoming much stronger and switched more rapidly and it is essential that safety advice remains appropriate and current. Using a systematic methodology, this review aims to identify the clinical safety implications in performing MRI at field strengths of 3 Tesla (T) and above and determine whether the current clinical safety guidelines are appropriate. Method: References were sourced from The Cochrane Library, Centre for Reviews and Dissemination Science Direct, PubMed and Google Scholar. Related websites searched included The British Institute of Radiology, Society of Radiographers, Royal College of Radiologists, The Institution of Engineering and Technology, IMRSER (Institute for Magnetic Resonance Safety, Education, and Research), MagNet (NHS PASA). References supplied in retrieved papers were also checked for potential relevance. The use of consistent search terminology and inclusion and exclusion criteria ensured quality and provided rigour to conclusions drawn. Conclusion: According to the literature retrieved, the current body of knowledge has allowed safety guidelines to be established for patient safety and these are both appropriate and valid at field strengths of 3 T.

Implications of the 2014 Androgen Excess and Polycystic Ovary Syndrome Society guidelines on polycystic ovarian morphology for polycystic ovary syndrome diagnosis.

Science.gov (United States)

Christ, J P; Gunning, M N; Fauser, B C J M

2017-10-01

The Androgen Excess and Polycystic Ovary Syndrome Society (AEPCOS) has recommended an updated threshold for polycystic ovarian morphology (PCOM) of 25 follicles or more, 10 ml or more of ovarian volume, or both. We describe the effect of these guidelines on reproductive and metabolic characteristics in 404 women. These women were separated into four groups: group A: hyperandrogenism and oligo-amenorrhoea (n = 157); group B: hyperandrogenism or oligo-amenorrhoea and PCOM meeting AEPCOS 2014 criteria (n = 125); group C: hyperandrogenism or oligo-amenorrhoea and PCOM meeting Rotterdam 2003 but not AEPCOS 2014 criteria (n = 72); and group D: non-PCOS not meeting either criteria (n = 50). Groups B, C and D did not differ across any metabolic markers. The AEPCOS 2014 guidelines may have limited utility in distinguishing metabolic risk factors and result in the exclusion of a large group of oligo-anovulatory women. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

It’s all about safety signs!

CERN Multimedia

2013-01-01

Their first occurrence may date back to the Egyptian hieroglyphs, but today they can be found everywhere: on our clothes labels as care labels, in train stations and airports to guide us, during the Olympics to identify various sports, on our dashboards, etc.   Safety wise, they are used to indicate a danger, a prohibition, an obligation, a safety exit, firefighting equipment, etc. The HSE Unit has decided to update the 150 safety signs used on the CERN site and, to correspond with this, recently published a Safety Guideline GS-1-0-1, available on the Safety Unit website. The Guideline contains more than 150 safety signs as well as diverse information regarding the meaning of the signs, their location and how to use them. The Guideline will shortly be completed with a new Safety Rule that will replace the former Security Code A3, “Safety colours and safety signs”. Please be informed that you also have the option to create new safety signs, provided that you first g...

[Methodology report of the 2017 guidelines on fibromyalgia syndrome].

Science.gov (United States)

Häuser, W; Nothacker, M

2017-06-01

The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was planned for April 2017. The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n = 8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest. A systematic search of the literature from December 2010 to May 2016 was performed in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine version 2009. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. Efficacy, risks, patient preferences and applicability of therapies available were weighed up against each other. The guidelines were reviewed and approved by the board of directors of the societies engaged in the development of the guidelines. The guidelines are published in several forms, i.e. complete and short scientific versions and clinical practice and patient versions.

[Admission, discharge and triage guidelines for paediatric intensive care units in Spain].

Science.gov (United States)

de la Oliva, Pedro; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Rey-Galán, Corsino; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; de Carlos-Vicente, Juan Carlos; Hernández-Rastrollo, Ramón; Holanda-Peña, María Soledad; Pilar-Orive, Francisco Javier; Ocete-Hita, Esther; Rodríguez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis

2018-05-01

A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Proposal of guidelines for structuring an independent regulation body for the Brazilian nuclear sector

International Nuclear Information System (INIS)

Nicoll Junior, Ricardo

2016-01-01

Regulatory bodies are responsible for regulation in various sectors of society. In Brazil, they work in various areas for the development of the country and have as main objective the social, economic and national development. The progress of new technologies in the nuclear field and their commercialization underscores the need for regulation according to international safety standards. The present research searches through an extensive review of the literature identify the international guidelines for regulatory bodies and make a comparative analysis between Brazil and five countries that have independent regulatory bodies in the nuclear sector. The purpose of the work is to contribute to the Brazilian public sectors, with an evaluation of the country's regulation in the perception of specialists and propose guidelines for the structuring of an independent regulatory body, respecting international agreements and the legislation in force in the country. (author)

Development of human factors design review guidelines

International Nuclear Information System (INIS)

Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul

1997-10-01

The Objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25, Human factors engineering program review model' and '26, Review criteria for human actors aspects of advanced controls and instrumentation', which are related to the development of human factors safety regulation guides be ing performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and reviewing the reference documents of NUREG-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides in KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we well update the guidelines by reviewing the literature related to alarm design published after 1994

Development of human factors design review guidelines

Energy Technology Data Exchange (ETDEWEB)

Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul [Korea Atomic Energy Research Institute, Taejon (Korea)

1997-10-01

The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: 25. Human Factors Engineering Program Review Model and 26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation, which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and reviewing the reference documents of NUREG-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides in KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we will update the guidelines by reviewing the literature related to alarm design published after 1994. (author). 12 refs., 5 figs., 2 tabs.

The New 2016 European Society of Cardiology/European Association for Cardio-Thoracic Surgery Guidelines: Enough Guidance? Enough Evidence?

Science.gov (United States)

Castellá, Manuel

2018-04-01

For the first time, the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have joined forces to develop consensus guidelines for the management of atrial fibrillation (AF). One of the main issues is the integrated care of patients with AF, with emphasis on multidisciplinary teams of general physicians, cardiologists, stroke specialists and surgeons, together with the patient's involvement for better management of AF. These guidelines also help in the detection of risk factors and concomitant cardiovascular diseases, stroke prevention therapies, including anticoagulation and antiplatelet therapies after acute coronary episodes, major haemorrhages or strokes. In the field of ablation, surgery plays an important role as concomitant with other surgical procedures, and it should be considered in symptomatic patients with the highest level of evidence. Asymptomatic patients with mitral insufficiency should also be considered for combined mitral and AF surgery if they have new-onset AF. In patients with stand-alone AF, recommendations for minimally invasive ablation have an increased level of recommendation and should be considered as the same level as catheter ablation in patients with persistent or long-standing persistent AF or with paroxysmal AF who fail catheter ablation. Surgical occlusion or exclusion of the left atrial appendage may be considered for stroke prevention in patients with AF about to have surgery. Nevertheless, not enough is known to avoid long-term anticoagulation in patients at risk of stroke even if the left atrial appendage has been excluded. These Guidelines provide a full spectrum of recommendations on the management of patients with AF including prevention, treatment and complications based on the latest published evidence.

Essentials from the 2015 European AIDS Clinical Society (EACS) guidelines for the treatment of adult HIV-positive persons.

Science.gov (United States)

Ryom, L; Boesecke, C; Gisler, V; Manzardo, C; Rockstroh, J K; Puoti, M; Furrer, H; Miro, J M; Gatell, J M; Pozniak, A; Behrens, G; Battegay, M; Lundgren, J D

2016-02-01

The European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android. The 2015 version of the EACS guidelines contains major revisions in all sections; antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Among the key revisions is the recommendation of ART for all HIV-positive persons, irrespectively of CD4 count, based on the Strategic Timing of AntiRetroviral Treatment (START) study results. The recommendations for the preferred and the alternative ART options have also been revised, and a new section on the use of pre-exposure prophylaxis (PrEP) has been added. A number of new antiretroviral drugs/drug combinations have been added to the updated tables on drug-drug interactions, adverse drug effects, dose adjustment for renal/liver insufficiency and for ART administration in persons with swallowing difficulties. The revisions of the coinfection section reflect the major advances in anti-hepatitis C virus (HCV) treatment with direct-acting antivirals with earlier start of treatment in individuals at increased risk of liver disease progression, and a phasing out of interferon-containing treatment regimens. The section on opportunistic diseases has been restructured according to individual pathogens/diseases and a new overview table has been added on CD4 count thresholds for different primary prophylaxes. The diagnosis and management of HIV infection and related coinfections, opportunistic diseases and comorbidities continue to require a multidisciplinary effort for which the 2015 version of the EACS guidelines provides an easily accessable and updated overview. © 2015 British HIV Association.

How do SAGES members rate its guidelines?

Science.gov (United States)

Hope, William W; Richardson, William; Fanelli, Robert; Stefanidis, Dimitrios

2014-04-01

The development of practice guidelines should take into consideration the opinions of end users. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has implemented several changes in its guideline development and dissemination process based on previous end-user input. An anonymous electronic survey was conducted via e-mail solicitation in September 2011. Respondents were asked to submit their feedback on the 26 guidelines produced by our society using a 32-item questionnaire and to suggest topics for new guideline development and areas of improvement. Responses from the survey were received by 494 people, of whom 474 (96 %) were clinicians; 373 (75 %) were general, laparoscopic, or bariatric surgeons; and 324 (65 %) held leadership roles within their institution. Most respondents were 35-44 years old (36 %), male (83 %), and had been in practice for over 10 years (54 %). A total of 383 (81 %) had used our guidelines, and, of those, 96 % agreed with their content. Guideline quality was rated 4.34; value 4.27; and ease of access 3.97 on a five-point Likert scale. The most commonly referenced guideline in the survey regarded surgical treatment of reflux (67 %), followed by laparoscopy during pregnancy (51 %). The three most common reasons guidelines were accessed were to update knowledge (68 %), to maximize patient care through evidence-based treatment (51 %), and to obtain a critical literature review. The majority of respondents indicated they greatly value and agree with our guidelines. These results indicate that recent efforts to improve our guidelines have succeeded.

Joint IAEA/NEA IRS guidelines

International Nuclear Information System (INIS)

1997-01-01

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

Practice Guidelines for Primary Care of Acute Abdomen 2015.

Science.gov (United States)

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

2016-01-01

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

Guidelines for personal exposure monitoring of chemicals: Part III.

Science.gov (United States)

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

2018-01-25

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

Guidelines for personal exposure monitoring of chemicals: Part IV.

Science.gov (United States)

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

2018-03-27

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

Guidelines for personal exposure monitoring of chemicals: Part II.

Science.gov (United States)

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

2017-11-25

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

Guidelines for personal exposure monitoring of chemicals: Part I.

Science.gov (United States)

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

2017-09-28

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

Guidelines for personal exposure monitoring of chemicals: Part V.

Science.gov (United States)

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

2018-05-25

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

Safety system status monitoring

International Nuclear Information System (INIS)

Lewis, J.R.; Morgenstern, M.H.; Rideout, T.H.; Cowley, P.J.

1984-03-01

The Pacific Northwest Laboratory has studied the safety aspects of monitoring the preoperational status of safety systems in nuclear power plants. The goals of the study were to assess for the NRC the effectiveness of current monitoring systems and procedures, to develop near-term guidelines for reducing human errors associated with monitoring safety system status, and to recommend a regulatory position on this issue. A review of safety system status monitoring practices indicated that current systems and procedures do not adequately aid control room operators in monitoring safety system status. This is true even of some systems and procedures installed to meet existing regulatory guidelines (Regulatory Guide 1.47). In consequence, this report suggests acceptance criteria for meeting the functional requirements of an adequate system for monitoring safety system status. Also suggested are near-term guidelines that could reduce the likelihood of human errors in specific, high-priority status monitoring tasks. It is recommended that (1) Regulatory Guide 1.47 be revised to address these acceptance criteria, and (2) the revised Regulatory Guide 1.47 be applied to all plants, including those built since the issuance of the original Regulatory Guide

Safety system status monitoring

Energy Technology Data Exchange (ETDEWEB)

Lewis, J.R.; Morgenstern, M.H.; Rideout, T.H.; Cowley, P.J.

1984-03-01

The Pacific Northwest Laboratory has studied the safety aspects of monitoring the preoperational status of safety systems in nuclear power plants. The goals of the study were to assess for the NRC the effectiveness of current monitoring systems and procedures, to develop near-term guidelines for reducing human errors associated with monitoring safety system status, and to recommend a regulatory position on this issue. A review of safety system status monitoring practices indicated that current systems and procedures do not adequately aid control room operators in monitoring safety system status. This is true even of some systems and procedures installed to meet existing regulatory guidelines (Regulatory Guide 1.47). In consequence, this report suggests acceptance criteria for meeting the functional requirements of an adequate system for monitoring safety system status. Also suggested are near-term guidelines that could reduce the likelihood of human errors in specific, high-priority status monitoring tasks. It is recommended that (1) Regulatory Guide 1.47 be revised to address these acceptance criteria, and (2) the revised Regulatory Guide 1.47 be applied to all plants, including those built since the issuance of the original Regulatory Guide.

Saudi Oncology Society clinical management guidelines for renal cell carcinoma

Directory of Open Access Journals (Sweden)

Shouki Bazarbashi

2011-01-01

Full Text Available In this report, guidelines for the evaluation, medical and surgical management of renal cell carcinoma is presented. It is categorized according to the stage of the disease using the tumor node metastasis staging system, 7th edition. The recommendations are presented with supporting evidence level.

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition).

Science.gov (United States)

Satoh, Tetsurou; Isozaki, Osamu; Suzuki, Atsushi; Wakino, Shu; Iburi, Tadao; Tsuboi, Kumiko; Kanamoto, Naotetsu; Otani, Hajime; Furukawa, Yasushi; Teramukai, Satoshi; Akamizu, Takashi

2016-12-30

Thyroid storm is an endocrine emergency which is characterized by multiple organ failure due to severe thyrotoxicosis, often associated with triggering illnesses. Early suspicion, prompt diagnosis and intensive treatment will improve survival in thyroid storm patients. Because of its rarity and high mortality, prospective intervention studies for the treatment of thyroid storm are difficult to carry out. We, the Japan Thyroid Association and Japan Endocrine Society taskforce committee, previously developed new diagnostic criteria and conducted nationwide surveys for thyroid storm in Japan. Detailed analyses of clinical data from 356 patients revealed that the mortality in Japan was still high (∼11%) and that multiple organ failure and acute heart failure were common causes of death. In addition, multimodal treatment with antithyroid drugs, inorganic iodide, corticosteroids and beta-adrenergic antagonists has been suggested to improve mortality of these patients. Based on the evidence obtained by nationwide surveys and additional literature searches, we herein established clinical guidelines for the management of thyroid storm. The present guideline includes 15 recommendations for the treatment of thyrotoxicosis and organ failure in the central nervous system, cardiovascular system, and hepato-gastrointestinal tract, admission criteria for the intensive care unit, and prognostic evaluation. We also proposed preventive approaches to thyroid storm, roles of definitive therapy, and future prospective trial plans for the treatment of thyroid storm. We hope that this guideline will be useful for many physicians all over the world as well as in Japan in the management of thyroid storm and the improvement of its outcome.

Japanese guidelines for childhood asthma 2017.

Science.gov (United States)

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

2017-04-01

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

ASSET guidelines

International Nuclear Information System (INIS)

1990-11-01

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

2018 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Focused Update of the Guidelines for the Use of Antiplatelet Therapy.

Science.gov (United States)

Mehta, Shamir R; Bainey, Kevin R; Cantor, Warren J; Lordkipanidzé, Marie; Marquis-Gravel, Guillaume; Robinson, Simon D; Sibbald, Matthew; So, Derek Y; Wong, Graham C; Abunassar, Joseph G; Ackman, Margaret L; Bell, Alan D; Cartier, Raymond; Douketis, James D; Lawler, Patrick R; McMurtry, Michael S; Udell, Jacob A; van Diepen, Sean; Verma, Subodh; Mancini, G B John; Cairns, John A; Tanguay, Jean-François

2018-03-01

Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescription in various clinical contexts and risk/benefit relationships. The Guidelines Committee of the Canadian Cardiovascular Society and Canadian Association of Interventional Cardiology publishes regular updates of its recommendations, taking into consideration the most recent clinical evidence. The present update to the 2011 and 2013 Canadian Cardiovascular Society APT guidelines incorporates new evidence on how to optimize APT use, particularly in situations in which few to no data were previously available. The recommendations update focuses on the following primary topics: (1) the duration of dual APT (DAPT) in patients who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome and non-acute coronary syndrome indications; (2) management of DAPT in patients who undergo noncardiac surgery; (3) management of DAPT in patients who undergo elective and semiurgent coronary artery bypass graft surgery; (4) when and how to switch between different oral antiplatelet therapies; and (5) management of antiplatelet and anticoagulant therapy in patients who undergo PCI. For PCI patients, we specifically analyze the particular considerations in patients with atrial fibrillation, mechanical or bioprosthetic valves (including transcatheter aortic valve replacement), venous thromboembolic disease, and established left ventricular thrombus or possible left ventricular thrombus with reduced ejection fraction after ST-segment elevation myocardial infarction. In addition to specific recommendations, we provide values and preferences and practical tips to aid the practicing clinician in the day to day use of these important agents. Copyright © 2018. Published by Elsevier Inc.

Technical Issues and Proposes on the Legislation of Probabilistic Safety Assessment in Periodic Safety Review

International Nuclear Information System (INIS)

Hwang, Seok-Won; Jeon, Ho-Jun; Na, Jang-Hwan

2015-01-01

Korean Nuclear Power Plants have performed a comprehensive safety assessment reflecting design and procedure changes and using the latest technology every 10 years. In Korea, safety factors of PSR are revised to 14 by revision of IAEA Safety Guidelines in 2003. In the revised safety guidelines, safety analysis field was subdivided into deterministic safety analysis, PSA (Probabilistic safety analysis), and hazard analysis. The purpose to examine PSA as a safety factor on PSR is to make sure that PSA results and assumptions reflect the latest state of NPPs, validate the level of computer codes and analytical models, and evaluate the adequacy of PSA instructions. In addition, its purpose is to derive the plant design change, operating experience of other plants and safety enhancement items as well. In Korea, PSA is introduced as a new factor. Thus, the overall guideline development and long-term implementation strategy are needed. Today in Korea, full-power PSA model revision and low-power and shutdown (LPSD) PSA model development is being performed as a part of the post Fukushima action items for operating plants. The scope of the full-power PSA is internal/external level 1, 2 PSA. But in case of fire PSA, the scope is level 1 PSA using new method, NUREG/CR-6850. In case of LPSD PSA, level 1 PSA for all operating plants, and level 2 PSA for 2 demonstration plants are under development. The result of the LPSD PSA will be used as major input data for plant specific SAMG (Severe Accident Management Guideline). The scope of PSA currently being developed in Korea cannot fulfill 'All Mode, All Scope' requirements recommended in the IAEA Safety Guidelines. Besides the legislation of PSA, step-by-step development strategy for non-performed scopes such as level 3 PSA and new fire PSA is one of the urgent issues in Korea. This paper suggests technical issues and development strategies for each PSA technical elements.