WorldWideScience

Sample records for unit objectives guidelines

  1. 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...

  2. 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...

  3. Key articles and guidelines relative to intensive care unit pharmacology.

    Science.gov (United States)

    Erstad, Brian L; Jordan, Ché J; Thomas, Michael C

    2002-12-01

    Compilations of key articles and guidelines in a particular clinical practice area are useful not only to clinicians who practice in that area, but to all clinicians. We compiled pertinent articles and guidelines pertaining to drug therapy in the intensive care unit setting from the perspective of an actively practicing critical care pharmacist. This document also may serve to stimulate other experienced clinicians to undertake a similar endeavor in their practice areas.

  4. 77 FR 51113 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2012-08-23

    ... and responsibility to analyze sentencing issues, including operation of the federal sentencing.../or guideline changes that may be appropriate. (4) Continuation of its work on economic crimes... authority and responsibility, under 28 U.S.C. 991(b)(1)(B) and Braxton v. United States, 500 U.S. 344 (1991...

  5. Labor Studies Programs: Objectives, Proposals, Policies, Outlines & Guidelines.

    Science.gov (United States)

    International Union, United Automobile, Aerospace and Agricultural Implement Workers of America, Detroit, MI.

    This document outlines a labor studies program which may lead to several levels of achievement: a certificate in labor studies, an associate degree, an associate of arts degree, or a transfer of credits leading to a baccalaureate degree. The program is intended for labor union members or for anyone else interested in labor studies. Objectives of…

  6. Behavioral Objectives for Selected Units in Business Education.

    Science.gov (United States)

    Hill, Richard K., Ed.; Schmidt, B. June, Ed.

    This is a catalog of behavioral objectives organized by units. Each unit contains an outline of the content, a goal statement, and general and specific objectives. The catalog contains a total of 48 units on: business behavior and psychology; business law; business math; business principles and organization; business terminology; communication and…

  7. 76 FR 3193 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2011-01-19

    ...Pursuant to section 994(a), (o), and (p) of title 28, United States Code, the United States Sentencing Commission is considering promulgating certain amendments to the sentencing guidelines, policy statements, and commentary. This notice sets forth the proposed amendments and, for each proposed amendment, a synopsis of the issues addressed by that amendment. This notice also sets forth a number of issues for comment, some of which are set forth together with the proposed amendments; some of which are set forth independent of any proposed amendment; and one of which (regarding retroactive application of proposed amendments) is set forth in the SUPPLEMENTARY INFORMATION portion of this notice. The proposed amendments and issues for comment in this notice are as follows: (1) A proposed amendment on drug trafficking, including (A) a proposal to repromulgate as a permanent amendment the emergency, temporary amendment in response to the Fair Sentencing Act of 2010, Public Law 111-220, regarding offenses involving crack cocaine and regarding certain aggravating and mitigating circumstances in drug trafficking cases, and (B) a proposed change to Sec. 2D1.1 (Unlawful Manufacturing, Importing, Exporting, or Trafficking (Including Possession with Intent to Commit These Offenses); Attempt or Conspiracy) to implement the directive in section 4 of the Secure and Responsible Drug Disposal Act of 2010, Public Law 111-273, and related issues for comment on drug trafficking; (2) a proposed amendment on firearms, including proposed changes to Sec. 2M5.2 (Exportation of Arms, Munitions, or Military Equipment or Services Without Required Validated Export License) regarding certain cases involving small arms and ammunition crossing the border and related issues for comment, including whether revisions to Sec. 2K2.1 (Unlawful Receipt, Possession, or Transportation of Firearms or Ammunition; Prohibited Transactions Involving Firearms or Ammunition) and related guidelines may be

  8. Enteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients

    OpenAIRE

    Pasinato, Valeska Fernandes; Berbigier, Marina Carvalho; Rubin, Bibiana de Almeida; Castro, Kamila; Moraes,Rafael Barberena; Perry, Ingrid Dalira Schweigert

    2013-01-01

    Objective Evaluate the compliance of septic patients' nutritional management with enteral nutrition guidelines for critically ill patients. Methods Prospective cohort study with 92 septic patients, age ≥18 years, hospitalized in an intensive care unit, under enteral nutrition, evaluated according to enteral nutrition guidelines for critically ill patients, compliance with caloric and protein goals, and reasons for not starting enteral nutrition early or for discontinuing it. Prognostic scores...

  9. Cognitive Task Analysis of Experts in Designing Multimedia Learning Object Guideline (M-LOG)

    Science.gov (United States)

    Razak, Rafiza Abdul; Palanisamy, Punithavathy

    2013-01-01

    The purpose of this study was to design and develop a set of guidelines for multimedia learning objects to inform instructional designers (IDs) about the procedures involved in the process of content analysis. This study was motivated by the absence of standardized procedures in the beginning phase of the multimedia learning object design which is…

  10. Community Mitigation Guidelines to Prevent Pandemic Influenza - United States, 2017.

    Science.gov (United States)

    Qualls, Noreen; Levitt, Alexandra; Kanade, Neha; Wright-Jegede, Narue; Dopson, Stephanie; Biggerstaff, Matthew; Reed, Carrie; Uzicanin, Amra

    2017-04-21

    When a novel influenza A virus with pandemic potential emerges, nonpharmaceutical interventions (NPIs) often are the most readily available interventions to help slow transmission of the virus in communities, which is especially important before a pandemic vaccine becomes widely available. NPIs, also known as community mitigation measures, are actions that persons and communities can take to help slow the spread of respiratory virus infections, including seasonal and pandemic influenza viruses.These guidelines replace the 2007 Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States - Early, Targeted, Layered Use of Nonpharmaceutical Interventions (https://stacks.cdc.gov/view/cdc/11425). Several elements remain unchanged from the 2007 guidance, which described recommended NPIs and the supporting rationale and key concepts for the use of these interventions during influenza pandemics. NPIs can be phased in, or layered, on the basis of pandemic severity and local transmission patterns over time. Categories of NPIs include personal protective measures for everyday use (e.g., voluntary home isolation of ill persons, respiratory etiquette, and hand hygiene); personal protective measures reserved for influenza pandemics (e.g., voluntary home quarantine of exposed household members and use of face masks in community settings when ill); community measures aimed at increasing social distancing (e.g., school closures and dismissals, social distancing in workplaces, and postponing or cancelling mass gatherings); and environmental measures (e.g., routine cleaning of frequently touched surfaces).Several new elements have been incorporated into the 2017 guidelines. First, to support updated recommendations on the use of NPIs, the latest scientific evidence available since the influenza A (H1N1)pdm09 pandemic has been added. Second, a summary of lessons learned from the 2009 H1N1 pandemic response is presented to underscore

  11. Quantum objects as elementary units of causality and locality

    CERN Document Server

    Diel, Hans H

    2016-01-01

    The author's attempt to construct a local causal model of quantum theory (QT) that includes quantum field theory (QFT) resulted in the identification of "quantum objects" as the elementary units of causality and locality. Quantum objects are collections of particles (including single particles) whose collective dynamics and measurement results can only be described by the laws of QT and QFT. Local causal models of quantum objects' internal dynamics are not possible if a locality is understood as a space-point locality. Within quantum objects, state transitions may occur which instantly affect the whole quantum object. The identification of quantum objects as the elementary units of causality and locality has two primary implications for a causal model of quantum objects: (1) quantum objects run autonomously with system-state update frequencies based on their local proper times and with either no or minimal dependency on external parameters. (2) The laws of physics that describe global (but relativistic) inter...

  12. 75 FR 3525 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2010-01-21

    ... proposed changes to the guidelines' treatment of offenses involving commodities fraud, paleontological resources, unauthorized disclosures of personal information regarding health insurance eligibility, and...

  13. 77 FR 28225 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2012-05-11

    ... example, assault, kidnapping, and murder. As a result, the guidelines generally have addressed these...; Attempted Murder), 2A2.2 (Aggravated Assault) and 2A4.1 (Kidnapping, Abduction, Unlawful Restraint)....

  14. 76 FR 58564 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2011-09-21

    ... compilation of studies on, and analysis of, recidivism by child pornography offenders; and (C) possible... study of the statutory and guideline definitions of ``crime of violence'', ``aggravated felony... offense is categorically a ``crime of violence'', ``aggravated felony'', ``violent felony'', or ``drug...

  15. 78 FR 4197 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2013-01-18

    ... involving pre-retail medical products to implement the directive in the SAFE DOSES Act, Public Law 112-186... guidelines applicable to offenses involving counterfeit or adulterated drugs or counterfeit military parts, including (A) a proposed amendment on offenses involving counterfeit military goods and services, including...

  16. 78 FR 32533 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2013-05-30

    .... (4) Continuation of its work on economic crimes, including (A) a comprehensive, multi-year study of... that may be appropriate in light of the information obtained from such study. (5) Continuation of its multi-year study of the statutory and guideline definitions of ``crime of violence'',...

  17. 77 FR 31069 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2012-05-24

    ... its work on economic crimes, including (A) a comprehensive, multi-year study of '2B1.1 (Theft... light of the information obtained from such study. (5) Continuation of its multi-year study of the statutory and guideline definitions of ``crime of violence'', possibly including recommendations to...

  18. 76 FR 45007 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2011-07-27

    ... directives in section 1079A of the Dodd-Frank Wall Street Reform and Consumer Protection Act, Public Law...) Continuation of its multi-year study of the statutory and guideline definitions of ``crime of violence... conflicts regarding whether any offense is categorically a ``crime of violence'', ``aggravated...

  19. 75 FR 54698 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2010-09-08

    ... promulgate sentencing guidelines and policy statements for Federal courts. Section 994 also directs the... ``, and Crime Victims' Rights'' after ``Agreements''; and in Note 3 by redesignating subdivisions (a... criminal history score. A conforming change is made in Sec. 2P1.1 (Escape, Instigating or Assisting...

  20. Managerial guidelines to support parents during the hospitalisation of their children in a private paediatric unit.

    Science.gov (United States)

    Verwey, M; Jooste, K

    2009-09-01

    The purpose of this article is to describe managerial guidelines to support parents with the hospitalisation of their child in a private paediatric unit. The hospitalisation of a child is regarded as a major stressor for both parents and child. The role of the family in participating in a child's illness is slowly being recognised (Kibel & Wagstaff 2001:544), but the South African government per se has not yet issued any formal reports on parental participation in the hospitalisation process. The study explored and described the nursing care experiences of parents regarding the hospitalisation of their child in a paediatric unit; managerial guidelines to support parents with their lived experiences of their child's hospitalisation in a paediatric unit. To achieve the purpose and the objectives of the research, an interpretive-phenomenological qualitative approach was used in the research design and methods. Research was conducted through unstructured individual interviews, narrative diaries and field notes and data were analysed through open-coding (Tesch, 1990). Parents were asked to respond to the question "How did you experience your child's hospitalisation in the paediatric ward", followed by probing when the responses of the parents were ambiguous. Purposive sampling was used to achieve saturation of data and seven parents were interviewed and fifteen parents completed narrative diaries. The model of Lincoln and Guba (1985) was used to ensure trustworthiness. Ethical considerations were maintained throughout the study and consent was obtained from the respondents. The recommendations of the research were that attention should be given to 1) empowering parents to participate in their child's care; 2) guiding nursing personnel to plan the discharge process; 3) including parents in the unit routine; 4) fostering a trusting relationship with parents; 5) promoting the communication of information; and 6) creating a therapeutic environment for parents.

  1. 75 FR 41927 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2010-07-19

    ... United States Sentencing Commission is an independent agency in the judicial branch of the United States..., and judicial branches of government, and other interested parties, to study the manner in which United... might be appropriate in light of the information obtained from that study. (12) Resolution of...

  2. Nurses’ Perceptions of Critical Issues Requiring Consideration in the Development of Guidelines for Professional Registered Nurse Staffing for Perinatal Units

    Science.gov (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Wilson, Jane; Ruhl, Catherine

    2012-01-01

    Objective To solicit input from registered nurse members of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) on critical considerations for review and revision of existing nurse staffing guidelines. Design Thematic analysis of responses to a cross-sectional on-line survey question: “Please give the staffing task force your input on what they should consider in the development of recommendations for staffing of perinatal units.” Participants N = 884 AWHONN members. Main Outcome Measure Descriptions of staffing concerns that should be considered when evaluating and revising existing perinatal nurse staffing guidelines. Results Consistent themes identified included the need for revision of nurse staffing guidelines due to requirements for safe care, increases in patient acuity and complexity, invisibility of the fetus and newborn as separate and distinct patients, difficulties in providing comprehensive care during labor and for mother-baby couplets under current conditions, challenges in staffing small volume units, and the negative effect of inadequate staffing on nurse satisfaction and retention. Conclusion Participants overwhelmingly indicated current nurse staffing guidelines were inadequate to meet the needs of contemporary perinatal clinical practice and required revision based on significant changes that had occurred since 1983 when the original staffing guidelines were published. PMID:22690743

  3. 78 FR 26425 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2013-05-06

    ..., the simple movement of a stolen trade secret within a domestic multinational company (e.g., from a United States office to an overseas office of the same company) may not pose the same risks or harms. More generally, the Commission heard that foreign actors increasingly target United States companies...

  4. Nursing Activities Score: an updated guideline for its application in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Katia Grillo Padilha

    2015-12-01

    Full Text Available ABSTRACT Objective To describe nursing workload in Intensive Care Units (ICU in different countries according to the scores obtained with Nursing Activities Score (NAS and to verify the agreement among countries on the NAS guideline interpretation. Method This cross-sectional study considered 1-day measure of NAS (November 2012 obtained from 758 patients in 19 ICUs of seven countries (Norway, the Netherlands, Spain, Poland, Egypt, Greece and Brazil. The Delphi technique was used in expertise meetings and consensus. Results The NAS score was 72.8% in average, ranging from 44.5% (Spain to 101.8% (Norway. The mean NAS score from Poland, Greece and Egypt was 83.0%, 64.6% and 57.1%, respectively. The NAS score was similar in Brazil (54.0% and in the Netherlands (51.0%. There were doubts in the understanding of five out 23 items of the NAS (21.7% which were discussed until researchers’ consensus. Conclusion NAS score were different in the seven countries. Future studies must verify if the fine standardization of the guideline can have a impact on differences in the NAS results.

  5. Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Kerawala, C; Roques, T; Jeannon, J-P; Bisase, B

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and management of patients with cancer of the oral cavity and the lip. Recommendations • Surgery remains the mainstay of management for oral cavity tumours. (R) • Tumour resection should be performed with a clinical clearance of 1 cm vital structures permitting. (R) • Elective neck treatment should be offered for all oral cavity tumours. (R) • Adjuvant radiochemotherapy in the presence of advanced neck disease or positive margins improves control rates. (R) • Early stage lip cancer can be treated equally well by surgery or radiation therapy. (R).

  6. Accelerated space object tracking via graphic processing unit

    Science.gov (United States)

    Jia, Bin; Liu, Kui; Pham, Khanh; Blasch, Erik; Chen, Genshe

    2016-05-01

    In this paper, a hybrid Monte Carlo Gauss mixture Kalman filter is proposed for the continuous orbit estimation problem. Specifically, the graphic processing unit (GPU) aided Monte Carlo method is used to propagate the uncertainty of the estimation when the observation is not available and the Gauss mixture Kalman filter is used to update the estimation when the observation sequences are available. A typical space object tracking problem using the ground radar is used to test the performance of the proposed algorithm. The performance of the proposed algorithm is compared with the popular cubature Kalman filter (CKF). The simulation results show that the ordinary CKF diverges in 5 observation periods. In contrast, the proposed hybrid Monte Carlo Gauss mixture Kalman filter achieves satisfactory performance in all observation periods. In addition, by using the GPU, the computational time is over 100 times less than that using the conventional central processing unit (CPU).

  7. Objective evaluation of oral presentation skills using Inertial Measurement Units.

    Science.gov (United States)

    Sessa, Salvatore; Kong, Weisheng; Zhang, Di; Cosentino, Sarah; Manawadu, Udara; Kawasaki, Motoji; Thomas, George Thuruthel; Suzuki, Tomohiro; Tsumura, Ryosuke; Takanishi, Atsuo

    2015-01-01

    Oral presentation is considered as one of the most sought after skills by companies and professional organizations and program accreditation agencies. However, both learning process and evaluation of this skill are time demanding and complex tasks that need dedication and experience. Furthermore, the role of the instructor is fundamental during the presentation assessment. The instructor needs to consider several verbal and nonverbal communications cues sent in parallel and this kind of evaluation is often subjective. Even if there are oral presentation rubrics that try to standardize the evaluation, they are not an optimal solution because they do not provide the presenter a real-time feedback. In this paper, we describe a system for behavioral monitoring during presentations. We propose an ecological measurement system based on Inertial Measurement Units to evaluate objectively the presenter's posture through objective parameters. The system can be used to provide a real-time feedback to the presenters unobtrusively.

  8. Key articles and guidelines relative to intensive care unit pharmacotherapy: 2009 update.

    Science.gov (United States)

    Erstad, Brian L; Brophy, Gretchen M; Martin, Steven J; Haas, Curtis E; Devlin, John W; Welage, Lynda S; Dager, William E

    2009-10-01

    Compilations of key articles and guidelines in a particular clinical practice area are useful not only to clinicians who practice in that area, but also to all clinicians. We compiled pertinent articles and guidelines pertaining to drug therapy in the intensive care setting from the perspective of experienced critical care pharmacists. A broad assembly of practitioners with expertise in various areas of intensive care unit pharmacology were involved in the compilation of this update.

  9. Object-Oriented Approach to Modeling Units of Pneumatic Systems

    Directory of Open Access Journals (Sweden)

    Yu. V. Kyurdzhiev

    2014-01-01

    Full Text Available The article shows the relevance of the approaches to the object-oriented programming when modeling the pneumatic units (PU.Based on the analysis of the calculation schemes of aggregates pneumatic systems two basic objects, namely a cavity flow and a material point were highlighted.Basic interactions of objects are defined. Cavity-cavity interaction: ex-change of matter and energy with the flows of mass. Cavity-point interaction: force interaction, exchange of energy in the form of operation. Point-point in-teraction: force interaction, elastic interaction, inelastic interaction, and inter-vals of displacement.The authors have developed mathematical models of basic objects and interactions. Models and interaction of elements are implemented in the object-oriented programming.Mathematical models of elements of PU design scheme are implemented in derived from the base class. These classes implement the models of flow cavity, piston, diaphragm, short channel, diaphragm to be open by a given law, spring, bellows, elastic collision, inelastic collision, friction, PU stages with a limited movement, etc.A numerical integration of differential equations for the mathematical models of PU design scheme elements is based on the Runge-Kutta method of the fourth order. On request each class performs a tact of integration i.e. calcu-lation of the coefficient method.The paper presents an integration algorithm of the system of differential equations. All objects of the PU design scheme are placed in a unidirectional class list. Iterator loop cycle initiates the integration tact of all the objects in the list. One in four iteration makes a transition to the next step of integration. Calculation process stops when any object shows a shutdowns flag.The proposed approach was tested in the calculation of a number of PU designs. With regard to traditional approaches to modeling, the authors-proposed method features in easy enhancement, code reuse, high reliability

  10. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Mitchell, A L; Gandhi, A; Scott-Coombes, D; Perros, P

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the management of thyroid cancer in adults and is based on the 2014 British Thyroid Association guidelines. Recommendations • Ultrasound scanning (USS) of the nodule or goitre is a crucial investigation in guiding the need for fine needle aspiration cytology (FNAC). (R) • FNAC should be considered for all nodules with suspicious ultrasound features (U3-U5). If a nodule is smaller than 10 mm in diameter, USS guided FNAC is not recommended unless clinically suspicious lymph nodes on USS are also present. (R) • Cytological analysis and categorisation should be reported according to the current British Thyroid Association Guidance. (R) • Ultrasound scanning assessment of cervical nodes should be done in FNAC-proven cancer. (R) • Magnetic resonance imaging (MRI) or computed tomography (CT) should be done in suspected cases of retrosternal extension, fixed tumours (local invasion with or without vocal cord paralysis) or when haemoptysis is reported. When CT with contrast is used pre-operatively, there should be a two-month delay between the use of iodinated contrast media and subsequent radioactive iodine (I131) therapy. (R) • Fluoro-deoxy-glucose positron emission tomography imaging is not recommended for routine evaluation. (G) • In patients with thyroid cancer, assessment of extrathyroidal extension and lymph node disease in the central and lateral neck compartments should be undertaken pre-operatively by USS and cross-sectional imaging (CT or MRI) if indicated. (R) • For patients with Thy 3f or Thy 4 FNAC a diagnostic hemithyroidectomy is recommended. (R) • Total thyroidectomy is recommended for patients with tumours greater than 4 cm in diameter or tumours of any size in association with any of the following characteristics: multifocal disease, bilateral disease, extrathyroidal

  11. Non-melanoma skin cancer: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Newlands, C; Currie, R; Memon, A; Whitaker, S; Woolford, T

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides consensus recommendations on the management of cutaneous basal cell carcinoma and squamous cell carcinoma in the head and neck region on the basis of current evidence. Recommendations • Royal College of Pathologists minimum datasets for NMSC should be adhered to in order to improve patient care and help work-force planning in pathology departments. (G) • Tumour depth is of critical importance in identifying high-risk cutaneous squamous cell carcinoma (cSCC), and should be reported in all cases. (R) • Appropriate imaging to determine the extent of primary NMSC is indicated when peri-neural involvement or bony invasion is suspected. (R) • In the clinically N0 neck, radiological imaging is not beneficial, and a policy of watchful waiting and patient education can be adopted. (R) • Patients with high-risk NMSC should be treated by members of a skin cancer multidisciplinary team (MDT) in secondary care. (G) • Non-infiltrative basal cell carcinoma (BCC) Radiotherapy (RT) is an effective therapy for primary BCC and cSCC. (R) • Re-excision should be carried out for incompletely excised high-risk BCC or where there is deep margin involvement. (R) • Incompletely excised high-risk cSCC should be re-excised. (R) • Further surgery should involve confirmed marginal clearance before reconstruction. (R) • P+ N0 disease: Resection should include involved parotid tissue, combined with levels I-III neck dissection, to include the external jugular node. (R) • P+ N+ disease: Resection should include level V if that level is clinically or radiologically involved. (R) • Adjuvant RT should include level V if not dissected. (R) • P0 N+ disease: Anterior neck disease should be managed with levels I-IV neck dissection to include the external jugular node. (R) • P0 N+ posterior echelon nodal disease (i

  12. Effectiveness of supporting intensive care units on implementing the guideline 'End-of-life care in the intensive care unit, nursing care': a cluster randomized controlled trial

    NARCIS (Netherlands)

    Noome, M.; Dijkstra, B.M.; Leeuwen, E. van; Vloet, L.C.M.

    2017-01-01

    AIM: The aim of this study was to examine the effectiveness of supporting intensive care units on implementing the guidelines. BACKGROUND: Quality of care can be achieved through evidence-based practice. Guidelines can facilitate evidence-based practice, such as the guidelines 'End-of-life care in t

  13. 77 FR 26238 - Fisheries of the United States; National Standard 1 Guidelines

    Science.gov (United States)

    2012-05-03

    ... that the international agreement exception applies to stocks that are subject to ``any bilateral or multilateral treaty, convention, or agreement which relates to fishing and to which the United States is party... subject to international agreements are not required to have ACLs. The NS1 Guidelines describe that the...

  14. Carbon accounting rules and guidelines for the United States Forest Sector

    Science.gov (United States)

    Richard A. Birdsey

    2006-01-01

    The United States Climate Change initiative includes improvements to the U.S. Department of Energy's Voluntary Greenhouse Gas Reporting Program. The program includes specific accounting rules and guidelines for reporting and registering forestry activities that reduce atmospheric CO2 by increasing carbon sequestration or reducing emissions....

  15. Compilation of the neonatal palliative care clinical guideline in neonatal intensive care unit.

    Science.gov (United States)

    Zargham-Boroujeni, Ali; Zoafa, Aniyehsadat; Marofi, Maryam; Badiee, Zohreh

    2015-01-01

    Clinical guidelines are important instruments for increasing the quality of clinical practice in the treatment team. Compilation of clinical guidelines is important due to special condition of the neonates and the nurses facing critical conditions in the neonatal intensive care unit (NICU). With 98% of neonatal deaths occurring in NICUs in the hospitals, it is important to pay attention to this issue. This study aimed at compilation of the neonatal palliative care clinical guidelines in NICU. This study was conducted with multistage comparative strategies with localization in Isfahan in 2013. In the first step, the components of the neonatal palliative care clinical guidelines were determined by searching in different databases. In the second stage, the level of expert group's consensus with each component of neonatal palliative care in the nominal group and focus group was investigated, and the clinical guideline was written based on that. In the third stage, the quality and applicability were determined with the positive viewpoints of medical experts, nurses, and members of the science board of five cities in Iran. Data were analyzed by descriptive statistics through SPSS. In the first stage, the draft of neonatal palliative care was designed based on neonates', their parents', and the related staff's requirements. In the second stage, its rank and applicability were determined and after analyzing the responses, with agreement of the focus group, the clinical guideline was written. In the third stage, the means of indication scores obtained were 75%, 69%, 72%, 72%, and 68% by Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. The compilation of the guideline can play an effective role in provision of neonatal care in nursing.

  16. European Society of Gastrointestinal Endoscopy (ESGE) guideline: the use of electrosurgical units.

    Science.gov (United States)

    Rey, J F; Beilenhoff, U; Neumann, C S; Dumonceau, J M

    2010-09-01

    Electrosurgery is used in the majority of endoscopic therapeutic procedures. An understanding of the fundamental electrosurgical principles and various settings available on electrosurgical units is essential for the safe and effective use of electrosurgery during endoscopy. The aims of these technical guidelines are to: (1) expose physical principles relevant to the understanding of electrosurgery during endoscopy; (2) describe and provide practical recommendations regarding electrosurgical units that are commonly in use; (3) discuss the clinical relevance of technologies recently implemented in newer electrosurgical units; and (4) review factors relevant to commonly performed therapeutic procedures, including polypectomy, sphincterotomy, contact thermal hemostasis, and argon plasma coagulation.

  17. Dietetic practices in adult hemodialysis units compared to k/doqi guidelines, lebanon

    Directory of Open Access Journals (Sweden)

    mirey karavetian

    2012-06-01

    Full Text Available Hospitals in Lebanon mostly employ only one dietitian to conduct all dietetic/food service/administrative tasks including hemodialysis (HD units which are exclusively hospital based. Little is known about dietetic practices in these (HD units. Kidney Disease Outcomes Quality Initiative (KDOQI and American Dietetic Association (ADA presented evidence that the presence of a competent dietitian in the HD unit has benefits on HD patient’s health and quality of life and is cost effective. This study aimed to reveal the current practices provided by dietitians to HD patients in Lebanon compared to KDOQI nutrition guidelines. A 36 item anonymous self-administered questionnaire was sent to all HD units in Lebanon (n=55. The questionnaire included 2 sections: 1 demographics and professional characteristics; 2 routine clinical practice Thirty eight (69% of the dietitians responded; only 34 were of use. The questions in survey were categorical, thus only the answers with the majority of the respondents will be reported: 97% were female. 82% were within the age of 21–34, 62% had 3–10 years in clinical practice and 44% had only 0–2 years exposure to renal patients. Most dietitians (69% worked in hospitals with 50–150 inpatients and 26–75 HD patients. Sixty nine percent of dietitians spent more than 36 hours per week in the hospital, while 85% spent less than 10 hours per week in the HD unit. As to the level of applying KDOQI nutrition guidelines in routine practice, of the 23 guidelines asked, all dietitians used at least 1 guideline, 17% used 5 and 23% used 10 guidelines. Only one dietitian applied all guidelines. A total compliance to guidelines score was developed as a percentage of total compliance which showed 37±15.51% (min14, max 73. Barriers identified were lack of time and lack of integration into the medical team. It is evident that dietetic practices in Lebanon targeting HD patients need support in all aspects: time, knowledge

  18. Multi-Objective Optimization Design for Cooling Unit of Automotive Exhaust-Based Thermoelectric Generators

    Science.gov (United States)

    Qiang, J. W.; Yu, C. G.; Deng, Y. D.; Su, C. Q.; Wang, Y. P.; Yuan, X. H.

    2016-03-01

    In order to improve the performance of cooling units for automotive thermoelectric generators, a study is carried out to optimize the cold side and the fin distributions arranged on its inner faces. Based on the experimental measurements and numerical simulations, a response surface model of different internal structures is built to analyze the heat transfer and pressure drop characteristics of fluid flow in the cooling unit. For the fin distributions, five independent variables including height, length, thickness, space and distance from walls are considered. An experimental study design incorporating the central composite design method is used to assess the influence of fin distributions on the temperature field and the pressure drop in the cooling units. The archive-based micro genetic algorithm (AMGA) is used for multi-objective optimization to analyze the sensitivity of the design variables and to build a database from which to construct the surrogate model. Finally, improvement measures are proposed for optimization of the cooling system and guidelines are provided for future research.

  19. Cement Manufacturing Plant Guidelines: An Approach to Reconciling the Financing of Cement with Climate Change Objectives

    OpenAIRE

    2010-01-01

    Cement manufacturing is an energy-intensive process, requiring high fuel consumption to operate cement kilns, which in turn generates carbon dioxide (CO2). These Guidelines aim to provide clear and quantitative Minimum Climate Change Performance Criteria necessary for IDB to support projects, as well as guidance on assessing and reducing the greenhouse gas (GHG) emissions of projects. The purpose of the Cement Manufacturing Plant guidelines is to set forth an approach for the financing of new...

  20. Pre-hospital care after a seizure: Evidence base and United Kingdom management guidelines.

    Science.gov (United States)

    Osborne, Andrew; Taylor, Louise; Reuber, Markus; Grünewald, Richard A; Parkinson, Martin; Dickson, Jon M

    2015-01-01

    Seizures are a common presentation to pre-hospital emergency services and they generate significant healthcare costs. This article summarises the United Kingdom (UK) Ambulance Service guidelines for the management of seizures and explores the extent to which these guidelines are evidence-based. Summary of the Clinical Practice Guidelines of the UK Joint Royal Colleges Ambulance Liaison Committee relating to the management of seizures. Review of the literature relating to pre-hospital management of seizure emergencies. Much standard practice relating to the emergency out of hospital management of patients with seizures is drawn from generic Advanced Life Support (ALS) guidelines although many patients do not need ALS during or after a seizure and the benefit of many ALS interventions in seizure patients remains to be established. The majority of studies identified pertain to medical treatment of status epilepticus. These papers show that benzodiazepines are safe and effective but it is not possible to draw definitive conclusions about the best medication or the optimal route of administration. The evidence base for current pre-hospital guidelines for seizure emergencies is incomplete. A large proportion of patients are transported to hospital after a seizure but many of these may be suitable for home management. However, there is very little research into alternative care pathways or criteria that could be used to help paramedics avoid transport to hospital. More research is needed to improve care for people after a seizure and to improve the cost-effectiveness of the healthcare systems within which they are treated. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  1. What Is the Unit of Visual Attention? Object for Selection, but Boolean Map for Access

    Science.gov (United States)

    Huang, Liqiang

    2010-01-01

    In the past 20 years, numerous theories and findings have suggested that the unit of visual attention is the object. In this study, I first clarify 2 different meanings of unit of visual attention, namely the unit of access in the sense of measurement and the unit of selection in the sense of division. In accordance with this distinction, I argue…

  2. Energy Objectives for the United States Department of Defense

    Science.gov (United States)

    2013-08-01

    Service, Library of Congress Schwartz, M., Blakely, K., & O’Rourke, R ., for the Congressional Research Service (CRS) 2012 14 More capable warfighting...Report FT602T1) Crowley, T. D., Corrie, T. D., Diamond, D. B., Funk, S. D., Hansen , W. A., Stenhoff, A. D., & Swift, D. C., for Logistics Management...Memorandum] Assistant Secretary of the Navy for Research, Development, and Acquisition 2011 28 Department of the Navy ( DON ) objectives for FY 2012 and

  3. Therapeutic hypothermia in Italian Intensive Care Units after 2010 resuscitation guidelines: still a lot to do.

    Science.gov (United States)

    Gasparetto, Nicola; Scarpa, Daniele; Rossi, Sandra; Persona, Paolo; Martano, Luigi; Bianchin, Andrea; Castioni, Carlo Alberto; Ori, Carlo; Iliceto, Sabino; Cacciavillani, Luisa

    2014-03-01

    Therapeutic hypothermia (TH) is one of three interventions that have demonstrated to improve patients' neurological outcome after cardiac arrest. The aim of this study was to investigate the effect of the 2010 resuscitation guidelines on TH implementation in various Italian Intensive Care Units (ICU). A structured questionnaire was submitted to Italian ICU. The questionnaire was addressed to determine the procedures of TH in each ICU or, on the contrary, the reason for not employing the therapy. We obtained complete information from 770 of 847 Italian ICU (91%). Out of 405 Units included in the analysis only 223 (55.1%) reported to use TH in comatose patients after return of spontaneous circulation. The trend of TH implementation shows a stable increase, particularly after 2006 but there is no evident acceleration after the strong indication of the 2010 guidelines. There was a rise of about 3.4 times in the number of Italian ICU using TH as compared to the 2007 survey (an increase of 68% per year). One hundred and eighty-two (44.9%) units did not use TH mainly because of lack of equipment, economic issues or the conviction of the difficulty of execution. TH is still under-used in Italy (55.1%) even though the therapy is strongly recommended in the 2010 guidelines. However, the increase in the adoption of hypothermia has been significant in the past 5 years (68%/years) and the awareness of the efficacy is almost consolidated among intensivists, being logistic problems the leading cause for non-adoption. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Ethnography of "Local Universality": Admission Practices in an Intensive Care Unit Among Guidelines, Routines, and Humour

    Directory of Open Access Journals (Sweden)

    Roberto Lusardi

    2015-04-01

    Full Text Available The article analyses the existing gap between the formal dimension of evidence-based medicine (EBM, as constituted by protocols, procedures, and guidelines, and actual professional practices in relation to a specific issue: the admission of patients to an intensive care unit (ICU. The results of a case study, carried out in the ICU of a hospital in the north of Italy between 2006 and 2007 are reported. The study was performed using ethnographic methods: participant observation, ethnographic interviews, and semi-structured interviews. Empirical data have been analysed using a grounded theory approach. The results show how three dimensions (macrosocial, organisational-interactional, and individual become intertwined with the operational guidelines that have been drafted on the basis of international evidence. The standardisation process that the guidelines presuppose results in the adoption of a variety of different local styles with respect to the approach that individual doctors take in relation to the admission of a patient to an ICU. These styles can range from strict adherence to the international criteria to a greater compliance with medical–legal, organisational, and individual needs. Furthermore, the results of the study demonstrate how relational knowledge, as a form of situated knowledge, can allow the personnel involved to activate local resources (organisational, professional, and personal in order to incorporate the formal prescriptions of EBM in professional practice. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1502261

  5. Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States

    Science.gov (United States)

    Moore, Andrew; Nelson, Christina; Molins, Claudia; Mead, Paul

    2016-01-01

    In the United States, Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks. Patients with an erythema migrans lesion and epidemiologic risk can receive a diagnosis without laboratory testing. For all other patients, laboratory testing is necessary to confirm the diagnosis, but proper interpretation depends on symptoms and timing of illness. The recommended laboratory test in the United States is 2-tiered serologic analysis consisting of an enzyme-linked immunoassay or immunofluorescence assay, followed by reflexive immunoblotting. Sensitivity of 2-tiered testing is low (30%–40%) during early infection while the antibody response is developing (window period). For disseminated Lyme disease, sensitivity is 70%–100%. Specificity is high (>95%) during all stages of disease. Use of other diagnostic tests for Lyme disease is limited. We review the rationale behind current US testing guidelines, appropriate use and interpretation of tests, and recent developments in Lyme disease diagnostics. PMID:27314832

  6. Consensus guidelines on analgesia and sedation in dying intensive care unit patients

    Directory of Open Access Journals (Sweden)

    Lemieux-Charles Louise

    2002-08-01

    Full Text Available Abstract Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1 Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9; 2 Deputy chief provincial coroners (N = 5; 3 Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12. Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia.

  7. Current status of preventive cardiology training among United States cardiology fellowships and comparison to training guidelines.

    Science.gov (United States)

    Pack, Quinn R; Keteyian, Steven J; McBride, Patrick E; Weaver, W Douglas; Kim, Henry E

    2012-07-01

    We evaluated preventive cardiology education in United States cardiology fellowship programs and their adherence to Core Cardiovascular Training Symposium training guidelines, which recommend 1 month of training, faculty with expertise, and clinical experience in cardiac rehabilitation, lipid disorder management, and diabetes management as a part of the prevention curricula. We sent an anonymous survey to United States cardiology program directors and their chief fellow. The survey assessed the program curricula, rotation structure, faculty expertise, obstacles, and recommended improvements. The results revealed that 24% of surveyed programs met the Core Cardiovascular Training Symposium guidelines with a dedicated 1-month rotation in preventive cardiology, 24% had no formalized training in preventive cardiology, and 30% had no faculty with expertise in preventive cardiology, which correlated with fewer rotations in prevention than those with specialized faculty (p = 0.009). Fellows rotated though the following experiences (% of programs): cardiac rehabilitation, 71%; lipid management, 37%; hypertension, 15%; diabetes, 7%; weight management/obesity, 6%; cardiac nutrition, 6%; and smoking cessation, 5%. The program directors cited "lack of time" as the greatest obstacle to providing preventive cardiology training and the chief fellows reported "lack of a developed curriculum" (p = 0.01). The most recommended improvement was for the American College of Cardiology to develop a web-based curriculum/module. In conclusion, most surveyed United States cardiology training programs currently do not adhere to basic preventive cardiovascular medicine Core Cardiovascular Training Symposium recommendations. Additional attention to developing curricular content and structure, including the creation of an American College of Cardiology on-line knowledge module might improve fellowship training in preventive cardiology.

  8. [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

  9. Carbon accounting rules and guidelines for the United States forest sector.

    Science.gov (United States)

    Birdsey, Richard A

    2006-01-01

    The United States Climate Change Initiative includes improvements to the U.S. Department of Energy's Voluntary Greenhouse Gas Reporting Program. The program includes specific accounting rules and guidelines for reporting and registering forestry activities that reduce atmospheric CO2 by increasing carbon sequestration or reducing emissions. In the forestry sector, there is potential for the economic value of emissions credits to provide increased income for landowners, to support rural development, to facilitate the practice of sustainable forest management, and to support restoration of ecosystems. Forestry activities with potential for achieving substantial reductions include, but are not limited to: afforestation, mine land reclamation, forest restoration, agroforestry, forest management, short-rotation biomass energy plantations, forest protection, wood production, and urban forestry. To be eligible for registration, the reported reductions must use methods and meet standards contained in the guidelines. Forestry presents some unique challenges and opportunities because of the diversity of activities, the variety of practices that can affect greenhouse gases, year-to-year variability in emissions and sequestration, the effects of activities on different forest carbon pools, and accounting for the effects of natural disturbance.

  10. Interim Guidelines for Pregnant Women During a Zika Virus Outbreak--United States, 2016.

    Science.gov (United States)

    Petersen, Emily E; Staples, J Erin; Meaney-Delman, Dana; Fischer, Marc; Ellington, Sascha R; Callaghan, William M; Jamieson, Denise J

    2016-01-22

    CDC has developed interim guidelines for health care providers in the United States caring for pregnant women during a Zika virus outbreak. These guidelines include recommendations for pregnant women considering travel to an area with Zika virus transmission and recommendations for screening, testing, and management of pregnant returning travelers. Updates on areas with ongoing Zika virus transmission are available online (http://wwwnc.cdc.gov/travel/notices/). Health care providers should ask all pregnant women about recent travel. Pregnant women with a history of travel to an area with Zika virus transmission and who report two or more symptoms consistent with Zika virus disease (acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis) during or within 2 weeks of travel, or who have ultrasound findings of fetal microcephaly or intracranial calcifications, should be tested for Zika virus infection in consultation with their state or local health department. Testing is not indicated for women without a travel history to an area with Zika virus transmission. In pregnant women with laboratory evidence of Zika virus infection, serial ultrasound examination should be considered to monitor fetal growth and anatomy and referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is recommended. There is no specific antiviral treatment for Zika virus; supportive care is recommended.

  11. Some Design-Objectives and Design-Guidelines for Automotive Friction Clutch Based on Clutch Engagement Dynamics

    Science.gov (United States)

    Tripathi, K.

    2014-01-01

    Dynamics of the driveline and the vehicle during clutch engagement is a complex phenomenon. Time domain analysis of different state variables is performed through numerical solution of sixth-order driveline model using an indigenous computer program. The study revealed that different design objectives like driver and passenger comfort, smoothness of engagement, wear of friction surfaces, power loss, and heat generation are in mutual conflict, with respect to the sub-ranges of operational parameters. The overall outcome of this study is presented in the form of a matrix, relating the sub-ranges of operational parameters with engagement quality parameters, which may be used as a guideline for clutch design for different design objectives. The engagement quality parameters may also be used for building a cost function for overall optimization of clutch.

  12. Establishing a quality management system for unit-use testing based on NCCLS proposed guideline (EP18-P).

    Science.gov (United States)

    Whitley, R J; Santrach, P J; Phillips, D L

    2001-05-01

    Point of care tests often employ unit-use test devices. By their very nature (single use, disposable, self-contained) such devices present unique challenges for quality assurance (QA) and quality control (QC). The proposed NCCLS guideline (EP18-P) recommends a quality management system for unit-use testing. The document addresses regulatory considerations, proposes the development of a partnership between users and manufacturers, provides a source of error matrix, and suggests practical approaches to quality monitoring, identification and management of these potential problems. The key to the success of this guideline is cooperation and open exchange of information among manufacturers, users, regulators, and accrediting agencies.

  13. Outcomes of Emergency Medical Patients Admitted to an Intermediate Care Unit With Detailed Admission Guidelines.

    Science.gov (United States)

    Simpson, Catherine E; Sahetya, Sarina K; Bradsher, Robert W; Scholten, Eric L; Bain, William; Siddique, Shazia M; Hager, David N

    2017-01-01

    An important, but not well characterized, population receiving intermediate care is that of medical patients admitted directly from the emergency department. To characterize emergency medical patients and their outcomes when admitted to an intermediate care unit with clearly defined admission guidelines. Demographic data, admitting diagnoses, illness severity, comorbid conditions, lengths of stay, and hospital mortality were characterized for all emergency medical patients admitted directly to an intermediate care unit from July through December 2012. A total of 317 unique patients were admitted (mean age, 54 [SD, 16] years). Most patients were admitted with respiratory (26.5%) or cardiac (17.0%) syndromes. The mean (SD) Acute Physiology and Chronic Health Evaluation score version II, Simplified Acute Physiology Score version II, and Charlson Comorbidity Index were 15.6 (6.5), 20.7 (11.8), and 2.7 (2.3), respectively. Severity of illness and length of stay were significantly different for patients who required intensive care within 24 hours of admission (n = 16) or later (n = 25), patients who continued with inter mediate care for more than 24 hours (n = 247), and patients who were downgraded or discharged in less than 24 hours (n = 29). Overall hospital mortality was 4.4% (14 deaths). Emergency medical patients with moderate severity of illness and comorbidity can be admitted to an intermediate level of care with relatively infrequent transfer to intensive care and relatively low mortality. ©2016 American Association of Critical-Care Nurses.

  14. Heel blood sampling in European neonatal intensive care units: compliance with pain management guidelines

    DEFF Research Database (Denmark)

    Losacco, Valentina; Cuttini, Marina; Greisen, Gorm

    2011-01-01

    Objective To describe the use of heel blood sampling and non-pharmacological analgesia in a large representative sample of neonatal intensive care units (NICUs) in eight European countries, and compare their self-reported practices with evidence-based recommendations. Methods Information on use...... admissions per year were included in this analysis. Results Use of heel blood sampling appeared widespread. Most units in the Netherlands, UK, Denmark, Sweden and France predominantly adopted mechanical devices, while manual lance was still in use in the other countries. The two Scandinavian countries...... and France were the most likely, and Belgium and Spain the least likely to employ recommended combinations of evidence-based pain management measures. Conclusions Heel puncture is a common procedure in preterm neonates, but pain appears inadequately treated in many units and countries. Better compliance...

  15. A method for subdividing clinical guidelines into process modules with associated triggers and objectives to facilitate implementation.

    Science.gov (United States)

    Luckmann, Roger S; Boxwala, Aziz A; Greenes, Robert A

    2003-01-01

    Representation of multi-step clinical guidelines (CG) and their implementation in computerized decision support (DS) systems are complex and logistically challenging tasks. However, many simple rules based on CGs (e.g., medical logic modules), have been successfully implemented through a few popular DS models (e.g., prevention reminders, order entry systems). To facilitate mapping of CGs to practical DS models, we propose an empirical method for sub-dividing CGs into modules according to the locus in a clinical process flow model where implementation would be most effective (e.g., post-encounter provider order entry). We further propose a classification of triggers and objectives for CG modules that provides a framework for a DS system to implement the module Successful application of the method to ten diverse CGs in the outpatient setting is described.

  16. An evaluation of safety guidelines to restrict exposure to stray radiofrequency radiation from short-wave diathermy units

    Science.gov (United States)

    Shields, Nora; O'Hare, Neil; Gormley, John

    2004-07-01

    Short-wave diathermy (SWD), a form of radiofrequency radiation used therapeutically by physiotherapists, may be applied in continuous (CSWD) or pulsed (PSWD) mode using either capacitive or inductive methods. Stray radiation emitted by these units may exceed exposure guidelines close to the equipment. Discrepant guidelines exist on a safe distance from an operating unit for operators and other personnel. Stray electric (E-field) and magnetic (H-field) field strengths from 10 SWD units in six departments were examined using a PMM 8053 meter and two isotropic probes (EP-330, HP-032). A 5 l saline phantom completed the patient circuit. Measurements were recorded in eight directions between 0.5 m and 2 m at hip and eye levels while the units operated at maximum output and data compared to current guidelines. Results found stray fields from capacitive CSWD fell below operator limits at 2 m (E-field 4.8-39.8 V/m; H-field 0.015-0.072 A/m) and at 1 m for inductive CSWD (E-field 0-36 V/m; H-field 0.01-0.065 A/m). Capacitive PSWD fields fell below the limits at 1.5 m (E-field 1.2-19.9 V/m; H-field 0.002-0.045 A/m) and at 1m for inductive PSWD (E-field 0.7-4.0 V/m; H-field 0.009-0.03 A/m). An extra 0.5 m was required before fields fell below the guidelines for other personnel. These results demonstrate, under a worst case scenario, emissions from SWD exceed the guidelines for operators at distances currently recommended as safe. Future guidelines should include recommendations for personnel other than physiotherapists.

  17. An evaluation of safety guidelines to restrict exposure to stray radiofrequency radiation from short-wave diathermy units

    Energy Technology Data Exchange (ETDEWEB)

    Shields, Nora [School of Physiotherapy, La Trobe University, Victoria 3086 (Australia); O' Hare, Neil [Department of Medical Physics and Bioengineering, St James' s Hospital, Dublin 8 (Ireland); Gormley, John [School of Physiotherapy, Trinity College Dublin, Trinity Centre for Health Sciences, St James' s Hospital, Dublin 8 (Ireland)

    2004-07-07

    Short-wave diathermy (SWD), a form of radiofrequency radiation used therapeutically by physiotherapists, may be applied in continuous (CSWD) or pulsed (PSWD) mode using either capacitive or inductive methods. Stray radiation emitted by these units may exceed exposure guidelines close to the equipment. Discrepant guidelines exist on a safe distance from an operating unit for operators and other personnel. Stray electric (E-field) and magnetic (H-field) field strengths from 10 SWD units in six departments were examined using a PMM 8053 meter and two isotropic probes (EP-330, HP-032). A 5 l saline phantom completed the patient circuit. Measurements were recorded in eight directions between 0.5 m and 2 m at hip and eye levels while the units operated at maximum output and data compared to current guidelines. Results found stray fields from capacitive CSWD fell below operator limits at 2 m (E-field 4.8-39.8 V/m; H-field 0.015-0.072 A/m) and at 1 m for inductive CSWD (E-field 0-36 V/m; H-field 0.01-0.065 A/m). Capacitive PSWD fields fell below the limits at 1.5 m (E-field 1.2-19.9 V/m; H-field 0.002-0.045 A/m) and at 1m for inductive PSWD (E-field 0.7-4.0 V/m; H-field 0.009-0.03 A/m). An extra 0.5 m was required before fields fell below the guidelines for other personnel. These results demonstrate, under a worst case scenario, emissions from SWD exceed the guidelines for operators at distances currently recommended as safe. Future guidelines should include recommendations for personnel other than physiotherapists.

  18. Lay epidemiology and the interpretation of low-risk drinking guidelines by adults in the United Kingdom.

    Science.gov (United States)

    Lovatt, Melanie; Eadie, Douglas; Meier, Petra S; Li, Jessica; Bauld, Linda; Hastings, Gerard; Holmes, John

    2015-12-01

    To explore how the concept of lay epidemiology can enhance understandings of how drinkers make sense of current UK drinking guidelines. Qualitative study using 12 focus groups in four sites in northern England and four sites in central Scotland. Participants were 66 male and female drinkers, aged between 19 and 65 years, of different socio-economic backgrounds. Data were analysed thematically using a conceptual framework of lay epidemiology. Current drinking guidelines were perceived as having little relevance to participants' drinking behaviours and were generally disregarded. Daily guidelines were seen as irrelevant by drinkers whose drinking patterns comprised heavy weekend drinking. The amounts given in the guidelines were seen as unrealistic for those motivated to drink for intoxication, and participants measured alcohol intake in numbers of drinks or containers rather than units. Participants reported moderating their drinking, but this was out of a desire to fulfil work and family responsibilities, rather than concerns for their own health. The current Australian and Canadian guidelines were preferred to UK guidelines, as they were seen to address many of the above problems. Drinking guidelines derived from, and framed within, solely epidemiological paradigms lack relevance for adult drinkers who monitor and moderate their alcohol intake according to their own knowledge and risk perceptions derived primarily from experience. Insights from lay epidemiology into how drinkers regulate and monitor their drinking should be used in the construction of drinking guidelines to enhance their credibility and efficacy. © 2015 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  19. Development of the Stroke-unit Discharge Guideline: choice of assessment instruments for prediction in the subacute phase post-stroke.

    NARCIS (Netherlands)

    Meijer, R.; Limbeek, J. van; Haan, R. de

    2006-01-01

    The purpose of this paper is to present the design of an evidence-based dataset of assessment instruments for the prognostic factors of the Stroke-unit Discharge Guideline (SDG), a consensus based guideline for the decision of the discharge destination from the hospital stroke unit. In our systemati

  20. Development of the Stroke-unit Discharge Guideline: choice of assessment instruments for prediction in the subacute phase post-stroke

    NARCIS (Netherlands)

    R. Meijer; J. van Limbeek; R. de Haan

    2006-01-01

    The purpose of this paper is to present the design of an evidence-based dataset of assessment instruments for the prognostic factors of the Stroke-unit Discharge Guideline (SDG), a consensus based guideline for the decision of the discharge destination from the hospital stroke unit. In our systemati

  1. Development of the Stroke-unit Discharge Guideline: choice of assessment instruments for prediction in the subacute phase post-stroke.

    NARCIS (Netherlands)

    Meijer, R.; Limbeek, J. van; Haan, R. de

    2006-01-01

    The purpose of this paper is to present the design of an evidence-based dataset of assessment instruments for the prognostic factors of the Stroke-unit Discharge Guideline (SDG), a consensus based guideline for the decision of the discharge destination from the hospital stroke unit. In our

  2. Guidelines for the Psychosocial Evaluation of Living Unrelated Kidney Donors in the United States

    National Research Council Canada - National Science Library

    Dew, M. A; Jacobs, C. L; Jowsey, S. G; Hanto, R; Miller, C; Delmonico, F.L

    2007-01-01

    ..., in Washington, DC, to develop guidelines for the psychosocial evaluation of prospective living kidney donors who have neither a biologic nor longstanding emotional relationship with the transplant candidate...

  3. Challenge Identification for the Objective Provision Tree Application to the Effectiveness Evaluation for the Accident Management Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Huichang [TUEV Rheinland Korea Ltd., Seoul (Korea, Republic of); Kim, Hanchul; Lee, Sunghan [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2013-05-15

    As a part of the OPT application for the effectiveness evaluation of the accident management guidelines, challenges which could threaten the safety functions required to maintain the safety, were identified. The identification of detailed provisions in terms of the accident management guidelines is being performed and the visualizing the identified elements of OPT is also under performance. With this logical structure of OPT, the provision of useful tool to evaluate the effectiveness of accident management guideline framework, is expected. The OPT method is a highly logical and top-down approach to identify the vulnerable aspect of the framework which includes the accident management guidelines, such as Emergency Operating Procedures (EOPs), Severe Accident Management Guides (SAMGs) and even Extensive Damage Mitigating Guidelines and FLEX guides. In virtue of this logical tool, the evaluation for the framework of the accident management guidelines was tried in this study.

  4. Do United States’ Teachers Know and Adhere to the National Guidelines on Asthma Management in the Classroom? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Yudilyn Jaramillo

    2015-01-01

    Full Text Available Proper asthma management in schools is important in achieving optimum asthma control in children with asthma. The National Heart, Lung, and Blood Institute (NHLBI has developed guidelines on classroom asthma management. We conducted a systematic review to examine teacher knowledge of the NHLBI guidelines on asthma management in the classroom. We searched PubMed and EMBASE using search terms “asthma management,” “teacher(s,” “school teacher,” and “public school.” The inclusion criteria were articles published in English from 1994 to May 2014 that focus on schools in the United States (US. From 535 titles and abstracts, 9 studies met inclusion criteria. All studies reported that school teachers did not know the policies and procedures of asthma management. Teachers relied on school nurses to handle medical emergencies. Some studies identified that lack of full-time school nurses was a barrier to asthma management. Only one study showed directly that classroom teachers were not following the NHLBI guidelines on asthma management. Our literature review revealed that US teachers do not know the NHLBI guidelines on asthma management in the classroom. Future research should focus on interventions targeted toward training classroom teachers on asthma management as per NHLBI guidelines to ultimately improve asthma management in schools.

  5. Practice Patterns and Opinions on Current Clinical Practice Guidelines Regarding the Management of Delirium in the Intensive Care Unit.

    Science.gov (United States)

    Mo, Yoonsun; Zimmermann, Anthony E; Thomas, Michael C

    2017-04-01

    The aim of this study was to determine current delirium practices in the intensive care unit (ICU) setting and evaluate awareness and adoption of the 2013 Pain, Agitation, and Delirium (PAD) guidelines with emphasis on delirium management. A large-scale, multidisciplinary, online survey was administered to physician, pharmacist, nurse, and mid-level practitioner members of the Society of Critical Care Medicine (SCCM) between September 2014 and October 2014. A total of 635 respondents completed the survey. Nonpharmacologic interventions such as early mobilization were used in most ICUs (83%) for prevention of delirium. A majority of respondents (97%) reported using pharmacologic agents to treat hyperactive delirium. Ninety percent of the respondents answered that they were aware of the 2013 PAD guidelines, and 75% of respondents felt that their delirium practices have been changed as a result of the new guidelines. In addition, logistic regression analysis of this study showed that respondents who use delirium screening tools were twice more likely to be fully aware of key components of the updated guidelines (odds ratio [OR] = 2.07, 95% confidence interval [CI] = 1.20-3.60). Most critical care practitioners are fully aware and knowledgeable of key recommendations in the new guidelines and have changed their delirium practices accordingly.

  6. Do United States' teachers know and adhere to the national guidelines on asthma management in the classroom? A systematic review.

    Science.gov (United States)

    Jaramillo, Yudilyn; Reznik, Marina

    2015-01-01

    Proper asthma management in schools is important in achieving optimum asthma control in children with asthma. The National Heart, Lung, and Blood Institute (NHLBI) has developed guidelines on classroom asthma management. We conducted a systematic review to examine teacher knowledge of the NHLBI guidelines on asthma management in the classroom. We searched PubMed and EMBASE using search terms "asthma management," "teacher(s)," "school teacher," and "public school." The inclusion criteria were articles published in English from 1994 to May 2014 that focus on schools in the United States (US). From 535 titles and abstracts, 9 studies met inclusion criteria. All studies reported that school teachers did not know the policies and procedures of asthma management. Teachers relied on school nurses to handle medical emergencies. Some studies identified that lack of full-time school nurses was a barrier to asthma management. Only one study showed directly that classroom teachers were not following the NHLBI guidelines on asthma management. Our literature review revealed that US teachers do not know the NHLBI guidelines on asthma management in the classroom. Future research should focus on interventions targeted toward training classroom teachers on asthma management as per NHLBI guidelines to ultimately improve asthma management in schools.

  7. Studying the incommensurability that unites us: persuasion across discourse communities, persuasion via boundary objects

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, G. D. (Gregory D.)

    2003-01-01

    In the science studies literature the theoretical construct of boundary objects has been developed to explain how diverse communities clustered around a scientific subject area cooperate to advance that area. Boundary objects are 'scientific objects that inhabit several intersecting social worlds . . . and satisfy the informational requirements of each of them' (Star and Griesemer 393). Star and Griesemer's foundational article showed that these objects can be shared by communities ranging from academic researchers to amateur enthiasts, adminsitrators, philanthropists, and technicians. While each community understands the object differently, there is enough commonality in the understanding of the object to unite these distinct social worlds and facilitate cooperation among them.

  8. Managing Highway Maintenance: Maintenance Management--by Objectives, Unit 10, Level 2.

    Science.gov (United States)

    Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

    Part of the series "Managing Highway Maintenance," the unit deals with management by objectives--its definition, how it works, and necessary steps for application. It is designed for maintenance supervisors who are familiar with maintenance management systems. The format is a programed, self-instructional approach in which questions are…

  9. Aqueous treatment of water-sensitive paper objects: capillary unit, blotter wash or paraprint wash?

    NARCIS (Netherlands)

    H. Schalkx; P. Iedema; B. Reissland; B. van Velzen

    2011-01-01

    Blotter washing andwashing with the capillary unit are both methods used for aqueoustreatment of water-sensitive paper objects. The challenge of thistreatment is to remove water-soluble products while keeping thewater-sensitive medium in its place. In this article the two methodsare compared, along

  10. Danish Guidelines 2015 for percutaneous Dilatational Tracheostomy in the Intensive Care Unit

    DEFF Research Database (Denmark)

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

    2015-01-01

    Percutaneous dilatational tracheostomy is a common procedure in intensive care. This updated Danish national guideline describes indications, contraindications and complications, and gives recommendations for timing, anaesthesia, and technique, use of fibre bronchoscopy and ultrasound guidance...

  11. Key articles and guidelines relative to intensive care unit pharmacology--2004.

    Science.gov (United States)

    Erstad, Brian L; Martin, Steven J; Brophy, Gretchen M; Haas, Curtis E; Jacobi, Judith; Welage, Lynda S; Thomas, Michael C

    2005-04-01

    Compilations of key articles and guidelines in a particular clinical practice area are useful not only to clinicians who practice in that area, but to all clinicians. We compiled pertinent articles and guidelines pertaining to drug therapy in the intensive care setting from the perspective of actively practicing critical care pharmacists. This document differs from the original 2002 version in that a broader assembly of intensive care practitioners was involved in the compilation.

  12. Implementing clinical guidelines for nutrition in a neurosurgical intensive care unit.

    Science.gov (United States)

    Annette, Hansson; Wenström, Yvonne

    2005-12-01

    Patients in neurosurgical intensive care have individual needs concerning nutrition because of their conditions. An important therapeutic goal is to prevent the development of malnutrition as it contributes to an increase in mortality and enhances the risk of complications in these patients. The health-care team has a mutual responsibility for this, although it is a complex task and a correct assessment of patients' nutritional needs is vital. Multidisciplinary clinical guidelines focused on nutrition might help the health-care staff in decision-making and allowing individualized treatment for patients. The aim of this study was to evaluate the implementation and use of such a guideline. The results show that the guideline is used in varying degrees by the health-care team. Areas that focused on more practical aspects of nutritional support seemed to have a unified approach, whereas areas on nutritional assessment and routine nutrition orders demonstrated both a lack of knowledge and unclear role responsibilities. The results reveal how different professional groups in health care perceive the implementation of a clinical guideline. Some areas need further clarification, there needs to be continuing development of nutritional guidelines, and education of staff is needed in order to enhance the nutritional care of patients.

  13. Guidelines International Network: toward international standards for clinical practice guidelines.

    Science.gov (United States)

    Qaseem, Amir; Forland, Frode; Macbeth, Fergus; Ollenschläger, Günter; Phillips, Sue; van der Wees, Philip

    2012-04-03

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. Institute of Medicine and the United Kingdom's National Institute for Health and Clinical Excellence have developed recommendations to define trustworthy guidelines within their locales. Many groups charged with guideline development find the lengthy list of standards developed by such organizations to be aspirational but infeasible to follow in entirety. Founded in 2002, the Guidelines International Network (G-I-N) is a network of guideline developers that includes 93 organizations and 89 individual members representing 46 countries. The G-I-N board of trustees recognized the importance of guideline development processes that are both rigorous and feasible even for modestly funded groups to implement and initiated an effort toward consensus about minimum standards for high-quality guidelines. In contrast to other existing standards for guideline development at national or local levels, the key components proposed by G-I-N will represent the consensus of an international, multidisciplinary group of active guideline developers. This article presents G-I-N's proposed set of key components for guideline development. These key components address panel composition, decision-making process, conflicts of interest, guideline objective, development methods, evidence review, basis of recommendations, ratings of evidence and recommendations, guideline review, updating processes, and funding. It is hoped that this article promotes discussion and eventual agreement on a set of international standards for guideline development.

  14. Adherence to guidelines in bleeding oesophageal varices and effects on outcome: comparison between a specialized unit and a community hospital

    DEFF Research Database (Denmark)

    Hobolth, Lise; Krag, Aleksander; Malchow-Møller, Axel

    2010-01-01

    is difficult. Our aims were to compare adherence to evidence-based guidelines in BOV between a specialized unit and a community hospital, and to investigate whether differences in adherence affected the outcome. METHODS: Two cohorts hospitalized during 2000-2007 with a first episode of BOV were retrospectively...... enrolled, one in a community hospital comprising 66 patients and one in a specialized unit comprising 111 patients. Data on treatment, rebleeding and mortality were collected from medical records according to the Baveno III/IV Criteria. RESULTS: Treatments in the specialized unit versus the community...... shunt therapy was initiated in 91 vs. 74% (P specialized vs. community). Six-week mortality was 17 vs. 24% (P = 0.25) with 5-day mortality of 6 vs. 3% (P = 0.34) and mortality day 6-42, 12 vs. 22% (P = 0.07) (specialized vs. community). Failure to control bleeding and failure to prevent...

  15. Physical therapists' guideline adherence on early mobilization and intensity of practice at dutch acute stroke units: a country-wide survey

    NARCIS (Netherlands)

    Otterman, N.M.; Wees, P.J. van der; Bernhardt, J.; Kwakkel, G.

    2012-01-01

    BACKGROUND AND PURPOSE: Clinical practice guidelines for patients with stroke recommend early stroke rehabilitation at acute hospital stroke units. The present study aimed to (1) explore the organization of early stroke rehabilitation; (2) investigate current practice with respect to early

  16. Guidelines for malaria prevention in travellers from the United Kingdom for 2001.

    Science.gov (United States)

    Bradley, D J; Bannister, B

    2001-06-01

    These guidelines on malaria prevention are designed to aid health care workers who advise travellers, particularly those who will be overseas for less than a year. The present, and any future, revisions are the responsibility of the Advisory Committee on Malaria Prevention in UK travellers (ACMP; membership given at the end of the Guidelines). This has replaced the consensus meetings which produced earlier versions from 1980 to the the 1997 version. The guidelines are in three parts. The first part is a summary that emphasises modifications to the advice given in the last set of guidelines, published in 1997. The second part discusses the issues addressed in formulating the guidelines. Oversimplified lists of recommendations by country can be misleading. The second part also addresses the health care worker's consultation with prospective travellers. Doctors, practice nurses and pharmacists are asked to read this section to ensure that due attention is paid to the traveller's history and destination. The third part gives specific recommendations for travellers to specific destinations and some details of individual drugs. Fuller information on some drugs now less used was given in earlier versions of the guidelines. These guidelines reflect experienced professional opinion. Data are inadequate for unequivocal views to be given on several issues, but all available evidence has been taken into consideration. There is often a range of acceptable options, but to meet the requests of general practitioners the guidelines aim to give one recommended option and state the alternatives, suggesting when and how different regimens can be used to good effect. However, there are now several options for effective prophylaxis of highly chloroquine-resistant falciparum malaria, and the choice between them will depend on details of the journey and individual preferences. Decisions on the terms under which different drugs are licensed for use are the responsibility of the Licensing

  17. Conformity to the surviving sepsis campaign international guidelines among physicians in a general intensive care unit in Nairobi.

    Science.gov (United States)

    Mung'ayi, V; Karuga, R

    2010-08-01

    There are emerging therapies for managing septic critically-ill patients. There is little data from the developing world on their usage. To determine the conformity rate for resuscitation and management bundles for septic patients amongst physicians in a general intensive care unit. Cross sectional observational study. The general intensive care unit, Aga Khan University Hospital,Nairobi. Admitting physicians from all specialties in the general intensive care unit. The physicians had high conformity rates of 92% and 96% for the fluid resuscitation and use of va so pressors respectively for the initial resuscitation bundle. They had moderate conformity rates for blood cultures prior to administering antibiotics (57%) and administration of antibiotics within first hour of recognition of septic shock (54%). There was high conformity rate to the glucose control policy (81%), use of protective lung strategy in acute lung injury/Acute respiratory distress syndrome, venous thromboembolism prophylaxis (100%) and stress ulcer prophylaxis (100%) in the management bundle. Conformity was moderate for use of sedation, analgesia and muscle relaxant policy (69%), continuous renal replacement therapies (54%) and low for steroid policy (35%), administration ofdrotrecogin alfa (0%) and selective digestive decontamination (15%). There is varying conformity to the international sepsis guidelines among physicians caring for patients in our general ICU. Since increased conformity would improve survival and reduce morbidity, there is need for sustained education and guideline based performance improvement.

  18. Measure Guideline. Five Steps to Implement the Public Housing Authority Energy-Efficient Unit Turnover Checklist

    Energy Technology Data Exchange (ETDEWEB)

    Liaukus, Christine [Building American Research Alliance, Kent, WA (United States)

    2015-07-09

    Five Steps to Implementing the PHA Energy Efficient Unit Turnover Package (ARIES, 2014) is a guide to prepare for the installation of energy efficient measures during a typical public housing authority unit turnover. While a PHA is cleaning, painting and readying a unit for a new resident, there is an opportunity to incorporate energy efficiency measures to further improve the unit's performance. The measures on the list are simple enough to be implemented by in-house maintenance personnel, inexpensive enough to be folded into operating expenses without needing capital budget, and fast enough to implement without substantially changing the number of days between occupancies, a critical factor for organizations where the demand for dwelling units far outweighs the supply. The following guide lays out a five step plan to implement the EE Unit Turnover Package in your PHA, from an initial Self-Assessment through to Package Implementation.

  19. United Kingdom Infrared Telescope's Spectrograph Observations of Human-Made Space Objects

    Science.gov (United States)

    Buckalew, Brent; Abercromby, Kira; Lederer, Susan; Frith, James; Cowardin, Heather

    2017-01-01

    Presented here are the results of the United Kingdom Infrared Telescope (UKIRT) spectral observations of human-made space objects taken from 2014 to 2015. The data collected using the UIST infrared spectrograph cover the wavelength range 0.7-2.5 micrometers. Overall, data were collected on 18 different orbiting objects at or near the geosynchronous (GEO) regime. Thirteen of the objects are spacecraft, one is a rocket body, and four are cataloged as debris pieces. The remotely collected data are compared to the laboratory-collected reflectance data on typical spacecraft materials; thereby general materials are identified but not specific types. These results highlight the usefulness of observations in the infrared by focusing on features from hydrocarbons and silicon. The spacecraft show distinct features due to the presence of solar panels. Signature variations between rocket bodies, due to the presence of various metals and paints on their surfaces, show a clear distinction from those objects with solar panels, demonstrating that one can distinguish most spacecraft from rocket bodies through infrared spectrum analysis. Finally, the debris pieces tend to show featureless, dark spectra. These results show that the laboratory data in its current state give excellent indications as to the nature of the surface materials on the objects. Further telescopic data collection and model updates to include more materials, noise, surface roughness, and material degradation are necessary to make better assessments of orbital object material types. A comparison conducted between objects observed previously with the NASA Infrared Telescope Facility (IRTF) shows similar materials and trends from the two telescopes and from the two distinct data sets. However, based on the current state of the model, infrared spectroscopic data are adequate to classify objects in GEO as spacecraft, rocket bodies, or debris.

  20. United Kingdom Infrared Telescope's Spectrograph Observations of Human-Made Space Objects

    Science.gov (United States)

    Buckalew, Brent; Abercromby, Kira; Lederer, Susan; Cowardin, Heather; Frith, James

    2017-01-01

    Presented here are the results of the United Kingdom Infrared Telescope (UKIRT) spectral observations of human-made space objects taken from 2014 to 2015. The data collected using the UKIRT 1-5 micron Imager Spectrometer (UIST) cover the wavelength range 0.7-2.5 micrometers. Overall, data were collected on 18 different orbiting objects at or near geosynchronous orbit (GEO). Two of the objects are controlled spacecraft, twelve are non-controlled spacecraft, one is a rocket body, and three are cataloged as debris. The remotely collected data are compared to the laboratory-collected reflectance data on typical spacecraft materials; thereby general materials are identified but not specific types. These results highlight the usefulness of observations in the infrared by focusing on features from hydrocarbons and silicon. The spacecraft, both the controlled and non-controlled, show distinct features due to the presence of solar panels whereas the rocket bodies do not. Signature variations between rocket bodies, due to the presence of various metals and paints on their surfaces, show a clear distinction from those objects with solar panels, demonstrating that one can distinguish most spacecraft from rocket bodies through infrared spectrum analysis. Finally, the debris pieces tend to show featureless, dark spectra. These results show that the laboratory data in its current state give well-correlated indications as to the nature of the surface materials on the objects. Further telescopic data collection and model updates to include noise, surface roughness, and material degradation are necessary to make better assessments of orbital object material types. A comparison conducted between objects observed previously with the NASA Infrared Telescope Facility (IRTF) shows similar materials and trends from the two telescopes and different times. However, based on the current state of the model, infrared spectroscopic data are adequate to classify objects in GEO as spacecraft

  1. Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection - United States, 2016.

    Science.gov (United States)

    Staples, J Erin; Dziuban, Eric J; Fischer, Marc; Cragan, Janet D; Rasmussen, Sonja A; Cannon, Michael J; Frey, Meghan T; Renquist, Christina M; Lanciotti, Robert S; Muñoz, Jorge L; Powers, Ann M; Honein, Margaret A; Moore, Cynthia A

    2016-01-29

    CDC has developed interim guidelines for health care providers in the United States who are caring for infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy. These guidelines include recommendations for the testing and management of these infants. Guidance is subject to change as more information becomes available; the latest information, including answers to commonly asked questions, can be found online (http://www.cdc.gov/zika). Pediatric health care providers should work closely with obstetric providers to identify infants whose mothers were potentially infected with Zika virus during pregnancy (based on travel to or residence in an area with Zika virus transmission [http://wwwnc.cdc.gov/travel/notices]), and review fetal ultrasounds and maternal testing for Zika virus infection (see Interim Guidelines for Pregnant Women During a Zika Virus Outbreak*) (1). Zika virus testing is recommended for 1) infants with microcephaly or intracranial calcifications born to women who traveled to or resided in an area with Zika virus transmission while pregnant; or 2) infants born to mothers with positive or inconclusive test results for Zika virus infection. For infants with laboratory evidence of a possible congenital Zika virus infection, additional clinical evaluation and follow-up is recommended. Health care providers should contact their state or territorial health department to facilitate testing. As an arboviral disease, Zika virus disease is a nationally notifiable condition.

  2. Adherence to a healthy diet according to the world health organization guidelines and all-cause mortality in elderly adults from europe and the United States

    NARCIS (Netherlands)

    Jankovic, N.; Geelen, A.; Streppel, M.T.; Groot, L.C.P.G.M. de; Orfanos, P.; Hooven, E.H. van den; Pikhart, H.; Boffetta, P.; Trichopoulou, A.; Bobak, M.; Bueno-De-Mesquita, H.B.; Kee, F.; Franco, O.H.; Park, Y.; Hallmans, G.; Tjonneland, A.; May, A.M.; Pajak, A.; Malyutina, S.; Kubinova, R.; Amiano, P.; Kampman, E.; Feskens, E.J.

    2014-01-01

    The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly

  3. Fresh Frozen Plasma Administration in the Neonatal Intensive Care Unit: Evidence-Based Guidelines.

    Science.gov (United States)

    Motta, Mario; Del Vecchio, Antonio; Chirico, Gaetano

    2015-09-01

    Neonates receiving fresh frozen plasma (FFP) should do so according to evidence-based guidelines so as to reduce inappropriate use of this life-saving and costly blood product and to minimize associated adverse effects. The consensus-based uses of FFP in neonatology involve neonates with active bleeding and associated coagulopathy. However, because of limited and poor-quality evidence, considerable FFP utilization occurs outside these recommendations. In this review, we describe what we conclude are currently the best practices for the use of FFP in neonates, including interpreting neonatal coagulation tests and strategies for reducing unnecessary FFP transfusions.

  4. Observational Iinearization and tracking objective excitation control strategy based on phasor measurement unit

    Institute of Scientific and Technical Information of China (English)

    QIU Xiaoyan; LI Xingyuan; WANG Xiaoyan

    2007-01-01

    To improve the transient stability ofmultimachine power systems,observational linearization and tracking objective excitation control laws were derived from the phasor measurement unit (PMU),observational linearization,and tracking objective control theory based on synchronized coordinates and reference generator coordinates.The control strategies utilized real-time state variables obtained by PMU to linearize the state equations of the system,and then the linear optimal control strategy was used to design excitation controllers.The inaccuracy of the local linearization method and the complexity of the system models designed in the exact linearization method for nonlinear systems were avoided.Therefore,the control strategies were applied in real time.Simulation results show that the proposed method can improve the transient stability of power systems more efficiently than nonlinear optimal excitation control.

  5. Two-level, two-objective evolutionary algorithms for solving unit commitment problems

    Energy Technology Data Exchange (ETDEWEB)

    Georgopoulou, Chariklia A.; Giannakoglou, Kyriakos C. [National Technical University of Athens, School of Mechanical Engineering, Laboratory of Thermal Turbomachines, Parallel CFD and Optimization Unit, P.O. Box 64069, Athens 157 10 (Greece)

    2009-07-15

    A two-level, two-objective optimization scheme based on evolutionary algorithms (EAs) is proposed for solving power generating Unit Commitment (UC) problems by considering stochastic power demand variations. Apart from the total operating cost to cover a known power demand distribution over the scheduling horizon, which is the first objective, the risk of not fulfilling possible demand variations forms the second objective to be minimized. For this kind of problems with a high number of decision variables, conventional EAs become inefficient optimization tools, since they require a high number of evaluations before reaching the optimal solution(s). To considerably reduce the computational burden, a two-level algorithm is proposed. At the low level, a coarsened UC problem is defined and solved using EAs to locate promising solutions at low cost: a strategy for coarsening the UC problem is proposed. Promising solutions migrate upwards to be injected into the high level EA population for further refinement. In addition, at the high level, the scheduling horizon is partitioned in a small number of subperiods of time which are optimized iteratively using EAs, based on objective function(s) penalized to ensure smooth transition from/to the adjacent subperiods. Handling shorter chromosomes due to partitioning increases method's efficiency despite the need for iterating. The proposed two-level method and conventional EAs are compared on representative test problems. (author)

  6. Levels and Patterns of Objectively Assessed Physical Activity and Compliance with Different Public Health Guidelines in University Students.

    Directory of Open Access Journals (Sweden)

    Natalia María Arias-Palencia

    Full Text Available Physical activity (PA is associated with health enhancement. The aim of this study was to assess: 1 levels and patterns of PA in university students by using accelerometers; and 2 the percentage of fulfilment of PA recommendations for adults, according to different public health guidelines.Observational cross-sectional study (Cuenca's Adults Study involving 296 (206 women healthy Spanish university students aged 18-25 years old. Participants wore the ActiGraph GT1M accelerometer for seven consecutive days. Total PA, steps and time spent in sedentary time, light, moderate, vigorous, and moderate to vigorous PA (MVPA was assessed, and the prevalence of sufficient PA was calculated according to various public health guidelines.No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (p<0.05. Only 30.3% of participants accumulated 30 min/day at least five days a week of MVPA. A total of 5.4% of students met the recommendation of 150 min/week of MVPA or 75 min/week of vigorous PA, in PA bouts of at least 10 min. using the same definition, but on five or more days a week, only 0.5% students were found to meet the recommendation. In addition, only 0.5% of students met the recommendation of 30 min/day of MVPA, at least five days a week and in bouts of at least 10 min. Finally, 28.1% of the students met the recommendation of 10,000 steps/day.Our study shows a high incidence of sedentary time in university students. The number of students meeting PA recommendations significantly differed depending on the recommendation proposed. Specific strategies to promote PA in this population are necessary as well as an agreement as to which PA guidelines should be used.

  7. Incidence of Exposure of Patients in the United States to Multiple Drugs for Which Pharmacogenomic Guidelines Are Available

    Science.gov (United States)

    Xu, Hong; Blagec, Kathrin; Empey, Philip E.; Malone, Daniel C.; Ahmed, Seid Mussa; Ryan, Patrick; Hofer, Sebastian; Boyce, Richard D.

    2016-01-01

    Pre-emptive pharmacogenomic (PGx) testing of a panel of genes may be easier to implement and more cost-effective than reactive pharmacogenomic testing if a sufficient number of medications are covered by a single test and future medication exposure can be anticipated. We analysed the incidence of exposure of individual patients in the United States to multiple drugs for which pharmacogenomic guidelines are available (PGx drugs) within a selected four-year period (2009–2012) in order to identify and quantify the incidence of pharmacotherapy in a nation-wide patient population that could be impacted by pre-emptive PGx testing based on currently available clinical guidelines. In total, 73 024 095 patient records from private insurance, Medicare Supplemental and Medicaid were included. Patients enrolled in Medicare Supplemental age > = 65 or Medicaid age 40–64 had the highest incidence of PGx drug use, with approximately half of the patients receiving at least one PGx drug during the 4 year period and one fourth to one third of patients receiving two or more PGx drugs. These data suggest that exposure to multiple PGx drugs is common and that it may be beneficial to implement wide-scale pre-emptive genomic testing. Future work should therefore concentrate on investigating the cost-effectiveness of multiplexed pre-emptive testing strategies. PMID:27764192

  8. Implementing Best Practice Guidelines in Pain Assessment and Management on a Women's Psychiatric Inpatient Unit: Exploring Patients' Perceptions.

    Science.gov (United States)

    Rolin-Gilman, Cheryl; Fournier, Bonnie; Cleverley, Kristin

    2017-06-01

    Assessing and managing chronic pain in women with histories of interpersonal trauma, mood disorders and co-morbid addiction is complex. The aim of this paper is to report on the findings from a quality improvement project exploring women's experiences who have co-occurring mental health issues, addiction and chronic pain. Exploring perceptions was an initial step in implementing the Registered Nurses' Association of Ontario (RNAO) Best Practice Guideline (BPG) on the Assessment and Management of Pain. Focus group discussions were conducted using an exploratory design with 10 women who were hospitalized in an acute psychiatric unit. Our findings suggest that these women view their pain as complex and often feel powerless within an acute psychiatric setting resorting to coping through self management. The women expressed the importance of therapeutic relationships with clinicians in assessing and managing their pain. The implications of this study suggest that patients have a key role in informing the implementation and applicability of best practice guidelines. Validating the patient's personal pain management experience and particular psychological and physical therapies were suggested as strategies to enhance the patient's quality of life. Many clinicians working in mental health are knowledgeable about these therapies, but may not be aware of the application to managing physical pain. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  9. Psychological management for head and neck cancer patients: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Humphris, G

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and interventions for the psychological management in this patient group. Recommendations • Audit of information supplied to patients and carers should be conducted on an annual basis to update and review content and media presentation. (G) • Patients and carers should be invited to discuss treatment options and relate possible outcomes to functional retention or loss to provide a patient-centred approach. (G) • Clinical staff should inspect their systems of assessment to make them sensitive enough to identify patients with psychological difficulties. (G) • Flexibility, rather than rigid formulation is required to assess patients frequently, and to allow for change in circumstances to be noted. (G) • Multidisciplinary teams should determine the supportive care services available and commission extra assistance to provide patients and carers with timely information, education or brief supportive advice. (G) • Multidisciplinary teams need to inspect specialist services for mental health interventions at structured and complex levels for the small proportion of patients with more serious, but rarer, psychological difficulties. (G) • Clinical staff at all levels should receive communication skills training to raise and maintain consultation expertise with difficult patient and/or carer interactions. (G).

  10. Speech and swallow rehabilitation in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Clarke, P; Radford, K; Coffey, M; Stewart, M

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The disease itself and the treatment can have far reaching effects on speech and swallow function, which are consistently prioritised by survivors as an area of concern. This paper provides recommendations on the assessments and interventions for speech and swallow rehabilitation in this patient group. Recommendations • All multidisciplinary teams should have rehabilitation patient pathways covering all stages of the patient's journey including multidisciplinary and pre-treatment clinics. (G) • Clinicians treating head and neck cancer patients should consult the National Cancer Rehabilitation Pathway for head and neck cancers. (G) • All head and neck cancer patients should have a pre-treatment assessment of speech and swallowing. (G) • A programme of prophylactic exercises and the teaching of swallowing manoeuvres can reduce impairments, maintain function and enable a speedier recovery. (R) • Continued speech and language therapist input is important in maintaining voice and safe and effective swallow function following head and neck cancer treatment. (R) • Disease recurrence must be ruled out in the management of stricture and/or stenosis. (R) • Continuous radial expansion balloons offer a safe, effective dilation method with advantages over gum elastic bougies. (R) • Site, length and completeness of strictures as well as whether they are in the presence of the larynx or not, need to be assessed when establishing the likelihood of surgically improved outcome. (G) • Primary surgical voice restoration should be offered to all patients undergoing laryngectomy. (R) • Attention to surgical detail and long-term speech and language therapist input is required to optimise speech and swallowing after laryngectomy. (G) • Patients should commence wearing heat and moisture exchange devices as soon as possible after

  11. [Consensus on objectives and action guidelines on low density lipoproteins-cholesterol control in very high risk cardiovascular patients].

    Science.gov (United States)

    Galve, Enrique; Guijarro-Herraiz, Carlos; Masana-Marin, Luis; Cordero-Fort, Alberto

    2016-01-01

    Cardiovascular disease is the leading cause of death in developed countries. Among cardiovascular disease risk factors one of the most relevant is low-density lipoprotein-associated cholesterol (LDL-c), but there is controversy about the methods used to control it. The aim was to obtain an expert opinion to clarify the most relevant issues regarding the control of dyslipidemia in very high cardiovascular risk patients. A survey with 55 items, stratified into 4 blocks: LDL-c as a therapeutic target, therapeutic goals, causes of the failure to achieve LDL-c goals, and recommendations to optimize their achievement, was addressed to 41 specialists (Cardiology and Internal Medicine) using the Delphi method to achieve professional consensus criteria. A high consensus was reached among all items, in line with the European recommendations. The panelists considered that the goal of 70mg/dl for LDL-c for high cardiovascular disease risk (mainly vascular disease, diabetes mellitus, and renal failure), using combined treatment when necessary. Lack of adherence and therapeutic inertia were considered the main reasons for treatment failure. The Spanish experts show an elevated consensus with the European recommendations, confirming the LDL-c control target of <70mg/dl. The simplification of the guidelines and the combined treatment may favor an improvement the achievement of lipid target goals. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  12. Oral Health Disparities as Determined by Selected Healthy People 2020 Oral Health Objectives for the United States, ...

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Oral Health Disparities as Determined by Selected Healthy People 2020 Oral Health Objectives for the United States, 2009–2010 Recommend ...

  13. Working Memory Units Are All in Your Head: Factors That Influence Whether Features or Objects Are the Favored Units

    Science.gov (United States)

    Vergauwe, Evie; Cowan, Nelson

    2015-01-01

    We compared two contrasting hypotheses of how multifeatured objects are stored in visual working memory (vWM); as integrated objects or as independent features. A new procedure was devised to examine vWM representations of several concurrently held objects and their features and our main measure was reaction time (RT), allowing an examination of…

  14. Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

    Science.gov (United States)

    Robson, A; Sturman, J; Williamson, P; Conboy, P; Penney, S; Wood, H

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. (R) • Patients with hypertension of over 180/110 or associated target organ damage, should have antihypertensive medication started pre-operatively as per British Hypertension Society guidelines. (R) • Rapidly correcting pre-operative hypertension with beta blockade appears to cause higher mortality due to stroke and hypotension and should not be used. (R) • Patients with poorly controlled or unstable ischaemic heart disease should be referred for cardiology assessment pre-operatively. (G) • Patients within one year of drug eluting stents should be discussed with the cardiologist who was responsible for their percutaneous coronary intervention pre-operatively with regard to cessation of antiplatelet medication due to risk of stent thrombosis. (G) • Patients with multiple recent stents should be managed in a centre with access to interventional cardiology. (G) • Surgery after myocardial infarction should be delayed if possible to reduce mortality risk. (R) • Patients with critical aortic stenosis (AS) should be considered for pre-operative intervention. (G) • Clopidogrel should be discontinued 7 days pre-operatively; warfarin should be discontinued 5 days pre-operatively. (R) • Patients with thromboembolic disease or artificial heart valves require heparin therapy to bridge peri-operative warfarin cessation, this should start 2 days after last warfarin dose. (R) • Cardiac drugs other than angotensin-converting enzyme inhibitors and angiotensin

  15. Summary guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-09-01

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

  16. Guidelines, processes and tools for coastal ecosystem restoration, with examples from the United States

    Energy Technology Data Exchange (ETDEWEB)

    Thom, Ronald M.; Diefenderfer, Heida L.; Adkins, Jeffery E.; Judd, Chaeli; Anderson, Michael G.; Buenau, Kate E.; Borde, Amy B.; Johnson, Gary E.

    2011-02-01

    This paper presents a systematic approach to coastal restoration projects in five phases: planning, implementation, performance assessment, adaptive management, and dissemination of results. Twenty features of the iterative planning process are synthesized. The planning process starts with a vision, a description of the ecosystem and landscape, and goals. A conceptual model and planning objectives are developed, a site is selected using prioritization techniques, and numerical models contribute to preliminary designs as needed. Performance criteria and reference sites are selected and the monitoring program is designed. The monitoring program is emphasized as a tool to assess project performance and identify problems affecting progression toward project goals, in an adaptive management framework. Key approaches to aspects of the monitoring program are reviewed and detailed with project examples. Within the planning process, cost analysis involves budgeting, scheduling, and financing. Finally, documentation is peer reviewed prior to making construction plans and final costing.

  17. Evaluation of rationality in prescribing, adherence to treatment guidelines, and direct cost of treatment in intensive cardiac care unit: A prospective observational study

    Directory of Open Access Journals (Sweden)

    Rohan P. Christian

    2014-01-01

    Full Text Available Background: Cardiovascular diseases (CVDs remain the most common cause of sudden death. Hence, appropriate drug therapy in intensive cardiac care unit (ICCU is crucial in managing cardiovascular emergencies and to decrease morbidity and mortality. Objective: To evaluate prescribing pattern of drugs and direct cost of therapy in patients admitted in ICCU. Materials and Methods: Patients admitted in ICCU of a tertiary care teaching hospital were enrolled. Demographic data, clinical history, and complete drug therapy received during their stay in ICCU were noted. Data were analyzed for drug utilization pattern and direct cost of treatment calculated using patient′s hospital and pharmacy bills. Rationality of therapy was evaluated based on American College of Cardiology/American Heart Association (ACC/AHA guidelines. Result: Data of 170 patients were collected over 2 months. Mean age of patients was 54.67 ± 13.42 years. Male to female ratio was 2.33:1. Most common comorbid condition was hypertension 76 (44.7%. Most common diagnosis was acute coronary syndrome (ACS 49.4%. Mean stay in ICCU was 4.42 ± 1.9 days. Mean number of drugs prescribed per patient was 11.43 ± 2.85. Antiplatelet drugs were the most frequently prescribed drug group (86.5%. Mean cost of pharmacotherapy per patient was `2701.24 ± 3111.94. Mean direct cost of treatment per patient was `10564.74 ± 14968.70. Parenteral drugs constituted 42% of total drugs and 90% of total cost of pharmacotherapy. Cost of pharmacotherapy was positively correlated with number of drugs (P = 0.000 and duration of stay (P = 0.027. Conclusion: Antiplatelet drugs were the most frequently prescribed drug group. Mean number of drugs per encounter were high, which contributed to the higher cost of pharmacotherapy. ACC/AHA guidelines were followed in majority of the cases.

  18. Planning for people? An evaluation of objectives for managing visitors at wildlife refuges in the United States

    Science.gov (United States)

    Jeffrey J. Brooks; Robert Massengale

    2011-01-01

    This study evaluates the quality of planning objectives for visitor services as written in Comprehensive Conservation Plans for the National Wildlife Refuge System of the United States. Planners in the U.S. Fish and Wildlife Service are predominantly writing public use objectives that address wildlife recreation and education. Results indicate that planners are writing...

  19. Space Object Collision Probability via Monte Carlo on the Graphics Processing Unit

    Science.gov (United States)

    Vittaldev, Vivek; Russell, Ryan P.

    2017-09-01

    Fast and accurate collision probability computations are essential for protecting space assets. Monte Carlo (MC) simulation is the most accurate but computationally intensive method. A Graphics Processing Unit (GPU) is used to parallelize the computation and reduce the overall runtime. Using MC techniques to compute the collision probability is common in literature as the benchmark. An optimized implementation on the GPU, however, is a challenging problem and is the main focus of the current work. The MC simulation takes samples from the uncertainty distributions of the Resident Space Objects (RSOs) at any time during a time window of interest and outputs the separations at closest approach. Therefore, any uncertainty propagation method may be used and the collision probability is automatically computed as a function of RSO collision radii. Integration using a fixed time step and a quartic interpolation after every Runge Kutta step ensures that no close approaches are missed. Two orders of magnitude speedups over a serial CPU implementation are shown, and speedups improve moderately with higher fidelity dynamics. The tool makes the MC approach tractable on a single workstation, and can be used as a final product, or for verifying surrogate and analytical collision probability methods.

  20. Managing Highway Maintenance: Instructor's Manual for Management by Objectives Review, Unit 11, All Levels.

    Science.gov (United States)

    Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

    Part of the series "Managing Highway Maintenance," the unit is designed for the training group leader and contains selected highlights and suggested discussion questions from six units of training: maintenance activities, work units, and classifying work; maintenance feature inventories; how to conduct a maintenance feature inventory;…

  1. Guidelines for Cognitive Behavioral Training within Doctoral Psychology Programs in the United States: Report of the Inter-Organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education

    Science.gov (United States)

    Klepac, Robert K.; Ronan, George F.; Andrasik, Frank; Arnold, Kevin D.; Belar, Cynthia D.; Berry, Sharon L.; Christofff, Karen A.; Craighead, Linda W.; Dougher, Michael J.; Dowd, E. Thomas; Herbert, James D.; McFarr, Lynn M.; Rizvi, Shireen L.; Sauer, Eric M.; Strauman, Timothy J.

    2012-01-01

    The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a yearlong series of…

  2. Guidelines for Cognitive Behavioral Training within Doctoral Psychology Programs in the United States: Report of the Inter-Organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education

    Science.gov (United States)

    Klepac, Robert K.; Ronan, George F.; Andrasik, Frank; Arnold, Kevin D.; Belar, Cynthia D.; Berry, Sharon L.; Christofff, Karen A.; Craighead, Linda W.; Dougher, Michael J.; Dowd, E. Thomas; Herbert, James D.; McFarr, Lynn M.; Rizvi, Shireen L.; Sauer, Eric M.; Strauman, Timothy J.

    2012-01-01

    The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a yearlong series of…

  3. GRADE guidelines

    DEFF Research Database (Denmark)

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

    2013-01-01

    and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers....

  4. Diagnosis of post-traumatic sepsis according to "Sepsis guidelines": a cross-sectional survey of sepsis in a trauma intensive care unit

    Directory of Open Access Journals (Sweden)

    Hao TANG

    2016-04-01

    Full Text Available Objective  To investigate the prevalence and risk factors of post-traumatic sepsis, and to evaluate the rationality of the 1992, 2001 and 2012 international sepsis definitions in diagnosing post-traumatic sepsis in a trauma intensive care unit (ICU in China. Methods  A one-day cross-sectional survey of trauma patients who met the inclusion criteria was conducted from 8:00 a.m., June 16, 2014 to 8:00 a.m., June 17, 2014 in the trauma ICU of Daping Hospital. The survey data included demographic information, clinical characteristics, pertinent scores (APACHE Ⅱ, SOFA, GCS, ISS and injury mechanism. According to the definition of sepsis as depicted in the 1992, 2001, and 2012 "International Guideline of Sepsis", the patients were divided into A, B and C groups. The infection site, infection pathogens, and key medical treatment were recorded, the infection identified, and the 28day mortality recorded. A positive pathogen culture of respiratory and urinary tracts, blood, cerebrospinal fluid, and wound secretion was adopted as the diagnostic "gold standard" for septic infection. The diagnostic sensitivity and specificity of the three versions of the guidelines were statistically analyzed and the diagnostic feasibility of each definition was assessed. Results  A total of 30 trauma patients were enrolled, twenty-three patients met the 1992 sepsis criteria, 22 met the 2001 criteria, and 20 met the 2012 criteria. The prevalence rates were 76.7%, 73.3%, and 66.7%, respectively, and there was no significant statistical difference. Four patients died within 28 days, which was in line with the diagnostic criteria of the three versions of the sepsis criteria. The 28-day mortality in the three sepsis guidelines groups was 17.4%, 18.2%, and 25.0%, respectively, indicating no statistical difference. By adopting culture-positive pathogens as the "gold standard" of septic infection, the diagnostic sensitivity and specificity of the group A was 77.8% and 25

  5. [Pediatric drug development: ICH harmonized tripartite guideline E11 within the United States of America, the European Union, and Japan].

    Science.gov (United States)

    Pflieger, M; Bertram, D

    2014-10-01

    To address the lack of appropriate pediatric drugs available on the global market, in 2000 the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) issued the ICH E11 guideline regarding the Clinical Investigation of Medicinal Products in the Pediatric Population. This guideline considerably changes the environment of drug development for children. It has been written specifically to harmonize, promote, and facilitate high-quality and ethical clinical research for children within the ICH regions, i.e., the United States of America (USA), the European Union (EU), and Japan. This article details the various regulations applicable in each ICH region following the publication of the guideline. The framework of rewards, incentives, and obligations for pharmaceutical companies established for the development of pediatric drugs are compared. It appears that the USA and the EU have both developed specific regulations for pediatric drug development while Japan has not. However, in Japan, pharmaceutical companies (PCs) are encouraged to develop pediatric drugs voluntarily, and they may be granted additional months of market exclusivity or the postponement of the drug re-examination deadline. In both the USA and the EU, regulations aimed to increase the number of clinical studies conducted in children, in order to ensure that the necessary data are generated, determining the conditions in which a drug may be authorized to treat the pediatric population. PCs are encouraged to develop pediatric assessment, including pediatric clinical trials, which is described in a pediatric plan submitted to the relevant authorities. A system of rewards for PCs submitting an application for marketing authorization containing pediatric use information has been put in place to cover the additional investment for testing drugs in children. Subject to conditions, these rewards consist in a 6-month extension of the patent or

  6. Institute of Medicine 2009 Gestational Weight Gain Guideline Knowledge: Survey of Obstetrics/Gynecology and Family Medicine Residents of the United States

    Science.gov (United States)

    Moore Simas, Tiffany A.; Waring, Molly E.; Sullivan, Gina M. T.; Liao, Xun; Rosal, Milagros C.; Hardy, Janet R.; Berry, Robert E.

    2014-01-01

    Background In 2009, the Institute of Medicine revised gestational weight gain recommendations; revisions included body mass index (BMI) category cut-point changes and provision of range of gain for obese women. Our objective was to examine resident prenatal care providers’ knowledge of revised guidelines. Methods Anonymous electronic survey of Obstetrics/Gynecology and Family Medicine residents across U.S. from January–April 2010. Results 660 completed the survey; 79% female and 69% aged 21–30 years. When permitted to select ≥1 response, 87.0% reported using BMI to assess weight status at initial visits, 44.4% reported using “clinical impression based on patient appearance”, and 1.4% reported not using any parameters. When asked the most important baseline parameter for providing recommendations, 35.8% correctly identified pre-pregnancy BMI, 2.1% reported “I don’t provide guidelines,” and 4.5% reported “I do not discuss gestational weight gain.” 57.6% reported not being aware of new guidelines. Only 7.6% selected correct BMI ranges for each category. Only 5.8% selected correct gestational weight gain ranges. Only 2.3% correctly identified both BMI cutoffs and recommended gestational weight gain ranges per 2009 guidelines. Conclusions Guideline knowledge is the foundation of accurate counseling, yet resident prenatal care providers were minimally aware of the 2009 Institute of Medicine gestational weight gain guidelines almost a year after their publication. PMID:24344704

  7. Suggested Guidelines for Teaching Units (Grades K-12) on Consumers, the Economy, and the U.S. Constitution.

    Science.gov (United States)

    Knauer, Virginia H.; Steeves, Robert F.

    To focus classroom learning experiences on the freedoms and privileges enjoyed by consumers in the U.S. free market economy is the goal of these guidelines. Students learn how the U.S. Constitution relates to the free market system through a variety of teaching strategies. The guidelines can easily be adapted for use in a variety of classroom…

  8. MEGARA optical design: the new integral field unit and multi-object spectrograph for the GTC 10m telescope

    Science.gov (United States)

    García-Vargas, María. Luisa; Sánchez-Blanco, Ernesto; Carrasco, Esperanza; Gil de Paz, Armando; Páez, Gonzalo; Pérez, Ana; Gallego, Jesús; Sánchez, Francisco; Vílchez, José M.

    2012-12-01

    We describe the optical design of MEGARA, the future optical Integral Field Unit (IFU) and Multi-Object Spectrograph (MOS) for the 10.4-m Gran Telescopio CANARIAS (GTC). MEGARA is being built by a Consortium of public research institutions led by the Universidad Complutense de Madrid (UCM, Spain) that also includes INAOE (Mexico), IAA-CSIC (Spain) and UPM (Spain).

  9. Responses of infrared-sensitive tectal units of the pit viper Crotalus atrox to moving objects.

    Science.gov (United States)

    Kaldenbach, Felix; Bleckmann, Horst; Kohl, Tobias

    2016-06-01

    Rattlesnakes perceive IR radiation with their pit organs. This enables them to detect and strike towards warm-blooded prey even in the dark. In addition, the IR sense allows rattlesnakes to find places for thermoregulation. Animate objects (e.g., prey) tend to move and thus cause moving IR images across the pit membrane. Even when an object is stationary, scanning head movements of rattlesnakes will result in moving IR images across the pit membrane. We recorded the neuronal activity of IR-sensitive tectal neurons of the rattlesnake Crotalus atrox while stimulating the snakes with an IR source that moved horizontally at various velocities. As long as object velocity was low (angular velocity of ~5°/s) IR-sensitive tectal neurons hardly showed any responses. With increasing object velocity though, neuronal activity reached a maximum at ~50°/s. A further increase in object velocity up to ~120°/s resulted in a slight decrease of neuronal activity. Our results demonstrate the importance of moving stimuli for the snake's IR detection abilities: in contrast to fast moving objects, stationary or slowly moving objects will not be detected when the snake is motionless, but might be detected by scanning head movements.

  10. The United Nations University: The Concept, History, Structure, Financing, Objectives, Centres and Programmes. Guest Editorial.

    Science.gov (United States)

    Reddy, J.

    2000-01-01

    The United Nations University (UNU) is an international academic organization which brings together leading international scholars to tackle world problems. This article describes for South African scholars, institutions, governments, and their agencies the importance of the work being undertaken by the UNU and encourages their participation. (EV)

  11. Reimbursements and frequency of tests in privately insured testicular cancer patients in the United States: Implications to national guidelines

    Directory of Open Access Journals (Sweden)

    Mohamed H Kamel

    2017-01-01

    Conclusions: Testicular cancer is not an inexpensive disease. Surgery is the less utilized than radiation and chemotherapy despite lower cost. This may have implications to national guidelines and training since these treatments often carry the same grade of recommendation.

  12. Land development in the United Kingdom: private property rights and public policy objectives

    OpenAIRE

    J Corkindale

    1999-01-01

    The system of land-use planning in the United Kingdom has remained essentially unchanged since the introduction of the 1947 Town and Country Planning Acts. There has been rather little progress since then in the economic evaluation of this system or in the development of more market-based approaches to land-use planning. The author discusses some of the reasons for the lack of economic evaluation, develops decision criteria for conducting such economic evaluation, and goes on to indicate the ...

  13. Optimal placement of distributed generation units in distribution systems via an enhanced multi-objective particle swarm optimization algorithm

    Institute of Scientific and Technical Information of China (English)

    Shan CHENG; Min-you CHEN; Rong-jong WAI; Fang-zong WANG

    2014-01-01

    This paper deals with the optimal placement of distributed generation (DG) units in distribution systems via an enhanced multi-objective particle swarm optimization (EMOPSO) algorithm. To pursue a better simulation of the reality and provide the designer with diverse alternative options, a multi-objective optimization model with technical and operational con-straints is constructed to minimize the total power loss and the voltage fluctuation of the power system simultaneously. To enhance the convergence of MOPSO, special techniques including a dynamic inertia weight and acceleration coefficients have been inte-grated as well as a mutation operator. Besides, to promote the diversity of Pareto-optimal solutions, an improved non-dominated crowding distance sorting technique has been introduced and applied to the selection of particles for the next iteration. After verifying its effectiveness and competitiveness with a set of well-known benchmark functions, the EMOPSO algorithm is em-ployed to achieve the optimal placement of DG units in the IEEE 33-bus system. Simulation results indicate that the EMOPSO algorithm enables the identification of a set of Pareto-optimal solutions with good tradeoff between power loss and voltage sta-bility. Compared with other representative methods, the present results reveal the advantages of optimizing capacities and loca-tions of DG units simultaneously, and exemplify the validity of the EMOPSO algorithm applied for optimally placing DG units.

  14. Uptake and Utilization of Practice Guidelines in Hospitals in the United States: the Case of Routine Episiotomy.

    Science.gov (United States)

    Kozhimannil, Katy B; Karaca-Mandic, Pinar; Blauer-Peterson, Cori J; Shah, Neel T; Snowden, Jonathan M

    2017-01-01

    The gap between publishing and implementing guidelines differs based on practice setting, including hospital geography and teaching status. On March 31, 2006, a Practice Bulletin published by the American College of Obstetricians and Gynecologists (ACOG) recommended against the routine use of episiotomy and urged clinicians to make judicious decisions to restrict the use of the procedure. This study investigated changes in trends of episiotomy use before and after the ACOG Practice Guideline was issued in 2006, focusing on differences by hospital geographic location (rural/urban) and teaching status. In a retrospective analysis of discharge data from the Nationwide Inpatient Sample (NIS)-a 20% sample of US hospitals-5,779,781 hospital-based births from 2002 to 2011 (weighted N = 28,067,939) were analyzed using multivariable logistic regression analysis to measure odds of episiotomy and trends in episiotomy use in vaginal deliveries. The overall episiotomy rate decreased from 20.3% in 2002 to 9.4% in 2011. Across all settings, a comparatively larger decline in episiotomy rates preceded the issuance of the ACOG Practice Guideline (34.0% decline), rather than following it (23.9% decline). The episiotomy rate discrepancies between rural, urban teaching, and urban nonteaching hospitals remained steady prior to the guideline's release; however, differences between urban nonteaching and urban teaching hospitals narrowed between 2007 and 2011 after the guideline was issued. Teaching status was a strong predictor of odds of episiotomy, with urban nonteaching hospitals having the highest rates of noncompliance with evidence-based practice. Issuance of clinical guidelines precipitated a narrowing of this discrepancy. Copyright © 2016 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  15. Optimization of Fuel Consumption and Emissions for Auxiliary Power Unit Based on Multi-Objective Optimization Model

    Directory of Open Access Journals (Sweden)

    Yongpeng Shen

    2016-02-01

    Full Text Available Auxiliary power units (APUs are widely used for electric power generation in various types of electric vehicles, improvements in fuel economy and emissions of these vehicles directly depend on the operating point of the APUs. In order to balance the conflicting goals of fuel consumption and emissions reduction in the process of operating point choice, the APU operating point optimization problem is formulated as a constrained multi-objective optimization problem (CMOP firstly. The four competing objectives of this CMOP are fuel-electricity conversion cost, hydrocarbon (HC emissions, carbon monoxide (CO emissions and nitric oxide (NO x emissions. Then, the multi-objective particle swarm optimization (MOPSO algorithm and weighted metric decision making method are employed to solve the APU operating point multi-objective optimization model. Finally, bench experiments under New European driving cycle (NEDC, Federal test procedure (FTP and high way fuel economy test (HWFET driving cycles show that, compared with the results of the traditional fuel consumption single-objective optimization approach, the proposed multi-objective optimization approach shows significant improvements in emissions performance, at the expense of a slight drop in fuel efficiency.

  16. Humanizing the impostor: object relations and illness equations in the neonatal intensive care unit.

    Science.gov (United States)

    Landzelius, Kyra Marie

    2003-03-01

    In this paper I explore a seemingly mundane and inconsequential act--that of placing dolls and stuffed animals into newborns' incubator machines, in what I dub a kind of "teddy bear diplomacy," whereby mothers ornament their babies' high tech life-support prostheses with commonplace toys and trinkets. Using hospital ethnography and maternal interviews, I probe the psychodynamic significations of these ornamenting acts, which aspire to domesticate, animate and even humanize the incubator, itself a cyborg womb that displaces maternal purpose and problematizes bonding. The stress triggered by a high-risk infant and the double bind imposed by the therapeutic protocol lead me to here examine the intersubjectivity of illness in mothers' comorbidity and satellite syndromes. I argue that teddy bears and like artifacts serve as countertransitional objects to materially symbolize and perform the imagined mother-child dyad. Moreover, as autopoetic devices in the metamorphosis of maternal identity, they may empower a mother's vicarious participation in her child's healing, and thereby work towards closure of her own intersubjective afflictions.

  17. Pharmacist-led implementation of a vancomycin guideline across medical and surgical units: impact on clinical behavior and therapeutic drug monitoring outcomes

    Directory of Open Access Journals (Sweden)

    Phillips CJ

    2015-10-01

    Full Text Available Cameron J Phillips,1–3 David L Gordon3,4 1Division of Pharmacy, SA Pharmacy, Flinders Medical Centre, Bedford Park, 2School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, 3Department of Microbiology and Infectious Diseases, School of Medicine, Flinders University, Adelaide, 4Department of Microbiology and Infectious Diseases, SA Pathology, Flinders Medical Centre, Bedford Park, SA, Australia Background: Vancomycin is the antibiotic of choice for the treatment of serious infections such as methicillin-resistant Staphylococcus aureus (MRSA. Inappropriate prescribing of vancomycin can lead to therapeutic failure, antibiotic resistance, and drug toxicity. Objective: To examine the effectiveness of pharmacist-led implementation of a clinical practice guideline for vancomycin dosing and monitoring in a teaching hospital. Methods: An observational pre–post study design was undertaken to evaluate the implementation of the vancomycin guideline. The implementation strategy principally involved education, clinical vignettes, and provision of pocket guidelines to accompany release of the guideline to the hospital Intranet. The target cohort for clinical behavioral change was junior medical officers, as they perform the majority of prescribing and monitoring of vancomycin in hospitals. Assessment measures were recorded for vancomycin prescribing, therapeutic drug monitoring, and patient outcomes. Results: Ninety-nine patients, 53 pre- and 46 post-implementation, were included in the study. Prescribing of a loading dose increased from 9% to 28% (P=0.02, and guideline adherence to starting maintenance dosing increased from 53% to 63% (P=0.32. Dose adjustment by doctors when blood concentrations were outside target increased from 53% to 71% (P=0.12, and correct timing of initial concentration measurement increased from 43% to 57% (P=0.23. Appropriately timed trough concentrations improved from 73% to 81% (P=0.08. Pre-dose (trough

  18. Curriculum Guidelines for Periodontics.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

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

  19. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

    1999-04-01

    The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs.

  20. Development, dissemination and implementation of a sedation and analgesic guideline in a pediatric intensive care unit...it takes creativity and collaboration.

    Science.gov (United States)

    Thomas, Margot; Dhanani, Sonny; Irwin, Danica; Writer, Hilary; Doherty, Dermot

    2010-01-01

    Sedation and analgesia are administered to critically ill children to provide comfort and pain relief, decrease anxiety and to promote patient safety in relation to life-saving treatments. A comprehensive practice guideline focused on ways to implement evidence-based sedation and analgesia practices was developed, disseminated and implemented by an interprofessional team in the pediatric intensive care unit (PICU) at the Children's Hospital of Eastern Ontario (CHEO) in Ottawa, Canada. The goals of this quality of care initiative were to (1) reduce inconsistent practices, (2) improve patient outcomes related to comfort, and (3) enhance collaboration among health care team members caring for critically ill children. An evidence-based sedation and analgesia management (SAM) guideline for critically ill, intubated and ventilated infants and children was developed over a six-month period by a team composed of PICU physicians, pharmacists and nurses. The quality of patient care initiative focused on consistent use of (a) validated sedation and analgesia assessment tools, (b) a goal-directed approach by identifying daily therapeutic target scores and titrating interventions accordingly, and (c) non-pharmacologic, pharmacologic and adjunctive measures. The authors describe their experience in the development, dissemination and implementation of an interprofessional guideline directed at improving sedation and analgesia and patient safety in the PICU. Tools developed to support the practice change, challenges and lessons learned are shared.

  1. Common input to motor units of intrinsic and extrinsic hand muscles during two-digit object hold.

    Science.gov (United States)

    Winges, Sara A; Kornatz, Kurt W; Santello, Marco

    2008-03-01

    Anatomical and physiological evidence suggests that common input to motor neurons of hand muscles is an important neural mechanism for hand control. To gain insight into the synaptic input underlying the coordination of hand muscles, significant effort has been devoted to describing the distribution of common input across motor units of extrinsic muscles. Much less is known, however, about the distribution of common input to motor units belonging to different intrinsic muscles and to intrinsic-extrinsic muscle pairs. To address this void in the literature, we quantified the incidence and strength of near-simultaneous discharges of motor units residing in either the same or different intrinsic hand muscles (m. first dorsal, FDI, and m. first palmar interosseus, FPI) during two-digit object hold. To extend the characterization of common input to pairs of extrinsic muscles (previous work) and pairs of intrinsic muscles (present work), we also recorded electromyographic (EMG) activity from an extrinsic thumb muscle (m. flexor pollicis longus, FPL). Motor-unit synchrony across FDI and FPI was weak (common input strength, CIS, mean +/- SE: 0.17 +/- 0.02). Similarly, motor units from extrinsic-intrinsic muscle pairs were characterized by weak synchrony (FPL-FDI: 0.25 +/- 0.02; FPL-FPI: 0.29 +/- 0.03) although stronger than FDI-FPI. Last, CIS from within FDI and FPI was more than three times stronger (0.70 +/- 0.06 and 0.66 +/- 0.06, respectively) than across these muscles. We discuss present and previous findings within the framework of muscle-pair specific distribution of common input to hand muscles based on their functional role in grasping.

  2. Guidelines for cognitive behavioral training within doctoral psychology programs in the United States: report of the Inter-organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education.

    Science.gov (United States)

    Klepac, Robert K; Ronan, George F; Andrasik, Frank; Arnold, Kevin D; Belar, Cynthia D; Berry, Sharon L; Christofff, Karen A; Craighead, Linda W; Dougher, Michael J; Dowd, E Thomas; Herbert, James D; McFarr, Lynn M; Rizvi, Shireen L; Sauer, Eric M; Strauman, Timothy J

    2012-12-01

    The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a year-long series of conferences, and developed a consensus on optimal doctoral education and training in cognitive and behavioral psychology. The recommendations assume solid foundational training that is typical within applied psychology areas such as clinical and counseling psychology programs located in the United States. This article details the background, assumptions, and resulting recommendations specific to doctoral education and training in cognitive and behavioral psychology, including competencies expected in the areas of ethics, research, and practice.

  3. A Multi-Objective Unit Commitment Model for Setting Carbon Tax to Reduce CO2 Emission: Thailand's Electricity Generation Case

    Directory of Open Access Journals (Sweden)

    Nuchjarin Intalar

    2015-07-01

    Full Text Available Carbon tax policy is a cost-effective instrument for emission reduction. However, setting the carbon tax is one of the challenging task for policy makers as it will lead to higher price of emission-intensive sources especially the utility price. In a large-scale power generation system, minimizing the operational cost and the environmental impact are conflicting objectives and it is difficult to find the compromise solution. This paper proposes a methodology of finding a feasible carbon tax rate on strategic level using the operational unit commitment model. We present a multi-objective mixed integer linear programming model to solve the unit commitment problem and consider the environmental impacts. The methodology of analyzing of the effect of carbon tax rates on the power generation, operating cost, and CO2 emission is also provided. The trade-off relationship between total operating cost and total CO2 emission is presented in the Pareto-optimal curve to analyze the feasible carbon tax rate that is influencing on electricity operating cost. The significant outcome of this paper is a modeling framework for the policy makers to determine the possible carbon tax that can be imposed on the electricity generation.

  4. Hierarchical Object-Based Mapping of Riverscape Units and in-Stream Mesohabitats Using LiDAR and VHR Imagery

    Directory of Open Access Journals (Sweden)

    Luca Demarchi

    2016-01-01

    Full Text Available In this paper, we present a new, semi-automated methodology for mapping hydromorphological indicators of rivers at a regional scale using multisource remote sensing (RS data. This novel approach is based on the integration of spectral and topographic information within a multilevel, geographic, object-based image analysis (GEOBIA. Different segmentation levels were generated based on the two sources of Remote Sensing (RS data, namely very-high spatial resolution, near-infrared imagery (VHR and high-resolution LiDAR topography. At each level, different input object features were tested with Machine Learning classifiers for mapping riverscape units and in-stream mesohabitats. The GEOBIA approach proved to be a powerful tool for analyzing the river system at different levels of detail and for coupling spectral and topographic datasets, allowing for the delineation of the natural fluvial corridor with its primary riverscape units (e.g., water channel, unvegetated sediment bars, riparian densely-vegetated units, etc. and in-stream mesohabitats with a high level of accuracy, respectively of K = 0.91 and K = 0.83. This method is flexible and can be adapted to different sources of data, with the potential to be implemented at regional scales in the future. The analyzed dataset, composed of VHR imagery and LiDAR data, is nowadays increasingly available at larger scales, notably through European Member States. At the same time, this methodology provides a tool for monitoring and characterizing the hydromorphological status of river systems continuously along the entire channel network and coherently through time, opening novel and significant perspectives to river science and management, notably for planning and targeting actions.

  5. Association of proximity and density of parks and objectively measured physical activity in the United States: A systematic review.

    Science.gov (United States)

    Bancroft, Carolyn; Joshi, Spruha; Rundle, Andrew; Hutson, Malo; Chong, Catherine; Weiss, Christopher C; Genkinger, Jeanine; Neckerman, Kathryn; Lovasi, Gina

    2015-08-01

    One strategy for increasing physical activity is to create and enhance access to park space. We assessed the literature on the relationship of parks and objectively measured physical activity in population-based studies in the United States (US) and identified limitations in current built environment and physical activity measurement and reporting. Five English-language scholarly databases were queried using standardized search terms. Abstracts were screened for the following inclusion criteria: 1) published between January 1990 and June 2013; 2) US-based with a sample size greater than 100 individuals; 3) included built environment measures related to parks or trails; and 4) included objectively measured physical activity as an outcome. Following initial screening for inclusion by two independent raters, articles were abstracted into a database. Of 10,949 abstracts screened, 20 articles met the inclusion criteria. Five articles reported a significant positive association between parks and physical activity. Nine studies found no association, and six studies had mixed findings. Our review found that even among studies with objectively measured physical activity, the association between access to parks and physical activity varied between studies, possibly due to heterogeneity of exposure measurement. Self-reported (vs. independently-measured) neighborhood park environment characteristics and smaller (vs. larger) buffer sizes were more predictive of physical activity. We recommend strategies for further research, employing standardized reporting and innovative study designs to better understand the relationship of parks and physical activity.

  6. Guidelines, evidence, and cultural factors.

    NARCIS (Netherlands)

    Christiaens, T.; Backer, D. de; Burgers, J.S.; Baerheim, A.

    2004-01-01

    OBJECTIVE: To compare four recent guidelines on uncomplicated cystitis and to examine how cultural factors may have affected recommendations. DESIGN: Descriptive study with a qualitative analysis of authors' reasons for recommendations. MATERIAL: Guidelines for general practitioners published

  7. Three Decades of International Guidelines for Environment-Related Education: A Critical Hermeneutic of the United Nations Discourse

    Science.gov (United States)

    Sauve, Lucie; Berryman, Tom; Brunelle, Renee

    2007-01-01

    The UNESCO-UNEP International Environmental Education Program (1975-1995) provided impetus for developing, legitimizing, and institutionalizing environmental education. More recently, UNESCO was mandated by the United Nations to carry out a worldwide shift towards education for sustainable development. As international organizations'…

  8. Cervical cancer prevention: new guidelines in the United States and new opportunities for low- and middle-income countries.

    Science.gov (United States)

    Waxman, Alan G

    2013-06-01

    Developments from late 2011 to early 2013, including consensus conferences and the introduction of low-cost, rapid-turnaround testing of human papillomavirus, will change prevention strategies for cervical cancer in the United States and in low- and middle-income countries.

  9. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available AUTHOR GUIDELINES Indian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s. http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols 1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic

  10. Consent for routine neonatal procedures: A study of practices in Irish neonatal units. How do we compare with the gold standard BAPM guidelines?

    LENUS (Irish Health Repository)

    Ryan, M A

    2017-06-01

    The Irish National Consent Policy (NCP)¹ proposes that the legal requirement for consent extends to all forms of interventions, investigations and treatment, carried out on or behalf of the Health Service Executive (HSE). This study employs a quantitative descriptive approach to investigate the practices for obtaining consent for an identified group of routine neonatal procedures in neonatal facilities throughout Ireland. The BAPM (British Association of Perinatal Medicine)² guidelines were identified as ‘gold standard’ for the purposes of this study. The results indicated a lack of consistency between participating units pertaining to the modes of consent utilised and notable variances from ‘gold standard’ guidelines. Unanimity was evident for 3 procedures only (administering BCG, 6-in-1, and donor breast milk to infant). Significant findings related to EEG with video recordings, MRI\\/CT and gastro intestinal imaging, screening of an infant with suspected substance abuse or retinopathy of prematurity screening (ROP), administration of Vitamin K, and the carrying out of a lumbar puncture.

  11. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    Full Text Available Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.  http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionPAGE CONTENTSGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic-only material should be submitted and sent for peer review simultaneously with the primary manuscript.2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because

  12. Health Economic Evaluation of a Strict Glucose Control Guideline Implemented Using Point-of-Care Testing in Three Intensive Care Units in The Netherlands.

    Science.gov (United States)

    van Hooijdonk, Roosmarijn T M; Steuten, Lotte M G; Kip, Michelle M A; Monteban, Helma; Mulder, Marianne R; van Braam Houckgeest, Floris; van der Sluijs, Johannes P; Abu-Hanna, Ameen; Spronk, Peter E; Schultz, Marcus J

    2015-08-01

    Point-of-care testing of blood glucose (BG-POCT) is essential for safe and effective insulin titrations in critically ill patients under glucose control with insulin. The costs associated with this practice are considered substantial, especially when more frequent blood glucose (BG) testing is needed, as with more strict glucose control (SGC) aiming for lower BG levels. The objective of this study was to estimate, from a hospital perspective, the incremental cost effectiveness of an SGC guideline, aiming for BG levels of 4.4-6.1 mmol/L, compared to the situation before implementation of that guideline (aiming for BG levels levels >6.1 mmol/L), 'hypoglycaemia' (defined as BG levels levels increased by 1.4% (i.e., from 881 to 895 per 1000 patients). This translates to an incremental cost-effectiveness ratio of €25 per additional patient within the target glucose level. The model outcomes are most sensitive to changes in ICU length of stay. The increase in the number of patients and time within target glucose levels is achieved with a small increase in total direct hospital costs.

  13. Multitarget stool DNA for colorectal cancer screening:A review and commentary on the United States Preventive Services Draft Guidelines

    Institute of Scientific and Technical Information of China (English)

    Barry M Berger; Bernard Levin; Robert J Hilsden

    2016-01-01

    Multitarget stool DNA(mt-sDNA) testing was approved for average risk colorectal cancer(CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program(2014).The United States Preventive Services Task Force(USPSTF) October 2015 draft recommendation for CRC screening included mt-s DNA as an "alternative" screening test that "may be useful in select clinical circumstances",despite its very high sensitivity for early stage CRC.The evidence supporting mt-s DNA for routine screening use is robust.The clinical efficacy of mt-s DNA as measured by sensitivity,specificity,life-years gained(LYG),and CRC deaths averted is similar to or exceeds that of the other more specifically recommended screening options included in the draft document,especially those requiring annual testing adherence.In a population with primarily irregular screening participation,tests with the highest point sensitivity and reasonable specificity are more likely to favorably impact CRC related morbidity and mortality than those depending on annual adherence.This paper reviews the evidence supporting mt-s DNA for routine screening and demonstrates,using USPSTF’s modeling data,that mt-s DNA at three-year intervals provides significant clinical net benefits and fewer complications per LYG than annual fecal immunochemical testing,high sensitivity guaiac based fecal occult blood testing and 10-year colonoscopy screening.

  14. An Extended Objective Evaluation of the 29-km Eta Model for Weather Support to the United States Space Program

    Science.gov (United States)

    Nutter, Paul; Manobianco, John

    1998-01-01

    This report describes the Applied Meteorology Unit's objective verification of the National Centers for Environmental Prediction 29-km eta model during separate warm and cool season periods from May 1996 through January 1998. The verification of surface and upper-air point forecasts was performed at three selected stations important for 45th Weather Squadron, Spaceflight Meteorology Group, and National Weather Service, Melbourne operational weather concerns. The statistical evaluation identified model biases that may result from inadequate parameterization of physical processes. Since model biases are relatively small compared to the random error component, most of the total model error results from day-to-day variability in the forecasts and/or observations. To some extent, these nonsystematic errors reflect the variability in point observations that sample spatial and temporal scales of atmospheric phenomena that cannot be resolved by the model. On average, Meso-Eta point forecasts provide useful guidance for predicting the evolution of the larger scale environment. A more substantial challenge facing model users in real time is the discrimination of nonsystematic errors that tend to inflate the total forecast error. It is important that model users maintain awareness of ongoing model changes. Such changes are likely to modify the basic error characteristics, particularly near the surface.

  15. 20 CFR 30.318 - Can the FAB consider objections to HHS's reconstruction of a radiation dose or to the guidelines...

    Science.gov (United States)

    2010-04-01

    ... at 42 CFR part 82, is binding on the FAB. The FAB reviewer may determine, however, that objections... CFR part 81, is also binding on the FAB (see § 30.213). However, since OWCP applies this methodology... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Can the FAB consider objections to...

  16. An official American Thoracic Society Clinical Practice guideline: the diagnosis of intensive care unit-acquired weakness in adults.

    Science.gov (United States)

    Fan, Eddy; Cheek, Fern; Chlan, Linda; Gosselink, Rik; Hart, Nicholas; Herridge, Margaret S; Hopkins, Ramona O; Hough, Catherine L; Kress, John P; Latronico, Nicola; Moss, Marc; Needham, Dale M; Rich, Mark M; Stevens, Robert D; Wilson, Kevin C; Winkelman, Chris; Zochodne, Doug W; Ali, Naeem A

    2014-12-15

    Profound muscle weakness during and after critical illness is termed intensive care unit-acquired weakness (ICUAW). To develop diagnostic recommendations for ICUAW. A multidisciplinary expert committee generated diagnostic questions. A systematic review was performed, and recommendations were developed using the Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Severe sepsis, difficult ventilator liberation, and prolonged mechanical ventilation are associated with ICUAW. Physical rehabilitation improves outcomes in heterogeneous populations of ICU patients. Because it may not be feasible to provide universal physical rehabilitation, an alternative approach is to identify patients most likely to benefit. Patients with ICUAW may be such a group. Our review identified only one case series of patients with ICUAW who received physical therapy. When compared with a case series of patients with ICUAW who did not receive structured physical therapy, evidence suggested those who receive physical rehabilitation were more frequently discharged home rather than to a rehabilitative facility, although confidence intervals included no difference. Other interventions show promise, but fewer data proving patient benefit existed, thus precluding specific comment. Additionally, prior comorbidity was insufficiently defined to determine its influence on outcome, treatment response, or patient preferences for diagnostic efforts. We recommend controlled clinical trials in patients with ICUAW that compare physical rehabilitation with usual care and further research in understanding risk and patient preferences. Research that identifies treatments that benefit patients with ICUAW is necessary to determine whether the benefits of diagnostic testing for ICUAW outweigh its burdens.

  17. Deriving cleanup guidelines for radionuclides at Brookhaven National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Meinhold, A.F.; Morris, S.C.; Dionne, B.; Moskowitz, P.D.

    1997-01-01

    Past activities at Brookhaven National Laboratory (BNL) resulted in soil and groundwater contamination. As a result, BNL was designated a Superfund site under the Comprehensive Environmental Response Compensation and Liability Act (CERCLA). BNL`s Office of Environmental Restoration (OER) is overseeing environmental restoration activities at the Laboratory. With the exception of radium, there are no regulations or guidelines to establish cleanup guidelines for radionuclides in soils at BNL. BNL must derive radionuclide soil cleanup guidelines for a number of Operable Units (OUs) and Areas of Concern (AOCs). These guidelines are required by DOE under a proposed regulation for radiation protection of public health and the environment as well as to satisfy the requirements of CERCLA. The objective of this report is to propose a standard approach to deriving risk-based cleanup guidelines for radionuclides in soil at BNL. Implementation of the approach is briefly discussed.

  18. Multi-Agent Many-Objective Robust Decision Making: Supporting Cooperative Regional Water Portfolio Planning in the Eastern United States

    Science.gov (United States)

    Herman, J. D.; Zeff, H. B.; Reed, P. M.; Characklis, G. W.

    2013-12-01

    In the Eastern United States, water infrastructure and institutional frameworks have evolved in a historically water-rich environment. However, large regional droughts over the past decade combined with continuing population growth have marked a transition to a state of water scarcity, for which current planning paradigms are ill-suited. Significant opportunities exist to improve the efficiency of water infrastructure via regional coordination, namely, regional 'portfolios' of water-related assets such as reservoirs, conveyance, conservation measures, and transfer agreements. Regional coordination offers the potential to improve reliability, cost, and environmental impact in the expected future state of the world, and, with informed planning, to improve robustness to future uncertainty. In support of this challenge, this study advances a multi-agent many-objective robust decision making (multi-agent MORDM) framework that blends novel computational search and uncertainty analysis tools to discover flexible, robust regional portfolios. Our multi-agent MORDM framework is demonstrated for four water utilities in the Research Triangle region of North Carolina, USA. The utilities supply nearly two million customers and have the ability to interact with one another via transfer agreements and shared infrastructure. We show that strategies for this region which are Pareto-optimal in the expected future state of the world remain vulnerable to performance degradation under alternative scenarios of deeply uncertain hydrologic and economic factors. We then apply the Patient Rule Induction Method (PRIM) to identify which of these uncertain factors drives the individual and collective vulnerabilities for the four cooperating utilities. Our results indicate that clear multi-agent tradeoffs emerge for attaining robustness across the utilities. Furthermore, the key factor identified for improving the robustness of the region's water supply is cooperative demand reduction. This type

  19. Guideline.gov: A Database of Clinical Specialty Guidelines.

    Science.gov (United States)

    El-Khayat, Yamila M; Forbes, Carrie S; Coghill, Jeffrey G

    2017-01-01

    The National Guidelines Clearinghouse (NGC), also known as Guideline.gov, is a database of resources to assist health care providers with a central depository of guidelines for clinical specialty areas in medicine. The database is provided free of charge and is sponsored by the U.S. Department of Health and Human Services and the Agency for Healthcare Research and Quality. The guidelines for treatment are updated regularly, with new guidelines replacing older guidelines every five years. There are hundreds of current guidelines with more added each week. The purpose and goal of NGC is to provide physicians, nurses, and other health care providers, insurance companies, and others in the field of health care with a unified database of the most current, detailed, relevant, and objective clinical practice guidelines.

  20. Cancer screening in the United States, 2016: A review of current American Cancer Society guidelines and current issues in cancer screening.

    Science.gov (United States)

    Smith, Robert A; Andrews, Kimberly; Brooks, Durado; DeSantis, Carol E; Fedewa, Stacey A; Lortet-Tieulent, Joannie; Manassaram-Baptiste, Deana; Brawley, Otis W; Wender, Richard C

    2016-01-01

    Each year the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines, including the update of the breast cancer screening guideline, discuss quality issues in colorectal cancer screening and new developments in lung cancer screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey.

  1. Electrical safety guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

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

  2. [Guidelines for clinical practice].

    Science.gov (United States)

    Vleugels, A M

    1997-01-01

    Clinical practice guidelines are systematically developed statements that are intended to support medical decision making in well-defined clinical situations. Essentially, their object is to reduce the variability in medical practice, to improve quality, and to make appropriated control of the financial resources possible. Internationally, ever more organisations, associations, and institutions are concerned with the development of guidelines in many different areas of care. Making implicit knowledge explicit is one of the associated advantages of guidelines: they have a potential utility in training, in process evaluation, and in the reevaluation of outcome studies. In liability issues, their existence has a double effect: they can be used to justify medical behaviour, and they constitute a generally accepted reference point. A derivative problem is the legal liability of the compilers of the guidelines. The principle of the guideline approach can be challenged academically: science cannot give a definition of optimal care with absolute certainty. What is called objectivity often rests on methodologically disputable analyses; also the opinion of opinion leaders is not always a guarantee for scientific soundness. Moreover, patients are not all identical: biological variability, situational factors, patient expectations, and other elements play a role in this differentiation. Clinicians are often hesitant with respect to clinical guidelines: they are afraid of cookbook medicine and curtailment of their professional autonomy. Patients fear reduction of individualization of care and the use of guidelines as a rationing instrument. The effects of the introduction of clinical practice guidelines on medical practice, on the results and on the cost of care vary but are generally considered to be favourable. The choice of appropriate strategies in development, dissemination, and implementation turns out to be of critical importance. The article ends with concrete

  3. Investigating Patients with Recent Onset of Chest Pain Against NICE Guidelines in a District General Hospital Setting in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Azeem S Sheikh

    2012-09-01

    Full Text Available Background: Chest pain is a very common symptom leading to a significant number of patients visiting the primary care trusts, emergency departments and a huge number of emergency hospital admissions.Objective: The objective of our audit was to investigate whether patients with recent onset of chest pain referred to the Rapid Access Chest Pain Clinic were being investigated in accordance with the recommendations by the National Institute for Health and Clinical Excellence (NICE, in a busy District General Hospital setting.Design: Retrospective collection of dataSetting: Southend University Hospital NHS Foundation TrustPatients: We collected data over a period of three months for all the patients who underwent invasive coronary angiogram after being referred via Rapid Access Chest Pain Clinic (RACPC or General Cardiology Clinic presenting with recent onset of chest pain. A total of 157 patients were enrolled in the study. The patients were then categorised into four groups based upon their description of symptoms, age and risk factors, as defined by NICE.Results: We found that 86% (135/157 patients had estimated likelihood of CAD >60% and 51% of these had unnecessary non-invasive investigations contrary to what NICE recommends. This shows that adhering to the NICE guidelines would have saved a substantial amount of hospital resources and time of the healthcare team and the patients.Conclusions: The development of strategies for cost-conscious quality care must begin with the history, risk factors for coronary artery disease and patients’ investigations should be based on their risk stratification.

  4. Adherence to the Otitis Media with Effusion Clinical Practice Guideline by Providers in a United States Air Force Medical Treatment Facility

    Science.gov (United States)

    2013-01-31

    limited evidence that these guidelines have achieved the desired goals of reducing health costs, improving quality of care, and limiting malpractice ...the importance of accurate diagnosis, the academic community should reexamine techniques for improving otoscopic skills" (p. 573). Maj Pengilly...costs, and limiting malpractice liability. Summary Compliance with the use of treatment recommendations found in the OME guideline (Stool et al

  5. Clinical guidelines.

    Science.gov (United States)

    Uppal, Elaine

    2016-01-01

    This article is part of the Advancing practice series which is aimed at exploring practice issues in more depth, considering topics that are frequently encountered and facilitating the development of new insights. Elaine Uppal focuses on the importance of all midwives developing guideline writing skills to ensure that local, national and international midwifery/maternity guidelines are up to date, relevant and reflect midwifery knowledge alongside 'gold' standard evidence. The article aims to consider the development, use and critical appraisal of clinical guidelines. It will define and explain guidelines; discuss their development and dissemination; and consider issues relating to their use in practice. Techniques to critique and develop guidelines using the AGREE tool will be outlined in the form of practice challenges to be undertaken by the individual or in a group.

  6. Object crowding.

    Science.gov (United States)

    Wallace, Julian M; Tjan, Bosco S

    2011-05-25

    Crowding occurs when stimuli in the peripheral fields become harder to identify when flanked by other items. This phenomenon has been demonstrated extensively with simple patterns (e.g., Gabors and letters). Here, we characterize crowding for everyday objects. We presented three-item arrays of objects and letters, arranged radially and tangentially in the lower visual field. Observers identified the central target, and we measured contrast energy thresholds as a function of target-to-flanker spacing. Object crowding was similar to letter crowding in spatial extent but was much weaker. The average elevation in threshold contrast energy was in the order of 1 log unit for objects as compared to 2 log units for letters and silhouette objects. Furthermore, we examined whether the exterior and interior features of an object are differentially affected by crowding. We used a circular aperture to present or exclude the object interior. Critical spacings for these aperture and "donut" objects were similar to those of intact objects. Taken together, these findings suggest that crowding between letters and objects are essentially due to the same mechanism, which affects equally the interior and exterior features of an object. However, for objects defined with varying shades of gray, it is much easier to overcome crowding by increasing contrast.

  7. The ChemCam Instrument Suite on the Mars Science Laboratory (MSL) Rover: Science Objectives and Mast Unit Description

    Science.gov (United States)

    Maurice, S.; Wiens, R. C.; Saccoccio, M.; Barraclough, B.; Gasnault, O.; Forni, O.; Mangold, N.; Baratoux, D.; Bender, S.; Berger, G.; Bernardin, J.; Berthé, M.; Bridges, N.; Blaney, D.; Bouyé, M.; Caïs, P.; Clark, B.; Clegg, S.; Cousin, A.; Cremers, D.; Cros, A.; DeFlores, L.; Derycke, C.; Dingler, B.; Dromart, G.; Dubois, B.; Dupieux, M.; Durand, E.; d'Uston, L.; Fabre, C.; Faure, B.; Gaboriaud, A.; Gharsa, T.; Herkenhoff, K.; Kan, E.; Kirkland, L.; Kouach, D.; Lacour, J.-L.; Langevin, Y.; Lasue, J.; Le Mouélic, S.; Lescure, M.; Lewin, E.; Limonadi, D.; Manhès, G.; Mauchien, P.; McKay, C.; Meslin, P.-Y.; Michel, Y.; Miller, E.; Newsom, H. E.; Orttner, G.; Paillet, A.; Parès, L.; Parot, Y.; Pérez, R.; Pinet, P.; Poitrasson, F.; Quertier, B.; Sallé, B.; Sotin, C.; Sautter, V.; Séran, H.; Simmonds, J. J.; Sirven, J.-B.; Stiglich, R.; Striebig, N.; Thocaven, J.-J.; Toplis, M. J.; Vaniman, D.

    2012-09-01

    ChemCam is a remote sensing instrument suite on board the "Curiosity" rover (NASA) that uses Laser-Induced Breakdown Spectroscopy (LIBS) to provide the elemental composition of soils and rocks at the surface of Mars from a distance of 1.3 to 7 m, and a telescopic imager to return high resolution context and micro-images at distances greater than 1.16 m. We describe five analytical capabilities: rock classification, quantitative composition, depth profiling, context imaging, and passive spectroscopy. They serve as a toolbox to address most of the science questions at Gale crater. ChemCam consists of a Mast-Unit (laser, telescope, camera, and electronics) and a Body-Unit (spectrometers, digital processing unit, and optical demultiplexer), which are connected by an optical fiber and an electrical interface. We then report on the development, integration, and testing of the Mast-Unit, and summarize some key characteristics of ChemCam. This confirmed that nominal or better than nominal performances were achieved for critical parameters, in particular power density (>1 GW/cm2). The analysis spot diameter varies from 350 μm at 2 m to 550 μm at 7 m distance. For remote imaging, the camera field of view is 20 mrad for 1024×1024 pixels. Field tests demonstrated that the resolution (˜90 μrad) made it possible to identify laser shots on a wide variety of images. This is sufficient for visualizing laser shot pits and textures of rocks and soils. An auto-exposure capability optimizes the dynamical range of the images. Dedicated hardware and software focus the telescope, with precision that is appropriate for the LIBS and imaging depths-of-field. The light emitted by the plasma is collected and sent to the Body-Unit via a 6 m optical fiber. The companion to this paper (Wiens et al. this issue) reports on the development of the Body-Unit, on the analysis of the emitted light, and on the good match between instrument performance and science specifications.

  8. The ChemCam Instrument Suite on the Mars Science Laboratory (MSL) Rover: Science Objectives and Mast Unit Description

    Science.gov (United States)

    Maurice, S.; Wiens, R.C.; Saccoccio, M.; Barraclough, B.; Gasnault, O.; Forni, O.; Mangold, N.; Baratoux, D.; Bender, S.; Berger, G.; Bernardin, J.; Berthé, M.; Bridges, N.; Blaney, D.; Bouyé, M.; Caïs, P.; Clark, B.; Clegg, S.; Cousin, A.; Cremers, D.; Cros, A.; DeFlores, L.; Derycke, C.; Dingler, B.; Dromart, G.; Dubois, B.; Dupieux, M.; Durand, E.; d'Uston, L.; Fabre, C.; Faure, B.; Gaboriaud, A.; Gharsa, T.; Herkenhoff, K.; Kan, E.; Kirkland, L.; Kouach, D.; Lacour, J.-L.; Langevin, Y.; Lasue, J.; Le Mouélic, S.; Lescure, M.; Lewin, E.; Limonadi, D.; Manhès, G.; Mauchien, P.; McKay, C.; Meslin, P.-Y.; Michel, Y.; Miller, E.; Newsom, Horton E.; Orttner, G.; Paillet, A.; Parès, L.; Parot, Y.; Pérez, R.; Pinet, P.; Poitrasson, F.; Quertier, B.; Sallé, B.; Sotin, C.; Sautter, V.; Séran, H.; Simmonds, J.J.; Sirven, J.-B.; Stiglich, R.; Striebig, N.; Thocaven, J.-J.; Toplis, M.J.; Vaniman, D.

    2012-01-01

    ChemCam is a remote sensing instrument suite on board the "Curiosity" rover (NASA) that uses Laser-Induced Breakdown Spectroscopy (LIBS) to provide the elemental composition of soils and rocks at the surface of Mars from a distance of 1.3 to 7 m, and a telescopic imager to return high resolution context and micro-images at distances greater than 1.16 m. We describe five analytical capabilities: rock classification, quantitative composition, depth profiling, context imaging, and passive spectroscopy. They serve as a toolbox to address most of the science questions at Gale crater. ChemCam consists of a Mast-Unit (laser, telescope, camera, and electronics) and a Body-Unit (spectrometers, digital processing unit, and optical demultiplexer), which are connected by an optical fiber and an electrical interface. We then report on the development, integration, and testing of the Mast-Unit, and summarize some key characteristics of ChemCam. This confirmed that nominal or better than nominal performances were achieved for critical parameters, in particular power density (>1 GW/cm2). The analysis spot diameter varies from 350 μm at 2 m to 550 μm at 7 m distance. For remote imaging, the camera field of view is 20 mrad for 1024×1024 pixels. Field tests demonstrated that the resolution (˜90 μrad) made it possible to identify laser shots on a wide variety of images. This is sufficient for visualizing laser shot pits and textures of rocks and soils. An auto-exposure capability optimizes the dynamical range of the images. Dedicated hardware and software focus the telescope, with precision that is appropriate for the LIBS and imaging depths-of-field. The light emitted by the plasma is collected and sent to the Body-Unit via a 6 m optical fiber. The companion to this paper (Wiens et al. this issue) reports on the development of the Body-Unit, on the analysis of the emitted light, and on the good match between instrument performance and science specifications.

  9. Epetra developers coding guidelines.

    Energy Technology Data Exchange (ETDEWEB)

    Heroux, Michael Allen; Sexton, Paul Michael

    2003-12-01

    Epetra is a package of classes for the construction and use of serial and distributed parallel linear algebra objects. It is one of the base packages in Trilinos. This document describes guidelines for Epetra coding style. The issues discussed here go beyond correct C++ syntax to address issues that make code more readable and self-consistent. The guidelines presented here are intended to aid current and future development of Epetra specifically. They reflect design decisions that were made in the early development stages of Epetra. Some of the guidelines are contrary to more commonly used conventions, but we choose to continue these practices for the purposes of self-consistency. These guidelines are intended to be complimentary to policies established in the Trilinos Developers Guide.

  10. Primary care guidelines

    DEFF Research Database (Denmark)

    Ijäs, Jarja; Alanen, Seija; Kaila, Minna

    2009-01-01

    -sectional telephone survey. SETTING: All municipal health centres in Finland. SUBJECTS: Health centres where both the head physician and the senior nursing officer responded. MAIN OUTCOME MEASURES: Agreement in views of the senior executives on the adoption of clinical practices as recommended in the Hypertension......OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p

  11. German Guidelines.

    Science.gov (United States)

    Kruis, Wolfgang; Nguyen, Gia P; Leifeld, Ludger

    2016-10-01

    Because of its frequency, diverticular disease is a burden on health care systems. Only few formal guidelines covering all aspects of the disease exist. Here, some selected statements from the German guidelines are given. The guidelines include significant recommendations for the diagnosis and management of diverticular disease. Both diagnosis and management depend definitely on clear definitions of the situation of an individual patient. Therefore, a new classification is proposed that is based on earlier suggestions. An internationally established classification would not only enable better patient care but could also lead to studies with comparable results.

  12. Metadata Guidelines

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document provides guidelines on metadata and metadata requirements for ServCat documents. Information on metadata is followed by an instructional flowchart and...

  13. Hierarchical object-based mapping of riverscape units and in-stream mesohabitats using LiDAR and VHR imagery

    OpenAIRE

    Luca Demarchi; Simone Bizzi; Hervé Piégay

    2015-01-01

    In this paper, we present a new, semi-automated methodology for mapping hydromorphological indicators of rivers at a regional scale using multisource remote sensing (RS) data. This novel approach is based on the integration of spectral and topographic information within a multilevel, geographic, object-based image analysis (GEOBIA). Different segmentation levels were generated based on the two sources of Remote Sensing (RS) data, namely very-high spatial resolution, near-infrared imagery (VHR...

  14. Pharmacologic treatment of migraine. Comparison of guidelines.

    NARCIS (Netherlands)

    Schuurmans, A.; Weel, C. van

    2005-01-01

    OBJECTIVE: To compare guidelines (not the primary studies) for pharmacologic treatment of migraine as to methods of guideline development; recommendations, particularly on triptans; and quality of supporting evidence (with emphasis on comparative studies of triptans versus ergot alkaloids and nonste

  15. Improving the use of research evidence in guideline development: 1. Guidelines for guidelines

    Directory of Open Access Journals (Sweden)

    Oxman Andrew D

    2006-11-01

    Full Text Available Abstract Background The World Health Organization (WHO, like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the first of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. Objectives We reviewed the literature on guidelines for the development of guidelines. Methods We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. Key questions and answers We found no experimental research that compared different formats of guidelines for guidelines or studies that compared different components of guidelines for guidelines. However, there are many examples, surveys and other observational studies that compared the impact of different guideline development documents on guideline quality. What have other organizations done to develop guidelines for guidelines from which WHO can learn? • Establish a credible, independent committee that evaluates existing methods for developing guidelines or that updates existing ones. • Obtain feedback and approval from various stakeholders during the development process of guidelines for guidelines. • Develop a detailed source document (manual that guideline developers can use as reference material. What should be the key components of WHO guidelines for guidelines? • Guidelines for guidelines should include information and instructions about the following components: 1 Priority setting; 2 Group composition and consultations; 3 Declaration and avoidance of conflicts of interest; 4 Group processes; 5

  16. GRADE Equity Guidelines 3

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  17. Curricular Guidelines for Neuroanatomy.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

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

  18. IT governance guidelines for directors

    CERN Document Server

    Calder, Alan

    2005-01-01

    This important new book – 'IT Governance: Guidelines for Directors' provides directors, executives, managers and professional advisers with clear, pragmatic guidelines for ensuring that IT and the business work together for the same strategic objectives

  19. Cancer screening in the United States, 2017: A review of current American Cancer Society guidelines and current issues in cancer screening.

    Science.gov (United States)

    Smith, Robert A; Andrews, Kimberly S; Brooks, Durado; Fedewa, Stacey A; Manassaram-Baptiste, Deana; Saslow, Debbie; Brawley, Otis W; Wender, Richard C

    2017-03-01

    Answer questions and earn CME/CNE Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the authors summarize current American Cancer Society cancer screening guidelines, describe an update of their guideline for using human papillomavirus vaccination for cancer prevention, describe updates in US Preventive Services Task Force recommendations for breast and colorectal cancer screening, discuss interim findings from the UK Collaborative Trial on Ovarian Cancer Screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey. CA Cancer J Clin 2017;67:100-121. © 2017 American Cancer Society. © 2017 American Cancer Society.

  20. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    Dietary guidelines are issued regularly in most developed countries. In almost all cases they are concerned solely with the nutritional aspects of food and eating and are based on an understanding of food exclusively as a source of nutrients. In recent years, however, a growing number of proposals...... in a number of countries have addressed the issue of making dietary guidelines that integrate health and sustainability, but in all cases they have been met with different kinds of resistance. This article reviews the development towards an integrated understanding of health and sustainability in relation...... and the role of expert cultures for the elaboration and communication of messages about health and sustainability. Finally, the article briefly points to some answers to the complexity of issues surrounding the creation of dietary guidelines...

  1. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening.

    Science.gov (United States)

    Smith, Robert A; Manassaram-Baptiste, Deana; Brooks, Durado; Doroshenk, Mary; Fedewa, Stacey; Saslow, Debbie; Brawley, Otis W; Wender, Richard

    2015-01-01

    Each year, the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection along with a report on data and trends in cancer screening rates and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines. The latest data on utilization of cancer screening from the National Health Interview Survey (NHIS) also is described, as are several issues related to screening coverage under the Affordable Care Act, including the expansion of the Medicaid program.

  2. The object of the unitization agreement under the Brazilian legal system; O objeto do acordo de unitizacao no sistema juridico brasileiro

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Tatiana Zuma [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The concept of unitization was incorporated in the Brazilian law through the article 27 of Law n. 9.478/97 (Petroleum Act). There is unitization when a deposit of oil or natural gas extends by two or more contiguous blocks, whose rights of exploration and production belong to different concessionaires and in which case such concessionaires may conclude an Agreement for Individualization of Production (hereinafter referred to Unitization Agreement). This study intends to examine the object of the unitization agreement and to define the limits of the area on which the concessionaires of the neighbouring areas should exercise the production joint operations. Therefore, it was studied the concepts of Block (Petroleum Act, article 6, XIII), Field (Petroleum Act, article 6, XIV), and Reservoir (Petroleum Act, article 6, X and XI), and the articles 26 and 27 of the Petroleum Act were interpreted systematically. The Comparative Law has also been examined and used as a basis for the conclusions presented in this study. (author)

  3. Reflections on the United States National Institutes of Health draft guidelines for research involving human pluripotent stem cells--theological perspective.

    Science.gov (United States)

    Sotis, J J

    2000-01-01

    Since the human embryonic stem cell research involves destruction of human embryos and, therefore, hinges on the fundamental question of the status of the embryo, it is essential to examine this status carefully in order to establish fitting guidelines for research. The US National Institutes of Health has proposed its own guidelines on the matter recently (1999). The document, rooted in current pluralistic perspectives in moral philosophy (or bioethics), is criticised in this paper as morally inadequate. The argumentation of the criticism stems from the theological perspective on human personhood, which focuses on a continuity of personal identity from embryos to adult human beings. An additional concern for the author is the moral complicity in which the research dependent upon the destruction of human embryonic life is sanctioned.

  4. Update: Interim Guidelines for Health Care Providers Caring for Infants and Children with Possible Zika Virus Infection--United States, February 2016.

    Science.gov (United States)

    Fleming-Dutra, Katherine E; Nelson, Jennifer M; Fischer, Marc; Staples, J Erin; Karwowski, Mateusz P; Mead, Paul; Villanueva, Julie; Renquist, Christina M; Minta, Anna A; Jamieson, Denise J; Honein, Margaret A; Moore, Cynthia A; Rasmussen, Sonja A

    2016-02-26

    CDC has updated its interim guidelines for U.S. health care providers caring for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy and expanded guidelines to include infants and children with possible acute Zika virus disease. This update contains a new recommendation for routine care for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy but did not receive Zika virus testing, when the infant has a normal head circumference, normal prenatal and postnatal ultrasounds (if performed), and normal physical examination. Acute Zika virus disease should be suspected in an infant or child aged Zika virus during delivery is possible, acute Zika virus disease should also be suspected in an infant during the first 2 weeks of life 1) whose mother traveled to or resided in an affected area within 2 weeks of delivery and 2) who has ≥2 of the following manifestations: fever, rash, conjunctivitis, or arthralgia. Evidence suggests that Zika virus illness in children is usually mild. As an arboviral disease, Zika virus disease is nationally notifiable. Health care providers should report suspected cases of Zika virus disease to their local, state, or territorial health departments to arrange testing and so that action can be taken to reduce the risk for local Zika virus transmission. As new information becomes available, these guidelines will be updated: http://www.cdc.gov/zika/.

  5. Jogging Guidelines.

    Science.gov (United States)

    President's Council on Physical Fitness and Sports, Washington, DC.

    Jogging guidelines are set forth under the following headings: a) What Is Jogging; c) Why One Should Jog; c) How To Begin; d) What To Wear (with the emphasis on proper shoes); e) When and Where To Jog; and f) How To Jog. A 16-week basic program, outlined for inactive adults, recommends for each week the number of days to exercise, the distance,…

  6. Can Low-income Americans Afford to Satisfy MyPyramid Fruit and Vegetable Guidelines?

    Science.gov (United States)

    Stewart, Hayden; Hyman, Jeffrey; Frazao, Elizabeth; Buzby, Jean C.; Carlson, Andrea

    2011-01-01

    Objective: To estimate the costs of satisfying MyPyramid fruit and vegetable guidelines, with a focus on whether low-income households can bear these costs. Design: Descriptive analysis of the 2008 National Consumer Panel with information on the food purchases of 64,440 households across the contiguous United States was used to analyze the cost of…

  7. Author Guidelines

    OpenAIRE

    Istadi Istadi

    2011-01-01

    AUTHOR GUIDELINES Indian Journal of Community Health (IJCH) accepts only online submission of manuscript(s) by using Open Journal software (OJS) at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH)? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly ...

  8. Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure - United States, 2016.

    Science.gov (United States)

    Oduyebo, Titilope; Petersen, Emily E; Rasmussen, Sonja A; Mead, Paul S; Meaney-Delman, Dana; Renquist, Christina M; Ellington, Sascha R; Fischer, Marc; Staples, J Erin; Powers, Ann M; Villanueva, Julie; Galang, Romeo R; Dieke, Ada; Muñoz, Jorge L; Honein, Margaret A; Jamieson, Denise J

    2016-02-12

    CDC has updated its interim guidelines for U.S. health care providers caring for pregnant women during a Zika virus outbreak (1). Updated guidelines include a new recommendation to offer serologic testing to asymptomatic pregnant women (women who do not report clinical illness consistent with Zika virus disease) who have traveled to areas with ongoing Zika virus transmission. Testing can be offered 2-12 weeks after pregnant women return from travel. This update also expands guidance to women who reside in areas with ongoing Zika virus transmission, and includes recommendations for screening, testing, and management of pregnant women and recommendations for counseling women of reproductive age (15-44 years). Pregnant women who reside in areas with ongoing Zika virus transmission have an ongoing risk for infection throughout their pregnancy. For pregnant women with clinical illness consistent with Zika virus disease,* testing is recommended during the first week of illness. For asymptomatic pregnant women residing in areas with ongoing Zika virus transmission, testing is recommended at the initiation of prenatal care with follow-up testing mid-second trimester. Local health officials should determine when to implement testing of asymptomatic pregnant women based on information about levels of Zika virus transmission and laboratory capacity. Health care providers should discuss reproductive life plans, including pregnancy intention and timing, with women of reproductive age in the context of the potential risks associated with Zika virus infection.

  9. A structural equation model to investigate the impact of missing occlusal units on objective masticatory function in patients with shortened dental arches.

    Science.gov (United States)

    Fueki, K; Yoshida, E; Igarashi, Y

    2011-11-01

    The aim of this study was to investigate the impact of missing occlusal units (MOUs) on objective masticatory function with respect to food comminuting and mixing ability. Sixty partially dentate patients (mean age, 64·1 years) with shortened dental arches participated in the study. Food comminuting ability was assessed using a masticatory performance test with peanuts as a test food. Food mixing ability was assessed using a mixing ability test with a two-coloured wax cube. Maximum bite force (MBF) was measured using a pressure-sensitive film as a mediator for food comminuting and mixing ability. A structural equation model was constructed based on a hypothesis that MOUs would be associated with reduced MBF and impairment of food comminuting and mixing ability. Structural equation modelling analysis found significant direct effects of MOU on median particle size and mixing ability index (MAI) (P dental arches.

  10. Different Teams, Same Conclusions? A Systematic Review of Existing Clinical Guidelines for the Assessment and Treatment of Tinnitus in Adults

    Science.gov (United States)

    Fuller, Thomas E.; Haider, Haula F.; Kikidis, Dimitris; Lapira, Alec; Mazurek, Birgit; Norena, Arnaud; Rabau, Sarah; Lardinois, Rachelle; Cederroth, Christopher R.; Edvall, Niklas K.; Brueggemann, Petra G.; Rosing, Susanne N.; Kapandais, Anestis; Lungaard, Dorte; Hoare, Derek J.; Cima, Rilana F. F

    2017-01-01

    Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year of publication were applied to guidelines. Results: Clinical guidelines from Denmark, Germany, Sweden, The Netherlands, and the United States were included in the review. There was a high level of consistency across the guidelines with regard to recommendations for audiometric assessment, physical examination, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across the included guidelines. Differences between the guidelines centered on the use of imaging in assessment procedures and sound therapy as a form of treatment for tinnitus distress respectively. Conclusion: Given the level of commonality across tinnitus guidelines from different countries the development of a European guideline for the assessment and treatment of subjective tinnitus in adults seems feasible. This guideline would have the potential to benefit the large number of clinicians in countries where clinical guidelines do not yet exist, and would support standardization of treatment for patients across Europe. PMID:28275357

  11. 40 CFR 60.31d - Emissions guidelines.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Emissions guidelines. 60.31d Section 60...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Sulfuric Acid Production Units § 60.31d Emissions guidelines. Sulfuric acid production units. The...

  12. Dietary recommendations: comparing dietary guidelines from Brazil and the United States Recomendações dietéticas: comparação entre os guias alimentares brasileiro e americano

    Directory of Open Access Journals (Sweden)

    Rosely Sichieri

    2010-11-01

    Full Text Available The Brazilian dietary guidelines are based in part on mainstream United States' recommendations, in spite of the criticisms and shortcomings of the American guidelines. In this paper, Brazilian food guidelines are summarized and discussed in comparison with the USA recommendations. American and Brazilian dietary recommendations are quite similar in many aspects, particularly those related to variety in the diet, the importance of physical activity and weight management. Different to American guidelines, those from Brazil advise people to choose fresh foods, to prefer healthier types of fat, to limit trans fat intake and to eat good sources of protein, but does not recommend the consumption of whole grains. Besides the challenges related to their implementation, indicators for the evaluation of the effectiveness of these guidelines should be established from the beginning, particularly those related to changes in dietary habits and the prevalence of obesity.O guia alimentar brasileiro é baseado parcialmente nas recomendações americanas a despeito das críticas e problemas identificados no documento dos Estados Unidos. Neste artigo, as recomendações alimentares para o Brasil são resumidas e discutidas em comparação com as recomendações estadunidenses. Os guias alimentares brasileiro e americano são bastante similares em diversos aspectos, particularmente aqueles relacionados com a variação da dieta, a importância da atividade física e o gerenciamento do peso. Diferentemente dos Estados Unidos, o guia brasileiro estimula o consumo de alimentos frescos, aconselha o uso de fontes saudáveis de gorduras, a limitação do consumo de gordura trans, o consumo de boas fontes de proteínas, mas não indica o consumo de grãos integrais. Além dos desafios relacionados com a sua implantação, os indicadores para a avaliação da eficácia dos guias alimentares devem ser estabelecidos desde sua implantação, particularmente, os relacionados

  13. Configurable slit-mask unit of the Multi-Object Spectrometer for Infra-Red Exploration for the Keck telescope: integration and tests

    Science.gov (United States)

    Spanoudakis, Peter; Giriens, Laurent; Henein, Simon; Lisowski, Leszek; O'Hare, Aidan; Onillon, Emmanuel; Schwab, Philippe; Theurillat, Patrick

    2008-07-01

    A Configurable Slit Unit (CSU) has been developed for the Multi-Object Spectrometer for Infra-Red Exploration (MOSFIRE) instrument to be installed on the Keck 1 Telescope on Mauna Kea, Hawaii. MOSFIRE will provide NIR multi-object spectroscopy over a field of view of 6.1' x 6.1'. The reconfigurable mask allows the formation of 46 optical slits in a 267 x 267 mm2 field of view. The mechanism is an evolution of a former prototype designed by CSEM and qualified for the European Space Agency (ESA) as a candidate for the slit mask on NIRSpec for the James Webb Space Telescope (JWST). The CSU is designed to simultaneously displace masking bars across the field-of-view (FOV) to mask unwanted light. A set of 46 bar pairs are used to form the MOSFIRE focal plane mask. The sides of the bars are convoluted so that light is prevented from passing between adjacent bars. The slit length is fixed (5.1 mm) but the width is variable down to 200 μm with a slit positioning accuracy of +/- 18 μm. A two-bar prototype mechanism was designed, manufactured and cryogenically tested to validate the modifications from the JWST prototype. The working principle of the mechanism is based on an improved "inch-worm" stepping motion of 92 masking bars forming the optical mask. Original voice coil actuators are used to drive the various clutches. The design makes significant use of flexure structures.

  14. Curriculum Guidelines for Clinical Dental Hygiene.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    The American Association of Dental Schools curriculum guidelines for clinical dental hygiene include definitions, notes on the interrelationship of courses, an overview of course objectives, and suggested primary educational goals, prerequisites, core content, specific objectives, sequencing, faculty, and facilities. (MSE)

  15. A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the intensive care unit

    Science.gov (United States)

    YAZDANI, MAJID; SABETIAN, GOLNAR; RA'OFI, SHAHIN; ROUDGARI, AMIR; FEIZI, MONIREH

    2015-01-01

    Introduction Ventilator-associated pneumonia (VAP) is one of the most popular nosocomial infections in the intensive care units and the nurse's role in preventing it is very important. The aim of this study was to compare the effect of two methods of face to face training and work- shop clinical guidelines in prevention of VAP. Methods In this experimental randomized clinical trial, the knowledge and practice of nurses in ICUs were studied in two groups: face to face training (35 nurses) and workshops (40 nurses) by using clinical guidelines in prevention of VAP in one of the hospitals of Shiraz University of Medical Sciences. The level of knowledge and practice in each group was assessed by self-report questionnaire, knowledge questionnaire and also direct observation of practice, before and after training. Data were analyzed with descriptive statistics, paired t-test, independent t-test, McNemar test, Fisher’s exact, sign and Chi-square test, using SPSS 14. Results This study demonstrated that both methods of face to face training and workshop were very effective. The incidence of inappropriate pressure of cuff in the tracheal tubes and tracheostomy tubes was significantly reduced after training (p=0.001). But, by comparison of these two methods and the relationship between the variables revealed that no significant difference was found between the two groups of face to face training and workshop. Conclusion Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands. PMID:25927070

  16. Knowledge, attitudes and use of the guidelines for the treatment of moderate to severe plaque psoriasis among Dutch dermatologists.

    NARCIS (Netherlands)

    Wakkee, M.; Lugtenberg, M.; Spuls, P.I.; Jong, E.M.G.J. de; Thio, H.B.; Westert, G.P.; Nijsten, T.

    2008-01-01

    BACKGROUND: In 2003, the Dutch psoriasis guidelines were among the first evidence-based medicine guidelines in dermatology. Although pivotal, the implementation of dermatological guidelines has not been assessed. OBJECTIVES: To evaluate various aspects that affect implementation of clinical guidelin

  17. 12 CFR 412.11 - Payment guidelines.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Payment guidelines. 412.11 Section 412.11 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ACCEPTANCE OF PAYMENT FROM A NON-FEDERAL SOURCE FOR TRAVEL EXPENSES § 412.11 Payment guidelines. (a) Payments from a non-Federal source, other...

  18. Malaria Treatment (United States)

    Science.gov (United States)

    ... a CDC Malaria Branch clinician. malaria@cdc.gov Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  19. Guidelines for Description

    NARCIS (Netherlands)

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

    2013-01-01

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

  20. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the Content 1.1.1   Subheading of the Content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  1. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the content 1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  2. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the content 1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  3. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

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

  4. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

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

  5. How well are European Society of Cardiology (ESC) guidelines adhered to in patients with syncope?

    LENUS (Irish Health Repository)

    O'Dwyer, C

    2010-01-01

    The ESC guidelines on syncope were published in 2001 and updated in 2004. Adherence to the recommendations enables early stratification of low and high risk patients and prevents unnecessary investigations and admissions. Vasovagal syncope (VVS) is the commonest cause of syncope in all age groups and a low risk condition. The study objective was to determine whether the ESC guidelines were adhered to prior to referral to a syncope unit; 100 consecutive patients with unexplained syncope (52 +\\/- 23 (15-91) years); 53 female. Sixty-six patients had VVS. Forty nine (75%) of patients with VVS had undergone unnecessary investigations prior to diagnosis and 31 (47%) were admitted to hospital for investigation. Research from other countries confirms that adherence to the ESC guidelines expediates accurate diagnosis, improves resource utilization and reduces health care cost. Greater awareness amongst Irish practitioners of guidelines may improve syncope management and reduce costs.

  6. Object and Objective Lost?

    DEFF Research Database (Denmark)

    Lopdrup-Hjorth, Thomas

    2015-01-01

    This paper explores the erosion and problematization of ‘the organization’ as a demarcated entity. Utilizing Foucault's reflections on ‘state-phobia’ as a source of inspiration, I show how an organization-phobia has gained a hold within Organization Theory (OT). By attending to the history...... of this organization-phobia, the paper argues that OT has become increasingly incapable of speaking about its core object. I show how organizations went from being conceptualized as entities of major importance to becoming theoretically deconstructed and associated with all kinds of ills. Through this history......, organizations as distinct entities have been rendered so problematic that they have gradually come to be removed from the center of OT. The costs of this have been rather significant. Besides undermining the grounds that gave OT intellectual credibility and legitimacy to begin with, the organization-phobia...

  7. [Transfer of allogeneic stem cell transplant recipients to the intensive care unit: Guidelines from the Francophone society of marrow transplantation and cellular therapy (SFGM-TC)].

    Science.gov (United States)

    Moreau, Anne-Sophie; Bourhis, Jean-Henri; Contentin, Nathalie; Couturier, Marie-Anne; Delage, Jeremy; Dumesnil, Cécile; Gandemer, Virginie; Hichri, Yosr; Jost, Edgar; Platon, Laura; Jourdain, Mercé; Pène, Frédéric; Yakoub-Agha, Ibrahim

    2016-11-01

    Transferring a patient undergoing an allogeneic stem cell transplantation to the intensive care unit (ICU) is always a challenging situation on a medical and psychological point of view for the patient and his relatives as well as for the medical staff. Despite the progress in hematology and intensive care during the last decade, the prognosis of these patients admitted to the ICU remains poor and mortality is around 50 %. The harmonization working party of the SFGM-TC assembled hematologists and intensive care specialist in order to improve conditions and modalities of the transfer of a patient after allogeneic stem cell transplantation to the ICU. We propose a structured medical form comprising all essential information necessary for optimal medical care on ICU. Copyright © 2016. Published by Elsevier Masson SAS.

  8. Sound objects – Auditory objects – Musical objects

    DEFF Research Database (Denmark)

    Hjortkjær, Jens

    2015-01-01

    The auditory system transforms patterns of sound energy into perceptual objects but the precise definition of an ‘auditory object’ is much debated. In the context of music listening, Pierre Schaeffer argued that ‘sound objects’ are the fundamental perceptual units in ‘musical objects......’. In this paper, I review recent neurocognitive research suggesting that the auditory system is sensitive to structural information about real-world objects. Instead of focusing solely on perceptual sound features as determinants of auditory objects, I propose that real-world object properties are inherent...

  9. Sound objects – Auditory objects – Musical objects

    DEFF Research Database (Denmark)

    Hjortkjær, Jens

    2016-01-01

    The auditory system transforms patterns of sound energy into perceptual objects but the precise definition of an ‘auditory object’ is much debated. In the context of music listening, Pierre Schaeffer argued that ‘sound objects’ are the fundamental perceptual units in ‘musical objects......’. In this paper, I review recent neurocognitive research suggesting that the auditory system is sensitive to structural information about real-world objects. Instead of focusing solely on perceptual sound features as determinants of auditory objects, I propose that real-world object properties are inherent...

  10. Evaluation of a local ICU sedation guideline on goal-directed administration of sedatives and analgesics

    Directory of Open Access Journals (Sweden)

    DeGrado JR

    2011-05-01

    Full Text Available Jeremy R DeGrado1, Kevin E Anger1, Paul M Szumita1, Carol D Pierce2, Anthony F Massaro31Department of Pharmacy, 2Department of Nursing, 3Department of Pulmonary Medicine, Brigham and Women's Hospital, Boston, MA, USAPurpose: Sedatives and analgesics are commonly used in mechanically ventilated patients in the intensive care unit. Sedation guidelines have been shown to improve sedation management as well as various patient outcomes. The main objective was to evaluate adherence to a sedation guideline with both sedative prescribing and documentation of Richmond Agitation-Sedation Scale (RASS scores.Methods: In a retrospective chart review, data was collected on 111 medical intensive care unit patients mechanically ventilated via endotracheal tube for 12 hours or greater at Brigham and Women's Hospital. Fifty-seven patients were evaluated pre-guideline implementation and 54 patients were evaluated post-guideline.Results: Significant increases were seen in the post-guideline group in goal-directed sedation with a patient-specific RASS goal in the sedation order: 21.3 vs 85.4% (P < 0.001, and mean number of sedation assessments per 24 hours using the RASS: 4.7 vs 11.4 (P < 0.001. Similarly, this group experienced a higher percentage of RASS scores at their sedation goal: 31.4 vs 44.1% (P < 0.001. No difference was seen in other clinical endpoints.Conclusion: Implementation and routine application of a hospital pain and sedation guideline was associated with significantly improved sedation metrics, such as goal-directed sedation, as well as frequency of sedation level assessment and documentation. An increase was observed in the time that post-guideline patients spent at or near their RASS goal.Keywords: sedation, agitation, guideline, RASS, mechanically ventilated, intensive care unit

  11. German Command’s Guidelines on Training of Wehrmacht’s Military Units at Soviet-German Front Based on the Front-line Experience in 1941-1942

    Directory of Open Access Journals (Sweden)

    Shendrikov Evgeniy Aleksandrovich

    2014-09-01

    Full Text Available he article analyzes the guidelines of the training division of the General Staff of German land forces on improving the fighting techniques of Wehrmacht’s military units on the basis of the front-line experience gained in armed hostilities with the Red Army in 1941-1942. The study of archives allowed the author to reveal drawbacks and shortcomings of Wehrmacht’s military units training in the period preceding the second major German advance in Summer of 1942. In particular, the following drawbacks were revealed: incatious movement through monitored terrains, insufficient camouflage security, lack of proper skills in overhead shooting, poor field engineering of the infantry, poor land navigation, defeat of tank attacks and finally, tank combating at close range. The article also contains the characteristics of profound and thorough training of German command for the summer campaign of 1942, which covered all major issues such as the actions of reconnaissance forces, the organization of officers and non-commissioned officers’ training, close combat instructions, training of infantry’s field engineering, night training, making reports etc. At the end of the article the author comes to the conclusion that despite the intensified training and correction of previous mistakes, German command failed to achieve radical turning point in the war, which ended in the total defeat of fascist Germany.

  12. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

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

  13. [AWMF-guideline: disorders related to cannabis].

    Science.gov (United States)

    Bonnet, U; Harries-Hedder, K; Leweke, F M; Schneider, U; Tossmann, P

    2004-06-01

    Actually, guidelines for treatment of substance-related disorders were written under the overall control of the DG-Sucht e. V. and the DGPPN e. V. This appears within the framework of the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaft (AWMF). The leading objective of these guidelines is the description of the current scientifically proven and evidence-based medicine in addiction to derive recommendations to therapy. In this context, the guideline for treatment of cannabis-related disorders is introduced.

  14. Management and Oversight of Services Acquisition Within the United States Air Force

    Science.gov (United States)

    2008-12-01

    47 Figure 14. Training Received............................................................................................48 Figure 15. QAP ...Surveillance Plan QAP Quality Assurance Personnel PSC Product Service Code SOO Statement of Objectives USA United States Army USN United States...Assurance Personnel ( QAP ), and the multi-functional teams (USAF, 2005). This policy has established clear guidelines and responsibilities for the USAF in

  15. A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    MAJID YAZDANI

    2015-04-01

    Full Text Available Introduction: Ventilator-associated pneumonia (VAP is one of the most popular nosocomial infections in the intensive care units and the nurse’s role in preventing it is very important. The aim of this study was to compare the effect of two methods of face to face training and work- shop clinical guidelines in prevention of VAP. Methods: In this experimental randomized clinical trial, the knowledge and practice of nurses in ICUs were studied in two groups: face to face training (35 nurses and workshops (40 nurses by using clinical guidelines in prevention of VAP in one of the hospitals of Shiraz University of Medical Sciences. The level of knowledge and practice in each group was assessed by selfreport questionnaire, knowledge questionnaire and also direct observation of practice, before and after training. Data were analyzed with descriptive statistics, paired t-test, independent t-test, McNemar test, Fisher’s exact, sign and Chi-square test, using SPSS 14. Results: This study demonstrated that both methods of face to face training and workshop were very effective. The incidence of inappropriate pressure of cuff in the tracheal tubes and tracheostomy tubes was significantly reduced after training (p=0.001. But, by comparison of these two methods and the relationship between the variables revealed that no significant difference was found between the two groups of face to face training and workshop. Conclusion: Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands.

  16. Complex perspectives on learning objectives

    DEFF Research Database (Denmark)

    Mørcke, Anne Mette; Wichmann-Hansen, Gitte; Guldbrand Nielsen, Dorte

    2006-01-01

    opposite perspectives: objectives as context-free theory-based rules versus objectives as personal practice-based guidelines. The students favoured theory-based objectives, which should be defined by experts conclusively as minimum levels and checklists. The senior doctors preferred practice...

  17. Guidelines on renal cell cancer

    NARCIS (Netherlands)

    Mickisch, G; Carballido, J; Hellsten, S; Schuize, H; Mensink, H

    2001-01-01

    Objectives., On behalf of the European Association of Urology (EAU), Guidelines for Diagnosis, Therapy and. Follow Up of Renal. Cell Carcinoma Patients were established. Criteria for recommendations were evidence based and included aspects of cost-effectiveness and clinical feasibility. Method: A sy

  18. Curriculum Guidelines on Forensic Dentistry.

    Science.gov (United States)

    Journal of Dental Education, 1990

    1990-01-01

    The American Association of Dental Schools' guidelines for curriculum design explain the scope of forensic dentistry and interrelationships with other fields, give an overview of the curriculum, and outline suggested primary educational goals, prerequisites, core content, specific behavioral objectives, sequencing, faculty and facility…

  19. Predoctoral Curriculum Guidelines for Biomaterials.

    Science.gov (United States)

    Journal of Dental Education, 1986

    1986-01-01

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

  20. Implementing guidelines in nursing homes

    DEFF Research Database (Denmark)

    Diehl, Heinz; Graverholt, Birgitte; Espehaug, Birgitte

    2016-01-01

    BACKGROUND: Research on guideline implementation strategies has mostly been conducted in settings which differ significantly from a nursing home setting and its transferability to the nursing home setting is therefore limited. The objective of this study was to systematically review the effects o...

  1. GUIDELINES FOR TREATMENT OF DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    CARMEN YOSSALETH BRICEÑO-GONZÁLEZ

    Full Text Available ABSTRACT Objectives: To determine the standard of treatment of degenerative lumbar spondylolisthesis in its different clinical presentations in UMAE Dr. Victorio de la Fuente Narváez. Methods: Six cases found in the literature were presented to 36 experts in spine surgery, along with treatment options, to thereby obtain a standard prescription for the treatment of degenerative lumbar spondylolisthesis. Analytical observational cross-sectional descriptive study. Results: It was found that the treatment of choice in cases of degenerative lumbar spondylolisthesis with axial symptoms is conservative. The surgical treatment of choice for both stable and unstable patients with radiculopathy and/or claudication is decompression + posterolateral graft + transpedicular instrumentation + discectomy (graft. Conclusions: We managed to define the degenerative lumbar spondylolisthesis treatment guidelines in our unit, which can serve as a basis for the development of a clinical practice guide.

  2. Initial impact of the acute otitis externa clinical practice guideline on clinical care.

    Science.gov (United States)

    Bhattacharyya, Neil; Kepnes, Lynn J

    2011-09-01

    Objectives. Determine the influence of the acute otitis externa clinical practice guideline on clinical care. Study Design. Cross-sectional study with historical controls. Setting. Outpatient departments in the United States. Methods. Cases of acute otitis externa occurring in 2004-2005 (before guideline publication) and 2007-2008 (after guideline publication) were extracted from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey. Prescribing rates for ototopical medications, analgesic recommendations, and oral antibiotics were determined and compared before and after guideline publication and relative to guideline recommendations. Results. An estimated 5.50 (standard error of the estimated mean, 0.38) million visits (mean age, 27.7 [1.7] years; 49.8% male) with a primary and singular coded diagnosis of acute otitis externa were studied (2.64 [0.26] million visits for 2004-2005 and 2.86 [0.28] million visits for 2007-2008). Prescribing rates for ototopical preparations were 67.2% (5.3%) and 67.6% (5.0%) before and after guideline publication, respectively (P = .955). Recommendation rates for analgesics were 14.2% (3.3%) and 20.6% (3.9%), respectively (P = .248). Prescription rates for oral antibiotics were 21.7% (4.8%) and 30.5% (3.6%), before and after, respectively (P = .166). Conclusion. Clinician behavior in the medical treatment of acute otitis externa has not significantly changed after guideline publication, despite clear, evidence-based guideline recommendations. These data have important implications for performance measures based on the guideline. Further efforts toward guideline dissemination are likely needed.

  3. Prioritizing dermatoses: rationally selecting guideline topics

    NARCIS (Netherlands)

    Borgonjen, R.J.; Everdingen, J.J. van; Kerkhof, P.C.M. van de; Spuls, P.I.

    2015-01-01

    BACKGROUND: Clinical practice guideline (CPG) development starts with selecting appropriate topics, as resources to develop a guideline are limited. However, a standardized method for topic selection is commonly missing and the way different criteria are used to prioritize is not clear. OBJECTIVES:

  4. EAU guidelines on primary urethral carcinoma

    NARCIS (Netherlands)

    Gakis, G.; Witjes, J.A.; Comperat, E.; Cowan, N.C.; Santis, M. de; Lebret, T.; Ribal, M.J.; Sherif, A.M.

    2013-01-01

    CONTEXT: The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). OBJECTIVE: To review the curre

  5. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

    Fall, Magnus; Baranowski, Andrew P.; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J.; Oberpenning, Frank; Williams, Amanda C. de C.

    2010-01-01

    Context: These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. Objective: To revise guidelines for the diagnosis,

  6. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

    Fall, Magnus; Baranowski, Andrew P.; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J.; Oberpenning, Frank; Williams, Amanda C. de C.

    2010-01-01

    Context: These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. Objective: To revise guidelines for the diagnosis,

  7. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

    Fall, Magnus; Baranowski, Andrew P.; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J.; Oberpenning, Frank; Williams, Amanda C. de C.

    Context: These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. Objective: To revise guidelines for the diagnosis,

  8. EAU guidelines on primary urethral carcinoma

    NARCIS (Netherlands)

    Gakis, G.; Witjes, J.A.; Comperat, E.; Cowan, N.C.; Santis, M. de; Lebret, T.; Ribal, M.J.; Sherif, A.M.

    2013-01-01

    CONTEXT: The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). OBJECTIVE: To review the curre

  9. Prioritizing dermatoses: rationally selecting guideline topics

    NARCIS (Netherlands)

    Borgonjen, R.J.; Everdingen, J.J. van; Kerkhof, P.C.M. van de; Spuls, P.I.

    2015-01-01

    BACKGROUND: Clinical practice guideline (CPG) development starts with selecting appropriate topics, as resources to develop a guideline are limited. However, a standardized method for topic selection is commonly missing and the way different criteria are used to prioritize is not clear. OBJECTIVES:

  10. Guidelines for asthma management: a review and comparison of 5 current guidelines.

    Science.gov (United States)

    Myers, Timothy R

    2008-06-01

    The first clinical practice guidelines for the assessment and management of asthma were published over 20 years ago in New Zealand and Australia. During the same period, British and Scottish groups were collaborating on a United Kingdom version of asthma guidelines. Shortly after the introduction of the New Zealand and Canadian guidelines, the National Heart, Lung, and Blood Institute of the United States National Institutes of Health participated in 2 additional asthma guideline endeavors, which were published in the early 1990s. The National Heart, Lung, and Blood Institute formed the National Asthma Education and Prevention Program to develop asthma guidelines for the United States, and participated with an international task force to develop guidelines for the treatment of asthma in all countries, which resulted in the formation of the Global Initiative for Asthma in the mid-1990s. The asthma guidelines issued by professional societies and other groups prior to the late 1990s were primarily based on consensus or expert opinion in each guideline committee, though those opinions were based on the available studies. The early guidelines played a vital role in bridging the gap between various treatment options and recent discoveries in basic science, and served as the vehicle to implementation into daily clinical practice. Asthma guidelines have been published and revised in dozens of countries around the world and have become reputable directives or "road maps" in asthma diagnosis, treatment, and management for patients of all ages. The guidelines have similar formats. The dissemination and implementation of the early guidelines was inconsistent, and they were criticized for not being evidence-based. As the knowledge of asthma pathophysiology continues to expand, along with basic science research on asthma diagnosis, treatment, and management, as well as education of the asthma patient, it is essential that the asthma guidelines be frequently updated and based on

  11. Dr. Martin Luther King: A Unit for Primary Grades.

    Science.gov (United States)

    Sweet, Kelli

    1986-01-01

    Presents a unit consisting of 4 lessons which focus on Dr. Martin Luther King, Jr.'s childhood, his adult life and family, his civil rights work, and the national holiday which commemorates his birthday. Each lesson features specific objectives, learning activities, and instructional guidelines for the teacher. (TRS)

  12. [General Strategies for Implementation of Clinical Practice Guidelines].

    Science.gov (United States)

    Valenzuela-Flores, Adriana Abigail; Viniegra-Osorio, Arturo; Torres-Arreola, Laura Laura

    2015-01-01

    The need to use clinical practice guidelines (CPG) arises from the health conditions and problems that public health institutions in the country face. CPG are informative documents that help improve the quality of care processes and patient safety; having among its objectives, to reduce the variability of medical practice. The Instituto Mexicano del Seguro Social designed a strategic plan for the dissemination, implementation, monitoring and control of CPG to establish an applicable model in the medical units in the three levels of care at the Instituto. This paper summarizes some of the strategies of the plan that were made with the knowledge and experience of clinicians and managers, with which they intend to promote the adoption of the key recommendations of the guidelines, to promote a sense of belonging for health personnel, and to encourage changes in organizational culture.

  13. [Achievement of therapeutic objectives].

    Science.gov (United States)

    Mantilla, Teresa

    2014-07-01

    Therapeutic objectives for patients with atherogenic dyslipidemia are achieved by improving patient compliance and adherence. Clinical practice guidelines address the importance of treatment compliance for achieving objectives. The combination of a fixed dose of pravastatin and fenofibrate increases the adherence by simplifying the drug regimen and reducing the number of daily doses. The good tolerance, the cost of the combination and the possibility of adjusting the administration to the patient's lifestyle helps achieve the objectives for these patients with high cardiovascular risk. Copyright © 2014 Sociedad Española de Arteriosclerosis y Elsevier España, S.L. All rights reserved.

  14. Methods of practice and guidelines for using survey-grade global navigation satellite systems (GNSS) to establish vertical datum in the United States Geological Survey

    Science.gov (United States)

    Rydlund, Paul H.; Densmore, Brenda K.

    2012-01-01

    flexibility regarding efficiency and quality of data collection. Quality assurance of survey-grade global positioning is often overlooked or not understood and perceived uncertainties can be misleading. GNSS users can benefit from a blueprint of data collection standards used to ensure consistency among USGS mission areas. A classification of GNSS survey qualities provide the user with the ability to choose from the highest quality survey used to establish objective points with low uncertainties, identified as a Level I, to a GNSS survey for general topographic control without quality assurance, identified as a Level IV. A Level I survey is strictly limited to post-processed methods, whereas Level II, Level III, and Level IV surveys integrate variations of a RT approach. Among these classifications, techniques involving blunder checks and redundancy are important, and planning that involves the assessment of the overall satellite configuration, as well as terrestrial and space weather, are necessary to ensure an efficient and quality campaign. Although quality indicators and uncertainties are identified in post-processed methods using CORS, the accuracy of a GNSS survey is most effectively expressed as a comparison to a local benchmark that has a high degree of confidence. Real-time and post-processed methods should incorporate these "trusted" benchmarks as a check during any campaign. Global positioning surveys are expected to change rapidly in the future. The expansion of continuously operating reference stations, combined with newly available satellite signals, and enhancements to the conterminous geoid, are all sufficient indicators for substantial growth in real-time positioning and quality thereof.

  15. Curriculum Guidelines for Pathology for Dental Hygienists.

    Science.gov (United States)

    Journal of Dental Education, 1987

    1987-01-01

    Guidelines for structuring a pathology curriculum for dental hygienists include: definition of the field and its subfields; relationships with other fields; primary educational goals, prerequisites, core content, specific behavioral objectives; and suggestions for sequencing, faculty, facilities, and occupational safety. (MSE)

  16. Canadian Thoracic Society Guidelines for Occupational Asthma

    Directory of Open Access Journals (Sweden)

    Susan M Tarlo

    1998-01-01

    Full Text Available OBJECTIVE: To provide broad guidelines and principles to help primary care physicians, occupational physicians, allergists and respirologists with the recognition, diagnosis and management of patients with occupational asthma (OA.

  17. Clinical Practice Guidelines and Industry

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2007-01-01

    Full Text Available In this section we shall see what Clinical Practice Guidelines (CPGs should be and what they are, the recent case of Xigris and a thriller-like manipulation by the concerned company to enter a performance 'bundle', CPG effectiveness/cost effectiveness and other considerations, how they serve Industry needs, and what methods can possibly assist them actualise their enormous potential.Introduction From the early nineties, a number of Clinical Practice Guidelines (CPGs have been created and published by many different associations and organizations at considerable expense. CPGs are supposed to serve an important purpose. They offer objective consensus of expert opinion on treatment and hence are trusted by hospitals and practicing physicians alike. They can reduce the possibility of inappropriate care being delivered, while helping introduce new knowledge into clinical practice (Grimshaw and Russell, 1993; Merritt et al. , 1997; Woolf et al. , 1999. They are a distillate of biomedical wisdom at a certain point of time applied to better and more efficient patient care. Hence, rigorously developed guidelines can translate complicated research findings into actionable recommendations of clinical care (Shiffman et al. , 2003; Haines and Jones, 1994. Clinical practice guidelines have generally been accepted as an objective consensus on evidence (Baird, 2003. Practice guidelines approved by expert panels are intended to standardize care in such a way as to improve health outcomes (Eichacker et al. , 2006. Major hospitals and knowledge updated physicians feel reassured they are doing the very best by following CPGs. State of the art, and such other fancy labels, can be justifiably applied to them.McMaster et al., (2007 have talked recently of getting guidelines to work in practice. In an effort to make CPGs more effective, developers of such guidelines have started grouping evidence-based interventions into what are called 'bundles'. The justification for

  18. The Analysis of Amount of Units of Multi-Objective Sample%多目标抽样中样本容量设计研究

    Institute of Scientific and Technical Information of China (English)

    林才生; 曾五一

    2005-01-01

    This paper first gives out the existence of the multi-object sample survey's optimum sample size, then analyses the recent research of this field, presents a new method of solving the multi-object sample survey's optimum sample size, and its mathematical proof。

  19. Adherence of pharmaceutical advertisements in medical journals to FDA guidelines and content for safe prescribing.

    Science.gov (United States)

    Korenstein, Deborah; Keyhani, Salomeh; Mendelson, Ali; Ross, Joseph S

    2011-01-01

    Physician-directed pharmaceutical advertising is regulated in the United States by the Food and Drug Administration (FDA); adherence to current FDA guidelines is unknown. Our objective was to determine adherence rates of physician-directed print advertisements in biomedical journals to FDA guidelines and describe content important for safe prescribing. Cross-sectional analysis of November 2008 pharmaceutical advertisements within top U.S.-based biomedical journals publishing original research. We excluded advertisements for devices, over the counter medications, and disease awareness. We utilized FDA guideline items identifying unique forms of advertisement bias to categorize advertisements as adherent to FDA guidelines, possibly non-adherent to at least 1 item, or non-adherent to at least 1 item. We also evaluated advertisement content important for safe prescribing, including benefit quantification, risk information and verifiable references. All advertisements were evaluated by 2 or more investigators, with differences resolved by discussion. Twelve journals met inclusion criteria. Nine contained pharmaceutical advertisements, including 192 advertisements for 82 unique products; median 2 per product (range 1-14). Six "teaser" advertisements presented only drug names, leaving 83 full unique advertisements. Fifteen advertisements (18.1%) adhered to all FDA guidelines, 41 (49.4%) were non-adherent with at least one form of FDA-described bias, and 27 (32.5%) were possibly non-adherent due to incomplete information. Content important for safe prescribing was often incomplete; 57.8% of advertisements did not quantify serious risks, 48.2% lacked verifiable references and 28.9% failed to present adequate efficacy quantification. Study limitations included its focus on advertisements from a single month, the subjectivity of FDA guidelines themselves, and the necessary subjectivity of determinations of adherence. Few physician-directed print pharmaceutical advertisements

  20. 41 CFR 109-39.301 - Utilization guidelines.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Utilization guidelines... Management System Vehicles § 109-39.301 Utilization guidelines. DOE activities utilizing GSA IFMS motor... meeting DOE utilization guidelines or established local use objectives, as appropriate. Those vehicles...

  1. Comparing consensus guidelines on thromboprophylaxis in orthopedic surgery

    NARCIS (Netherlands)

    M.C. Struijk-Mulder; H.B. Ettema; C.C. Verheyen; H.R. Büller

    2010-01-01

    BACKGROUND: Different guidelines exist regarding the prevention of venous thromboembolism (VTE) in orthopedic surgery. OBJECTIVES: We aimed to compare (inter)national guidelines and analyse differences. Methods: MEDLINE, the Cochrane Library and the internet were searched for guidelines on the preve

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

    Directory of Open Access Journals (Sweden)

    Lemieux-Charles Louise

    2009-07-01

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

  3. Factors influencing the implementation of the guideline triage in emergency departments: a qualitative study.

    NARCIS (Netherlands)

    Janssen, M.A.M.; Achterberg, T. van; Adriaansen, M.J.M.; Kampshoff, C.S.; Schalk, D.M.; Mintjes-de Groot, A.J.

    2012-01-01

    AIMS AND OBJECTIVES: The objectives are: (1) to identify factors that influence the implementation of the guideline Triage in emergency departments [2004] in emergency departments in the Netherlands, and (2) to develop tailored implementation strategies for implementation of this guideline.

  4. Performance Objectives

    Science.gov (United States)

    1978-12-01

    objectives may direct students’ learning (Duchastel and Merrill, 1973; Kapfer , 1970; Kibler et al., 1974), since such objectives may provide...matter learning. Journal of Educational Psychology, 62(1): 67-70 (1971). Kapfer , P. G. Behavioral objectives and the curriculum processor. Educational

  5. Exploration of knowledge of, adherence to, attitude and barriers toward evidence-based guidelines (EBGs for prevention of ventilator-associated pneumonia (VAP in healthcare workers of pediatric cardiac intensive care units (PCICUs: A Quali-Quantitative survey

    Directory of Open Access Journals (Sweden)

    Leila Jahansefat

    2016-09-01

    Full Text Available Implementation of evidence-based guidelines (EBGs is an effective measure for prevention of ventilator-associated pneumonia (VAP. Appropriate knowledge, attitude and adherence of healthcare workers (HCWs to EBGs are necessary factors for implementation of EBGs. This study was conducted with objective of evaluation of knowledge, attitude, and adherence of HCWs to EBGs for prevention of VAP and exploration of the barriers of their implementation in clinical practice. Totally, a total number of 45 HCWs of two pediatric cardiac surgery ICU (PCICUs participated in this quali-quantitative survey. Knowledge, attitude and adherence of participants was evaluated by a validated multiple-choice questionnaire and barriers of implementation of EBGs was extracted from participants’ answer to an open-ended question of our self-made questionnaire. Knowledge of HCWs was poor and significantly different between nurse assistants (RAs, nurses (RNs, and physicians (MDs (respectively, 1.25±0.95, 4.53±1.73, and 5.54±2.01, P=0.001. Likewise, attit ude of HCWs is not positive and significantly different between NAs, RNs, and MDs (respectively, 32.96±2.42, 34.00±2.44, 36.81±4.35, P=0.003. The adherence of HCWs is not good and different between RAs, RNs, and MDs (respectively, 11.50±1.00, 13.13±1.83, and 17.18±6.06, P= 0.17. The Barriers of implementation of EBGs was categorized into four category of individual, organizational, social, and educational factors. Unsatisfying status of knowledge, attitude, and adherence of HCWs is a challenging concern of health-care system, especially in PICUs. In addition to these well-known factors, poor implementation of EBGs is related to many other barriers which should recognized and taken into consideration for designation of infection controlling programs.

  6. Emergency Response Guideline Development

    Energy Technology Data Exchange (ETDEWEB)

    Gary D. Storrick

    2007-09-30

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

  7. Guidelines for strategic planning

    Energy Technology Data Exchange (ETDEWEB)

    1991-07-01

    Strategic planning needs to be done as one of the integral steps in fulfilling our overall Departmental mission. The role of strategic planning is to assure that the longer term destinations, goals, and objectives which the programs and activities of the Department are striving towards are the best we can envision today so that our courses can then be set to move in those directions. Strategic planning will assist the Secretary, Deputy Secretary, and Under Secretary in setting the long-term directions and policies for the Department and in making final decisions on near-term priorities and resource allocations. It will assist program developers and implementors by providing the necessary guidance for multi-year program plans and budgets. It is one of the essential steps in the secretary's Strategic Planning Initiative. The operational planning most of us are so familiar with deals with how to get things done and with the resources needed (people, money, facilities, time) to carry out tasks. Operating plans like budgets, capital line item projects, R D budgets, project proposals, etc., are vital to the mission of the Department. They deal, however, with how to carry out programs to achieve some objective or budget assumption. Strategic planning deals with the prior question of what it is that should be attempted. It deals with what objectives the many programs and activities of the Department of Department should be striving toward. The purpose of this document is to provide guidance to those organizations and personnel starting the process for the first time as well as those who have prepared strategic plans in the past and now wish to review and update them. This guideline should not be constructed as a rigid, restrictive or confining rulebook. Each organization is encouraged to develop such enhancements as they think may be useful in their planning. The steps outlined in this document represent a very simplified approach to strategic planning. 9 refs.

  8. Summary of proposed approach for deriving cleanup guidelines for radionuclides in soil at Brookhaven National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Meinhold, A.F.; Morris, S.C.; Dionne, B.; Moskowitz, P.D.

    1996-11-01

    Past activities at Brookhaven National Laboratory (BNL) resulted in soil and groundwater contamination. As a result, BNL was designated a Superfund site under the Comprehensive Environmental Response Compensation and Liability Act (CERCLA). BNL`s Office of Environmental Restoration (OER) is overseeing environmental restoration activities at the Laboratory, carried out under an Interagency Agreement (IAG) with the United States Department of Energy (DOE), the United States Environmental Protection Agency (EPA) and the New York State Department of Environmental Conservation (NYSDEC). The objective of this paper is to propose a standard approach to deriving risk-based cleanup guidelines for radionuclides in soil at BNL.

  9. Agreement between Cochrane Neonatal reviews and clinical practice guidelines for newborns in Denmark a cross sectional study

    DEFF Research Database (Denmark)

    Brok, Jesper; Greisen, Gorm; Madsen, Lars P

    2007-01-01

    OBJECTIVE: To assess agreement between Cochrane Neonatal Group reviews and clinical practice guidelines in Denmark. DESIGN: Retrospective analysis of clinical guidelines for newborn infants. Materials:All Cochrane neonatal reviews and Danish local clinical guidelines for newborn infants. MAIN OUT...

  10. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

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

  11. Curriculum Guidelines for Predoctoral Oral Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1987

    1987-01-01

    The American Association of Dental Schools' guidelines for oral radiology curricula give an overview of the field and its interrelationships with other fields and outline the primary educational objectives, prerequisites, core content, specific behavioral objectives, sequencing, faculty, facilities, and occupational hazards to be considered in…

  12. Curriculum Guidelines for Predoctoral Pediatric Dentistry.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

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

  13. Curriculum Guidelines for Predoctoral Oral Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1987

    1987-01-01

    The American Association of Dental Schools' guidelines for oral radiology curricula give an overview of the field and its interrelationships with other fields and outline the primary educational objectives, prerequisites, core content, specific behavioral objectives, sequencing, faculty, facilities, and occupational hazards to be considered in…

  14. A Multi-Objective Optimization Method for Post-Blackout Unit Restoration%电力系统大停电后机组恢复的多目标优化方法

    Institute of Scientific and Technical Information of China (English)

    朱冬雪; 顾雪平; 钟慧荣

    2013-01-01

    大停电后的机组恢复策略多为单目标优化,忽略了大量影响机组启动顺序的因素,为此提出了机组恢复的多目标优化策略.以机组启动后提供的发电量尽可能大、已恢复的电源点尽量在网架层面铺开、有利于后续厂站层机组和重要负荷的恢复为优化目标,建立机组恢复的多目标优化模型.先将恢复过程划分为一系列顺序执行的恢复时步,再将每一时步的优化问题转化成多目标“0/1背包”问题;结合最短路径法为机组恢复方案搜索恢复路径,采用快速非支配排序遗传算法进行求解;最后对每时步的Pareto最优方案排序,确定最优解.算例结果验证了该方法的有效性.%Most post-blackout unit restoration strategies are based on single-objective optimization and factors influencing the starting sequence of units are neglected.A multi-objective optimization strategy for post-blackout unit restoration is proposed and a multi-objective optimization model for unit restoration,in which following items are taken as optimization objectives:the generating capacity of restored units should be as much as possible,the restored units should be distributed in the network frame level as possible and the restored units are favorable to the restoration of important loads and follow-up units to be restored in power plant level,is built.Firstly,the restoration process is divided into a series of restoration steps to be executed sequentially; secondly,the optimization of each restoration step is turned into multi-objective 0/1 knapsack problem and combining with the shortest path method the restoration paths for unit restoration scheme are searched,and then the restoration paths are solved by.fast and elitist non-dominated sorting genetic algorithm and classic Dijkstra algorithm is employed to select restoration paths; finally,the Pareto optimal solutions are sorted to determine the optimal solution.The effectiveness of the proposed

  15. After Guidelines, What?

    Directory of Open Access Journals (Sweden)

    Dennis M Bowie

    2004-01-01

    Full Text Available In a recent survey, Canadian Thoracic Society (CTS members indicated that they feel our association should be involved in the production of guidelines (1. There is evidence in the literature that suggests guidelines can have some effect in changing behaviour, although this is variable and modest at best. Certainly, the production of guidelines is not without costs, particularly in time spent by experts in reviewing the literature and producing them. For good reasons, delays frequently occur in their production, often leading to recommendations that may be outdated. People sometimes forget that one of the most important reasons for producing guidelines is to identify questions that require future research.

  16. [Clinical guidelines in mental health: situation in Argentina].

    Science.gov (United States)

    Garay, Cristian J; Korman, Guido P

    2008-01-01

    The permanent update of mental health professionals has become an actual requirement. Nowadays, there is an important concern to offer to the patient's problems the best therapeutics that respond to their specific needs. The well known Clinical Guides are tools to address that objective. In the United Kingdom, USA, Canada, Germany, the Netherlands, France and some Latin American countries different organisms have been created with the objective to develop clinical guidelines. In Argentina, the situation is precarious. In Buenos Aires City, there are few efforts in such direction. An heterogeneous group of factors (social, economic, corporative, theoretical-academic or curricular and ideological) seem to difficult the development of a project of these characteristics, adapted to this population.

  17. Guidelines for accident prevention and emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Fthenakis, V.M.; Morris, S.C.; Moskowitz, P.D.

    1993-05-01

    This report reviews recent developments in the guidelines on chemical accident prevention, risk assessment, and management of chemical emergencies, principally in the United States and Europe, and discusses aspects of their application to developing countries. Such guidelines are either in the form of laws or regulations promulgated by governments, or of recommendations from international, professional, or non governmental organizations. In many cases, these guidelines specify lists of materials of concern and methods for evaluating safe usage of these materials and recommend areas of responsibility for different organizations; procedures to be included in planning, evaluation, and response; and appropriate levels of training for different classes of workers. Guidelines frequently address the right of communities to be informed of potential hazards and address ways for them to participate in planning and decision making.

  18. Up-scaling of multi-variable flood loss models from objects to land use units at the meso-scale

    Directory of Open Access Journals (Sweden)

    H. Kreibich

    2016-05-01

    Full Text Available Flood risk management increasingly relies on risk analyses, including loss modelling. Most of the flood loss models usually applied in standard practice have in common that complex damaging processes are described by simple approaches like stage-damage functions. Novel multi-variable models significantly improve loss estimation on the micro-scale and may also be advantageous for large-scale applications. However, more input parameters also reveal additional uncertainty, even more in upscaling procedures for meso-scale applications, where the parameters need to be estimated on a regional area-wide basis. To gain more knowledge about challenges associated with the up-scaling of multi-variable flood loss models the following approach is applied: Single- and multi-variable micro-scale flood loss models are up-scaled and applied on the meso-scale, namely on basis of ATKIS land-use units. Application and validation is undertaken in 19 municipalities, which were affected during the 2002 flood by the River Mulde in Saxony, Germany by comparison to official loss data provided by the Saxon Relief Bank (SAB.In the meso-scale case study based model validation, most multi-variable models show smaller errors than the uni-variable stage-damage functions. The results show the suitability of the up-scaling approach, and, in accordance with micro-scale validation studies, that multi-variable models are an improvement in flood loss modelling also on the meso-scale. However, uncertainties remain high, stressing the importance of uncertainty quantification. Thus, the development of probabilistic loss models, like BT-FLEMO used in this study, which inherently provide uncertainty information are the way forward.

  19. Agile Objects

    Science.gov (United States)

    German, Senta; Harris, Jim

    2017-01-01

    In this article, the authors argue that the art-historical canon, however it is construed, has little relevance to the selection of objects for museum-based teaching. Their contention is that all objects are fundamentally agile and capable of interrogation from any number of disciplinary standpoints, and that the canon of museum education,…

  20. IDSA releases updated coccidioidomycosis guidelines

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-09-01

    Full Text Available No abstract available. Article truncated at 150 words. The Infectious Diseases Society of America (IDSA has released updated Guidelines for the Treatment of Coccidioidomycosis, also known as cocci or Valley Fever (1. Coccidioidomycosis is a fungal infection endemic to the southwestern United States and a common cause of pneumonia and pulmonary nodules in this area. However, the infection can disseminate systemically especially in immunocompromised hosts and certain ethnic populations resulting in a variety of pulmonary and extrapulmonary complications. In addition to recommendations for these complications, the new guidelines address management of special at-risk populations, preemptive management strategies in at-risk populations and after unintentional laboratory exposure. The guidelines also suggest shorter courses of antibiotics for hospitalized patients and more ambulatory treatment for most individuals who have contracted Valley Fever. The panel was led by John N. Galgiani, MD, director of the Valley Fever Center for Excellence at the University of Arizona Health Sciences. Galgiani led a panel of 16 ...

  1. Engineering Technology Curriculum Guidelines

    Science.gov (United States)

    Gershon, J. J.

    1977-01-01

    Summarizes curriculum guidelines for the following engineering technologies: chemical, industrial, mining, petroleum, nuclear, civil, mechanical, electrical, automotive, and manufacturing. In a few years, these Engineering Council for Professional Development committee guidelines are intended to become the criteria by which programs will be judged…

  2. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D.; Dakin, B.; German, A.

    2012-04-01

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

  3. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-01

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

  4. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

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

  5. Nonstructural seismic restraint guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Butler, D.M.; Czapinski, R.H.; Firneno, M.J.; Feemster, H.C.; Fornaciari, N.R.; Hillaire, R.G.; Kinzel, R.L.; Kirk, D.; McMahon, T.T.

    1993-08-01

    The Nonstructural Seismic Restraint Guidelines provide general information about how to secure or restrain items (such as material, equipment, furniture, and tools) in order to prevent injury and property, environmental, or programmatic damage during or following an earthquake. All SNL sites may experience earthquakes of magnitude 6.0 or higher on the Richter scale. Therefore, these guidelines are written for all SNL sites.

  6. Maintenance Trades Guidelines

    Science.gov (United States)

    Weidner, Theodore J.

    2008-01-01

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

  7. Evidence-based guidelines

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  8. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

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

  9. Cancer screening in the United States, 2013: a review of current American Cancer Society guidelines, current issues in cancer screening, and new guidance on cervical cancer screening and lung cancer screening.

    Science.gov (United States)

    Smith, Robert A; Brooks, Durado; Cokkinides, Vilma; Saslow, Debbie; Brawley, Otis W

    2013-01-01

    Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are updated guidelines on cervical cancer screening and lung cancer screening with low-dose helical computed tomography. The latest data on the use of cancer screening from the National Health Interview Survey also are described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act of 2010.

  10. Trusted Objects

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.; PIERSON,LYNDON G.; WITZKE,EDWARD L.

    1999-10-27

    In the world of computers a trusted object is a collection of possibly-sensitive data and programs that can be allowed to reside and execute on a computer, even on an adversary's machine. Beyond the scope of one computer we believe that network-based agents in high-consequence and highly reliable applications will depend on this approach, and that the basis for such objects is what we call ''faithful execution.''

  11. Object theatre

    DEFF Research Database (Denmark)

    Ryöppy, Merja; Heiberg, Andreas

    2015-01-01

    possibilities to emerge. We present a study in which the Object Theatre approach is applied to redesign socially shared everyday products that are located in public places. This project demonstrates how Object Theatre offers a broad perspective form which to explore and present product interactions....... In particular, it emphasises the understanding of a product by relating and changing perspectives, and takes into account context of use and diverse social settings....

  12. The Dietary Guidelines For Americans 2005: Executive Summary

    Science.gov (United States)

    Health Educator, 2005

    2005-01-01

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

  13. 32 CFR Appendix A to Part 153 - Guidelines

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Guidelines A Appendix A to Part 153 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE REGULATIONS PERTAINING TO MILITARY...—Guidelines (a) Civilians employed by the Armed Forces outside the United States who commit felony...

  14. 39 CFR 775.8 - Environmental evaluation guidelines.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Environmental evaluation guidelines. 775.8 Section 775.8 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS NATIONAL ENVIRONMENTAL POLICY ACT PROCEDURES § 775.8 Environmental evaluation guidelines. (a) Approach. When dealing...

  15. The European Stroke Organisation Guidelines: a standard operating procedure

    DEFF Research Database (Denmark)

    Ntaios, George; Bornstein, Natan M; Caso, Valeria

    2015-01-01

    guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep...

  16. Guidelines for Comprehensive Sexuality Education: Kindergarten-12th Grade.

    Science.gov (United States)

    Sex Information and Education Council of the United States, Inc., New York, NY.

    The National Guidelines for Comprehensive Sexuality Education were developed by a Sex Information and Education Council of the United States (SIECUS) task force made up of health, education, and sex education professionals. The group was tasked with formulating sex education concepts and guidelines within four developmental levels, from…

  17. Fashion Objects

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2009-01-01

    This article attempts to create a framework for understanding modern fashion phenomena on the basis of Durkheim's sociology of religion. It focuses on Durkheim's conception of the relation between the cult and the sacred object, on his notion of 'exteriorisation', and on his theory of the social...... symbol in an attempt to describe the peculiar attraction of the fashion object and its social constitution. However, Durkheim's notions of cult and ritual must undergo profound changes if they are to be used in an analysis of fashion. The article tries to expand the Durkheimian cult, radically enlarging...... it without totally dispersing it; depicting it as held together exclusively by the sheer 'force' of the sacred object. Firstly, the article introduces the themes and problems surrounding Durkheim's conception of the sacred. Next, it briefly sketches an outline of fashion phenomena in Durkheimian categories...

  18. Implementation of the Surviving Sepsis Campaign guidelines.

    Science.gov (United States)

    Mukherjee, Vikramjit; Evans, Laura

    2017-10-01

    Early identification and appropriate management of sepsis improves outcomes. Despite convincing data showing the benefits of early recognition and treatment of sepsis and septic shock, implementation of such evidence-based therapy is suboptimal. This review describes methods that have been shown to improve bedside application of the evidence-based guidelines. The Surviving Sepsis Campaign (SSC) has developed guidelines for the management of severe sepsis and septic shock. The initial SSC guidelines were published in 2004; as evidence continued to evolve, the guidelines were updated, with the most recent iteration published in 2016. Guidelines by themselves can take years to change clinical practice. To affect more rapid change, the SSC guidelines are filtered into bundles to impact behavior change in a simple and uniform way. Implementation of the SSC bundles revolves around practice improvement measures. Hospitals that have successfully implemented these bundles have consistently shown improved outcomes and reductions in healthcare spending. Finally, the Centers for Medicare and Medicaid Services has approved SSC bundle compliance as a core measure, and hospitals in the United States are mandated to collect and report their data regularly to Centers for Medicare and Medicaid Services.

  19. EMI Messaging Guidelines

    CERN Document Server

    Cons, L.

    2011-01-01

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

  20. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

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

  1. Guidelines for Crisis Management.

    Science.gov (United States)

    Wimberley, Lloyd

    1985-01-01

    The article offers guidelines for crisis prediction, preplanning, support team development, and post-crisis management that can handle aggressive behavior and convey to the child the existence of a legitimate system for enhancing positive self control. (CL)

  2. London 2012 packaging guidelines

    OpenAIRE

    2013-01-01

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

  3. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

    Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....

  4. 考虑需求侧低碳资源的新型模糊双目标机组组合模型%A Novel Fuzzy Bi-objective Unit Commitment Model Considering Demand Side Low-carbon Resources

    Institute of Scientific and Technical Information of China (English)

    张宁; 胡兆光; 周渝慧; 肖欣; 王一依; 丛炘玮

    2014-01-01

    提出一种可促进电力系统碳减排的新型机组组合模型。相比于传统模型,该模型在以下两方面进行了改进:一是综合考虑供应侧资源与需求响应、电动汽车、分布式可再生能源发电等低碳的需求侧资源的最优组合;二是机组调度的规则在经济目标之外充分考虑碳排放目标,提出可计及目标相对优先级的模糊双目标优化方法。另外,在求解优化模型时,对粒子群优化算法进行改进,引入了遗传算法中的“交叉”、“变异”两个算子,提高了粒子群算法的全局寻优能力。通过对10机系统进行算例分析,验证了模型与算法的有效性。%A novel unit commitment model to promote carbon reduction of a power system is proposed.Compared with traditional models,this one is improved in the following two aspects.On the one hand,low-carbon demand side resources, such as demand response,vehicle to grid and distributed renewable energy generation,are considered together with power supply resources to achieve an optimal schedule.On the other hand,a new fuzzy bi-objective optimization approach that can reflect the relevant priority between objectives is presented to strike an effective balance between economic objective and carbon emission objective.To solve the unit commitment optimization problem,the particle swarm optimization (PSO) is improved by employing crossover operator and mutation operator from the genetic algorithm,which enhances the global optimization ability of PSO.Numerical studies of a 10-unit system have verified the effectiveness of the model and the algorithm.

  5. Algorithms for builder guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Balcomb, J D; Lekov, A B

    1989-06-01

    The Builder Guidelines are designed to make simple, appropriate guidelines available to builders for their specific localities. Builders may select from passive solar and conservation strategies with different performance potentials. They can then compare the calculated results for their particular house design with a typical house in the same location. Algorithms used to develop the Builder Guidelines are described. The main algorithms used are the monthly solar ratio (SLR) method for winter heating, the diurnal heat capacity (DHC) method for temperature swing, and a new simplified calculation method (McCool) for summer cooling. This paper applies the algorithms to estimate the performance potential of passive solar strategies, and the annual heating and cooling loads of various combinations of conservation and passive solar strategies. The basis of the McCool method is described. All three methods are implemented in a microcomputer program used to generate the guideline numbers. Guidelines for Denver, Colorado, are used to illustrate the results. The structure of the guidelines and worksheet booklets are also presented. 5 refs., 3 tabs.

  6. Web Accessibility and Guidelines

    Science.gov (United States)

    Harper, Simon; Yesilada, Yeliz

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

  7. Clinical practice guideline: screening and diagnosing autism.

    Science.gov (United States)

    Blackwell, J

    2001-12-01

    The clinical practice guideline (CPG) reviewed in this month's column concerns the screening and diagnosis of autism. Autism is the third most common developmental disability and affects more than 1 in 500 children, or nearly 400,000 people in the United States, in some form. Primary care providers of children, including pediatric nurse practitioners (PNPs) and family nurse practitioners (FNPs), should reasonably expect to care for at least one child with autism (CWA). The American Academy of Neurology (AAN) has therefore developed guidelines to help healthcare providers facilitate the early identification of children with autism.

  8. Examining recent expert elicitation, judgment guidelines: Value assumptions and the prospects for rationality

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, P.A. [Creighton Univ., Omaha, NE (United States). Dept. of Philosophy

    1999-12-01

    Any examination of the role of values in decisions on risk must take into consideration the increasing reliance on the expert judgment method. Today, reliance on expert judgment is conspicuously present in the documents and work associated with site characterization of Yucca Mountain as a host for the United States' first high level nuclear waste repository. The NRC encourages the use of probabilistic risk assessment's state of the art technology as a complement to deterministic approaches to nuclear regulatory activities. It considers expert judgment as one of those technologies. At the last International Conference on High-Level Nuclear Waste Development several presentations report on the use of expert elicitation sessions held during 1997 at Yucca Mountain. Over a decade ago, few guidelines existed for Department of Energy work in expert judgment. In an analysis of these guidelines, I described the author-advocate's view of the role of values in this method of risk assessment. I suggested that the guidelines assume naive positivism. I noted that the creators of these guidelines also tend toward scientific realism in their apologetic tone that expert judgment falls short of representing the way nature is. I also pointed to a tendency toward what I call a heightened or super-realism. Normal science represents the way the world is and for expert judgment this is only likely so. Expert judgment method, however, is capable of truly capturing expertise in a representative sense. The purpose of this paper is to examine new guidelines from the Department of Energy and the Nuclear Regulatory Commission, with a view to eliciting the epistemological assumptions about the role of values and the status of objectivity claimed for this method. Do these new guidelines also adopt naive positivism? Does the inability to encounter raw, pure, value-neutral expert judgment, reveal itself in these guidelines? Or do these guidelines adopt the belief that values are not

  9. Objective becoming

    CERN Document Server

    Skow, Bradford

    2015-01-01

    Bradford Skow presents an original defense of the 'block universe' theory of time, often said to be a theory according to which time does not pass. Along the way, he provides in-depth discussions of alternative theories of time, including those in which there is 'robust passage' of time or 'objective becoming': presentism, the moving spotlight theory of time, the growing block theory of time, and the 'branching time' theory of time. Skow explains why the moving spotlight theory is the best of these arguments, and rebuts several popular arguments against the thesis that time passes. He surveys the problems that the special theory of relativity has been thought to raise for objective becoming, and suggests ways in which fans of objective becoming may reconcile their view with relativistic physics. The last third of the book aims to clarify and evaluate the argument that we should believe that time passes because, somehow, the passage of time is given to us in experience. He isolates three separate arguments thi...

  10. Guidelines International Network: toward international standards for clinical practice guidelines.

    NARCIS (Netherlands)

    Qaseem, A.; Forland, F.; Macbeth, F.; Ollenschlager, G.; Phillips, S.; Wees, P.J. van der

    2012-01-01

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. In

  11. Methodological Quality of Consensus Guidelines in Implant Dentistry

    Science.gov (United States)

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

    2017-01-01

    Background Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. Objective To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. Methods The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Results Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p < 0.05). Conclusions Methodological improvement of consensus guidelines published in major implant dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions. PMID:28107405

  12. Limited effect of patient and disease characteristics on compliance with hospital antimicrobial guidelines

    NARCIS (Netherlands)

    Mol, PGM; Denig, P; Gans, ROB; NannanPanday, PV; Degener, JE; Laseur, M; Haaijer-Ruskamp, FM

    2006-01-01

    Objective: Physicians frequently deviate from guidelines that promote prudent use of antimicrobials. We explored to what extent patient and disease characteristics were associated with compliance with guideline recommendations for three common infections. Methods: In a 1-year prospective observation

  13. Limited effect of patient and disease characteristics on compliance with hospital antimicrobial guidelines

    NARCIS (Netherlands)

    Mol, PGM; Denig, P; Gans, ROB; NannanPanday, PV; Degener, JE; Laseur, M; Haaijer-Ruskamp, FM

    2006-01-01

    Objective: Physicians frequently deviate from guidelines that promote prudent use of antimicrobials. We explored to what extent patient and disease characteristics were associated with compliance with guideline recommendations for three common infections. Methods: In a 1-year prospective observation

  14. 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.

  15. Curricular Guidelines for Dental Auxiliary Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    AADS curricular guidelines suggest objectives for these areas of dental auxiliary radiology: physical principles of X-radiation in dentistry, related radiobiological concepts, principles of radiologic health, radiographic technique, x-ray films and intensifying screens, factors contributing to film quality, darkroom, and normal variations in…

  16. Curricular Guidelines for Dental Auxiliary Radiology.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

    AADS curricular guidelines suggest objectives for these areas of dental auxiliary radiology: physical principles of X-radiation in dentistry, related radiobiological concepts, principles of radiologic health, radiographic technique, x-ray films and intensifying screens, factors contributing to film quality, darkroom, and normal variations in…

  17. Curriculum Guidelines for Pathology and Oral Pathology.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines for dental school pathology courses describe the interrelationships of general, systemic, and oral pathology; primary educational goals; prerequisites; a core curriculum outline and behavioral objectives for each type of pathology. Notes on sequencing, faculty, facilities, and occupational hazards are included. (MSE)

  18. Surviving Objects

    OpenAIRE

    Murjas, Teresa

    2012-01-01

    Surviving Objects (2012) is a devised multi-media practice-as-research performance based on extensive interviews conducted with my elderly mother and recorded on a hand-held device. Our conversations concern her experiences as a child refugee following violent deportation by the Soviet Army from Eastern Poland to Siberia (1941), and her subsequent route, via Persia, to a British-run refugee camp in Northern Rhodesia, where she remained for 6 years before arriving in the UK. In order to aid my...

  19. The quality of European dermatological guidelines: critical appraisal of the quality of EDF guidelines using the AGREE II instrument.

    Science.gov (United States)

    Werner, R N; Marinović, B; Rosumeck, S; Strohal, R; Haering, N S; Weberschock, T; Dreher, A C; Nast, A

    2016-03-01

    Clinical practice guidelines are systematically developed tools to assist clinicians and health policy makers in decision making for clearly defined clinical situations. In the light of the demand for evidence-based medicine and quality in health care and the increasing methodological requirements concerning guidelines development, it is important to evaluate existing practice guidelines to systematically identify strengths and weaknesses. Currently, the most accepted tool for the methodological evaluation of guidelines is the Appraisal of Guidelines for Research & Evaluation (AGREE) Instrument. Intention of this assessment is to identify and critically appraise clinical practice guidelines commissioned by the European Dermatology Forum (EDF). A quality assessment of a predefined set of guidelines, including all available clinical practice guidelines published on the EDF guidelines internet site, was performed using the AGREE II instrument. To assure an objective assessment, four independent assessments were performed by evaluators situated in different European countries. Twenty-five EDF guidelines covering different dermatological topics were identified and evaluated. The assessment included seven guidelines developed on the highest methodological standard (systematic literature search and structured consensus conference, S3). Eighteen guidelines were identified that were based on either a structured consensus process (S2k), a systematic literature assessment (S2e) or on informal consensus only (S1). The methodological and reporting quality among the evaluated guidelines was heterogeneous. S3 guidelines generally received the highest scores. The domains 'clarity of presentation' and 'scope and purpose' achieved the highest mean ratings within the different domains of assessment, whereas the domains of 'applicability', 'stakeholder involvement' and 'editorial independence' scored poorly. Considering the large variations in the achieved scores, there is need for

  20. [Guideline "Cancer rehabilitation"].

    Science.gov (United States)

    van den Berg, Jan-Paul; Velthuis, Miranda J; Gijsen, Brigitte C M; Lindeman, Eline; van der Pol, Marjolein A; Hillen, Harry F P

    2011-01-01

    Initiated by IKNL (Integraal Kankercentrum Nederland), a multidisciplinary guideline for cancer rehabilitation for adult oncology patients has been developed. The guideline describes the rehabilitation care of adult patients with cancer, during and after treatment. The guideline focuses on (a) prevalence of complaints either resulting from cancer or the treatment, (b) detection of these complaints and indicated referral, (c) the intake procedure before cancer rehabilitation, (d) intervention and evaluation within cancer rehabilitation and (e) the importance of patient empowerment. The guideline is directed at all professionals giving care to patients with cancer. It concerns those (such as medical specialists, general practitioners and nurses) who are responsible for detecting cancer-related complaints and for referral to cancer rehabilitation, as well as health care professionals involved in cancer rehabilitation care (such as consultants in rehabilitation medicine, physiotherapists and psychologists). The main goal of the guideline is that every cancer patient or ex-cancer patient with (residual) complaints resulting from cancer or its treatment receives timely and appropriate cancer rehabilitation.

  1. Ecoflood guidelines : how to use floodplains for flood risk reduction

    NARCIS (Netherlands)

    Blackwell, M.S.A.; Maltby, E.; Gerritsen, A.L.; Haasnoot, M.; Hoffmann, C.C.; Kotowski, W.; Leenen, E.J.T.M.; Okruszko, T.; Penning, W.E.; Piorkowski, H.; Platteeuw, M.; Querner, E.P.; Siedlecki, T.; Swart, de E.O.A.M.

    2005-01-01

    The main objective of these guidelines is to promote the use of floodplains as natural flood defence measures, while at the same time optimising other compatible functions and values through conservation and restoration. It is intended that these guidelines will be used as a tool primarily by policy

  2. Operational research on implementation of tuberculosis guidelines in Mozambique

    NARCIS (Netherlands)

    M.A. Brouwer

    2015-01-01

    The overall objective of this thesis is to assess how guideline implementation and evaluation contribute to health care decision-making and to assess what critical factors contribute to successful or unsuccessful implementation of TB control guidelines through case studies mainly conducted in Mozamb

  3. The 2015 Dutch food-based dietary guidelines

    NARCIS (Netherlands)

    Kromhout, D.; Spaaij, C.J.K.; Goede, de J.; Weggemans, R.M.; Brug, Johannes; Geleijnse, Johanna M.; Goudoever, van Johannes B.; Hoes, Arno W.; Hopman, Maria T.E.; Iestra, Jolein A.; Mensink, Ronald P.; Pijl, Hanno; Romijn, Johannes A.; Schols, Annemie M.W.J.; Seidell, Jaap C.; Veer, van 't Pieter; Visser, Marjolein; Zwietering, Marcel H.

    2016-01-01

    The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and f

  4. The 2015 Dutch food-based dietary guidelines

    NARCIS (Netherlands)

    Kromhout, D; Spaaij, C J K; de Goede, J; Weggemans, R M; Iestra, JA; Hoes, Arno W.

    2016-01-01

    The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food

  5. The effect of orthodontic referral guidelines: A randomised controlled trial

    OpenAIRE

    Conboy, Frances; O'Brien, K.

    2000-01-01

    Objective To develop and evaluate the effectiveness of referral guidelines for the referral of orthodontic patients to consultant and specialist practijioner orthodontists. Design Single centre randomised controlled trial with random allocation of referral guidelines for orthodontic treatment to general dental practitioners. Setting Hospital orthodontic departments and specialist orthodontic practices in Manchester and Stockport. Subjects General dental practitioners and the patients they ref...

  6. Fermions as Topological Objects

    Directory of Open Access Journals (Sweden)

    Yershov V. N.

    2006-01-01

    Full Text Available A preon-based composite model of the fundamental fermions is discussed, in which the fermions are bound states of smaller entities — primitive charges (preons. The preon is regarded as a dislocation in a dual 3-dimensional manifold — a topological object with no properties, save its unit mass and unit charge. It is shown that the dualism of this manifold gives rise to a hierarchy of complex structures resembling by their properties three families of the fundamental fermions. Although just a scheme for building a model of elementary particles, this description yields a quantitative explanation of many observable particle properties, including their masses.

  7. Objective thermomechanics

    CERN Document Server

    Fülöp, Tamás

    2015-01-01

    An irreversible thermodynamical theory of solids is presented where the kinematic quantities are defined in an automatically objective way. Namely, auxiliary elements like reference frame, reference time and reference configuration are avoided by formulating the motion of the continuum on spacetime directly, utilizing the Weyl-Matolcsi description of spacetime. This restricts the range of definable kinematic quantities heavily. Solids are distinguished from fluids by possessing not only an instantaneous metric tensor but a relaxed metric, too, that represents the natural geometric structure of the solid. The comparison of the instantaneous metric to the relaxed one is the basis of the definition of the elastic state variable, the elastic deformedness tensor. Thermal expansion is conceived as the temperature dependence of the relaxed metric. As opposed to this reversible type of change, plasticity means an irreversible change in the relaxed metric, and is describable via a plastic change rate tensor. The relat...

  8. Factors Influencing the Use of Psychotropic Medication for Challenging Behaviour in the United Kingdom: A Q Method Investigation

    Science.gov (United States)

    Wastell, Sarah; Skirrow, Paul; Hare, Dougal Julian

    2016-01-01

    Objectives: The use of pharmacological interventions to manage challenging behaviour displayed by adults with intellectual disabilities remains controversial, with current clinical guidelines in the United Kingdom advocating the use of less invasive psychological interventions. This exploratory study aimed to discover what views and beliefs are…

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

    Energy Technology Data Exchange (ETDEWEB)

    Carter, R.J.

    1997-07-01

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

  10. Guideline Implementation: Hand Hygiene.

    Science.gov (United States)

    Goldberg, Judith L

    2017-02-01

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

  11. Safety objectives for 2014

    CERN Multimedia

    HSE Unit

    2014-01-01

    This is the third year in which the CERN Management has presented annual safety objectives for the Organization, the “HSE Objectives”.   The HSE objectives for 2014, which were announced by the Director-General at his traditional New Year’s address to the staff and were presented at the first Enlarged Directorate meeting of the year, have been drawn up and agreed in close collaboration between the DSOs, the HSE Unit and the DG himself. From safety in the workplace to radiation and environmental protection, the document emphasises that “Safety is a priority for CERN” and that safety policy is a key element in how the Organization is run. And, like all policies, it generates objectives that “serve as a general framework for action”. The HSE objectives are broken down into the following fields: occupational health and safety on sites and in the workplace, radiation protection, radiation safety, environmental protection, emerge...

  12. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

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

  13. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

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

  14. Scottish Intercollegiate Guidelines Network (SIGN) guidelines on tonsillectomy: a three cycle audit of clinical record keeping and adherence to national guidelines.

    Science.gov (United States)

    Williams, Alun; Lee, Patrick; Kerr, Alastair

    2002-06-01

    Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the indication for tonsillectomy in the management of sore throat were published in January 1999. To determine adherence to these guidelines in our unit, clinical records were examined on admission for tonsillectomy. Three cohorts were analysed. The first listed prior to SIGN, the second after SIGN and the third after presentation of the results of cohorts 1 and 2. The records were examined for documentation of the number of attacks of tonsillitis in the preceding year. The first cohort revealed poor documentation of attacks of tonsillitis (30 per cent). The subsequent cohorts showed progressive improvement in record keeping (74 per cent and 96 per cent). The adherence to SIGN guidelines for those with adequate documentation also improved (75 per cent, 80 per cent, 93.5 per cent). The importance of adequate record keeping to enable audit of practice and the impact of national guidelines on practice are discussed.

  15. Adherence of pharmaceutical advertisements in medical journals to FDA guidelines and content for safe prescribing.

    Directory of Open Access Journals (Sweden)

    Deborah Korenstein

    Full Text Available BACKGROUND: Physician-directed pharmaceutical advertising is regulated in the United States by the Food and Drug Administration (FDA; adherence to current FDA guidelines is unknown. Our objective was to determine adherence rates of physician-directed print advertisements in biomedical journals to FDA guidelines and describe content important for safe prescribing. METHODS AND FINDINGS: Cross-sectional analysis of November 2008 pharmaceutical advertisements within top U.S.-based biomedical journals publishing original research. We excluded advertisements for devices, over the counter medications, and disease awareness. We utilized FDA guideline items identifying unique forms of advertisement bias to categorize advertisements as adherent to FDA guidelines, possibly non-adherent to at least 1 item, or non-adherent to at least 1 item. We also evaluated advertisement content important for safe prescribing, including benefit quantification, risk information and verifiable references. All advertisements were evaluated by 2 or more investigators, with differences resolved by discussion. Twelve journals met inclusion criteria. Nine contained pharmaceutical advertisements, including 192 advertisements for 82 unique products; median 2 per product (range 1-14. Six "teaser" advertisements presented only drug names, leaving 83 full unique advertisements. Fifteen advertisements (18.1% adhered to all FDA guidelines, 41 (49.4% were non-adherent with at least one form of FDA-described bias, and 27 (32.5% were possibly non-adherent due to incomplete information. Content important for safe prescribing was often incomplete; 57.8% of advertisements did not quantify serious risks, 48.2% lacked verifiable references and 28.9% failed to present adequate efficacy quantification. Study limitations included its focus on advertisements from a single month, the subjectivity of FDA guidelines themselves, and the necessary subjectivity of determinations of adherence

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

    Directory of Open Access Journals (Sweden)

    Joslyn S. Kirby

    2015-01-01

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

  17. Pharmacogenetics: from bench to byte--an update of guidelines

    NARCIS (Netherlands)

    Swen, J.J.; Nijenhuis, M.; Boer, A. de; Grandia, L.; Maitland-van der Zee, A.H.; Mulder, H.; Rongen, G.A.P.J.M.; Schaik, R.H. van; Schalekamp, T.; Touw, D.J.; Weide, J. van der; Wilffert, B.; Deneer, V.H.; Guchelaar, H.J.

    2011-01-01

    Currently, there are very few guidelines linking the results of pharmacogenetic tests to specific therapeutic recommendations. Therefore, the Royal Dutch Association for the Advancement of Pharmacy established the Pharmacogenetics Working Group with the objective of developing pharmacogenetics-based

  18. Pharmacogenetics : From Bench to Byte-An Update of Guidelines

    NARCIS (Netherlands)

    Swen, J.J.; Nijenhuis, M.; De Boer, A.; Grandia, L.; Maitland-Van Der Zee, A.H.; Mulder, H.; Rongen, G.A.P.J.M.; Van Schaik, R.H.N.; Schalekamp, T.; Touw, D.J.; Van Der Weide, J.; Wilffert, B.; Deneer, V.H.M.; Guchelaar, H.-J.

    2011-01-01

    Currently, there are very few guidelines linking the results of pharmacogenetic tests to specific therapeutic recommendations. Therefore, the Royal Dutch Association for the Advancement of Pharmacy established the Pharmacogenetics Working Group with the objective of developing pharmacogenetics-based

  19. Curriculum Guidelines on Predoctoral Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    The American Association of Dental Schools' Curriculum Guidelines include an introduction to the discipline and its interrelationships with other disciplines, prerequisites, a core content outline, specific behavioral objectives, and notes on sequencing and faculty. (MSE)

  20. Update on management options in the treatment of nosocomial and ventilator assisted pneumonia: review of actual guidelines and economic aspects of therapy

    Directory of Open Access Journals (Sweden)

    Wilke M

    2013-12-01

    Full Text Available Michael Wilke,1 Rolf Grube1 1Dr. Wilke GmbH, Munich, Germany Objective: Nosocomial or more exactly, hospital-acquired (HAP and ventilator-associated pneumonia (VAP are frequent conditions when treating intensive care unit (ICU patients that are only exceeded by central line-associated bloodstream infections. In Germany, approximately 18,900 patients per year suffer from a VAP and another 4,200 from HAP. We therefore reviewed the current guidelines about HAP and VAP, from different sources, regarding the strategies to address individual patient risks and medication strategies for initial intravenous antibiotic treatment (IIAT. Material and methods: We conducted an analysis of the recent guidelines for the treatment of HAP. The current guidelines of the American Thoracic Society, the treatment recommendations of the Paul-Ehrlich-Gesellschaft (PEG, the guidelines from the British Society for Antimicrobial Chemotherapy, the VAP guideline of the Canadian Critical Care trials group, as well as the new German S3-guideline for HAP were examined. Results: All guidelines are based on grading systems that assess the evidence underlying the recommendations. However, each guideline uses different grading systems. One common aspect of these guidelines is the risk assessment of the patients for decision making regarding IIAT. Most guidelines have different recommendations depending on the risk of the presence of multidrug resistant (MDR bacteria. In guidelines using risk assessment, for low-risk patients (early onset, no MDR risk aminopenicillins with beta-lactamase inhibitors (BLI, second or third generation cephalosporins, quinolones, or ertapenem are recommended. For patients with higher risk, imipenem, meropenem, fourth generation cephalosporins, ceftazidime or piperacillin/tazobactam are recommended. The PEG recommendations include a combination therapy in cases of very high risk (late onset, MDR risk, ICU, and organ failure of either piperacillin

  1. Field Campaign Guidelines

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-01

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

  2. Record Keeping Guidelines

    Science.gov (United States)

    American Psychologist, 2007

    2007-01-01

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

  3. Children's Advertising Guidelines.

    Science.gov (United States)

    Council of Better Business Bureaus, Inc., New York, NY.

    These guidelines have been developed for the use of advertisers and advertising agencies and for the self-regulatory mechanism which these groups have established, the National Advertising Division, to help ensure that advertising directed to children is truthful, accurate, and fair to children's perceptions. Preliminary sections set forth basic…

  4. 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…

  5. Curricular Guidelines for Endodontics.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

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

  6. Tinnitus guidelines and treatment

    DEFF Research Database (Denmark)

    Larsen, Dalia Gustaityté; Ovesen, Therese

    2014-01-01

    In this study literature search was performed on tinnitus guidelines and treatment. Tinnitus can be described as the perception of sound in the absence of external acoustic stimulation, and validated questionnaires, oto-neurological examination, audiometry tests, MRI and angiography are necessary...

  7. Guidelines for heart transplantation

    OpenAIRE

    de Jonge, N; Kirkels, J.H.; Klöpping, C.; Lahpor, J.R.; Caliskan, K.; Maat, A.P.W.M.; Brügemann, J; Erasmus, M.E.; Klautz, R. J. M.; Verwey, H.F; Oomen, A.; Peels, C.H.; Golüke, A.E.J.; Nicastia, D.; Koole, M.A.C.

    2008-01-01

    Based on the changes in the field of heart transplantation and the treatment and prognosis of patients with heart failure, these updated guidelines were composed by a committee under the supervision of both the Netherlands Society of Cardiology and the Netherlands Association for Cardiothoracic surgery (NVVC and NVT).

  8. Guidelines for heart transplantation

    NARCIS (Netherlands)

    Kirkels, J. H.; Klopping, C.; Lahpor, J. R.; Caliskan, K.; Maat, A. P. W. M.; Brugemann, J.; Erasmus, M. E.; Klautz, R. J. M.; Verwey, H. F.; Oomen, A.; Peels, C. H.; Goluke, A. E. J.; Nicastia, D. M.; Koole, M. A. C.; Balk, A. H. M. M.; de Jonge, N.

    Based on the changes in the field of heart transplantation and the treatment and prognosis of patients with heart failure, these updated guidelines were composed by a committee under the supervision of both the Netherlands Society of Cardiology and the Netherlands Association for Cardiothoracic

  9. ADULT INFLUENZA VACCINATION GUIDELINE

    African Journals Online (AJOL)

    immune system status, and degree of similarity of the virus strains contained .... unethically influence the content of the guideline. All funds ... more severe response to such infections. .... 2 - gcC in cold chain, and stored in the fridge and not the.

  10. Measure Guideline: Evaporative Condensers

    Energy Technology Data Exchange (ETDEWEB)

    German, A [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

    2012-03-01

    This measure guideline on evaporative condensers provides information on properly designing, installing, and maintaining evaporative condenser systems as well as understanding the benefits, costs, and tradeoffs. This is a prescriptive approach that outlines selection criteria, design and installation procedures, and operation and maintenance best practices.

  11. Curricular Guidelines for Endodontics.

    Science.gov (United States)

    Journal of Dental Education, 1981

    1981-01-01

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

  12. Osteoporosis: therapeutic guidelines. Guidelines for practice management of osteoporosis.

    Science.gov (United States)

    Khan, Sana N; Craig, Latasha; Wild, Robert

    2013-12-01

    Therapeutic guidelines of osteoporosis are reviewed from North American Menopause Society, American Association of Clinical Endocrinologists, American College of Obstetrics and Gynecology, and the National Osteoporosis Foundation. The various guidelines are compared and discussed.

  13. Time to detoxify medical literature from guideline overdose

    Institute of Scientific and Technical Information of China (English)

    Dinesh Vyas; Arpita K Vyas

    2012-01-01

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

  14. Influenza vaccination: key facts for general practitioners in Europe—a synthesis by European experts based on national guidelines and best practices in the United Kingdom and the Netherlands

    Science.gov (United States)

    Kassianos, George; Blank, Patricia; Falup-Pecurariu, Oana; Kuchar, Ernest; Kyncl, Jan; De Lejarazu, Raul Ortiz; Nitsch-Osuch, Aneta; van Essen, Gerrit A

    2016-01-01

    Currently there is no influenza vaccination guidance for European general practitioners. Furthermore, although the European Council recommends a target seasonal influenza vaccination rate of 75% in the elderly (65 years and above) and in anyone aged >6 months with a chronic medical condition, there remain wide discrepancies throughout Europe. A harmonised guideline regarding not only vaccination strategy but also for the consistent diagnosis of influenza across Europe is essential to support a common approach for the implementation of seasonal influenza vaccination across Europe. This document is based on pre-existing guidelines available in the UK and Netherlands and has been approved by a group of European experts for use throughout Europe. As well as providing a standardised influenza diagnosis, it also reviews the current recommendations for influenza vaccination, the types of vaccine available, the contraindications, vaccine use in special populations (in pregnancy, children, and in those with egg allergy), and concomitant administration with other vaccines. The effectiveness, safety, and timing of the seasonal influenza vaccine are also reviewed. A second section provides practical guidance for general practitioners for the implementation of a seasonal influenza vaccination program, including the selection and notification of those eligible for vaccination, as well as suggestions for the organisation of a vaccination programme. Finally, suggested responses to common patient misconceptions and frequently asked questions are included. The aim of this article is to harmonise the diagnosis of seasonal influenza and the approach of European general practitioners to seasonal influenza vaccination in order to better identify influenza outbreaks and to move towards reaching the target vaccination rate of 75% throughout Europe. PMID:27540408

  15. 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.

  16. Guidelines for Better Heart Health

    Science.gov (United States)

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

  17. Offshore waste treatment guidelines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-12-15

    These guidelines were prepared to aid offshore oil and gas operators in the management of waste materials related to petroleum drilling and production operations in offshore areas regulated by the Canada-Newfoundland and Labrador Offshore Petroleum Board (CNLOPB) and the Canada-Nova Scotia Offshore Petroleum Board (CNSOPB). A description of the relevant sections of the regulatory regime applicable to Canada's offshore oil and gas operations was included. Offshore operators are expected to take all reasonable measures to minimize the volumes of waste materials generated by their operations. The guidelines included recommendations for identifying, monitoring, and reporting discharges; performance expectations for specific discharges; requirements for greenhouse gas (GHG) and other air emissions; methods of characterizing and monitoring produced water, drilling muds, and desalination brine. Operational discharges associated with the installation and maintenance of subsea systems were also reviewed, and qualifications of analytical laboratories were presented. 24 refs., 2 appendices.

  18. Guidelines or gospels?

    Science.gov (United States)

    Sundt, Thoralf M

    2016-06-01

    In the interest of advancing evidenced-based medicine, enthusiasm for clinical practice guidelines has skyrocketed. They have a genuine impact on clinical practice and are frequently referenced in the literature. Their construction is complex and labor intensive, and has significant limitations given the necessary process as well as the data available. There has been less focus on their appropriate clinical application as dictated by these inherent limitations. It is worthwhile taking a step back and considering how we know what we think we know based on statistical analysis of biomedical data sets and the real implications of those population data for making predictions about the individual patient we encounter in the clinic. These data as used to establish guidelines for care should be the foundation and starting point for our thoughtful recommendations and decision making, not the final word. The importance of nuance in clinical judgment remains even in this "evidence-based" world.

  19. Neighborhood environments and objectively measured physical activity in 11 countries.

    Science.gov (United States)

    Cerin, Ester; Cain, Kelli L; Conway, Terry L; Van Dyck, Delfien; Hinckson, Erica; Schipperijn, Jasper; De Bourdeaudhuij, Ilse; Owen, Neville; Davey, Rachel C; Hino, Adriano Akira Ferreira; Mitáš, Josef; Orzanco-Garralda, Rosario; Salvo, Deborah; Sarmiento, Olga L; Christiansen, Lars B; Macfarlane, Duncan J; Schofield, Grant; Sallis, James F

    2014-12-01

    Environmental changes are potentially effective population-level physical activity (PA) promotion strategies. However, robust multisite evidence to guide international action for developing activity-supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively measured PA outcomes, between-site differences in such associations, and the extent to which perceived environmental attributes explain between-site differences in PA. This was a cross-sectional study conducted in 16 cities located in Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and United States of America. Participants were 6968 adults residing in administrative units stratified by socioeconomic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min·wk of MVPA). Most perceived neighborhood attributes were positively associated with the PA outcomes in the pooled, site-adjusted, single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix-access were significant predictors of both PA outcomes in the fully adjusted models. Environmental attributes accounted for within-site variability in MVPA, corresponding to an SD of 3 min·d or 21 min·wk. Large between-site differences in PA outcomes were observed; 15.9%-16.8% of these differences were explained by perceived environmental attributes. All neighborhood attributes were associated with between-site differences in the total effects of the perceived environment on PA outcomes. Residents' perceptions of neighborhood attributes that facilitate walking were positively associated with objectively measured MVPA and meeting the guidelines for cancer/weight gain prevention at

  20. Measure Guideline: Evaporative Condensers

    Energy Technology Data Exchange (ETDEWEB)

    German, A.; Dakin, B.; Hoeschele, M.

    2012-03-01

    The purpose of this measure guideline on evaporative condensers is to provide information on a cost-effective solution for energy and demand savings in homes with cooling loads. This is a prescriptive approach that outlines selection criteria, design and installation procedures, and operation and maintenance best practices. This document has been prepared to provide a process for properly designing, installing, and maintaining evaporative condenser systems as well as understanding the benefits, costs, and tradeoffs.

  1. Guideline implementation: Surgical attire.

    Science.gov (United States)

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  2. [Conservation Units.

    Science.gov (United States)

    Texas Education Agency, Austin.

    Each of the six instructional units deals with one aspect of conservation: forests, water, rangeland, minerals (petroleum), and soil. The area of the elementary school curriculum with which each correlates is indicated. Lists of general and specific objectives are followed by suggested teaching procedures, including ideas for introducing the…

  3. [Conservation Units.

    Science.gov (United States)

    Texas Education Agency, Austin.

    Instructional units deal with each aspect of conservation: forests, wildlife, rangelands, water, minerals, and soil. The area of the secondary school curriculum with which each is correlated is indicated. Lists of general and specific objectives are followed by suggested teaching procedures, including ideas for introducing the topic, questions to…

  4. 英国和日本学前课程目标的比较*--以两国新版的学前课程纲要为蓝本%Comparative Study on Preschool Curriculum Objectives between U.K. and Japan--based on the Newest Edition of Preschool Curriculum Guideline

    Institute of Scientific and Technical Information of China (English)

    曹能秀

    2016-01-01

    Based on Statutory Framework for the Early Years Foundation Stage issued by British Department of Education and Kindergarten Education Guidelines issued by Japanese Ministry of Education, Culture, Sports, Science and Technology, this paper compares the preschool curriculum objectives between the two countries. The results suggest that the two‘guidelines’ share some common points in the basic principles and contents. However, there are a lot of differences in meanings, framework, division of curriculum areas as well as the emphasized areas. Generally speaking, in recent years, Britain has been paying more attention to reform and update preschool curriculum objectives to improve preschool education quality in accordance with the changes of the times, the advancement of science and the social requirements. The preschool curriculum reform in the U.K. and Japan could provide good reference for the reform in China.%本文以英国教育部2014年颁布的《早期基础阶段法定框架》和2008年日本文部科学省发布的《幼儿园教育要领》为蓝本,对两国学前课程目标进行比较。结果显示,当前两者所依据的基本原则及内容有很多共同点,但其含义、结构、课程领域划分和侧重的领域有所不同,领域目标和具体目标也有许多不同之处。总体而言,英国近年来比日本更注重根据时代的变化、科学的进步和社会的诉求,不断改革学前课程目标,提高学前教育质量。英国和日本当前的学前课程改革对我国具有重要的借鉴意义。

  5. Clinical Practice Guidelines for postoperative period of thoracic surgery.

    Directory of Open Access Journals (Sweden)

    Frank Carlos Alvarez Li

    2009-03-01

    Full Text Available Clinical Practice Guidelines for postoperative period of thoracic surgery. It is the period between the suture of the surgical wound and the total rehabilitation of the patient, which usually occurs in the Intensive Care Unit. This document includes a review and update of the main aspects such as classification, postoperative treatment, stressing the actions to face any complication. It includes assessment guidelines focused on the most important aspects to be accomplished.

  6. Guidelines for use of fishes in research

    Science.gov (United States)

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

    2014-01-01

    mammals and other vertebrates, in general. Policies, regulations, and recommendations developed for research on mammals, birds, reptiles, or even amphibians are frequently inappropriate for research with fishes. The Guidelines also address some of the ethical concerns that motivate guidelines used for research with other vertebrates, while being mindful of the unique physiology and general nature of fishes. The Guidelines were developed for general use by investigators within the United States; therefore, the roles, responsibilities, and informational needs of Institutional Animal Care and Use Committees (IACUCs) were given specific attention. All United States institutions that use vertebrate animals for research, teaching, research training, and biological testing are required to create an IACUC to oversee and evaluate all aspects of the institution’s animal care and use program. Investigators from other nations who read this document may disregard specific references to U.S. state and federal laws and regulations, as their institutional infrastructure and processes may differ from those of an internal committee such as IACUCs. The principles described herein, however, are applicable to research on fishes regardless of geographic location. Investigators in other nations may benefit by modifying any of the specific provisions pertaining to the United States, thereby adopting guidelines consistent with the laws and regulations of their own government. The UFR Committee urges that the Guidelines be endorsed and adopted (adapted, where necessary) by those state and federal authorities with regulatory responsibilities for fishes, offices with federal oversight (e.g., National Institutes of Health, Office of Laboratory Animal Welfare; http://grants.nih.gov/grants/olaw/olaw.htm) as well as by universities and other institutions and authorities using fishes and aquatic animals within their research and teaching programs.

  7. The implementation of venous leg ulcer guidelines: process analysis of the intervention used in a multi-centre, pragmatic, randomized, controlled trial.

    Science.gov (United States)

    Marshall, J L; Mead, P; Jones, K; Kaba, E; Roberts, A P

    2001-11-01

    The production and implementation of clinical practice guidelines is currently a high political priority and a rapidly developing field within healthcare in the United Kingdom (UK). Their purpose is to provide clinicians with a synthesis of the best available external evidence and operationalize the implementation of evidence-based practice. Despite indications that clinical guidelines can make a difference to the quality of patient care, there is some evidence that practitioners struggle with their application. The aim of this paper is to report one element of a trial undertaken by three collaborating universities in the Northern and Yorkshire Region of the UK health service during 1997-1998. The objective was to understand what makes guidelines acceptable and usable, or otherwise, to health professionals. The findings reported in this paper describe the process of care in those general practices that elected to implement guidelines for the management of patients with venous leg ulcers. We conclude that planning for training, resource and quality improvement processes must be built into a team's guidelines implementation procedures. A preliminary needs analysis of the contextual 'hurdles and levers' within each primary healthcare team is also necessary to identify individual issues that must be addressed if the process is to succeed. These findings provide some lessons for successful implementation of clinical guidelines in general. Recommendations for nursing policy makers, managers, practitioners and researchers are included.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. [Obligation of guideline recommendations: Perception survey among guideline developers].

    Science.gov (United States)

    Weberschock, Tobias; Dreher, Andreas; Follmann, Markus; Nothacker, Monika; Kopp, Ina; Rosumek, Stefanie; Nast, Alexander

    2016-01-01

    Specific recommendations form the centerpiece of medical guidelines. The intended strength of a recommendation is usually expressed by the use of different wordings. Recent investigations showed that guideline users (recipients) interpret the binding character of wordings in different ways. The perception of different wording and their binding character of the strength of guideline recommendations among guideline developers (sender) have so far not been investigated in the German-speaking area. German-speaking guideline developers were invited online and at specialist meetings to participate in a survey investigating 13 different terms used in guideline recommendations. The aim was to measure their perceived binding character on a visual analog scale (VAS: 0-100). Additional demographic and occupational data were collected. The results were compared with data from a previous survey among guideline users. Overall, 136 guideline developers with an average of 4.2 (median 3) guideline (co-) authorships participated in the survey. While guideline developers interpreted the two imperative recommendations "must" and "must not" with a similarly high level of obligation, the level of obligation was not rated homogenously for strong and weak recommendations like "shall" or "should". Two out of five negative formulations were perceived as more binding than their corresponding positive formulations. In comparisons with the ratings of the guideline users the terms "darf nicht" (must not), (-5.8 VAS, p≤0.0001) and "muss" (must), (-2.9 VAS, p≤0.0006) were perceived as less binding by the guideline developers, as was "sollte nicht"(should not) (-6.6 VAS, p≤0.0001) and "kann nicht empfohlen werden" (cannot be recommended) (-9.4 VAS, p≤0.0001). Only "soll" (shall) was perceived as more binding (+8.7 VAS, p≤0.0001). The current survey demonstrates that guideline developers perceive the binding character of terms used in guideline recommendations in a similar way as it was

  10. Curriculum development for a national cardiotocography education program: a Delphi survey to obtain consensus on learning objectives.

    Science.gov (United States)

    Thellesen, Line; Hedegaard, Morten; Bergholt, Thomas; Colov, Nina P; Hoegh, Stinne; Sorensen, Jette L

    2015-08-01

    To define learning objectives for a national cardiotocography (CTG) education program based on expert consensus. A three-round Delphi survey. One midwife and one obstetrician from each maternity unit in Denmark were appointed based on CTG teaching experience and clinical obstetric experience. Following national and international guidelines, the research group determined six topics as important when using CTG: fetal physiology, equipment, indication, interpretation, clinical management, and communication/responsibility. In the first Delphi round, participants listed one to five learning objectives within the predefined topics. Responses were analyzed by a directed approach to content analysis. Phrasing was modified in accordance with Bloom's taxonomy. In the second and third Delphi rounds, participants rated each objective on a five-point relevance scale. Consensus was predefined as objectives with a mean rating value of ≥ 3. A prioritized list of CTG learning objectives. A total of 42 midwives and obstetricians from 21 maternity units were invited to participate, of whom 26 completed all three Delphi rounds, representing 18 maternity units. The final prioritized list included 40 objectives. The highest ranked objectives emphasized CTG interpretation and clinical management. The lowest ranked objectives emphasized fetal physiology. Mean ratings of relevance ranged from 3.15 to 5.00. National consensus on CTG learning objectives was achieved using the Delphi methodology. This was an initial step in developing a valid CTG education program. A prioritized list of objectives will clarify which topics to emphasize in a CTG education program. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. The effects of a nursing guideline on depression in psychogeriatric nursing home residents with dementia.

    OpenAIRE

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J M

    2011-01-01

    OBJECTIVE: To study the effects of introducing a nursing guideline on depression in residents with dementia of psychogeriatric nursing home wards. METHODS: A multi-center controlled clinical trial with randomization at ward level was used to study the effects of the guideline introduction. Nursing teams were trained in applying the guideline to their own residents diagnosed with depression in dementia. Key elements of the nursing guideline are increasing individualized pleasant activities and...

  12. Uniform guidelines improve client care.

    Science.gov (United States)

    Barnett, B

    1994-12-01

    Uniform national guidelines on the delivery of family planning methods and services improve client care, assuming these guidelines are based on current scientific information. Compliance with these guidelines yields safe and efficient delivery of family planning services. Service providers need information, training, supplies, and guidelines to deliver quality services. Guidelines contribute to consistency among family planning programs in different settings. Even though clinics may not provide the same services, the guidelines allow them to provide the same standards of care. Specifically, eligibility criteria, contraindications, and follow-up schedules are the same regardless of the service delivery point. Various international health organizations (such as World Health Organization, USAID, Program for International Training in Health, International Planned Parenthood Federation, and Association for Voluntary Surgical Contraception) have developed guidelines for family planning service delivery. Governments can use these documents to develop national family planning guidelines and policies. They should adapt the guidelines to local needs and consider program resources. After development of the national guidelines, training, workshops, and dissemination of written materials should be provided for policymakers, physicians, nurses, and other health providers. Countries that have either developed or are working to draft their own national guidelines are Cameroon, Ghana, Mexico, and Nepal.

  13. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

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

  14. Nurses' experiences of guideline implementation

    DEFF Research Database (Denmark)

    Alanen, Seija; Välimäki, Marita; Kaila, Minna

    2009-01-01

    AIMS: The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines? BACKGROUND: The implementation of clinical guidelines seems...... to local circumstances, seems to be crucial for successful implementation. CONCLUSIONS: Clinical guidelines can be promising tools in enhancing evidence-based nursing practice, as nurses see them as practical work tools in patient care and so are willing to adopt them. However, support from management...... and physicians is needed to ensure the successful implementation of guidelines into nursing practices. RELEVANCE TO CLINICAL PRACTICE: Based on the findings of this study and previous knowledge of guideline implementation some practical recommendations are suggested. Select the most relevant guidelines...

  15. The GuideLine Implementability Appraisal (GLIA: development of an instrument to identify obstacles to guideline implementation

    Directory of Open Access Journals (Sweden)

    Hsiao Allen

    2005-07-01

    Full Text Available Abstract Background Clinical practice guidelines are not uniformly successful in influencing clinicians' behaviour toward best practices. Implementability refers to a set of characteristics that predict ease of (and obstacles to guideline implementation. Our objective is to develop and validate a tool for appraisal of implementability of clinical guidelines. Methods Indicators of implementability were identified from the literature and used to create items and dimensions of the GuideLine Implementability Appraisal (GLIA. GLIA consists of 31 items, arranged into 10 dimensions. Questions from 9 of the 10 dimensions are applied individually to each recommendation of the guideline. Decidability and Executability are critical dimensions. Other dimensions are Global, Presentation and Formatting, Measurable Outcomes, Apparent Validity, Flexibility, Effect on Process of Care, Novelty/Innovation, and Computability. We conducted a series of validation activities, including validation of the construct of implementability, expert review of content for clarity, relevance, and comprehensiveness, and assessment of construct validity of the instrument. Finally, GLIA was applied to a draft guideline under development by national professional societies. Results Evidence of content validity and preliminary support for construct validity were obtained. The GLIA proved to be useful in identifying barriers to implementation in the draft guideline and the guideline was revised accordingly. Conclusion GLIA may be useful to guideline developers who can apply the results to remedy defects in their guidelines. Likewise, guideline implementers may use GLIA to select implementable recommendations and to devise implementation strategies that address identified barriers. By aiding the design and operationalization of highly implementable guidelines, our goal is that application of GLIA may help to improve health outcomes, but further evaluation will be required to support

  16. Multi-objective Optimization of Unit Restoration During Network Reconstruction Considering Line Restoration Sequence%考虑线路投入顺序的网架重构机组恢复多目标优化

    Institute of Scientific and Technical Information of China (English)

    朱海南; 刘玉田

    2014-01-01

    合理的机组恢复顺序和可靠的恢复路径对系统的快速恢复具有重要影响。分析了网架重构的机组恢复过程,建立了新的网架重构机组恢复多目标优化模型。优化目标为待恢复机组提供的发电量尽可能大,并兼顾线路恢复操作的可靠性和对后续恢复的影响。通过设置优化问题的求解域,松弛优化目标的主次关系,并引入差分进化-分布估计算法(DE-EDA)提高求解效率。所述方法能同时给出 Pareto 最优的机组恢复顺序、目标网架重构方案及线路投入顺序。算例仿真结果表明,设置求解域可减少计算量,提高求解速度;使用 DE-EDA 获得的最优解具有更好的收敛性和分布性。%The rational generator start-up sequence and reliable restoration paths are very important for fast restoration of a power system.The unit restoration process of network reconstruction is analyzed,and a new multi-objective optimization model of unit restoration is proposed.The main optimization goal is to maximize the total power generation capability,and the restoration reliability of transmission lines and the impact on successive restoration process are also considered.The solution domain is set to slacken the constraint on primary and secondary optimization goals,while the differential evolution-estimation of distribution algorithm(DE-EDA)is introduced to improve the solution efficiency.Meanwhile,the Pareto-optimal generator start-up sequence,target network reconstruction plan as well as line restoration sequence can be obtained.Simulation results show that the computation burden can be reduced significantly by setting the solution domain and that the Pareto solutions obtained by DE-EDA have better convergence and distribution. This work is supported by National High Technology Research and Development Program of China (863 Program) (No.201 1AA05A1 18) and National Natural Science Foundation of China(No.50877044).

  17. Integrating ergonomics into engineering design: the role of objects.

    Science.gov (United States)

    Hall-Andersen, Lene Bjerg; Broberg, Ole

    2014-05-01

    The objective of this study was to explore the role of objects in integrating ergonomic knowledge in engineering design processes. An engineering design case was analyzed using the theoretical concepts of boundary objects and intermediary objects: Boundary objects facilitate collaboration between different knowledge domains, while the aim of an intermediary object is to circulate knowledge and thus produce a distant effect. Adjustable layout drawings served as boundary objects and had a positive impact on the dialog between an ergonomist and designers. An ergonomic guideline document was identified as an intermediary object. However, when the ergonomic guidelines were circulated in the design process, only some of the guidelines were transferred to the design of the sterile processing plant. Based on these findings, recommendations for working with objects in design processes are included.

  18. Integrating ergonomics into engineering design: The role of objects

    DEFF Research Database (Denmark)

    Hall-Andersen, Lene Bjerg; Broberg, Ole

    2014-01-01

    The objective of this study was to explore the role of objects in integrating ergonomic knowledge in engineering design processes. An engineering design case was analyzed using the theoretical concepts of boundary objects and intermediary objects: Boundary objects facilitate collaboration between...... different knowledge domains, while the aim of an intermediary object is to circulate knowledge and thus produce a distant effect. Adjustable layout drawings served as boundary objects and had a positive impact on the dialog between an ergonomist and designers. An ergonomic guideline document was identified...... as an intermediary object. However, when the ergonomic guidelines were circulated in the design process, only some of the guidelines were transferred to the design of the sterile processing plant. Based on these findings, recommendations for working with objects in design processes are included. © 2013 Elsevier Ltd...

  19. Vitamin D supplementation guidelines.

    Science.gov (United States)

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

    2017-02-12

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

  20. Utilization of trauma guidelines by ER nurses in Thailand

    Institute of Scientific and Technical Information of China (English)

    Krongdai Unhasuta RN

    2012-01-01

    Objective: To improving trauma nursing practice in Thailand and other countries. Methods:As part of a larger study of 164 ER nurses, 83 nurses provided narrative responses to questions of CNPG utilization and barriers to implementation. Using a qualitative descriptive design and analysis, three major themes were identified: Guidelines reflect good practice; Nurses do not always follow guidelines; and System problems limit use. Results: The results suggest optimized guideline adherence would require using judgment in following CNPG; ensuring organized teamwork is essential; and providing maximum resources would promote optimal care.Conclusion: Clinical nursing practice guidelines (CNPG) have been developed in Thailand for resuscitation care of emergency room (ER) trauma patients. However, many nurses do not use guidelines effectively.

  1. Optimize awareness of hazards in underground coal mines caused by electrical ignitions and fires through appropriate training guidelines.

    CSIR Research Space (South Africa)

    Page, TPT

    1998-03-01

    Full Text Available The objective of the work reported in this document was to compile training guidelines to address the hazards arising from electrical ignitions and fires in underground coal mines. The resulting training guidelines, which contain recommended...

  2. Evaluating the effectiveness of an educational and feedback intervention aimed at improving consideration of sex differences in guideline development

    NARCIS (Netherlands)

    Keuken, D.G.; Haafkens, J.A.; Mohrs, J.; Klazinga, N.S.; Bindels, P.J.E.

    2010-01-01

    Objectives To investigate the effect of an educational and feedback intervention to enhance consideration of sex differences in clinical guideline development. Design Preintervention and postintervention questionnaires in intervention and control groups. Content analysis of intervention guidelines a

  3. Conscientious objection: a call to nursing leadership.

    Science.gov (United States)

    Ford, Natalie J; Fraser, Kimberly D; Marck, Patricia B

    2010-09-01

    In this paper we argue that nurse leaders need to work actively to create morally supportive environments for nurses in Canada that provide adequate room to exercise conscientious objection. Morally supportive environments engender a safe atmosphere to engage in open dialogue and action regarding conflict of conscience. The CNA's 2008 Code of Ethics for Registered Nurses has recognized the importance of conscientious objection in nursing and has created key guidelines for the registered nurse to follow when a conflict in conscience is being considered or declared. Nurse leaders need to further develop the understanding of conflicts of conscience through education, well-written guidelines for conscientious objection in workplaces and engagement in research to uncover underlying barriers to the enactment of conscientious objections. With advancements in technology, changing healthcare policies and increasing scope of practice, both reflection and dialogue on conscientious objection are critical for the continuing moral development of nurses in Canada.

  4. [Anemia: guidelines comparison].

    Science.gov (United States)

    Del Vecchio, Lucia

    2009-01-01

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

  5. Postdoctoral program guidelines.

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-01

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

  6. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however......, not gained any extensive application in clinical practice. The basic assumption in this thesis is that the scanty penetration is due to an inappropriate design process when designing computerized CPGs for clinical work practice. This thesis examines the application of guidance within areas where CPG...

  7. [CPR--guidelines 2000. New international guidelines for cardiopulmonary resuscitation].

    Science.gov (United States)

    Gervais, H W

    2001-03-01

    The "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. An International Consensus an Science" are the first true international CPR guidelines in the history of resuscitation medicine. Experts from major international resuscitation organizations (International Liaison Committee on Resuscitation, ILCOR) achieved a consensus of recommendations which had to pass a rigorous review procedure applying the tools of evidence-based medicine: all proposed guidelines or guideline changes had to be based on critically appraised pieces of evidence which had to be integrated into a final class of recommendations. The most important changes compared to previous recommendations from either the European Resuscitation Council or the American Heart Association are presented and commented upon.

  8. Canadian Schizophrenia Guidelines: Introduction and Guideline Development Process.

    Science.gov (United States)

    Pringsheim, Tamara; Addington, Donald

    2017-09-01

    The aim of the Canadian Schizophrenia Guidelines is to provide evidence-based recommendations for the treatment of schizophrenia and schizophrenia spectrum disorders. The target users are health care professionals. Recommendations are provided as guidance to physicians and patients, with the goal of improving the overall standard of care of individuals with schizophrenia. The guidelines were developed using the ADAPTE process, a systematic approach and alternative to de novo guideline development, in which an existing guideline is customised to suit the local context. We assembled a multidisciplinary team of experts, patients, and family carers from across Canada with the goal of involving individuals with diverse areas of expertise and offering different perspectives. We identified 6 guidelines that were suitable for adaptation. Recommendations from each guideline were extracted and, based on content, were reviewed by the relevant working group. Each working group examined the evidence from which the recommendation was derived and the acceptability and applicability of the recommendation to the Canadian context. Working groups also made decisions on modifications to recommendations when language or terms differed between the source guideline and the Canadian context. Each working group presented selected recommendations to the guideline panel at an in-person consensus meeting. Once the consensus process was completed, each working group created a manuscript with the recommendations adapted from the included guidelines, with the rationale for each recommendation. The process yielded an up-to-date list of evidence-based recommendations that are relevant and applicable in Canada.

  9. Las unidades de planificación y gestión territorial como directriz para la zonificación urbana (planning units and land management as guidelines for urban zoning

    Directory of Open Access Journals (Sweden)

    Ernesto Villegas Rodríguez

    2014-12-01

    Full Text Available RESUMEN: El presente artículo, derivado de investigación, presenta el marco conceptual y metodológico resultados del estudio de las Unidades de Planificación Territorial y de Gestión como Instrumento Operativo para la toma de Decisiones Urbano Rural, los POTs y PDM, instrumentos de planteamiento en el corto, mediano y largo plazo, en este orden la zonificación del territorio se convierte en la alternativa para plantear y fortalecer las Unidades de Gestión y Planificación Territorial donde se debe fortalecer la institucionalidad a partir de la incorporación de los actores y sectores público, privado y sociedad civil. ABSTRACT: This current article, derived from a piece of research, introduces in the theoretical and methodological frameworks, the results of a study of the Land Planning Units and of Management as an Operational Instrument for the Rural-Urban decisionmaking, the Territorial Ordering Plan –TOP– and Municipal Development Plan – MDP–, instruments of approach in the short, medium and long terms; in this order, the zoning of the territory becomes an alternative to raise and to strengthen the Management Units and the Territorial Planning, where the institutional framework must be consolidated from the incorporation of public, private actors and sectors, and the civil society.

  10. Guidelines for CSM project development.

    Science.gov (United States)

    1983-01-01

    This document summarizes guidelines for contraceptive social marketing project development prepared by the International Contraceptive Social Marketing Project (ICSMP) as an aid to consultants and technical assistance contractors. The ICSMP has developed a checklist to guide planning in 4 major areas: 1) project organization and management structure, 2) target market, 3) product line, and 4) pricing strategy and project costs. A clear statement of project objectives is essential, and these objectives must be internally consistent so that strategies to accomplish them can be unified. The position of each governmental entity and sponsoring agency involved in the social marketing project must be clearly understood. Projects receiving US government funds must have a mechanism for financial and programmatic reporting and accountability. Thorough knowledge of commercial rules and regulations in a country is necessary for planning. To ascertain whether the necessary resources are available, it is necessary to examine the existing marketing infrastructure in terms of distribution, advertising, market research, and packagaing capabilities. The target market should be specified in quantifiable terms; in addition, a consumer profile that defines the overall demographics of the country, the family planning environment, and potential social marketing consumers should be developed. The couple years of protection projection can be translated into the percentage of the target market that the project expects to capture. It is necessary to price products early in project development in order to assess program costs. Revenue projections should be based on previous calculations of couple year of protection goals, product line, product price, and price structure. Each element of the advertsing budget should be justifiable in terms of project objectives. Finally, positions and anticpated salaries for staff should be specified through the 1st 3 years of project implementation.

  11. Isolated systems with wind power. An implementation guideline

    DEFF Research Database (Denmark)

    Clausen, Niels-Erik; Bindner, Henrik W.; Frandsen, Sten Tronæs

    2001-01-01

    The overall objective of this research project is to study the development of methods and guidelines rather than "universal solutions" for the use of wind energy in isolated communities. So far most studies of isolated systems with wind power have beencase-oriented and it has proven difficult...... feasibility of isolated power supply systems with wind energy. General guidelines and checklists on which facts and data are needed to carry out a projectfeasibility analysis are presented as well as guidelines how to carry out the project feasibility study and the environmental analysis. The report outlines...

  12. The European Stroke Organisation Guidelines: a standard operating procedure.

    Science.gov (United States)

    Ntaios, George; Bornstein, Natan M; Caso, Valeria; Christensen, Hanne; De Keyser, Jacques; Diener, Hans-Christoph; Diez-Tejedor, Exuperio; Ferro, Jose M; Ford, Gary A; Grau, Armin; Keller, Emanuella; Leys, Didier; Russell, David; Toni, Danilo; Turc, Guillaume; Van der Worp, Bart; Wahlgren, Nils; Steiner, Thorsten

    2015-10-01

    In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations on the related module rather swiftly; with the previous approach of a single large Guideline Document, its entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines. After discussion within the European Stroke Organisation Guidelines Committee and significant input from European Stroke Organisation members as well as methodologists and analysts, this document presents the official standard operating procedure for

  13. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): nutritional assessment].

    Science.gov (United States)

    Ruiz-Santana, S; Arboleda Sánchez, J A; Abilés, J

    2011-11-01

    Current parameters to assess nutritional status in critically-ill patients are useful to evaluate nutritional status prior to admission to the intensive care unit. However, these parameters are of little utility once the patient's nutritional status has been altered by the acute process and its treatment. Changes in water distribution affect anthropometric variables and biochemical biomarkers, which in turn are affected by synthesis and degradation processes. Increased plasma levels of prealbumin and retinol -proteins with a short half-life- can indicate adequate response to nutritional support, while reduced levels of these proteins indicate further metabolic stress. The parameters used in functional assessment, such as those employed to assess muscular or immune function, are often altered by drugs or the presence of infection or polyneuropathy. However, some parameters can be used to monitor metabolic response and refeeding or can aid prognostic evaluation.

  14. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): respiratory failure].

    Science.gov (United States)

    Grau Carmona, T; López Martínez, J; Vila García, B

    2011-11-01

    Severe acute respiratory failure requiring mechanical ventilation is one of the most frequent reasons for admission to the intensive care unit. Among the most frequent causes for admission are exacerbation of chronic obstructive pulmonary disease and acute respiratory failure with acute lung injury (ALI) or with criteria of acute respiratory distress syndrome (ARDS). These patients have a high risk of malnutrition due to the underlying disease, their altered catabolism and the use of mechanical ventilation. Consequently, nutritional evaluation and the use of specialized nutritional support are required. This support should alleviate the catabolic effects of the disease, avoid calorie overload and, in selected patients, to use omega-3 fatty acid- and antioxidant-enriched diets, which could improve outcome.

  15. Guidelines for hazard evaluation procedures

    National Research Council Canada - National Science Library

    2008-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi 1 . Hazard Evaluation Procedures ... Management Overview ... ... Part I Preface 11 Introduction to the Guidelines 1.1 Background ... 1.2 Relationship...

  16. Experimental study on display-control stereotype and development of human factors guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Lee, Yong Hee; Oh, In Seok; Lee, Hyun Chul [KAERI, Taejon (Korea, Republic of); Cha, Woo Chang [Kumoh National Univ. of Technolgy, Gumi (Korea, Republic of)

    2003-01-01

    It is very important to develop the design guidelines which can be applicable for Korean operators for the purpose of designing the KSNP more safely. The objective of this project is to provide the standards, guidelines and bases applicable for HF-010 through the within-subject experiment for obtaining Korean operators' population stereotype for direction-of-movement of controls associated with displays on the control panels. Through the survey of researches on display compatibility and the classification of types of displays and controls in the main control room of Uljin units 3 and 4, methods for an experiment on the stereotype were established. Experimental interface prototypes for a total of 108 combinations of display and control types were implemented. Experimental data collection and analysis system was built in association with the interface prototypes. The experiment was performed with participation of 250 students as subjects. About 20 guideline items were developed based on the results obtained from our analysis of experimental data.

  17. [Clinical guideline 'Turner syndrome'].

    Science.gov (United States)

    van den Akker, Erica L T; van Alfen, A A E M Janiëlle; Sas, Theo C J; Kerstens, Michiel N; Cools, Martine; Lambalk, Cornelis B

    2014-01-01

    Turner syndrome occurs in women who are missing one X chromosome. The most obvious symptoms are small stature and ovarian failure. Turner patients have an increased risk of a large number of disorders, and should therefore have lifelong medical supervision. Recent insights into patient management have been incorporated into the guidelines. Patients are increasingly involved in their own treatment. In patients with 45,X karyotype, Y-chromosomal material is actively sought in a larger number of cells and/or other tissues, using FISH. Pubertal induction therapy, if required, is initiated at an appropriate age. Egg donation or vitrification are new therapeutic options for fertility treatment. Monitoring for cardiac and vascular disease using cardiac ultrasound and MRI is performed more often, partly in connection with the risk of aortal dissection. The coordination of care of patients with Turner syndrome is concentrated in specialized centres in the Netherlands and Belgium.

  18. Guidelines for publication

    Science.gov (United States)

    Rapp, Richard H.

    The AGU Publications Committee and the Board of Journal Editors recently adopted standards for the conduct of the publications process of AGU. These standards articulate the way in which we believe most geophysicists behave when acting as author, editor, or reviewer. We do not perceive a problem with the ethical conduct in any phase of the AGU publications activity. Rather we are presenting what is common practice as a reminder to us all and as help to those who may be just embarking on their scientific careers.We wish to thank in particular our colleagues in the American Chemical Society. With their permission we borrowed heavily from “Ethical Guidelines to Publication of Chemical Research” in the document presented below.

  19. Evidence-based guidelines

    DEFF Research Database (Denmark)

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

    2015-01-01

    for the prediction of long-term disability. With the introduction of a new generation of immunomodulatory and/or immunosuppressive drugs for the treatment of MS, MRI also makes an important contribution to the monitoring of treatment, and can be used to determine baseline tissue damage and detect subsequent repair....... This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We...... present recommendations on how and when to use MRI for disease monitoring, and discuss some promising MRI approaches that may be introduced into clinical practice in the near future....

  20. Space Debris Mitigation Guidelines

    Science.gov (United States)

    Johnson, Nicholas L.

    2011-01-01

    The purpose of national and international space debris mitigation guides is to promote the preservation of near-Earth space for applications and exploration missions far into the future. To accomplish this objective, the accumulation of objects, particularly in long-lived orbits, must be eliminated or curtailed.

  1. Analyses of IEQ and user satisfaction in 20 office buildings : significant findings to impact future design standards and guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Choi, J.; Loftness, V.; Aziz, A. [Carnegie Mellon Univ., Pittsburgh, PA (United States). Centre for Building Performance and Diagnostics

    2009-07-01

    This paper reported on a field study that provided supportive ideas for environmental standards and design guidelines for office environments which could satisfy indoor environmental quality (IEQ) requirements. IEQ is an important variable affecting occupant health, productivity as well as organization success. As such, occupant comfort and satisfaction must be ensured for each component of IEQ, notably thermal quality, air quality, lighting quality, and noise. In partnership with the General Services Administration, the Center for Building Performance and Diagnostics research team at Carnegie Mellon conducted a post-occupancy evaluation field study of 20 commercial office buildings throughout the United States. The objective and subjective data of IEQ obtained from the study were used for correlational analysis. The study results provide evidences to modify office environmental design guideline to improve physiological and environmental benefits. 5 refs., 1 tab., 10 figs.

  2. Lupus anticoagulant : performance of the tests as recommended by the latest ISTH guidelines

    NARCIS (Netherlands)

    Swadzba, J.; Iwaniec, T.; Pulka, M.; De Laat, B.; De Groot, P. G.; Musial, J.

    2011-01-01

    Objectives: Lupus anticoagulant (LA) is clinically the most relevant among all antiphospholipid antibody tests. Recently, new guidelines for LA detection were published. The objective of this retrospective cohort study was to compare tests recommended under these guidelines with other methods used f

  3. Factors influencing the implementation of the guideline triage in emergency departments: a qualitative study.

    NARCIS (Netherlands)

    Janssen, M.A.M.; Achterberg, T. van; Adriaansen, M.J.M.; Kampshoff, C.S.; Schalk, D.M.; Mintjes-de Groot, A.J.

    2012-01-01

    AIMS AND OBJECTIVES: The objectives are: (1) to identify factors that influence the implementation of the guideline Triage in emergency departments [2004] in emergency departments in the Netherlands, and (2) to develop tailored implementation strategies for implementation of this guideline. BACKGROU

  4. Adherence to clinical practice guidelines for low back pain in physical therapy: do patients benefit?

    NARCIS (Netherlands)

    Rutten, G.M.J.; Degen, S.; Hendriks, E.J.; Braspenning, J.C.C.; Harting, J.; Oostendorp, R.A.B.

    2010-01-01

    BACKGROUND: Various guidelines for the management of low back pain have been developed to enhance the effectiveness and efficiency of care. Evidence that guideline-adherent care results in better health outcomes, however, is not conclusive. OBJECTIVE: The main objective of this study was to assess w

  5. A violência como objeto da assistência em um hospital de trauma: "o olhar" da enfermagem Violence as object of care in a trauma intensive care unit: the nurses' "view"

    Directory of Open Access Journals (Sweden)

    Sandra Maria Cezar Leal

    2005-04-01

    Full Text Available A pesquisa apóia-se na tipologia dos estudos híbridos. O objetivo é conhecer e compreender o "olhar" e o fazer das trabalhadoras de enfermagem no cuidado ao paciente vítima de violência, hospitalizado em serviços de emergência em trauma. Foi realizada em um hospital público de emergência em trauma, em Porto Alegre. Os sujeitos são os profissionais da equipe de enfermagem das unidades de internação e os pacientes internados vítimas de violência, em 2001. Os dados quantitativos são originários dos registros de internação do hospital e foram analisados com índices freqüenciais absolutos e relativos, com auxílio do software Epi-Info; para os dados discursivos adotou-se a Análise de Conteúdo. Dos 697 pacientes hospitalizados, vítimas de violência, 90,5% eram do sexo masculino; 73% brancos e 27% negros ou descendentes dessa etnia; a faixa etária dos 11 aos 39 anos corresponde a 78,9% das internações; 47,9% agredidos por arma de fogo, 26,5% por arma branca, 25% por agressão física, 0,3% vítimas de estupro. Em relação ao "olhar" da enfermagem no cuidado ao paciente ficou evidente a preocupação das trabalhadoras e as dificuldades desse enfrentamento. Aponta-se, que os serviços públicos de saúde necessitam se auto-avaliar e propiciar a criação de espaços de co-responsabilização nesse processo.This study is based on hybrid typology. The objective is to know and understand the "perspective" and responses of the nurses when caring for a patient that was the victim of violence and hospitalized with services in a trauma intensive care unit. The study was carried out in Porto Alegre, in a public hospital in the emergency trauma center. The subjects are professionals of the nursing team from intensive care units and the patients hospitalized were victims of violence in 2001. The quantitative data came from the hospitalization records and were analyzed with absolute and relative frequency rates with help from Epi

  6. 41 CFR 109-27.5001 - Objectives.

    Science.gov (United States)

    2010-07-01

    ...-INVENTORY MANAGEMENT 27.50-Inventory Management Policies, Procedures, and Guidelines § 109-27.5001... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Objectives. 109-27.5001 Section 109-27.5001 Public Contracts and Property Management Federal Property Management...

  7. Reporting Guidelines for Music-based Interventions.

    Science.gov (United States)

    Robb, Sheri L; Burns, Debra S; Carpenter, Janet S

    2011-10-01

    Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to reporting seven different components of music-based interventions including intervention theory, intervention content, intervention delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support CONSORT and TREND statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions.

  8. Wind energy and aviation interests - interim guidelines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

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

  9. Evaluating the effectiveness of pediatric pain management guidelines.

    Science.gov (United States)

    Habich, Michele; Wilson, Deeanna; Thielk, Dana; Melles, Grace L; Crumlett, Hillary S; Masterton, Joyce; McGuire, Julie

    2012-08-01

    In response to unit nursing quality and patient satisfaction concerns, the shared governance councils identified opportunities to improve overall assessment and management of pain in hospitalized pediatric patients. Together, the unit-shared governance councils evaluated current practice and reviewed the literature to develop comprehensive Pediatric Pain Assessment and Management Guidelines. The purpose of this study was to evaluate the effectiveness of implementing an evidence-based pain assessment and management guideline on nurses' knowledge, ability to assess and manage the patients' pain, and patient/family satisfaction with staff's management of pain. This intervention study with a pre-post design included three assessment intervals described as baseline and 3 and 6 months after guideline implementation. The sample included pediatric and pediatric intensive care unit (PICU) nursing staff, retrospective chart reviews of pediatric and PICU patients, and patient/parent satisfaction scores. No differences were found between nurses' knowledge and attitudes regarding pain before and after implementation of the guideline. Significant increases in pain assessment, use of correct tool, and reassessment were found following implementation. Although improving, there was no difference in patient/family satisfaction after guideline implementation. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Integrated Human Factors Design Guidelines for Sound Interface

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Lee, Yong Hee; Oh, In Seok; Lee, Hyun Chul [KAERI, Daejeon (Korea, Republic of); Cha, Woo Chang [Kumoh National Univ. of Technology, Gumi (Korea, Republic of)

    2004-05-15

    Digital MMI, such as CRT, LCD etc., has been used increasingly in the design of main control room of the Korean standard nuclear power plants following the YGN units 3 and 4. The utilization of digital MMI may introduce various kind of sound interface into the control room design. In this project, for five top-level guideline items, including Sound Formats, Alarms, Sound Controls, Communications, and Environments, a total of 147 detail guidelines were developed and a database system for these guidelines was developed. The integrated human factors design guidelines for sound interface and the database system developed in this project will be useful for the design of sound interface of digital MMI in Korean NPPs.

  11. Research on Reform of United Nations Assessment Guidelines for Mission Service%联合国维和警察甄选考试指南改革对维和语言培训的影响及对策研究

    Institute of Scientific and Technical Information of China (English)

    赵培江

    2012-01-01

    2012年2月颁布的《联合国单警维和任务区及特别政治任务区甄选考试标准作业程序》对联合国甄选考试的组织、实施程序、考查标准等方面都进行了较大的调整。从联合国维和警察甄选考试指南的改革入手,以语言考试为突破口,研究指南的改革对维和语言培训的影响,并制定相应的对策,对维和培训工作具有指导作用和借鉴意义。%As the UN published the Standard Operation Procedure Assessment of Individual Police Officers for Service in United Nations Peacekeeping Operations and Special Political Missions in February 2012, the implementing, proce- dure and standard of the assessments has been partly changed. What changes are, what influence it will bring to the peacekeeping training and what peacekeeping training centre should react to these chanl~es all have been essential facts for peacekeeping training. The paper starts from the reform in the assessment guidelines, breaks through the language assessments, researches in the influence for the peacekeeping brought by the new guidelines and finds some countermeasures, which is aimed to be helpful for the peacekeeping training.

  12. Guideline to Estimate Decommissioning Costs

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-10-15

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

  13. Cohesion in Multinational Military Units

    Science.gov (United States)

    2010-12-10

    He openly admitted his homosexual orientation at a staff meeting; by doing that he clearly stated his guidelines toward gays . He had developed a...of units and consequentially unit effectiveness (Dupuy 1993, 2948). Some nations permit openly gay and lesbian personnel and others may not. Social...may cause less tension. However, for some nations involvement of gays and lesbians in multinational units may be offensive, while other nations are

  14. Guidelines for Reporting Medical Research

    DEFF Research Database (Denmark)

    Johansen, Mathilde; Thomsen, Simon Francis

    2016-01-01

    accepted and used guidelines: PRISMA, CONSORT, STROBE, MOOSE, STARD, and SPIRIT. It is concluded that the implementation of these guidelines has led to only a moderate improvement in the quality of the reporting of medical research. There is still much work to be done to achieve accurate and transparent...

  15. Specialty Guidelines for Forensic Psychology

    Science.gov (United States)

    American Psychologist, 2013

    2013-01-01

    In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

  16. Specialty Guidelines for Forensic Psychology

    Science.gov (United States)

    American Psychologist, 2013

    2013-01-01

    In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

  17. Journal of Wildlife Management guidelines

    Science.gov (United States)

    William M. Block; Frank R. Thompson; Dawn Hanseder; Allison Cox; Anna Knipps

    2011-01-01

    These Guidelines apply to all Journal of Wildlife Management (JWM, The Journal) submissions. Publishing a professional manuscript proceeds most smoothly if authors understand the policy, procedures, format, and style of the outlet to which they are submitting a manuscript. These instructions supersede all previous guidelines. Manuscripts that clearly deviate from this...

  18. Statement of Management Objectives Missisquoi National Wildlife Refuge 1969

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The objectives in this report were designed to serve as guidelines for management and development of the refuge. These wildlife and recreational goals are based upon...

  19. The air quality in ventilation installations. Practical guidelines; Qualite de l'air dans les installations aerauliques. Guide pratique

    Energy Technology Data Exchange (ETDEWEB)

    Angeli, L. [France Air, 91 - Chilly Mazarin (France); Bianchina, M. [Unelvent, 93 - Le Bourget (France); Blazy, M. [Anjos, 01 - Torcieu (France); Boulanger, X. [Aldes, 21 - Chenove (France); Chiesa, M. [Atlantic (France); Duclos, M. [Groupe Titanair, 69 - Lyon (France); Hubert, D.; Kridorian, O. [Groupe Astato, Blanc Mesnil (France); Josserand, O. [Carrier (Belgium); Lancieux, C. [Camfil, 60 - Saint Martin Longueau (France); Lemaire, J.C. [Agence de l' Environnement et de la Maitrise de l' Energie, ADEME, 75 - Paris (France); Petit, Ph. [Compagnie Industrielle d' Applications Thermiques ( CIAT ), 75 - Paris (France); Ribot, B. [Electricite de France (EDF), 75 - Paris (France); Tokarek, S. [Gaz de France (GDF), 75 - Paris (France); Bernard, A.M.; Tissot, A. [Centre Technique des Industries Aerauliques et Thermiques (CETIAT), 69 - Villeurbanne (France)

    2004-07-01

    The present guide aims to provide design departments, maintenance companies and builders with practical guidelines and recommendations for the installation of ventilation and air-conditioning systems. The objective is to ensure good Indoor Air Quality (IAQ) and to safeguard the health and well-being of the occupants. The guide deals with aspects of design, dimensioning, installation and servicing, all of which play a major role in guaranteeing IAQ and duct-work hygiene. These steps are reviewed for the principal ventilation systems met in both residential and commercial premises. The first part presents the system and draws the attention of the user to specific points which require particular care in term of IAQ. The second part details recommended practice component by component, in respect of design, installation and servicing. Application of these simple guidelines during the various project stages is essential, in order to ensure a good IAQ in ventilation systems. Content: introduction; good ventilation; systems: exhaust ventilation, balanced ventilation, air handling unit, terminal ventilation units, impact of systems on indoor air quality, components: air inlet, air filter, heat recovery unit, heating or cooling coil, humidifier, mechanical fan unit, cowl and hybrid ventilation fan, mixing box, ventilation duct-work, air outlet and air terminal device; references.

  20. TrayGen: Arranging objects for exhibition and packaging

    KAUST Repository

    Yang, Yongliang

    2013-10-01

    We present a framework, called TrayGen, to generate tray designs for the exhibition and packaging of a collection of objects. Based on principles from shape perception and visual merchandising, we abstract a number of design guidelines on how to organize the objects on the tray for the exhibition of their individual features and mutual relationships. Our framework realizes these guidelines by analyzing geometric shapes of the objects and optimizing their arrangement. We demonstrate that the resultant tray designs not only save space, but also highlight the characteristic of each object and the inter-relations between objects. © 2013 The Eurographics Association and John Wiley & Sons Ltd.

  1. 50 CFR 35.2 - Objectives.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Objectives. 35.2 Section 35.2 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM WILDERNESS PRESERVATION AND MANAGEMENT General Rules § 35.2 Objectives. (a) Units...

  2. 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....

  3. 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....

  4. A hospital-site controlled intervention using audit and feedback to implement guidelines concerning inappropriate treatment of catheter-associated asymptomatic bacteriuria

    Science.gov (United States)

    2011-01-01

    Background Catheter-associated urinary tract infection (CAUTI) is one of the most common hospital-acquired infections. However, many cases treated as hospital-acquired CAUTI are actually asymptomatic bacteriuria (ABU). Evidence-based guidelines recommend that providers neither screen for nor treat ABU in most catheterized patients, but there is a significant gap between these guidelines and clinical practice. Our objectives are (1) to evaluate the effectiveness of an audit and feedback intervention for increasing guideline-concordant care concerning catheter-associated ABU and (2) to measure improvements in healthcare providers' knowledge of and attitudes toward the practice guidelines associated with the intervention. Methods/Design The study uses a controlled pre/post design to test an intervention using audit and feedback of healthcare providers to improve their compliance with ABU guidelines. The intervention and the control sites are two VA hospitals. For objective 1 we will review medical records to measure the clinical outcomes of inappropriate screening for and treatment of catheter-associated ABU. For objective 2 we will survey providers' knowledge and attitudes. Three phases of our protocol are proposed: the first 12-month phase will involve observation of the baseline incidence of inappropriate screening for and treatment of ABU at both sites. This surveillance for clinical outcomes will continue at both sites throughout the study. Phase 2 consists of 12 months of individualized audit and feedback at the intervention site and guidelines distribution at both sites. The third phase, also over 12 months, will provide unit-level feedback at the intervention site to assess sustainability. Healthcare providers at the intervention site during phase 2 and at both sites during phase 3 will complete pre/post surveys of awareness and familiarity (knowledge), as well as of acceptance and outcome expectancy (attitudes) regarding the relevant practice guidelines

  5. Conflict Resolution Unit.

    Science.gov (United States)

    Busselle, Tish

    This 7-day unit, intended for use with secondary students, contains a statement of rationale and objectives, lesson plans, class assignments, teacher and student bibliographies, and suggestions for instructional materials on conflict resolution between individuals, groups, and nations. Among the six objectives listed for the unit are: 1) explain…

  6. EAU guidelines on laser technologies.

    Science.gov (United States)

    Herrmann, Thomas R W; Liatsikos, Evangelos N; Nagele, Udo; Traxer, Olivier; Merseburger, Axel S

    2012-04-01

    The European Association of Urology (EAU) Guidelines Office has set up a guideline working panel to analyse the scientific evidence published in the world literature on lasers in urologic practice. Review the physical background and physiologic and technical aspects of the use of lasers in urology, as well as current clinical results from these new and evolving technologies, together with recommendations for the application of lasers in urology. The primary objective of this structured presentation of the current evidence base in this area is to assist clinicians in making informed choices regarding the use of lasers in their practice. Structured literature searches using an expert consultant were designed for each section of this document. Searches were carried out in the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Medline and Embase on the Dialog/DataStar platform. The controlled terminology of the respective databases was used, and both Medical Subject Headings and EMTREE were analysed for relevant entry terms. One Cochrane review was identified. Depending on the date of publication, the evidence for different laser treatments is heterogeneous. The available evidence allows treatments to be classified as safe alternatives for the treatment of bladder outlet obstruction in different clinical scenarios, such as refractory urinary retention, anticoagulation, and antiplatelet medication. Laser treatment for bladder cancer should only be used in a clinical trial setting or for patients who are not suitable for conventional treatment due to comorbidities or other complications. For the treatment of urinary stones and retrograde endoureterotomy, lasers provide a standard tool to augment the endourologic procedure. In benign prostatic obstruction (BPO), laser vaporisation, resection, or enucleation are alternative treatment options. The standard treatment for BPO remains transurethral resection of the prostate for

  7. Looking for Guidelines for the Production of Electronic Textbooks.

    Science.gov (United States)

    Landoni, M.; Wilson, R.; Gibb, F.

    2001-01-01

    Reports the results of two studies of electronic book production, including production on the World Wide Web, and explains EBONI (Electronic Books On-screen Interface) that focuses on the evaluation of electronic resources and compiling guidelines for publishing electronic materials on the Internet for the United Kingdom higher education…

  8. Looking for Guidelines for the Production of Electronic Textbooks.

    Science.gov (United States)

    Landoni, M.; Wilson, R.; Gibb, F.

    2001-01-01

    Reports the results of two studies of electronic book production, including production on the World Wide Web, and explains EBONI (Electronic Books On-screen Interface) that focuses on the evaluation of electronic resources and compiling guidelines for publishing electronic materials on the Internet for the United Kingdom higher education…

  9. 10 CFR 960.4 - Postclosure guidelines.

    Science.gov (United States)

    2010-01-01

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

  10. 10 CFR 960.5 - Preclosure guidelines.

    Science.gov (United States)

    2010-01-01

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

  11. 10 CFR 960.3 - Implementation guidelines.

    Science.gov (United States)

    2010-01-01

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

  12. [French guidelines on electroencephalogram].

    Science.gov (United States)

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

    2014-12-01

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

  13. The effects of a randomised multi-centre trial and international accreditation on availability and quality of clinical guidelines

    DEFF Research Database (Denmark)

    Juul, AB; Gluud, C; Wetterslev, J;

    2005-01-01

    To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation.......To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation....

  14. French Experience with Buprenorphine : Do Physicians Follow the Guidelines?

    Directory of Open Access Journals (Sweden)

    Morgane Guillou Landreat

    Full Text Available Opiate dependence affects about 15,479,000 people worldwide. The effectiveness of opiate substitution treatments (OST has been widely demonstrated. Buprenorphine plays a particular role in opiate dependence care provision in France. It is widely prescribed by physicians and national opiate substitution treatment guidelines have been available since 2004. In order to study the prescribing of buprenorphine, we used a questionnaire sent by email, to a large sample of physicians. These physicians were either in practice, or belonged to an addiction treatment network or a hospital. The main objective of this work was to measure the extent to which the theoretical, clinical attitude of physicians towards prescribing buprenorphine (BHD complied with the statutory guidelines. We showed that the physicians we interviewed rarely took into account the guidelines regarding buprenorphine prescription. The actual prescribing of Buprenorphine differed from the guidelines. Only 42% of independent Family Physicians (FPs, working outside the national health care system, had prescribed buprenorphine as a first-time prescription and 40% of FPs do not follow up patients on buprenorphine. In terms of compliance with the guidelines, 55% of FPs gave theoretical answers that only partially complied with the guidelines. The variations in compliance with the guidelines was noted according to different variables and took into particular account whether the physician were affiliated to a network or in training.

  15. French Experience with Buprenorphine : Do Physicians Follow the Guidelines?

    Science.gov (United States)

    Guillou Landreat, Morgane; Rozaire, Charles; Guillet, Jean Yves; Victorri Vigneau, Caroline; Le Reste, Jean Yves; Grall Bronnec, Marie

    2015-01-01

    Opiate dependence affects about 15,479,000 people worldwide. The effectiveness of opiate substitution treatments (OST) has been widely demonstrated. Buprenorphine plays a particular role in opiate dependence care provision in France. It is widely prescribed by physicians and national opiate substitution treatment guidelines have been available since 2004. In order to study the prescribing of buprenorphine, we used a questionnaire sent by email, to a large sample of physicians. These physicians were either in practice, or belonged to an addiction treatment network or a hospital. The main objective of this work was to measure the extent to which the theoretical, clinical attitude of physicians towards prescribing buprenorphine (BHD) complied with the statutory guidelines. We showed that the physicians we interviewed rarely took into account the guidelines regarding buprenorphine prescription. The actual prescribing of Buprenorphine differed from the guidelines. Only 42% of independent Family Physicians (FPs), working outside the national health care system, had prescribed buprenorphine as a first-time prescription and 40% of FPs do not follow up patients on buprenorphine. In terms of compliance with the guidelines, 55% of FPs gave theoretical answers that only partially complied with the guidelines. The variations in compliance with the guidelines was noted according to different variables and took into particular account whether the physician were affiliated to a network or in training.

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

    Directory of Open Access Journals (Sweden)

    Eccles Martin P

    2012-07-01

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

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

    Science.gov (United States)

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

    2012-07-04

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

  18. Writing for Consumers: Guidelines on Style and Content for Preparing HUD Publications. HUD Handbook No. 55502.

    Science.gov (United States)

    Department of Housing and Urban Development, Washington, DC.

    These guidelines are directed to writers of United States Department of Housing and Urban Development publications intended for public distribution. The primary purpose of the guidelines is to improve writing style and to increase sensitivity to the consumer viewpoint. Section one discusses the following topics: looking at the subject from a…

  19. Partners from the Beginning: Guidelines for Encouraging Partnerships between Parents and NICU and EI Professionals.

    Science.gov (United States)

    Bruns, Deborah A.; Steeples, Tammy

    2001-01-01

    This paper offers six guidelines to facilitate parent-professional partnerships in neonatal intensive care units and early intervention settings. The guidelines emphasize the need to individualize practices to match parent needs; involve parents; support, trust, and respect parents; adopt a strengths-based perspective; understand parents' and…

  20. EAU guidelines on iatrogenic trauma.

    Science.gov (United States)

    Summerton, Duncan J; Kitrey, Noam D; Lumen, Nicolaas; Serafetinidis, Efraim; Djakovic, Nenad

    2012-10-01

    The European Association of Urology (EAU) Trauma Guidelines Panel presents an updated iatrogenic trauma section of their guidelines. Iatrogenic injuries are known complications of surgery to the urinary tract. Timely and adequate intervention is key to their management. To assess the optimal evaluation and management of iatrogenic injuries and present an update of the iatrogenic section of the EAU Trauma Guidelines. A systematic search of the literature was conducted, consulting Medline and the Cochrane Register of Systematic reviews. No time limitations were applied, although the focus was on more recent publications. The expert panel developed statements and recommendations. Statements were rated according to their level of evidence, and recommendations received a grade following a rating system modified from the Oxford Centre for Evidence-based Medicine. Currently, only limited high-powered studies are available addressing iatrogenic injuries. Because the reporting of complications or sequelae of interventions is now increasingly becoming a standard requirement, this situation will likely change in the future. This section of the trauma guidelines presents an updated overview of the treatment of iatrogenic trauma that will be incorporated in the trauma guidelines available at the EAU Web site (http://www. uroweb.org/guidelines/online-guidelines/). Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  1. Quasi-objects, Cult Objects and Fashion Objects

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2011-01-01

    This article attempts to rehabilitate the concept of fetishism and to contribute to the debate on the social role of objects as well as to fashion theory. Extrapolating from Michel Serres’ theory of the quasi-objects, I distinguish two phenomenologies possessing almost opposite characteristics....... These two phenomenologies are, so I argue, essential to quasi-object theory, yet largely ignored by Serres’ sociological interpreters. They correspond with the two different theories of fetishism found in Marx and Durkheim, respectively. In the second half of the article, I introduce the fashion object...... as a unique opportunity for studying the interchange between these two forms of fetishism and their respective phenomenologies. Finally, returning to Serres, I briefly consider the theoretical consequences of introducing the fashion object as a quasi-object....

  2. Hypertension guideline implementation: experiences of Finnish primary care nurses

    DEFF Research Database (Denmark)

    Alanen, Seija; Ijäs, Jarja; Kaila, Minna;

    2008-01-01

    RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses. METHOD: We assessed the style of implementation and adoption of the national...... Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as 'disseminators' (n = 13) or 'implementers' (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers...... were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors. RESULTS: Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion...

  3. Criteria of Shari'ah supervisory committee: A comparative study between guidelines of Bangladesh Bank and Bank Negara Malaysia

    National Research Council Canada - National Science Library

    Muhammad Amanullah

    2015-01-01

    .... Likewise, Bank Negara Malaysia has provided some guidelines. The main objectives of this research paper are to highlight the guidelines of these two banks on these criteria, compare them and evaluate them in light of Shari'ah guidelines on these criteria spelled out by contemporary Muslim jurists.

  4. Proposed Radiation Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Davey, C. S.

    2004-07-01

    Current scientific evidence is that radiation at low levels is not harmful, but beneficial. This is borne out by both radiobiology and epidemiology. The ICRP 26 recommended limits of 50 mSv and 5 mSv per annum are comparable with the average natural background levels in Iran and Norway, respectively, and levels five times higher than that quoted for Iran are to be found in some populated parts of this world. The new limits proposed for ionising radiation are generated by comparison to existing recommended limits for essential minerals. There is a range of acceptable exposures to radiation, just as there is for minerals. The replacement for the ICRP 60 recommendations (20 mSv and 1 mSv for radiation workers and public respectively) should be higher limits of 200 mSv and 50 mSv. There should also be minimum recommended annual levels of 10 mSv, for both radiation workers and the public. The consequences of not proposing this change are continuing huge negative impacts to society. In cancer therapy, even the older guidelines caused unnecessary expense and delays. The cost to Canada is astronomical, when one considers the effect of the existing limits on the use of nuclear power, and the resulting use of hydrocarbons and the consequent increase in acid rain, etc. Of course, the same thing can be said of the entire world limited funds are diverted from areas where they would be better applied, and alternative solutions to societal needs are implemented, solutions which increase pollution and cause injury and death. It is time to reverse the current, expensive trend into misapplied ALARA, based on the paranoia about all things nuclear, which has developed since the linear no-threshold hypothesis was first proposed.propose the transition to a realistic and balanced approach to ionising radiation. (Author)

  5. 36 CFR 910.67 - Square guidelines.

    Science.gov (United States)

    2010-07-01

    ... DEVELOPMENT AREA Glossary of Terms § 910.67 Square guidelines. Square Guidelines establish the Corporation's... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Square guidelines. 910.67... planning area....

  6. Guideline Implementation: Processing Flexible Endoscopes.

    Science.gov (United States)

    Bashaw, Marie A

    2016-09-01

    The updated AORN "Guideline for processing flexible endoscopes" provides guidance to perioperative, endoscopy, and sterile processing personnel for processing all types of reusable flexible endoscopes and accessories in all procedural settings. This article focuses on key points of the guideline to help perioperative personnel safely and effectively process flexible endoscopes to prevent infection transmission. The key points address verification of manual cleaning, mechanical cleaning and processing, storage in a drying cabinet, determination of maximum storage time before reprocessing is needed, and considerations for implementing a microbiologic surveillance program. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  7. Guidelines for Reporting Medical Research

    DEFF Research Database (Denmark)

    Johansen, Mathilde; Thomsen, Simon Francis

    2016-01-01

    As a response to a low quality of reporting of medical research, guidelines for several different types of study design have been developed to secure accurate reporting and transparency for reviewers and readers from the scientific community. Herein, we review and discuss the six most widely...... accepted and used guidelines: PRISMA, CONSORT, STROBE, MOOSE, STARD, and SPIRIT. It is concluded that the implementation of these guidelines has led to only a moderate improvement in the quality of the reporting of medical research. There is still much work to be done to achieve accurate and transparent...... reporting of medical research findings....

  8. Managing electronic records: A guideline

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, J.G.

    1994-10-25

    A committee at Martin Marietta Energy Systems (MMES) has drafted a guideline to assist offices in the management of electronic records. This paper will address the activities surrounding its creating. The guideline is for use by creators, users, and custodians of any type of electronic information. The guideline supports and supplements requirements from DOE and the National Archives and Records Administration (NARA), other internal processes such as system reviews, and the comprehensive records management program. While an in-house publication, it could prove useful to other organizations implementing an electronic records management program.

  9. Managing electronic records: A guideline

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, J.

    1995-07-01

    A committee at Martin Marietta Energy Systems (MMES) has drafted a guideline to assist offices in the management of electronic records. This paper will address the activities surrounding its creating. The guideline is for use by creators, users, and custodians of any type of electronic information. The guideline supports and supplements requirements from DOE and the National Archives and Records Administration (NARA), other internal processes such as system reviews, and the comprehensive records management program. While an in-house publication, it could prove useful to other organizations implementing an electronic records management program.

  10. Program Educational Objectives Definition and Assessment for Accreditation Purposes

    Directory of Open Access Journals (Sweden)

    Noureddine Abbadeni

    2013-07-01

    Full Text Available Academic accreditation of degree programs is becoming an important mean for many institutions to improve the quality of their degree programs. Many programs, in particular computing and engineering, offered by many schools have engaged in the accreditation process with different accreditation bodies. The most known accreditation body in the Unites States of America for engineering, computing, technology, and applied science programs is ABET (Accreditation Board for Engineering and Technology. A key problem towards the satisfaction of ABET accreditation criteria is the appropriate definition and assessment of program educational objectives for a specific degree program. Program Educational Objectives are important as they represent the ultimate mean to judge the quality of a program. They related directly to student outcomes and curriculum of a degree program. We propose a set of guidelines to help understand how program educational objectives can be defined and assessed. We relate and use examples from our practical experience acquired while working on the ABET accreditation of a Software Engineering program;

  11. Interpretation for“2014 evidence-based guideline for the management of high blood pressure in adults”in the United States:discussion of the rational treatment of hypertension%美国《2014成人高血压循证管理指南》解读-探讨高血压的合理治疗

    Institute of Scientific and Technical Information of China (English)

    张磊; 姜红

    2015-01-01

    Hypertension is harmful to human health in the worldwide, which should be effectively controlled. Based on the results of high-quality randomized controlled trials, the“2014 evidence-based guideline for the management of high blood pressure in adults”(JNC8) in the United States brought us new ideas and perspectives that may be helpful in clinical practice. Because of the differences in epidemiological characteristics of hypertension between China and the United States or Europe, the characteristics of hypertensive patients in China should be taken into account in following the instruction of JNC8, so that we can promote the development in treatment of hypertension in China.%高血压严重危害全球人类健康,亟待有效控制。美国《2014成人高血压循证管理指南》(JNC8)是根据高质量临床随机对照试验的研究证据重新修订而成,带来诸多新理念和新观点,值得临床借鉴。然而,我国高血压流行病学特点与欧美国家之间存在差异,所以必须在符合我国国情的基础上,萃取其精髓,才能进一步有效推进我国临床高血压的防治工作。

  12. Concurrency Control Mechanism of Complex Objects

    Institute of Scientific and Technical Information of China (English)

    徐庆云; 王能斌

    1992-01-01

    A complex object is an abstraction and description of a complex entity of the real world.Many applications in such domains as CIMS,CAD and OA define and manipulate a complex object as a single unit.In this paper,a definition of the model of complex objects is given,and the concurrency control mechanism of complex objects in WHYMX object-oriented database system is described.

  13. A comparative review of the pharmacoeconomic guidelines in South Africa.

    Science.gov (United States)

    Carapinha, João L

    2017-01-01

    To compare the pharmacoeconomic guidelines in South Africa (SA) with other middle- and high-income countries. A comparative review of key features of the pharmacoeconomic guidelines in SA was undertaken using the Comparative Table of Pharmacoeconomic Guidelines developed by the International Society of Pharmacoeconomics and Outcomes Research, and published country-level pharmacoeconomics guidelines. A random sample of guidelines in high- and middle-income countries were analyzed if data on all key features were available. Key features of the pharmacoeconomic guidelines in SA were compared with those in other countries, and divergent features were identified and elaborated. Five upper middle-income countries (Brazil, Colombia, Cuba, Malaysia, and Mexico), one lower middle-income country (Egypt), and six high-income countries (Germany, Ireland, Norway, Portugal, Taiwan, and the Netherlands) were analyzed. The pharmacoeconomic guidelines in SA differ in important areas when compared with other countries. In SA, the study perspective and costs are limited to private health-insurance companies, complex modelling is discouraged and models require pre-approval, equity issues are not explicitly stated, a budget impact analysis is not required, and pharmacoeconomic submissions are voluntary. Future updates to the pharmacoeconomic guidelines in SA may include a societal perspective with limitations, incentivize complex and transparent models, and integrate equity issues. The pharmacoeconomic guidelines could be improved by addressing conflicting objectives with policies on National Health Insurance, incentivize private health insurance companies to disclose reimbursement data, and require the inclusion of a budget impact analysis in all pharmacoeconomic submissions. Further research is also needed on the impact of mandatory pharmacoeconomic submissions in middle-income countries.

  14. Adaptation of Traumatic Brain Injury Guidelines in Iran.

    Science.gov (United States)

    Abdollah Zadegan, Shayan; Ghodsi, Seyed Mohammad; Arabkheradmand, Jalil; Amirjamshidi, Abbas; Sheikhrezaei, Abdolreza; Khadivi, Masoud; Faghih Jouibari, Morteza; Tabatabaeifar, Seyed Mahmood; Sharifi, Guive; Abbaszadeh Ahranjani, Jalal; Motlagh Pirooz, Farhad; Tavakoli, Seyed Fakhredin; Mohit, Parviz; Alimohammadi, Yadollah; Rahimi-Movaghar, Vafa

    2016-05-01

    The National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country. The guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed. The following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge. The evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.

  15. Comparative assessment of bioanalytical method validation guidelines for pharmaceutical industry.

    Science.gov (United States)

    Kadian, Naveen; Raju, Kanumuri Siva Rama; Rashid, Mamunur; Malik, Mohd Yaseen; Taneja, Isha; Wahajuddin, Muhammad

    2016-07-15

    The concepts, importance, and application of bioanalytical method validation have been discussed for a long time and validation of bioanalytical methods is widely accepted as pivotal before they are taken into routine use. United States Food and Drug Administration (USFDA) guidelines issued in 2001 have been referred for every guideline released ever since; may it be European Medical Agency (EMA) Europe, National Health Surveillance Agency (ANVISA) Brazil, Ministry of Health and Labour Welfare (MHLW) Japan or any other guideline in reference to bioanalytical method validation. After 12 years, USFDA released its new draft guideline for comments in 2013, which covers the latest parameters or topics encountered in bioanalytical method validation and approached towards the harmonization of bioanalytical method validation across the globe. Even though the regulatory agencies have general agreement, significant variations exist in acceptance criteria and methodology. The present review highlights the variations, similarities and comparison between bioanalytical method validation guidelines issued by major regulatory authorities worldwide. Additionally, other evaluation parameters such as matrix effect, incurred sample reanalysis including other stability aspects have been discussed to provide an ease of access for designing a bioanalytical method and its validation complying with the majority of drug authority guidelines. Copyright © 2016. Published by Elsevier B.V.

  16. [Asthma clinical practice guidelines: advantages and pitfalls].

    Science.gov (United States)

    Plaza, Vicente; Bellido-Casado, Jesús; Alonso-Coello, Pablo; Rodrigo, Gustavo

    2009-01-01

    The Clinical Practice Guidelines on asthma have contributed towards unifying concepts and reaching a consensus on performances between different professional groups. However, they have failed in the overall improvement in the management of asthma, the final objective that they are meant to achieve. Today, almost 20 years after they appeared, the majority of asthmatic patients are still inadequately controlled, partly due to lack of follow up by doctors and the rest of health care staff who have to look after them. This lack of follow up of these recommendations is probably associated with a lack of well structured planning in their circulation and implementation. Also, although the recommendations of these guidelines agree in what is essential, they differ in other aspects, which in turn could be determining factors in clinical practice. The purpose of this article has been to establish the main differences in the recommendations that the principal clinical practice guidelines on the disease propose on the diagnosis, classification and treatment of asthma. To do this we have compared, The British Guideline on the Management of Asthma 2007, The Global Strategy for Asthma Management and Prevention/Global Initiative for Asthma 2006 (GINA), the National Prevention program for Education on Asthma (Programa Nacional de Prevención para la Educación del Asma) (NAEPP), the Spanish Guide for the Management of Asthma (Guía Española para el Manejo del Asma 2003) (GEMA) and the ALAT y SEPAR guides, Latin-America and Spain. Recommendations for the Prevention and Treatment of Asthma Exacerbation (América Latina y España. Recomendaciones para la Prevención y el Tratamiento de la Exacerbación Asmática 2008) (ALERTA).

  17. Method to integrate clinical guidelines into the electronic health record (EHR) by applying the archetypes approach.

    Science.gov (United States)

    Garcia, Diego; Moro, Claudia Maria Cabral; Cicogna, Paulo Eduardo; Carvalho, Deborah Ribeiro

    2013-01-01

    Clinical guidelines are documents that assist healthcare professionals, facilitating and standardizing diagnosis, management, and treatment in specific areas. Computerized guidelines as decision support systems (DSS) attempt to increase the performance of tasks and facilitate the use of guidelines. Most DSS are not integrated into the electronic health record (EHR), ordering some degree of rework especially related to data collection. This study's objective was to present a method for integrating clinical guidelines into the EHR. The study developed first a way to identify data and rules contained in the guidelines, and then incorporate rules into an archetype-based EHR. The proposed method tested was anemia treatment in the Chronic Kidney Disease Guideline. The phases of the method are: data and rules identification; archetypes elaboration; rules definition and inclusion in inference engine; and DSS-EHR integration and validation. The main feature of the proposed method is that it is generic and can be applied toany type of guideline.

  18. Some Guidelines for Energy Programs

    Science.gov (United States)

    Kryger, King C.

    1977-01-01

    This article offers guidelines for educational programs developed for the purpose of educating students and adults on the seriousness of the energy crises and the steps that must be taken to cope with it. (JD)

  19. Measure Guideline: Basement Insulation Basics

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-01

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

  20. [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.

  1. Total quality management implementation guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

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

  2. Reporting Quality of Social and Psychological Intervention Trials: A Systematic Review of Reporting Guidelines and Trial Publications

    OpenAIRE

    Grant, Sean P.; Evan Mayo-Wilson; Melendez-Torres, G. J.; Paul Montgomery

    2013-01-01

    BACKGROUND: Previous reviews show that reporting guidelines have improved the quality of trial reports in medicine, yet existing guidelines may not be fully suited for social and psychological intervention trials. OBJECTIVE/DESIGN: We conducted a two-part study that reviewed (1) reporting guidelines for and (2) the reporting quality of social and psychological intervention trials. DATA SOURCES: (1) To identify reporting guidelines, we systematically searched multiple electronic databases and ...

  3. Guidelines for glycol dehydrator design

    Energy Technology Data Exchange (ETDEWEB)

    Manning, W.P. (Coastal Chemical Co., Inc., Houston, TX (United States)); Wood, H.S. (Maloney-Crawford, Tulsa, OK (United States))

    1993-02-01

    Design guidelines can reduce hydrate-pluggage problems in the triethylene glycol (TEG) absorption process, thus eliminating downtime and lost production caused by water in natural gas. In addition, equipment can be properly sized by following prescribed troubleshooting tips. Guidelines are presented along with the instrumentation list to help one correctly size an absorber and reconcentrator. The paper discusses the following: the pump; gas-glycol heat exchanger; instrumentation; operating conditions; and dew point depression. Four design problems are then illustrated.

  4. FDH radiological design review guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Millsap, W.J.

    1998-09-29

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

  5. Japanese Guideline for Allergic Rhinitis

    OpenAIRE

    Kimihiro Okubo; Yuichi Kurono; Shigeharu Fujieda; Satoshi Ogino; Eiichi Uchio; Hiroshi Odajima; Hiroshi Takenaka; Kohtaro Baba

    2011-01-01

    Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 6th editi...

  6. Immunisation Guidelines for Ireland (2008)

    OpenAIRE

    Department of Health

    2008-01-01

    Immunisation Guidelines for Ireland (2008) This revised report on immunisation guidelines for Ireland has been prepared with the assistance of an active Committee from associated disciplines in Paediatrics, Infectious Diseases, General Practice, Public Health, Microbiology, Occupational Health, Travel Medicine and the Irish Medicines Board. The report itself continues to be simple and concise in design and of course does not claim to contain all information on any pharmacological material....

  7. Measure Guideline: Ventilation Guidance for Residential High-Performance New Construction - Multifamily

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-01

    The measure guideline provides ventilation guidance for residential high performance multifamily construction that incorporates the requirements of the ASHRAE 62.2 ventilation and indoor air quality standard. The measure guideline focus is on the decision criteria for weighing cost and performance of various ventilation systems. The measure guideline is intended for contractors, builders, developers, designers and building code officials. The guide may also be helpful to building owners wishing to learn more about ventilation strategies available for their buildings. The measure guideline includes specific design and installation instructions for the most cost effective and performance effective solutions for ventilation in multifamily units that satisfies the requirements of ASHRAE 62.2-2016.

  8. Family meetings in palliative care: Multidisciplinary clinical practice guidelines

    Directory of Open Access Journals (Sweden)

    O'Hanlon Brendan

    2008-08-01

    Full Text Available Abstract Background Support for family carers is a core function of palliative care. Family meetings are commonly recommended as a useful way for health care professionals to convey information, discuss goals of care and plan care strategies with patients and family carers. Yet it seems there is insufficient research to demonstrate the utlility of family meetings or the best way to conduct them. This study sought to develop multidisciplinary clinical practice guidelines for conducting family meetings in the specialist palliative care setting based on available evidence and consensus based expert opinion. Methods The guidelines were developed via the following methods: (1 A literature review; (2 Conceptual framework; (3 Refinement of the guidelines based on feedback from an expert panel and focus groups with multidisciplinary specialists from three palliative care units and three major teaching hospitals in Melbourne, Australia. Results The literature review revealed that no comprehensive exploration of the conduct and utility of family meetings in the specialist palliative care setting has occurred. Preliminary clinical guidelines were developed by the research team, based on relevant literature and a conceptual framework informed by: single session therapy, principles of therapeutic communication and models of coping and family consultation. A multidisciplinary expert panel refined the content of the guidelines and the applicability of the guidelines was then assessed via two focus groups of multidisciplinary palliative care specialists. The complete version of the guidelines is presented. Conclusion Family meetings provide an opportunity to enhance the quality of care provided to palliative care patients and their family carers. The clinical guidelines developed from this study offer a framework for preparing, conducting and evaluating family meetings. Future research and clinical implications are outlined.

  9. EAU Guidelines on Urethral Trauma.

    Science.gov (United States)

    Martínez-Piñeiro, Luis; Djakovic, Nenad; Plas, Eugen; Mor, Yoram; Santucci, Richard A; Serafetinidis, Efraim; Turkeri, Levent N; Hohenfellner, Markus

    2010-05-01

    These guidelines were prepared on behalf of the European Association of Urology (EAU) to assist urologists in the management of traumatic urethral injuries. To determine the optimal evaluation and management of urethral injuries by review of the world's literature on the subject. A working group of experts on Urological Trauma was convened to review and summarize the literature concerning the diagnosis and treatment of genitourinary trauma, including urethral trauma. The Urological Trauma guidelines have been based on a review of the literature identified using on-line searches of MEDLINE and other source documents published before 2009. A critical assessment of the findings was made, not involving a formal appraisal of the data. There were few high-powered, randomized, controlled trials in this area and considerable available data was provided by retrospective studies. The Working Group recognizes this limitation. The full text of these guidelines is available through the EAU Central Office and the EAU website (www.uroweb.org). This article comprises the abridged version of a section of the Urological Trauma guidelines. Updated and critically reviewed Guidelines on Urethral Trauma are presented. The aim of these guidelines is to provide support to the practicing urologist since urethral injuries carry substantial morbidity. The diversity of urethral injuries, associated injuries, the timing and availability of treatment options as well as their relative rarity contribute to the controversies in the management of urethral trauma. Copyright © 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  10. Ethnic specific recommendations in clinical practice guidelines: a first exploratory comparison between guidelines from the USA, Canada, the UK, and the Netherlands

    NARCIS (Netherlands)

    D.R. Manna; M.A. Bruijnzeels (Marc); H.G. Mokkink; M. Berg (Marc)

    2003-01-01

    textabstractOBJECTIVES: To investigate whether clinical practice guidelines in different countries take ethnic differences between patients into consideration and to assess the scientific foundation of such ethnic specific recommendations. DESIGN: Analysis of the primary care secti

  11. Examining object location and object recognition memory in mice.

    Science.gov (United States)

    Vogel-Ciernia, Annie; Wood, Marcelo A

    2014-10-08

    This unit is designed to provide sufficient instruction for the setup and execution of tests for object location and object recognition in adult mice. This task is ideally suited for the study of a variety of mouse models that examine disease mechanisms and novel therapeutic targets. By altering several key parameters, the experimenter can investigate short-term or long-term memory and look for either memory impairments or enhancements. Object location and object recognition memory tasks rely on a rodent's innate preference for novelty, and can be conducted sequentially in the same cohort of animals. These two tasks avoid the inherent stress induced with other common measures of rodent memory such as fear conditioning and the Morris water maze. This protocol covers detailed instructions on conducting both tasks, as well as key points concerning data collection, analysis, and interpretation.

  12. The European Association of Urology (EAU) guidelines methodology: a critical evaluation.

    Science.gov (United States)

    Aus, Gunnar; Chapple, Christopher; Hanûs, Tomas; Irani, Jacques; Lobel, Bernard; Loch, Tillmann; Mitropoulos, Dionysios; Parsons, Keith; Plass, Karin; Schmid, Hans-Peter

    2009-11-01

    Guidelines can be produced and written in numerous ways. The aim of the present article is to describe and evaluate the method currently used to produce the European Association of Urology (EAU) guidelines. The methodology is described in detail, compared to other urologic guidelines by members of the EAU Guidelines Office Board. The new methodology is evaluated by the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. The currently used methodology is adapted to the aims and objectives as established by the EAU for their guidelines; wide coverage (essentially all fields of urology) and useful to urologists all over Europe. The frequent updates are easily accessible in a printed and electronic format. The AGREE instrument supports these strong points, but also identifies potentially weak points, such as no patient involvement, no formal validation of the guidelines texts prior to publication, and lack of discussion of organisational barriers and cost implications. The currently used methodology for the production of EAU guidelines fulfils the association's main objectives related to their guidelines, but the texts will benefit from the inclusion of country-specific cost and organisational data. For the practising clinician, these guidelines will help to take science into clinical practice.

  13. 76 FR 24960 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2011-05-03

    ... ``Application Notes'' is amended in Note 3(F) by adding at the end the following: ``(viii) Federal Health Care... captioned ``Application Notes'' is amended in Note 3(A) by adding at the end the following: ``Likewise, a...)''. The Commentary to Sec. 2B1.1 captioned ``Application Notes'' is amended in Note 1 by inserting...

  14. Guideline for stress ulcer prophylaxis in the intensive care unit

    DEFF Research Database (Denmark)

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

    2014-01-01

    critically ill patients in the ICU outside the context of randomized controlled trials (GRADE 1C). No robust evidence supports recommendations for subpopulations in the ICU such as septic, burn, trauma, cardiothoracic or enterally fed patients. However, if SUP is considered clinically indicated in individual...... patients, we suggest using proton pump inhibitors over histamine-2-receptor antagonists (GRADE 2C)....

  15. 75 FR 27387 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2010-05-14

    ... condition or appearance, including physique, may be relevant in determining whether a departure is warranted...; mental and emotional conditions; and physical condition or appearance, including physique, ``may...

  16. 75 FR 54700 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2010-09-08

    ... attempted to bribe, a Federal, State, or local law enforcement official in connection with a drug... if the defendant [was ] convicted of bribing or attempting to bribe][bribed or attempted to bribe] a... witness intimidation, tampered with or destroyed evidence, or otherwise obstructed justice in...

  17. 75 FR 66188 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2010-10-27

    ... subdivision (C)(iii) by striking ``five kilograms of marihuana'' and inserting ``2 grams of cocaine base''; by inserting ``, and the cocaine base is equivalent to 7.142 kilograms of marihuana'' after ``16 kilograms of marihuana''; and by striking ``21'' and inserting ``23.142''. ] The Commentary to Sec. 2D1.1 captioned...

  18. 77 FR 2778 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2012-01-19

    ... harm to the public and the financial markets? If so, how? (C) Mortgage Fraud and Financial Institution... to the issue of harm to the public and financial markets, as raised by each of two directives to the... comment on mortgage fraud and financial institution fraud; and (D) issues for comment on the impact of...

  19. 78 FR 51820 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2013-08-21

    ... any related legislation. (10) Implementation of the Violence Against Women Reauthorization Act of 2013... response to any related legislation. (4) Continuation of its work on economic crimes, including (A) a... defendant's prior conviction (e.g., ``crime of violence,'' ``aggravated felony,'' ``violent felony,''...

  20. 78 FR 36641 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2013-06-18

    ...) to provide to the Commission its views on the Commission's activities and work, including proposed... represented by private practitioners through appointment under the Criminal Justice Act of 1964, within the federal criminal justice system; (2) has significant experience with federal sentencing or...

  1. 77 FR 51110 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2012-08-23

    ... published in the Federal Register. 77 FR 28225 (May 11, 2012). The Commission has made technical and... changes in connection with certain recently promulgated amendments. See 77 FR 28226 (May 11, 2012). The... Marihuana for No Remuneration''.-- 26 Departure Considerations.-- 26(A) Downward Departure Based on...

  2. 75 FR 54699 - Sentencing Guidelines for United States Courts

    Science.gov (United States)

    2010-09-08

    ... Congress warranting a Commission response. (6) Continuation of its review of child pornography offenses and... sentence; (B) a compilation of studies ] on, and analysis of, recidivism by child pornography offenders...

  3. Development of human factors design review guidelines(II)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul [Korea Atomic Energy Research Institute, Taejon (Korea)

    1998-06-01

    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). 11 refs., 2 figs., 2 tabs.

  4. Development of human factors design review guidelines(III)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1999-02-15

    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 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 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 system. Then we will update the guidelines by reviewing the literature related to alarm design published after 1994.

  5. Consumer involvement in dietary guideline development: opinions from European stakeholders.

    Science.gov (United States)

    Brown, Kerry A; Hermoso, Maria; Timotijevic, Lada; Barnett, Julie; Lillegaard, Inger Therese L; Řehůřková, Irena; Larrañaga, Ainhoa; Lončarević-Srmić, Azra; Andersen, Lene Frost; Ruprich, Jiří; Fernández-Celemín, Laura; Raats, Monique M

    2013-05-01

    The involvement of consumers in the development of dietary guidelines has been promoted by national and international bodies. Yet, few best practice guidelines have been established to assist with such involvement. Qualitative semi-structured interviews explored stakeholders' beliefs about consumer involvement in dietary guideline development. Interviews were conducted in six European countries: the Czech Republic, Germany, Norway, Serbia, Spain and the UK. Seventy-seven stakeholders were interviewed. Stakeholders were grouped as government, scientific advisory body, professional and academic, industry or non-government organisations. Response rate ranged from 45 % to 95 %. Thematic analysis was conducted with the assistance of NVivo qualitative software. Analysis identified two main themes: (i) type of consumer involvement and (ii) pros and cons of consumer involvement. Direct consumer involvement (e.g. consumer organisations) in the decision-making process was discussed as a facilitator to guideline communication towards the end of the process. Indirect consumer involvement (e.g. consumer research data) was considered at both the beginning and the end of the process. Cons to consumer involvement included the effect of vested interests on objectivity; consumer disinterest; and complications in terms of time, finance and technical understanding. Pros related to increased credibility and trust in the process. Stakeholders acknowledged benefits to consumer involvement during the development of dietary guidelines, but remained unclear on the advantage of direct contributions to the scientific content of guidelines. In the absence of established best practice, clarity on the type and reasons for consumer involvement would benefit all actors.

  6. EAU guidelines on urinary incontinence.

    Science.gov (United States)

    Thüroff, Joachim W; Abrams, Paul; Andersson, Karl-Erik; Artibani, Walter; Chapple, Christopher R; Drake, Marcus J; Hampel, Christian; Neisius, Andreas; Schröder, Annette; Tubaro, Andrea

    2011-03-01

    The first European Association of Urology (EAU) guidelines on incontinence were published in 2001. These guidelines were periodically updated in past years. The aim of this paper is to present a summary of the 2009 update of the EAU guidelines on urinary incontinence (UI). The EAU working panel was part of the 4th International Consultation on Incontinence (ICI) and, with permission of the ICI, extracted the relevant data. The methodology of the 4th ICI was a comprehensive literature review by international experts and consensus formation. In addition, level of evidence was rated according to a modified Oxford system and grades of recommendation were given accordingly. A full version of the EAU guidelines on urinary incontinence is available as a printed document (extended and short form) and as a CD-ROM from the EAU office or online from the EAU Web site (http://www.uroweb.org/guidelines/online-guidelines/). The extent and invasiveness of assessment of UI depends on severity and/or complexity of symptoms and clinical signs and is different for men, women, frail older persons, children, and patients with neuropathy. At the level of initial management, basic diagnostic tests are applied to exclude an underlying disease or condition such as urinary tract infection. Treatment is mostly conservative (lifestyle interventions, physiotherapy, physical therapy, pharmacotherapy) and is of an empirical nature. At the level of specialised management (when primary therapy failed, diagnosis is unclear, or symptoms and/or signs are complex/severe), more elaborate assessment is generally required, including imaging, endoscopy, and urodynamics. Treatment options include invasive interventions and surgery. Treatment options for UI are rapidly expanding. These EAU guidelines provide ratings of the evidence (guided by evidence-based medicine) and graded recommendations for the appropriate assessment and according treatment options and put them into clinical perspective. Copyright

  7. [EAU Guidelines on Urinary Incontinence].

    Science.gov (United States)

    Thüroff, J W; Abrams, P; Andersson, K-E; Artibani, W; Chapple, C R; Drake, M J; Hampel, C; Neisius, A; Schröder, A; Tubaro, A

    2011-01-01

    The first European Association of Urology (EAU) guidelines on incontinence were published in 2001. These guidelines were periodically updated in past years. The aim of this paper is to present a summary of the 2009 update of the EAU guidelines on urinary incontinence (UI). The EAU working panel was part of the 4th International Consultation on Incontinence (ICI) and, with permission of the ICI, extracted the relevant data. The methodology of the 4th ICI was a comprehensive literature review by international experts and consensus formation. In addition, level of evidence was rated according to a modified Oxford system and grades of recommendation were given accordingly. A full version of the EAU guidelines on urinary incontinence is available as a printed document (extended and short form) and as a CD-ROM from the EAU office or online from the EAU Web site (http://www.uroweb.org/guidelines/online-guidelines/). The extent and invasiveness of assessment of UI depends on severity and/or complexity of symptoms and clinical signs and is different for men, women, frail older persons, children, and patients with neuropathy. At the level of initial management, basic diagnostic tests are applied to exclude an underlying disease or condition such as urinary tract infection. Treatment is mostly conservative (lifestyle interventions, physiotherapy, physical therapy, pharmacotherapy) and is of an empirical nature. At the level of specialised management (when primary therapy failed, diagnosis is unclear, or symptoms and/or signs are complex/severe),more elaborate assessment is generally required, including imaging, endoscopy, and urodynamics. Treatment options include invasive interventions and surgery. Treatment options for UI are rapidly expanding. These EAU guidelines provide ratings of the evidence (guided by evidence-based medicine) and graded recommendations for the appropriate assessment and according treatment options and put them into clinical perspective. Copyright

  8. Implementing Bright Futures guidelines for well-child care in North Carolina.

    Science.gov (United States)

    Foy, Jane Meschan

    2013-01-01

    The Bright Futures guidelines published by the American Academy of Pediatrics offer a comprehensive agenda for improving the health of people from birth to age 21 years. The guidelines are the culmination of a century of multidisciplinary, multiorganizational efforts in the United States to prevent illness and promote health in children and adolescents, and, in turn, the adults they become. Regulations interpreting the Patient Protection and Affordable Care Act (ACA) specifically state that group health plans must, at a minimum, provide coverage for the preventive services recommended in the Bright Futures guidelines. Thus the ACA will be an impetus for implementation of the guidelines. This issue brief describes the genesis, history, and development of the guidelines. In addition, it briefly touches on each of the commentaries and other articles contained in this issue of the NCMJ dedicated to the implementation of Bright Futures guidelines.

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

    Science.gov (United States)

    Guthrie, Joanne F; Smallwood, David M

    2003-12-01

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

  10. GUIDELINES FOR THE BIOREMEDIATION OF OIL-CONTAMINATED SALT MARSHES

    Science.gov (United States)

    The objective of this document is to present a detailed technical guideline for use by spill responders for the cleanup of coastal wetlands contaminated with oil and oil products by using one of the least intrusive approachesbioremediation technology. This manual is a supplem...

  11. How GPs implement clinical guidelines in everyday clinical practice

    DEFF Research Database (Denmark)

    Videbæk Le, Jette; Hansen, Helle P; Riisgaard, Helle

    2015-01-01

    . OBJECTIVE: To investigate how GPs implement clinical guidelines in everyday clinical practice and how implementation approaches differ between practices. METHODS: Individual semi-structured open-ended interviews with seven GPs who were purposefully sampled with regard to gender, age and practice form...

  12. Curriculum Guidelines for Postdoctoral Oral Diagnosis/Oral Medicine.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    The American Association of Dental Schools' Curriculum Guidelines for oral diagnosis and medicine include a definition of the discipline, its interrelationships with other disciplines, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives, and notes on sequencing, faculty, and…

  13. Curricular Guidelines for Dental Hygiene Care for the Handicapped.

    Science.gov (United States)

    Journal of Dental Education, 1984

    1984-01-01

    The American Association of Dental Schools' guidelines for dental hygiene curriculum cover the scope and definitions of care for the handicapped, interrelationships between disciplines and courses, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives, sequencing, faculty, and…

  14. Implementation of locally adapted guidelines on type 2 diabetes

    NARCIS (Netherlands)

    van Bruggen, Rykel; Gorter, Kees J.; Stolk, Roland P.; Verhoeven, Rob P.; Rutten, Guy E. H. M.

    2008-01-01

    Objective. To assess the effects of a facilitator enhanced multifaceted intervention to implement a locally adapted guideline on the shared care for people with type 2 diabetes. Methods. During 1 year a cluster-randomized trial was performed in 30 general practices. In the intervention group, nurse

  15. American Association of Dental Schools Curricular Guidelines for Orthodontics.

    Science.gov (United States)

    Journal of Dental Education, 1980

    1980-01-01

    Guidelines reviewed and approved by the American Association of Dental Schools and sent to the Council on Dental Education in June 1979 are outlined. Educational goals and objectives and sequence of instruction (including growth and development, preclinical orthodontics, and clinical experience) are discussed. (MLW)

  16. Developing evidence-based guidelines for referral for short stature

    NARCIS (Netherlands)

    Grote, F.K.; Dommelen, P. van; Oostdijk, W.; Muinck Keizer-Schrama, S.M.P.F. de; Verkerk, P.H.; Wit, J.M.; Buuren, S. van

    2008-01-01

    Objective: To establish evidence based guidelines for growth monitoring on a population basis. Study design: Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population. Results

  17. Curriculum Guidelines for Periodontics for Dental Hygiene Programs.

    Science.gov (United States)

    Journal of Dental Education, 1986

    1986-01-01

    American Association of Dental Schools guidelines consist of an introduction to the field and its interrelationships with other fields of dental hygiene; an overview of the curriculum; outlines of primary educational goals, prerequisites, and specific content-related and clinical behavioral objectives; and recommendations concerning sequencing,…

  18. conformity to the surviving sepsis campaign international guidelines ...

    African Journals Online (AJOL)

    2010-08-08

    Aug 8, 2010 ... Sepsis is a systemic inflammatory response to presumed or ... humanity, no comprehensive clinical guidelines existed until 2002. ... Objectives:To determine the conformity rate for resuscitation and management bundles for septic ... volume ventilation that may reduce mortality. ... Stress ulcer prophylaxis.

  19. American Association of Dental Schools Curricular Guidelines for Orthodontics.

    Science.gov (United States)

    Journal of Dental Education, 1980

    1980-01-01

    Guidelines reviewed and approved by the American Association of Dental Schools and sent to the Council on Dental Education in June 1979 are outlined. Educational goals and objectives and sequence of instruction (including growth and development, preclinical orthodontics, and clinical experience) are discussed. (MLW)

  20. Assessing the IADC Space Debris Mitigation Guidelines: A Case for Ontology-based Data Management

    Science.gov (United States)

    Walls, R.; Gaylor, D.; Reddy, V.; Furfaro, R.; Jah, M.

    2016-09-01

    As the population of man-made debris orbiting the Earth increases, so does the risk of damaging collisions. The Inter-Agency Space Debris Coordination Committee (IADC) has issued space debris mitigation guidelines including a key recommendation that before mission's end, spacecraft should move far enough from GEO so as not to be an operational hazard to other objects in active missions. It can be extremely difficult to determine if a spacecraft or operator is in compliance with this guideline, as it requires prediction of future actions based upon many data types. Furthermore, there has been no comprehensive assessment of the adequacy or validity of the IADC recommendations. The EU strives for a Code of Conduct in space, the United Nations-Committee On Peaceful Uses of Outer Space (UN-COPUOS) strives for guidelines to ensure the Long Term Sustainability of Space Activities (LTSSA), the FAA is concerned with Space Traffic Management (STM), etc. If rules, policies, guidelines, and laws are put in place, how can any entity know who and what is adhering to them, when we don't even know how to quantify and assess behavior of space objects? The University of Arizona aims to address this salient issue. As part of its new Space Object Behavioral Sciences (SOBS) initiative, the University of Arizona is developing an ontology-based system to support integration, use, and sharing of space domain data. As a first use-case, we will test the system's ability to assess compliance with the IADC recommendation to move beyond GEO at the end of a mission as well as the adequacy and validity of recommendations. We describe the relevant data types gathered for this use-case, present a prototype ontology, and outline methods for combining semantic analysis with astrodynamics modeling. Without loss of generality, we present this method as an approach that will form the foundation of SOBS and be used to address pressing challenges in Space Situational Awareness (SSA), Orbital Safety

  1. 36 CFR 1191.1 - Accessibility guidelines.

    Science.gov (United States)

    2010-07-01

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

  2. 28 CFR 42.306 - Guidelines.

    Science.gov (United States)

    2010-07-01

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

  3. 28 CFR 42.404 - Guidelines.

    Science.gov (United States)

    2010-07-01

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

  4. 7 CFR 622.5 - Guidelines.

    Science.gov (United States)

    2010-01-01

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

  5. 28 CFR 2.36 - Rescission guidelines.

    Science.gov (United States)

    2010-07-01

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

  6. [WHO Surgical Safety Checklist and guideline for safe surgery 2009].

    Science.gov (United States)

    Nishiwaki, Kimitoshi; Ichikawa, Takao

    2014-03-01

    The World Health Organization (WHO) launched the Safe Surgery Saves Lives campaign in 2007 to improve safety of surgical care in the world. As a part of the campaign, the first edition of the Surgical Safety Checklist was created through an international consultative process in 2008 and the second edition was published in the WHO Guidelines for Safe Surgery 2009. The guidelines consist of ten essential objectives for safe surgery, and nine of the ten objectives are facilitated by introducing the surgical checklist in the operating room, which is designed to improve teamwork of the operating room member and to give them chances to use the safety processes consistently. It consists of nineteen check points scheduled to be used in three phases: before anesthesia induction, before any skin incision, and at the end of surgery. In this article we gave an outline of WHO Surgical Safety Checklist and WHO Guidelines for Safe Surgery 2009, and reviewed the evidence of the guidelines and checklist. Finally we presented the evidence indicating the efficacy of the WHO Surgical Safety Checklist, which included the pilot study attached in the guidelines showing that its use markedly decreased complications in patients undergoing noncardiac surgery in eight diverse international hospitals.

  7. Do guidelines on first impression make sense? Implementation of a chest pain guideline in primary care: a systematic evaluation of acceptance and feasibility

    Directory of Open Access Journals (Sweden)

    Kramer Lena

    2011-11-01

    Full Text Available Abstract Background Most guidelines concentrate on investigations, treatment, and monitoring instead of patient history and clinical examination. We developed a guideline that dealt with the different aetiologies of chest pain by emphasizing the patient's history and physical signs. The objective of this study was to evaluate the guideline's acceptance and feasibility in the context of a practice test. Methods The evaluation study was nested in a diagnostic cross-sectional study with 56 General Practitioners (GPs and 862 consecutively recruited patients with chest pain. The evaluation of the guideline was conducted in a mixed method design on a sub-sample of 17 GPs and 282 patients. Physicians' evaluation of the guideline was assessed via standardized questionnaires and case record forms. Additionally, practice nursing staff and selected patients were asked for their evaluation of specific guideline modules. Quantitative data was analyzed descriptively for frequencies, means, and standard deviations. In addition, two focus groups with a total of 10 GPs were held to gain further insights in the guideline implementation process. The data analysis and interpretation followed the standards of the qualitative content analysis. Results The overall evaluation of the GPs participating in the evaluation study regarding the recommendations made in the chest pain guideline was positive. A total of 14 GPs were convinced that there was a need for this kind of guideline and perceived the guideline recommendations as useful. While the long version was partially criticized for a perceived lack of clarity, the short version of the chest pain guideline and the heart score were especially appreciated by the GPs. However, change of clinical behaviour as consequence of the guideline was inconsistent. While on a concrete patient related level, GPs indicated to have behaved as the guideline recommended, the feedback on a more general level was heterogeneous. Several

  8. Selecting a Reference Object

    Science.gov (United States)

    Miller, Jared E.; Carlson, Laura A.; Hill, Patrick L.

    2011-01-01

    One way to describe the location of an object is to relate it to another object. Often there are many nearby objects, each of which could serve as a candidate to be the reference object. A common theoretical assumption is that features that make a given object salient relative to the candidate set are instrumental in determining which is selected.…

  9. Revised dietary guidelines for Koreans.

    Science.gov (United States)

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

    2008-01-01

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

  10. Guidelines for Authors

    Directory of Open Access Journals (Sweden)

    Abdullah Demir

    2016-06-01

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

  11. Guidelines for negotiating social research in communities living adjacent to transboundary protected areas: Kruger National Park

    NARCIS (Netherlands)

    B.N. Tapela (Barbara); B.E. Büscher (Bram); L. Maluleke (Lamson); W.C. Twine (Wayne); C. Steenkamp (Conrad)

    2009-01-01

    textabstractThe objective with these Guidelines is to assist local people and social researchers to negotiate equitable research agreements. This document lays out the purpose of the guidelines, provides some background information about the process that led to this document, and provides some gener

  12. Novel model-based dosing guidelines for gentamicin and tobramycin in preterm and term neonates

    NARCIS (Netherlands)

    P.A.J. Välitalo (Pyry A. J.); J.N. van den Anker (John); K. Allegaert (Karel); R.F.W. de Cock (Roosmarijn); M. de Hoog (Matthijs); S.H. Simons (Sinno); J.W. Mouton (Johan); C.A.J. Knibbe (Catherijne)

    2015-01-01

    textabstractObjectives: In the heterogeneous group of preterm and term neonates, gentamicin and tobramycin are mainly dosed according to empirical guidelines, after which therapeutic drug monitoring and subsequent dose adaptation are applied. In view of the variety of neonatal guidelines available,

  13. 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.; 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

  14. Adherence to the guideline 'Triage in emergency departments': a survey of Dutch emergency departments

    NARCIS (Netherlands)

    Janssen, M.J.; Achterberg, T. van; Adriaansen, M.J.M.; Kampshoff, C.S.; Mintjes-de Groot, J.

    2011-01-01

    AIMS AND OBJECTIVES: The aim of this study was to evaluate the adherence to the 2004 guideline Triage in emergency departments three years after dissemination in Dutch emergency departments. BACKGROUND: In 2004, a Dutch guideline Triage in emergency departments was developed. Triage is the first ste

  15. From Paper to Practice: Barriers to Adopting Nutrition Guidelines in Schools

    Science.gov (United States)

    Downs, Shauna M.; Farmer, Anna; Quintanilha, Maira; Berry, Tanya R.; Mager, Diana R.; Willows, Noreen D.; McCargar, Linda J.

    2012-01-01

    Objective: To explore the barriers associated with the adoption of the Alberta Nutrition Guidelines for Children and Youth in schools according to characteristics of the innovation (guidelines) and the organization (schools). Design: Cross-sectional telephone survey. Setting and Participants: Schools in Alberta, Canada. Principals from 357…

  16. Guidelines versus Practices in Cross-Lingual Assessment: A Disconcerting Disconnect

    Science.gov (United States)

    Rios, Joseph A.; Sireci, Stephen G.

    2014-01-01

    The International Test Commission's "Guidelines for Translating and Adapting Tests" (2010) provide important guidance on developing and evaluating tests for use across languages. These guidelines are widely applauded, but the degree to which they are followed in practice is unknown. The objective of this study was to perform a…

  17. Management of asthma and COPD patients: feasibility of the application of guidelines in general practice.

    NARCIS (Netherlands)

    Jans, M.P.; Schellevis, F.G.; Hensbergen, W. van; Dukkers van Emden, T.; Eijk, J.T.M. van

    1998-01-01

    Objective: To examine the feasibility of the application of guidelines to the management of asthma and chronic obstructive pulmonary disease (COPD) by assessing compliance with the guidelines and listing the barriers general practitioners (GPs) encountered during implementation. Insight into the fea

  18. Guidelines on anaemia : effect on primary-care midwives in The Netherlands

    NARCIS (Netherlands)

    Offerhaus, P; Fleuren, M; Wensing, M

    2005-01-01

    Objective: to assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands. Design: cross-sectional survey study. Setting: primary-care midwifery in The Netherlands. Pa

  19. Guidelines on anaemia: effect on primary-care midwives in The Netherlands.

    NARCIS (Netherlands)

    Offerhaus, P.M.; Fleuren, M.; Wensing, M.J.P.

    2005-01-01

    OBJECTIVE: To assess the adherence and perceived barriers for implementation of a clinical-practice guideline on anaemia, which was the first national guideline for primary-care midwifery in The Netherlands. DESIGN: Cross-sectional survey study. SETTING: Primary-care midwifery in The Netherlands. PA

  20. Economic evaluation of an occupational health care guideline for prevention of weight gain among employees

    NARCIS (Netherlands)

    Wier, M.F. van; Verweij, L.M.; Proper, K.I.; Hulshof, C.T.J.; Tulder, M.W. van; Mechelen, W. van

    2013-01-01

    OBJECTIVE:: To determine the cost-effectiveness and the financial return of a guideline for occupational physicians (OPs), aimed at the prevention of weight gain among employees. METHODS:: The guideline consisted of a company-environment scan and up to five individual sessions with an OP. Sixteen OP

  1. The updated EAU guidelines on muscle-invasive and metastatic bladder cancer.

    NARCIS (Netherlands)

    Stenzl, A.; Cowan, N.C.; Santis, M. de; Jakse, G.; Kuczyk, M.A.; Merseburger, A.S.; Ribal, M.J.; Sherif, A.; Witjes, J.A.

    2009-01-01

    CONTEXT: New data regarding diagnosis and treatment of muscle-invasive and metastatic bladder cancer (MiM-BC) has emerged and led to an update of the European Association of Urology (EAU) guidelines for MiM-BC. OBJECTIVE: To review the new EAU guidelines for MiM-BC. EVIDENCE ACQUISITION: A

  2. Communication guidelines as a learning tool: an exploration of user preferences in general practice

    NARCIS (Netherlands)

    Veldhuijzen, W.; Ram, P.M.; Weijden, T.T. van der; Vleuten, C.P.M. van der

    2013-01-01

    OBJECTIVE: To explore characteristics of written communication guidelines that enhance the success of training aimed at the application of the recommendations in the guidelines. METHODS: Seven mixed focus groups were held consisting of communication skill teachers and communication skill learners an

  3. The effects of a nursing guideline on depression in psychogeriatric nursing home residents with dementia.

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.

    2011-01-01

    OBJECTIVE: To study the effects of introducing a nursing guideline on depression in residents with dementia of psychogeriatric nursing home wards. METHODS: A multi-center controlled clinical trial with randomization at ward level was used to study the effects of the guideline introduction. Nursing t

  4. Dental management of patients using antithrombotic drugs: critical appraisal of existing guidelines

    NARCIS (Netherlands)

    van Diermen, D.E.; Aartman, I.H.A.; Baart, J.A.; Hoogstraten, J.

    2009-01-01

    Objectives The aims were: 1) to identify the guidelines available for management of dental invasive procedures in patients on antithrombotic drugs; 2) to assess their quality with the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument; and 3) to summarize their conclusions and re

  5. Feasibility of a wiki as a participatory tool for patients in clinical guideline development

    NARCIS (Netherlands)

    Breejen, E.M. den; Nelen, W.L.D.M.; Knijnenburg, J.M.; Burgers, J.S.; Hermens, R.P.M.G.; Kremer, J.A.M.

    2012-01-01

    BACKGROUND: Patient participation is essential in developing high-quality guidelines but faces practical challenges. Evidence on timing, methods, evaluations, and outcomes of methodologies for patient participation in guideline development is lacking. OBJECTIVE: To assess the feasibility of a wiki a

  6. National stroke association guidelines for the management of transient ischemic attacks

    NARCIS (Netherlands)

    Johnston, S. Claiborne; Nguyen-Huynh, Mai N.; Schwarz, Miriam E.; Fuller, Kate; Williams, Christina E.; Josephson, S. Andrew

    2006-01-01

    Objective: Transient ischemic attacks are common and important harbingers of subsequent stroke. Management varies widely, and most published guidelines have not been updated in several years. We sought to create comprehensive, unbiased, evidence-based guidelines for the management of patients with t

  7. Development of clinical practice guidelines.

    Science.gov (United States)

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

    2014-01-01

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

  8. Reporting guidelines for modelling studies

    Directory of Open Access Journals (Sweden)

    Bennett Carol

    2012-11-01

    Full Text Available Abstract Background Modelling studies are used widely to help inform decisions about health care and policy and their use is increasing. However, in order for modelling to gain strength as a tool for health policy, it is critical that key model factors are transparent so that users of models can have a clear understanding of the model and its limitations.Reporting guidelines are evidence-based tools that specify minimum criteria for authors to report their research such that readers can both critically appraise and interpret study findings. This study was conducted to determine whether there is an unmet need for population modelling reporting guidelines. Methods We conducted a review of the literature to identify: 1 guidance for reporting population modelling studies; and, 2 evidence on the quality of reporting of population modelling studies. Guidance for reporting was analysed using a thematic approach and the data was summarised as frequencies. Evidence on the quality of reporting was reviewed and summarized descriptively. Results There were no guidelines that specifically addressed the reporting of population modelling studies. We identified a number of reporting guidelines for economic evaluation studies, some of which had sections that were relevant population modelling studies. Amongst seven relevant records, we identified 69 quality criteria that have distinct reporting characteristics. We identified two papers that addressed reporting practices of modelling studies. Overall, with the exception of describing the data used for calibration, there was little consistency in reporting. Conclusions While numerous guidelines exist for developing and evaluating health technology assessment and economic evaluation models, which by extension could be applicable to population modelling studies, there is variation in their comprehensiveness and in the consistency of reporting these methods. Population modelling studies may be an area which would

  9. Dutch Venous Ulcer guideline update.

    Science.gov (United States)

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-01

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates.

  10. Specification of Concurrent Objects

    DEFF Research Database (Denmark)

    Sørensen, Morten U.

    relation over two objects and an event. In the model, objects can be composed by parallel composition, encapsulation, and hiding of operations. Refinement between objects is defined as fair trace inclusion.A specification language is presented where objects can be specified operationally by abstract......Concurrent objects are named concurrent processes that interact by invoking each other's operations. We describe how such concurrent objects can be specified, how objects can be composed, and how it can be shown that one object refines another.First a model is defined, based on a transition...

  11. Clinical imaging guidelines part 2: Risks, benefits, barriers, and solutions.

    Science.gov (United States)

    Malone, James; del Rosario-Perez, Maria; Van Bladel, Lodewijk; Jung, Seung Eun; Holmberg, Ola; Bettmann, Michael A

    2015-02-01

    A recent international meeting was convened by two United Nations bodies to focus on international collaboration on clinical appropriateness/referral guidelines for use in medical imaging. This paper, the second of 4 from this technical meeting, addresses barriers to the successful development/deployment of clinical imaging guidelines and means of overcoming them. It reflects the discussions of the attendees, and the issues identified are treated under 7 headings: ■ Practical Strategy for Development and Deployment of Guidelines; ■ Governance Arrangements and Concerns with Deployment of Guidelines; ■ Finance, Sustainability, Reimbursement, and Related Issues; ■ Identifying Benefits and Radiation Risks from Radiological Examinations; ■ Information Given to Patients and the Public, and Consent Issues; ■ Special Concerns Related to Pregnancy; and ■ The Research Agenda. Examples of topics identified include the observation that guideline development is a global task and there is no case for continuing it as the project of the few professional organizations that have been brave enough to make the long-term commitment required. Advocacy for guidelines should include the expectations that they will facilitate: (1) better health care delivery; (2) lower cost of that delivery; with (3) reduced radiation dose and associated health risks. Radiation protection issues should not be isolated; rather, they should be integrated with the overall health care picture. The type of dose/radiation risk information to be provided with guidelines should include the uncertainty involved and advice on application of the precautionary principle with patients. This principle may be taken as an extension of the well-established medical principle of "first do no harm." Copyright © 2015. Published by Elsevier Inc.

  12. Adherence of Surgeons to Antimicrobial Prophylaxis Guidelines in a Tertiary General Hospital in a Rapidly Developing Country

    Directory of Open Access Journals (Sweden)

    Ahmed Abdel-Aziz

    2013-01-01

    Full Text Available Objectives. To assess the standard practice of care of surgeons regarding surgical antibiotic prophylaxis, to identify gaps, and to set recommendations. Methods. A retrospective analysis of data obtained from different surgical units in a single center in Qatar over a 3-month period in 2012. A total of 101 patients who underwent surgery and followed regimes for surgical prophylaxis as per hospital guidelines were included in the study. Results. The overall use of antibiotic was 89%, whereas the current practice did not match the recommended hospital protocols in 53.5% of cases. Prolonged antibiotics use (59.3% was the commonest reason for nonadherence followed by the use of an alternative antibiotic to that recommended in the protocol (31.5% and no prophylaxis was used in 9.2% of cases. The rate of compliance was significantly higher among clean surgery than clean contaminated group (P=0.03. Forty-four percent of clean and 65% of clean-contaminated procedures showed noncompliance with the recommended surgical antimicrobial prophylaxis hospital guidelines. Conclusion. Lack of adherence to hospital protocols is not uncommon. This finding remains a challenge to encourage clinicians to follow hospital guidelines appropriately and to consistently apply the surgical antibiotic prophylaxis. The role of clinical pharmacist may facilitate this process across all surgical disciplines.

  13. [Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

    Science.gov (United States)

    Birkner, B

    2000-09-01

    The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.

  14. Guidelines for residential commissioning

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-01-31

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

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

    DEFF Research Database (Denmark)

    Kottner, Jan; Audigé, Laurent; Brorson, Stig;

    2011-01-01

    Results of reliability and agreement studies are intended to provide information about the amount of error inherent in any diagnosis, score, or measurement. The level of reliability and agreement among users of scales, instruments, or classifications is widely unknown. Therefore, there is a need...... for rigorously conducted interrater and intrarater reliability and agreement studies. Information about sample selection, study design, and statistical analysis is often incomplete. Because of inadequate reporting, interpretation and synthesis of study results are often difficult. Widely accepted criteria......, standards, or guidelines for reporting reliability and agreement in the health care and medical field are lacking. The objective was to develop guidelines for reporting reliability and agreement studies....

  16. Recommendations for Guidelines for Environment-Specific Magnetic-Field Measurements, Rapid Program Engineering Project #2

    Energy Technology Data Exchange (ETDEWEB)

    Electric Research and Management, Inc.; IIT Research Institute; Magnetic Measurements; Survey Research Center, University of California; T. Dan Bracken, Inc.

    1997-03-11

    The purpose of this project was to document widely applicable methods for characterizing the magnetic fields in a given environment, recognizing the many sources co-existing within that space. The guidelines are designed to allow the reader to follow an efficient process to (1) plan the goals and requirements of a magnetic-field study, (2) develop a study structure and protocol, and (3) document and carry out the plan. These guidelines take the reader first through the process of developing a basic study strategy, then through planning and performing the data collection. Last, the critical factors of data management, analysis reporting, and quality assurance are discussed. The guidelines are structured to allow the researcher to develop a protocol that responds to specific site and project needs. The Research and Public Information Dissemination Program (RAPID) is based on exposure to magnetic fields and the potential health effects. Therefore, the most important focus for these magnetic-field measurement guidelines is relevance to exposure. The assumed objective of an environment-specific measurement is to characterize the environment (given a set of occupants and magnetic-field sources) so that information about the exposure of the occupants may be inferred. Ideally, the researcher seeks to obtain complete or "perfect" information about these magnetic fields, so that personal exposure might also be modeled perfectly. However, complete data collection is not feasible. In fact, it has been made more difficult as the research field has moved to expand the list of field parameters measured, increasing the cost and complexity of performing a measurement and analyzing the data. The guidelines address this issue by guiding the user to design a measurement protocol that will gather the most exposure-relevant information based on the locations of people in relation to the sources. We suggest that the "microenvironment" become the base unit of area in a study, with

  17. A new approach to the identification of Landscape Quality Objectives (LQOs) as a set of indicators.

    Science.gov (United States)

    Sowińska-Świerkosz, Barbara Natalia; Chmielewski, Tadeusz J

    2016-12-15

    The objective of the paper is threefold: (1) to introduce Landscape Quality Objectives (LQOs) as a set of indicators; (2) to present a method of linking social and expert opinion in the process of the formulation of landscape indicators; and (3) to present a methodological framework for the identification of LQOs. The implementation of these goals adopted a six-stage procedure based on the use of landscape units: (1) GIS analysis; (2) classification; (3) social survey; (4) expert value judgement; (5) quality assessment; and (6) guidelines formulation. The essence of the research was the presentation of features that determine landscape quality according to public opinion as a set of indicators. The results showed that 80 such indicators were identified, of both a qualitative (49) and a quantitative character (31). Among the analysed units, 60% (18 objects) featured socially expected (and confirmed by experts) levels of landscape quality, and 20% (6 objects) required overall quality improvement in terms of both public and expert opinion. The adopted procedure provides a new tool for integrating social responsibility into environmental management. The advantage of the presented method is the possibility of its application in the territories of various European countries. It is flexible enough to be based on cartographic studies, landscape research methods, and environmental quality standards existing in a given country. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Automatic object recognition

    Science.gov (United States)

    Ranganath, H. S.; Mcingvale, Pat; Sage, Heinz

    1988-01-01

    Geometric and intensity features are very useful in object recognition. An intensity feature is a measure of contrast between object pixels and background pixels. Geometric features provide shape and size information. A model based approach is presented for computing geometric features. Knowledge about objects and imaging system is used to estimate orientation of objects with respect to the line of sight.

  19. Object oriented methods

    CERN Document Server

    Graham, Ian

    1994-01-01

    This book is a revision of Ian Graham's successful survey of the whole area of object technology. It covers object- oriented programming, object-oriented design, object- oriented analysis, object-oriented databases and treats several related technologies. New to this edition are more applications of object-oriented methods and more coverage of object-oriented database products available. Graham has also doubled the design and analysis material that examines over 60 different approaches - making this the most comprehensive book on the market. Also new is the foreword by Grady Booch.

  20. Comparison of Guidelines on Non-Muscle Invasive Bladder Cancer (EAU, CUA, AUA, NCCN, NICE).

    Science.gov (United States)

    Power, Nicholas E; Izawa, Jonathan

    2016-01-07

    Non-muscle invasive bladder cancer (NMIBC) represents a considerably diverse patient group and the management of this complex disease is debatable. A number of panels from Europe and North America have convened on the topic and recently released guideline documents. The purpose was to compare and contrast the NMIBC guideline recommendations from the EAU (Europe), CUA (Canada), NCCN (United States), AUA (United States), and NICE (United Kingdom). All unabridged guideline documents were reviewed by the authors and comparisons were completed according to major topics in NMIBC. Despite a paucity of high level evidence regarding the majority of management topics in NMIBC, there was general agreement among the various guideline panels. Differences mainly centered on the categories of evidence synthesized and grades of recommendations. Each document offers a unique presentation of the available literature and guideline recommendation. The guidelines for NMIBC from the EAU, CUA, AUA, NCCN, and NICE provide considerable consensus regarding the management of this often difficult disease. Clinicians are encouraged to familiarize themselves with all of the guidelines in order to determine which style of presentation would be most useful to their current practice.