Sample records for acceptance criteria defined

  1. Hanford Site Solid Waste Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1993-11-17

    This manual defines the Hanford Site radioactive, hazardous, and sanitary solid waste acceptance criteria. Criteria in the manual represent a guide for meeting state and federal regulations; DOE Orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to acceptance of radioactive and hazardous solid waste at the Hanford Site. It is not the intent of this manual to be all inclusive of the regulations; rather, it is intended that the manual provide the waste generator with only the requirements that waste must meet in order to be accepted at Hanford Site TSD facilities.

  2. Acceptance criteria for urban dispersion model evaluation

    NASA Astrophysics Data System (ADS)

    Hanna, Steven; Chang, Joseph

    2012-05-01

    The authors suggested acceptance criteria for rural dispersion models' performance measures in this journal in 2004. The current paper suggests modified values of acceptance criteria for urban applications and tests them with tracer data from four urban field experiments. For the arc-maximum concentrations, the fractional bias should have a magnitude <0.67 (i.e., the relative mean bias is less than a factor of 2); the normalized mean-square error should be <6 (i.e., the random scatter is less than about 2.4 times the mean); and the fraction of predictions that are within a factor of two of the observations (FAC2) should be >0.3. For all data paired in space, for which a threshold concentration must always be defined, the normalized absolute difference should be <0.50, when the threshold is three times the instrument's limit of quantification (LOQ). An overall criterion is then applied that the total set of acceptance criteria should be satisfied in at least half of the field experiments. These acceptance criteria are applied to evaluations of the US Department of Defense's Joint Effects Model (JEM) with tracer data from US urban field experiments in Salt Lake City (U2000), Oklahoma City (JU2003), and Manhattan (MSG05 and MID05). JEM includes the SCIPUFF dispersion model with the urban canopy option and the urban dispersion model (UDM) option. In each set of evaluations, three or four likely options are tested for meteorological inputs (e.g., a local building top wind speed, the closest National Weather Service airport observations, or outputs from numerical weather prediction models). It is found that, due to large natural variability in the urban data, there is not a large difference between the performance measures for the two model options and the three or four meteorological input options. The more detailed UDM and the state-of-the-art numerical weather models do provide a slight improvement over the other options. The proposed urban dispersion model acceptance

  3. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION, NEVADA SITE OFFICE

    This document establishes the U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal. Mixed waste generated within the State of Nevada by NNSA/NSO activities is accepted for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Site for storage or disposal.

  4. Nevada Test Site Waste Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

  5. Nevada Test Site Waste Acceptance Criteria (NTSWAC)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NNSA /NSO Waste Management Project

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, Nevada Test Site Waste Acceptance Criteria (NTSWAC). The NTSWAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive (LLW) and LLW Mixed Waste (MW) for disposal.

  6. Sensitivity and Specificity of Polysomnographic Criteria for Defining Insomnia

    PubMed Central

    Edinger, Jack D.; Ulmer, Christi S.; Means, Melanie K.

    2013-01-01

    Study Objectives: In recent years, polysomnography-based eligibility criteria have been increasingly used to identify candidates for insomnia research, and this has been particularly true of studies evaluating pharmacologic therapy for primary insomnia. However, the sensitivity and specificity of PSG for identifying individuals with insomnia is unknown, and there is no consensus on the criteria sets which should be used for participant selection. In the current study, an archival data set was used to test the sensitivity and specificity of PSG measures for identifying individuals with primary insomnia in both home and lab settings. We then evaluated the sensitivity and specificity of the eligibility criteria employed in a number of recent insomnia trials for identifying primary insomnia sufferers in our sample. Design: Archival data analysis. Settings: Study participants' homes and a clinical sleep laboratory. Participants: Adults: 76 with primary insomnia and 78 non-complaining normal sleepers. Measurements and Results: ROC and cross-tabs analyses were used to evaluate the sensitivity and specificity of PSG-derived total sleep time, latency to persistent sleep, wake after sleep onset, and sleep efficiency for discriminating adults with primary insomnia from normal sleepers. None of the individual criteria accurately discriminated PI from normal sleepers, and none of the criteria sets used in recent trials demonstrated acceptable sensitivity and specificity for identifying primary insomnia. Conclusions: The use of quantitative PSG-based selection criteria in insomnia research may exclude many who meet current diagnostic criteria for an insomnia disorder. Citation: Edinger JD; Ulmer CS; Means MK. Sensitivity and specificity of polysomnographic criteria for defining insomnia. J Clin Sleep Med 2013;9(5):481-491. PMID:23674940

  7. Acceptance Criteria Framework for Autonomous Biological Detectors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dzenitis, J M

    2006-12-12

    The purpose of this study was to examine a set of user acceptance criteria for autonomous biological detection systems for application in high-traffic, public facilities. The test case for the acceptance criteria was the Autonomous Pathogen Detection System (APDS) operating in high-traffic facilities in New York City (NYC). However, the acceptance criteria were designed to be generally applicable to other biological detection systems in other locations. For such detection systems, ''users'' will include local authorities (e.g., facility operators, public health officials, and law enforcement personnel) and national authorities [including personnel from the Department of Homeland Security (DHS), the BioWatch Program,more » the Centers for Disease Control and Prevention (CDC), and the Federal Bureau of Investigation (FBI)]. The panel members brought expertise from a broad range of backgrounds to complete this picture. The goals of this document are: (1) To serve as informal guidance for users in considering the benefits and costs of these systems. (2) To serve as informal guidance for developers in understanding the needs of users. In follow-up work, this framework will be used to systematically document the APDS for appropriateness and readiness for use in NYC.« less

  8. Definition of acceptance criteria for the ITER divertor plasma-facing components through systematic experimental analysis

    NASA Astrophysics Data System (ADS)

    Escourbiac, F.; Richou, M.; Guigon, R.; Constans, S.; Durocher, A.; Merola, M.; Schlosser, J.; Riccardi, B.; Grosman, A.

    2009-12-01

    Experience has shown that a critical part of the high-heat flux (HHF) plasma-facing component (PFC) is the armour to heat sink bond. An experimental study was performed in order to define acceptance criteria with regards to thermal hydraulics and fatigue performance of the International Thermonuclear Experimental Reactor (ITER) divertor PFCs. This study, which includes the manufacturing of samples with calibrated artificial defects relevant to the divertor design, is reported in this paper. In particular, it was concluded that defects detectable with non-destructive examination (NDE) techniques appeared to be acceptable during HHF experiments relevant to heat fluxes expected in the ITER divertor. On the basis of these results, a set of acceptance criteria was proposed and applied to the European vertical target medium-size qualification prototype: 98% of the inspected carbon fibre composite (CFC) monoblocks and 100% of tungsten (W) monoblock and flat tiles elements (i.e. 80% of the full units) were declared acceptable.

  9. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA, JUNE 2006

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION NEVADA SITE OFFICE

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

  10. 77 FR 51880 - Requirements for Maintenance of Inspections, Tests, Analyses, and Acceptance Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... Maintenance of Inspections, Tests, Analyses, and Acceptance Criteria AGENCY: Nuclear Regulatory Commission... construction activities through inspections, tests, analyses, and acceptance criteria (ITAAC) under a combined... inspections, tests, or analyses were performed as required, or that acceptance criteria are met, and to notify...

  11. Assessing Professionalism: A Theoretical Framework for Defining Clinical Rotation Assessment Criteria.

    PubMed

    Armitage-Chan, Elizabeth

    Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage "I know it when I see it" is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching.

  12. 46 CFR 28.275 - Acceptance criteria for instructors and course curricula.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Acceptance criteria for instructors and course curricula... the Aleutian Trade § 28.275 Acceptance criteria for instructors and course curricula. (a) A Fishing Vessel Safety Instructor shall submit a detailed course curriculum that relates directly to the...

  13. 46 CFR 28.275 - Acceptance criteria for instructors and course curricula.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Acceptance criteria for instructors and course curricula... the Aleutian Trade § 28.275 Acceptance criteria for instructors and course curricula. (a) A Fishing Vessel Safety Instructor shall submit a detailed course curriculum that relates directly to the...

  14. Objective criteria for acceptability and constancy tests of digital subtraction angiography.

    PubMed

    de las Heras, Hugo; Torres, Ricardo; Fernández-Soto, José Miguel; Vañó, Eliseo

    2016-01-01

    Demonstrate an objective procedure to quantify image quality in digital subtraction angiography (DSA) and suggest thresholds for acceptability and constancy tests. Series of images were obtained in a DSA system simulating a small (paediatric) and a large patient using the dynamic phantom described in the IEC and DIN standards for acceptance tests of DSA equipment. Image quality was quantified using measurements of contrast-to-noise ratio (CNR). Overall scores combining the CNR of 10-100 mg/ml Iodine at a vascular diameter of 1-4 mm in a homogeneous background were defined. Phantom entrance surface air kerma (Ka,e) was measured with an ionisation chamber. The visibility of a low-contrast vessel in DSA images has been identified with a CNR value of 0.50 ± 0.03. Despite using 14 times more Ka,e (8.85 vs 0.63 mGy/image), the protocol for large patients showed a decrease in the overall score CNRsum of 67% (4.21 ± 0.06 vs 2.10 ± 0.05). The uncertainty in the results of the objective method was below 5%. Objective evaluation of DSA images using CNR is feasible with dedicated phantom measurements. An objective methodology has been suggested for acceptance tests compliant with the IEC/DIN standards. The defined overall scores can serve to fix a reproducible baseline for constancy tests, as well as to study the device stability within one acquisition series and compare different imaging protocols. This work provides aspects that have not been included in the recent European guidelines on Criteria for Acceptability of Medical Radiological Equipment. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. Steam generator tube integrity flaw acceptance criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cochet, B.

    1997-02-01

    The author discusses the establishment of a flaw acceptance criteria with respect to flaws in steam generator tubing. The problem is complicated because different countries take different approaches to the problem. The objectives in general are grouped in three broad areas: to avoid the unscheduled shutdown of the reactor during normal operation; to avoid tube bursts; to avoid excessive leak rates in the event of an accidental overpressure event. For each degradation mechanism in the tubes it is necessary to know answers to an array of questions, including: how well does NDT testing perform against this problem; how rapidly doesmore » such degradation develop; how well is this degradation mechanism understood. Based on the above information it is then possible to come up with a policy to look at flaw acceptance. Part of this criteria is a schedule for the frequency of in-service inspection and also a policy for when to plug flawed tubes. The author goes into a broad discussion of each of these points in his paper.« less

  16. Development of quantitative risk acceptance criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Griesmeyer, J. M.; Okrent, D.

    Some of the major considerations for effective management of risk are discussed, with particular emphasis on risks due to nuclear power plant operations. Although there are impacts associated with the rest of the fuel cycle, they are not addressed here. Several previously published proposals for quantitative risk criteria are reviewed. They range from a simple acceptance criterion on individual risk of death to a quantitative risk management framework. The final section discussed some of the problems in the establishment of a framework for the quantitative management of risk.

  17. 78 FR 38411 - Vogtle Electric Generating Plant, Unit 4; Inspections, Tests, Analyses, and Acceptance Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... Plant, Unit 4; Inspections, Tests, Analyses, and Acceptance Criteria AGENCY: Nuclear Regulatory Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  18. Reinforced concrete pipe cracks : acceptance criteria [revised July 29, 2011].

    DOT National Transportation Integrated Search

    2011-07-01

    Inspection of recently placed reinforced concrete pipes often reveals cracks. Florida DOT was in : need of in-place crack acceptance criteria. This project was intended to determine the influential parameters : responsible for crack healing in in-pla...

  19. Can acceptable risk be defined in wildland firefighting?

    Treesearch

    David Clancy

    2011-01-01

    Risk is an ever-present challenge for fire agencies, fire managers, and firefighters, who must ensure that risks are managed at a level that is as low as reasonably practicable. This challenge provides a significant dilemma as there is no one prescriptive method for—or consensus on—defining "acceptable risk" in the field of firefighting....

  20. 40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective...

  1. Defining acceptable levels for ecological indicators: an approach for considering social values.

    PubMed

    Smyth, Robyn L; Watzin, Mary C; Manning, Robert E

    2007-03-01

    Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.

  2. Defining Acceptable Levels for Ecological Indicators: An Approach for Considering Social Values

    NASA Astrophysics Data System (ADS)

    Smyth, Robyn L.; Watzin, Mary C.; Manning, Robert E.

    2007-03-01

    Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.

  3. 40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

  4. 40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

  5. 40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

  6. 40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

  7. 40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

  8. Preliminary operational requirements and acceptability criteria for the cooperative breath analyzer

    DOT National Transportation Integrated Search

    1971-09-01

    This report presents a series of criteria and requirements relevant to establishing user acceptability for the cooperative alcohol analyzer being developed by the Transportation Systems Center. The information presented herein was obtained with the c...

  9. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and material...

  10. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and material...

  11. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and material...

  12. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  13. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  14. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  15. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  16. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  17. 10 CFR 50.46a - Acceptance criteria for reactor coolant system venting systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Acceptance criteria for reactor coolant system venting... criteria for reactor coolant system venting systems. Each nuclear power reactor must be provided with high point vents for the reactor coolant system, for the reactor vessel head, and for other systems required...

  18. 10 CFR 50.46a - Acceptance criteria for reactor coolant system venting systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Acceptance criteria for reactor coolant system venting... criteria for reactor coolant system venting systems. Each nuclear power reactor must be provided with high point vents for the reactor coolant system, for the reactor vessel head, and for other systems required...

  19. Corrosion control acceptance criteria for sacrificial anode type, cathodic protection systems (user guide)

    NASA Astrophysics Data System (ADS)

    Hock, Vincent F.; Noble, Michael; McLeod, Malcolm E.

    1994-07-01

    The Army currently operates and maintains more than 20,000 underground storage tanks and over 3000 miles of underground gas pipelines, all of which require some form of corrosion control. Cathodic protection is one method of corrosion control used to prevent corrosion-induced leaks when a steel structure is exposed to an aggressive soil. The corrosion control acceptance criteria for sacrificial anode type CP systems provides guidelines for the DEH/DPW cathodic protection installation inspectors whose responsibilities are to ensure that the materials and equipment specified are delivered to the job site and subsequently installed in accordance with the engineering drawings and specifications. The sacrificial anode CP acceptance criteria includes all components for the sacrificial anode system such as insulated conductors, anodes, anode backfills, and auxiliary equipment. The sacrificial anode CP acceptance criteria is composed of a checklist that lists each component and that contains a space for the inspector to either check 'yes' or 'no' to indicate whether the component complies with the job specifications. In some cases, the inspector must measure and record physical dimensions or electrical output and compare the measurements to standards shown in attached tables.

  20. Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey.

    PubMed

    Mataix-Cols, D; Fernández de la Cruz, L; Nakao, T; Pertusa, A

    2011-12-01

    The DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested. Obsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual. Altogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80-90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did. The proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

  1. Developing research criteria to define medical necessity in emergency medical services.

    PubMed

    Cone, David C; Schmidt, Terri A; Mann, N Clay; Brown, Lawrence

    2004-01-01

    "The Neely Conference: Developing Research Criteria to Define Medical Necessity in EMS" convened emergency medical services (EMS) physicians, researchers, administrators, providers, and federal agency representatives to begin the development of a set of uniform triage criteria and outcome measures that could be used to study and evaluate medical necessity among EMS patients. These standardized criteria might be used in research studies examining EMS dispatch and response (e.g., dispatch triage protocols, alternative response configurations), and EMS treatment and transport (e.g., field triage protocols, alternative care destinations). The conference process included review and analysis of the literature, expert judgment, and consensus building. There was general agreement on the following: 1. Any dispatch triage or field triage system that is developed must be designed to offer patients alternatives to EMS, not to refuse care to patients. 2. It is theoretically possible to develop a set of clinical criteria for need. Some groups of patients will clearly need a traditional EMS response and other groups will not, but this has yet to be defined. 3. In addition to clinical criteria, certain social and other nonclinical criteria such as pain or potential abuse may be used to justify a response. 4. Communication barriers, patient age, special needs, and other conditions complicate patient assessment but should not exclude patients from consideration for alternate triage or transport. 5. These research questions are important, and standard sets of outcome measures are needed so that different studies and innovative programs can be compared.

  2. Systemic inflammatory response syndrome criteria in defining severe sepsis.

    PubMed

    Kaukonen, Kirsi-Maija; Bailey, Michael; Pilcher, David; Cooper, D Jamie; Bellomo, Rinaldo

    2015-04-23

    The consensus definition of severe sepsis requires suspected or proven infection, organ failure, and signs that meet two or more criteria for the systemic inflammatory response syndrome (SIRS). We aimed to test the sensitivity, face validity, and construct validity of this approach. We studied data from patients from 172 intensive care units in Australia and New Zealand from 2000 through 2013. We identified patients with infection and organ failure and categorized them according to whether they had signs meeting two or more SIRS criteria (SIRS-positive severe sepsis) or less than two SIRS criteria (SIRS-negative severe sepsis). We compared their characteristics and outcomes and assessed them for the presence of a step increase in the risk of death at a threshold of two SIRS criteria. Of 1,171,797 patients, a total of 109,663 had infection and organ failure. Among these, 96,385 patients (87.9%) had SIRS-positive severe sepsis and 13,278 (12.1%) had SIRS-negative severe sepsis. Over a period of 14 years, these groups had similar characteristics and changes in mortality (SIRS-positive group: from 36.1% [829 of 2296 patients] to 18.3% [2037 of 11,119], P<0.001; SIRS-negative group: from 27.7% [100 of 361] to 9.3% [122 of 1315], P<0.001). Moreover, this pattern remained similar after adjustment for baseline characteristics (odds ratio in the SIRS-positive group, 0.96; 95% confidence interval [CI], 0.96 to 0.97; odds ratio in the SIRS-negative group, 0.96; 95% CI, 0.94 to 0.98; P=0.12 for between-group difference). In the adjusted analysis, mortality increased linearly with each additional SIRS criterion (odds ratio for each additional criterion, 1.13; 95% CI, 1.11 to 1.15; P<0.001) without any transitional increase in risk at a threshold of two SIRS criteria. The need for two or more SIRS criteria to define severe sepsis excluded one in eight otherwise similar patients with infection, organ failure, and substantial mortality and failed to define a transition point in

  3. Criteria required for an acceptable point-of-care test for UTI detection: Obtaining consensus using the Delphi technique.

    PubMed

    Weir, Nichola-Jane M; Pattison, Sally H; Kearney, Paddy; Stafford, Bob; Gormley, Gerard J; Crockard, Martin A; Gilpin, Deirdre F; Tunney, Michael M; Hughes, Carmel M

    2018-01-01

    Urinary Tract Infections (UTIs) are common bacterial infections, second only to respiratory tract infections and particularly prevalent within primary care. Conventional detection of UTIs is culture, however, return of results can take between 24 and 72 hours. The introduction of a point of care (POC) test would allow for more timely identification of UTIs, facilitating improved, targeted treatment. This study aimed to obtain consensus on the criteria required for a POC UTI test, to meet patient need within primary care. Criteria for consideration were compiled by the research team. These criteria were validated through a two-round Delphi process, utilising an expert panel of healthcare professionals from across Europe and United States of America. Using web-based questionnaires, panellists recorded their level of agreement with each criterion based on a 5-point Likert Scale, with space for comments. Using median response, interquartile range and comments provided, criteria were accepted/rejected/revised depending on pre-agreed cut-off scores. The first round questionnaire presented thirty-three criteria to the panel, of which 22 were accepted. Consensus was not achieved for the remaining 11 criteria. Following response review, one criterion was removed, while after revision, the remaining 10 criteria entered the second round. Of these, four were subsequently accepted, resulting in 26 criteria considered appropriate for a POC test to detect urinary infections. This study generated an approved set of criteria for a POC test to detect urinary infections. Criteria acceptance and comments provided by the healthcare professionals also supports the development of a multiplex point of care UTI test.

  4. How to pass a sensor acceptance test: using the gap between acceptance criteria and operational performance

    NASA Astrophysics Data System (ADS)

    Bijl, Piet

    2016-10-01

    When acquiring a new imaging system and operational task performance is a critical factor for success, it is necessary to specify minimum acceptance requirements that need to be met using a sensor performance model and/or performance tests. Currently, there exist a variety of models and test from different origin (defense, security, road safety, optometry) and they all do different predictions. This study reviews a number of frequently used methods and shows the effects that small changes in procedure or threshold criteria can have on the outcome of a test. For example, a system may meet the acceptance requirements but not satisfy the needs for the operational task, or the choice of test may determine the rank order of candidate sensors. The goal of the paper is to make people aware of the pitfalls associated with the acquisition process, by i) illustrating potential tricks to have a system accepted that is actually not suited for the operational task, and ii) providing tips to avoid this unwanted situation.

  5. Sample acceptance time criteria, electronic issue and alloimmunisation in thalassaemia.

    PubMed

    Trompeter, S; Baxter, L; McBrearty, M; Zatkya, E; Porter, J

    2015-12-01

    To determine the safety of a 1-week acceptance criteria of sample receipt in laboratory to transfusion commencement in transfusion dependent thalassaemia with respect to alloimmunisation. To determine the safety of electronic issue of blood components in such a setting. Retrospective audit of alloimmunisation (1999-2012) and blood exposure in registered thalassaemia patients at a central London thalassaemia centre where the acceptance criteria for the group and save sample from arrival in the laboratory to the time of issue of blood for transfusion for someone who has been transfused in the last 28 days was 1 week, and there was electronic issue protocol for patients who have always had a negative antibody screen (other than temporary positivity in pregnant women receiving prophylactic anti-D or anti Le-a, Anti Le-b and Anti P1 that are no longer detectable). There were 133 patients with thalassemia variants regularly attending UCLH for review. A total of 105 patients had transfusion dependent thalassaemia (TDT) (7 E-beta thalassaemia, 98 beta thalassaemia major). Ten of the 84 patients who received their transfusions at UCLH were alloimmunised. Seven of them had been alloimmunised prior to arrival at UCLH. Only two patients developed antibodies at UCLH during this period. The prevalence of alloantibody formation of 2% in UCLH transfused patients, with presumptive incidence of 0.01 alloantibodies per 100 units or 0·001 immunisations per person per year compares favourably with other reported series and suggests that 1 week interval with appropriate electronic issue is acceptable practice. © 2015 British Blood Transfusion Society.

  6. Criteria required for an acceptable point-of-care test for UTI detection: Obtaining consensus using the Delphi technique

    PubMed Central

    Kearney, Paddy; Stafford, Bob; Gormley, Gerard J.; Crockard, Martin A.; Gilpin, Deirdre F.

    2018-01-01

    Background Urinary Tract Infections (UTIs) are common bacterial infections, second only to respiratory tract infections and particularly prevalent within primary care. Conventional detection of UTIs is culture, however, return of results can take between 24 and 72 hours. The introduction of a point of care (POC) test would allow for more timely identification of UTIs, facilitating improved, targeted treatment. This study aimed to obtain consensus on the criteria required for a POC UTI test, to meet patient need within primary care. Methods Criteria for consideration were compiled by the research team. These criteria were validated through a two-round Delphi process, utilising an expert panel of healthcare professionals from across Europe and United States of America. Using web-based questionnaires, panellists recorded their level of agreement with each criterion based on a 5-point Likert Scale, with space for comments. Using median response, interquartile range and comments provided, criteria were accepted/rejected/revised depending on pre-agreed cut-off scores. Results The first round questionnaire presented thirty-three criteria to the panel, of which 22 were accepted. Consensus was not achieved for the remaining 11 criteria. Following response review, one criterion was removed, while after revision, the remaining 10 criteria entered the second round. Of these, four were subsequently accepted, resulting in 26 criteria considered appropriate for a POC test to detect urinary infections. Conclusion This study generated an approved set of criteria for a POC test to detect urinary infections. Criteria acceptance and comments provided by the healthcare professionals also supports the development of a multiplex point of care UTI test. PMID:29879161

  7. Defining fire and wilderness objectives: Applying limits of acceptable change

    Treesearch

    David N. Cole

    1995-01-01

    The Limits of Acceptable Change (LAC) planning process was developed to help define objectives for recreation management in wilderness. This process can be applied to fire in wilderness if its conceptual foundation is broadened. LAC would lead decision makers to identify a compromise between the goal of allowing fire to play its natural role in wilderness and various...

  8. 46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Non-standard components; acceptance criteria and procedures. 164.019-7 Section 164.019-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED...) Outer Envelope Fabric (exterior fabrics on wearable PFDs); (ii) Cover Fabric (for throwable PFDs); (iii...

  9. 46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Non-standard components; acceptance criteria and procedures. 164.019-7 Section 164.019-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED...) Outer Envelope Fabric (exterior fabrics on wearable PFDs); (ii) Cover Fabric (for throwable PFDs); (iii...

  10. Safety margins in zircaloy oxidation and embrittlement criteria for emergency core cooling system acceptance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williford, R.E.

    1986-09-01

    Current emergency core cooling system acceptance criteria for light water reactors specify that, under loss-of-coolant accident (LOCA) conditions, the Baker-Just (BJ) correlation must be used to calculate Zircaloy-steam oxidation, calculated peak cladding temperatures (PCT) must not exceed 1204/sup 0/C, and calculated oxidation must not exceed 17% equivalent cladding reacted (ECR). An appropriately defined minimum margin of safety was estimated for each of these criteria. The currently required BJ oxidation correlation provides margins only over the 1100 to 1500/sup 0/C temperature range at the 95% confidence level. The PCT margins for thermal shock and handling failures are adequate at oxidation temperaturesmore » above 1204/sup 0/C for up to 210 and 160 s, respectively, at the 95% confidence level. The ECR thermal shock and handling margins at the 50 and 95% confidence levels, respectively, range between 2 and 7% ECR for the BJ correlation, but vanish at temperatures above 1100 to 1160/sup 0/C for the best-estimate Cathcart-Pawel correlation. However, use of the Cathcart Pawel correlation for ''design basis'' LOCA calculations can be justified at the 85 to 88% confidence level if cooling rate effects can be neglected.« less

  11. What Is Trophoblast? A Combination of Criteria Define Human First-Trimester Trophoblast

    PubMed Central

    Lee, Cheryl Q.E.; Gardner, Lucy; Turco, Margherita; Zhao, Nancy; Murray, Matthew J.; Coleman, Nicholas; Rossant, Janet; Hemberger, Myriam; Moffett, Ashley

    2016-01-01

    Summary Controversy surrounds reports describing the derivation of human trophoblast cells from placentas and embryonic stem cells (ESC), partly due to the difficulty in identifying markers that define cells as belonging to the trophoblast lineage. We have selected criteria that are characteristic of primary first-trimester trophoblast: a set of protein markers, HLA class I profile, methylation of ELF5, and expression of microRNAs (miRNAs) from the chromosome 19 miRNA cluster (C19MC). We tested these criteria on cells previously reported to show some phenotypic characteristics of trophoblast: bone morphogenetic protein (BMP)-treated human ESC and 2102Ep, an embryonal carcinoma cell line. Both cell types only show some, but not all, of the four trophoblast criteria. Thus, BMP-treated human ESC have not fully differentiated to trophoblast. Our study identifies a robust panel, including both protein and non-protein-coding markers that, in combination, can be used to reliably define cells as characteristic of early trophoblast. PMID:26862703

  12. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  13. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  14. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  15. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  16. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  17. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  18. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  19. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  20. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  1. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  2. Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder.

    PubMed

    Silverstein, Brett; Angst, Jules

    2015-01-01

    Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1) The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2) Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetite/weight. (3) Several studies have found atypical depression to be comorbid with headaches, bulimia, and body image issues. (4) Most probands who report atypical depression meet criteria for "somatic depression," defined as depression associated with several of disordered eating, poor body image, headaches, fatigue, and insomnia. The gender difference in prevalence of atypical depression results from its overlap with somatic depression. Somatic depression is associated with psychosocial measures related to gender, linking it with the descriptions of atypical depression as "reactive" appearing in the studies upon which the original criteria for atypical depression were based. Conclusion. Insomnia, disordered eating, poor body image, and aches/pains should be added as criteria for atypical depression matching criteria for somatic depression defining a reactive depressive disorder possibly distinct from endogenous melancholic depression.

  3. Assessment of safety margins in zircaloy oxidation and embrittlement criteria for ECCS acceptance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williford, R.E.

    1986-04-01

    Current Emergency Core Cooling System (ECCS) Acceptance Criteria for light-water reactors include certain requirements pertaining to calculations of core performance during a Loss of Coolant Accident (LOCA). The Baker-Just correlation must be used to calculate Zircaloy-steam oxidation, calculated peak cladding temperatures (PCT) must not exceed 1204/sup 0/C, and calculated oxidation must not exceed 17% equivalent cladding reacted (17% ECR). The minimum margin of safety was estimated for each of these criteria, based on research performed in the last decade. Margins were defined as the amounts of conservatism over and above the expected extreme values computed from the data base atmore » specified confidence levels. The currently required Baker-Just oxidation correlation provides margins only over the 1100/sup 0/C to 1500/sup 0/C temperature range at the 95% confidence level. The PCT margins for thermal shock and handling failures are adequate at oxidation temperatures above 1204/sup 0/C for 210 and 160 seconds, respectively, at the 95% confidence level. ECR thermal shock and handling margins at the 50% and 95% confidence levels, respectively, range between 2% and 7% ECR for the Baker-Just correlation, but vanish at temperatures between 1100/sup 0/C and 1160/sup 0/C for the best-estimate Cathcart-Pawel correlation. Use of the Cathcart-Pawel correlation for LOCA calculations can be justified at the 85% to 88% confidence level if cooling rate effects can be neglected. 75 refs., 21 figs.« less

  4. 40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective... failed engine is an engine whose final test results pursuant to § 90.509(b), for one or more of the...

  5. 40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective... failed engine is an engine whose final test results pursuant to § 90.509(b), for one or more of the...

  6. Safety analysis, risk assessment, and risk acceptance criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jamali, K.; Stack, D.W.; Sullivan, L.H.

    1997-08-01

    This paper discusses a number of topics that relate safety analysis as documented in the Department of Energy (DOE) safety analysis reports (SARs), probabilistic risk assessments (PRA) as characterized primarily in the context of the techniques that have assumed some level of formality in commercial nuclear power plant applications, and risk acceptance criteria as an outgrowth of PRA applications. DOE SARs of interest are those that are prepared for DOE facilities under DOE Order 5480.23 and the implementing guidance in DOE STD-3009-94. It must be noted that the primary area of application for DOE STD-3009 is existing DOE facilities andmore » that certain modifications of the STD-3009 approach are necessary in SARs for new facilities. Moreover, it is the hazard analysis (HA) and accident analysis (AA) portions of these SARs that are relevant to the present discussions. Although PRAs can be qualitative in nature, PRA as used in this paper refers more generally to all quantitative risk assessments and their underlying methods. HA as used in this paper refers more generally to all qualitative risk assessments and their underlying methods that have been in use in hazardous facilities other than nuclear power plants. This discussion includes both quantitative and qualitative risk assessment methods. PRA has been used, improved, developed, and refined since the Reactor Safety Study (WASH-1400) was published in 1975 by the Nuclear Regulatory Commission (NRC). Much debate has ensued since WASH-1400 on exactly what the role of PRA should be in plant design, reactor licensing, `ensuring` plant and process safety, and a large number of other decisions that must be made for potentially hazardous activities. Of particular interest in this area is whether the risks quantified using PRA should be compared with numerical risk acceptance criteria (RACs) to determine whether a facility is `safe.` Use of RACs requires quantitative estimates of consequence frequency and magnitude.« less

  7. Defining Clinical Response Criteria and Early Response Criteria for Precision Oncology: Current State-of-the-Art and Future Perspectives.

    PubMed

    Subbiah, Vivek; Chuang, Hubert H; Gambhire, Dhiraj; Kairemo, Kalevi

    2017-02-15

    In this era of precision oncology, there has been an exponential growth in the armamentarium of genomically targeted therapies and immunotherapies. Evaluating early responses to precision therapy is essential for "go" versus "no go" decisions for these molecularly targeted drugs and agents that arm the immune system. Many different response assessment criteria exist for use in solid tumors and lymphomas. We reviewed the literature using the Medline/PubMed database for keywords "response assessment" and various known response assessment criteria published up to 2016. In this article we review the commonly used response assessment criteria. We present a decision tree to facilitate selection of appropriate criteria. We also suggest methods for standardization of various response assessment criteria. The relevant response assessment criteria were further studied for rational of development, key features, proposed use and acceptance by various entities. We also discuss early response evaluation and provide specific case studies of early response to targeted therapy. With high-throughput, advanced computing programs and digital data-mining it is now possible to acquire vast amount of high quality imaging data opening up a new field of "omics in radiology"-radiomics that complements genomics for personalized medicine. Radiomics is rapidly evolving and is still in the research arena. This cutting-edge technology is poised to move soon to the mainstream clinical arena. Novel agents with new mechanisms of action require advanced molecular imaging as imaging biomarkers. There is an urgent need for development of standardized early response assessment criteria for evaluation of response to precision therapy.

  8. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  9. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  10. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  11. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results pursuant to...

  12. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  13. 78 FR 65007 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 3

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 052-00026; NRC-2008-0252] Inspections, Tests, Analyses... Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  14. 78 FR 53484 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 4

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 052-00026; NRC-2008-0252] Inspections, Tests, Analyses... Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria (ITAAC) completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  15. 78 FR 53483 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 3

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 052-00025; NRC-2008-0252] Inspections, Tests, Analyses... Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria (ITAAC) completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  16. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... What controls and acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining...

  17. Parents' "Hard" Knowledge of Admission Criteria and Acceptance in Philadelphia's High School Choice Process

    ERIC Educational Resources Information Center

    Haxton, Clarisse L.; Neild, Ruth Curran

    2012-01-01

    We examine parents' knowledge of discrete, verifiable facts--what we call "hard knowledge"--in a high school application process. Using parent survey data (n = 658) from the School District of Philadelphia, this study examines whether parents knew the admission criteria and acceptance rate at the high school they most wanted their child…

  18. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  19. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  20. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  1. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  2. Expanded criteria donor kidneys for younger recipients: acceptable outcomes.

    PubMed

    Goplani, K R; Kute, V B; Vanikar, A V; Shah, P R; Gumber, M R; Patel, H V; Modi, P R; Trivedi, H L

    2010-12-01

    European senior programme (ESP) is well known for acceptable outcomes using expanded criteria donor (ECD) kidneys from donors older than 65 years for recipients older than 65 years. The incidence of end-stage renal disease (ESRD) is 229/million in India with a mean age of 45 years. We performed a retrospective analysis of transplantation of ECD versus standard criteria donor (SCD) kidneys into younger recipients. Forty-three ECD transplantations among 158 deceased donor organ transplantation (DDOT) were performed between January 2006 and December 2009. Among 43 transplantation from 30 donors, 14 were dual kidney transplantations (DKT) performed based upon biopsy evaluation. All recipients received thymoglobulin (rATG) induction followed by immunosuppression with a steroid, mycophenolate mofetil (MMF), and a calcineurin inhibitor. Statistical analysis used chi-square test and unpaired Student t test. Kaplan-Meier curves were used for survival analysis. For ECD the mean donor age was 64 ± 11 years. Cerebrovascular accidents (CVA) were the cause of death among 60% of donors, 73.13% of whom were hypertensive and 23.13% diabetic. Mean DKT donor age was 75 ± 9.17 years versus 60 ± 8.0 years for single kidney transplantation (SKT). Mean recipient age of DKT versus SKT was 44 ± 12.4 years versus 43 ± 14 years. Mean serum creatinine (SCr; mg/dL) of SKT patients was 1.64 ± 0.75 versus 1.68 ± 0.46 in DKT. Mean follow-up was 455 ± 352 days. Mean SCr of 43 ECD recipients of mean age, 43.4 ± 14.2 years was 1.61 ± 0.61 mg/dL. Among 43 recipients, 23.25% were diabetic, 41.86% displayed delayed graft function (DGF), and 23.25% experienced biopsy-proven acute rejection (BPAR). Patient survival rate was 72.09% and graft survival rate was 67.44%. For SCD transplantations (n = 115), the mean donor age was 36 ± 14 years and recipient mean age was 32.8 ± 14.07 years. Mean SCr was 1.32 ± 0.46 mg/dL with 26.95% recipients displaying DGF, whereas 20.86% had BPAR. In the SCD

  3. La composition academique: les limites de l'acceptabilite (Composition for Academic Purposes: Criteria for Acceptability).

    ERIC Educational Resources Information Center

    Grenall, G. M.

    1981-01-01

    Examines the pedagogical approaches and problems attendant to the development of English writing programs for foreign students. Discusses the skills necessary to handle course work, such as essay tests, term papers and reports, theses and dissertations, and focuses particularly on diagnostic problems and acceptability criteria. Societe Nouvelle…

  4. Preliminary Mark-18A (Mk-18A) Target Material Recovery Program Product Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Robinson, Sharon M.; Patton, Bradley D.

    2016-09-01

    The Mk-18A Target Material Recovery Program (MTMRP) was established in 2015 to preserve the unique materials, e.g. 244Pu, in 65 previously irradiated Mk-18A targets for future use. This program utilizes existing capabilities at SRS and Savannah River National Laboratory (SRNL) to process targets, recover materials from them, and to package the recovered materials for shipping to ORNL. It also utilizes existing capabilities at ORNL to receive and store the recovered materials, and to provide any additional processing of the recovered materials or residuals required to prepare them for future beneficial use. The MTMRP is presently preparing for the processing ofmore » these valuable targets which is expected to begin in ~2019. As part of the preparations for operations, this report documents the preliminary acceptance criteria for the plutonium and heavy curium materials to be recovered from the Mk-18A targets at SRNL for transport and storage at ORNL. These acceptance criteria were developed based on preliminary concepts developed for processing, transporting, and storing the recovered Mk-18A materials. They will need to be refined as these concepts are developed in more detail.« less

  5. 40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES Selective Enforcement Auditing § 89.510...

  6. Defining criteria for good environmental journalism and testing their applicability: An environmental news review as a first step to more evidence based environmental science reporting.

    PubMed

    Rögener, Wiebke; Wormer, Holger

    2017-05-01

    While the quality of environmental science journalism has been the subject of much debate, a widely accepted benchmark to assess the quality of coverage of environmental topics is missing so far. Therefore, we have developed a set of defined criteria of environmental reporting. This instrument and its applicability are tested in a newly established monitoring project for the assessment of pieces on environmental issues, which refer to scientific sources and therefore can be regarded as a special field of science journalism. The quality is assessed in a kind of journalistic peer review. We describe the systematic development of criteria, which might also be a model procedure for other fields of science reporting. Furthermore, we present results from the monitoring of 50 environmental reports in German media. According to these preliminary data, the lack of context and the deficient elucidation of the evidence pose major problems in environmental reporting.

  7. Data Acceptance Criteria for Standardized Human-Associated Fecal Source Identification Quantitative Real-Time PCR Methods.

    PubMed

    Shanks, Orin C; Kelty, Catherine A; Oshiro, Robin; Haugland, Richard A; Madi, Tania; Brooks, Lauren; Field, Katharine G; Sivaganesan, Mano

    2016-05-01

    There is growing interest in the application of human-associated fecal source identification quantitative real-time PCR (qPCR) technologies for water quality management. The transition from a research tool to a standardized protocol requires a high degree of confidence in data quality across laboratories. Data quality is typically determined through a series of specifications that ensure good experimental practice and the absence of bias in the results due to DNA isolation and amplification interferences. However, there is currently a lack of consensus on how best to evaluate and interpret human fecal source identification qPCR experiments. This is, in part, due to the lack of standardized protocols and information on interlaboratory variability under conditions for data acceptance. The aim of this study is to provide users and reviewers with a complete series of conditions for data acceptance derived from a multiple laboratory data set using standardized procedures. To establish these benchmarks, data from HF183/BacR287 and HumM2 human-associated qPCR methods were generated across 14 laboratories. Each laboratory followed a standardized protocol utilizing the same lot of reference DNA materials, DNA isolation kits, amplification reagents, and test samples to generate comparable data. After removal of outliers, a nested analysis of variance (ANOVA) was used to establish proficiency metrics that include lab-to-lab, replicate testing within a lab, and random error for amplification inhibition and sample processing controls. Other data acceptance measurements included extraneous DNA contamination assessments (no-template and extraction blank controls) and calibration model performance (correlation coefficient, amplification efficiency, and lower limit of quantification). To demonstrate the implementation of the proposed standardized protocols and data acceptance criteria, comparable data from two additional laboratories were reviewed. The data acceptance criteria

  8. Proposed GTA welding specification and acceptance criteria for the MC4163

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kwiatkowski, J.J.

    1991-04-12

    This specification documents the gas tungsten arc (GTA) welding process and production weld acceptance criteria requirements for the MC4163. This document is written specifically to apply to the welds on the MC4163 and is not to be used as a general gas tungsten arc welding specification. All sections of this specification must be complied with unless specifically exempted in writing. There are a total of five welds with three different joint designs required to fabricate the MC4163. In the order of fabrication they are (1) initiator closure disc, (2) nozzle to case girth welds, two and, (3) nozzle closure discmore » welds, two. This specification will only address the nozzle to case girth welds and the nozzle closure disc welds.« less

  9. Periodic benefit-risk assessment using Bayesian stochastic multi-criteria acceptability analysis

    PubMed Central

    Li, Kan; Yuan, Shuai Sammy; Wang, William; Wan, Shuyan Sabrina; Ceesay, Paulette; Heyse, Joseph F.; Mt-Isa, Shahrul; Luo, Sheng

    2018-01-01

    Benefit-risk (BR) assessment is essential to ensure the best decisions are made for a medical product in the clinical development process, regulatory marketing authorization, post-market surveillance, and coverage and reimbursement decisions. One challenge of BR assessment in practice is that the benefit and risk profile may keep evolving while new evidence is accumulating. Regulators and the International Conference on Harmonization (ICH) recommend performing periodic benefit-risk evaluation report (PBRER) through the product's lifecycle. In this paper, we propose a general statistical framework for periodic benefit-risk assessment, in which Bayesian meta-analysis and stochastic multi-criteria acceptability analysis (SMAA) will be combined to synthesize the accumulating evidence. The proposed approach allows us to compare the acceptability of different drugs dynamically and effectively and accounts for the uncertainty of clinical measurements and imprecise or incomplete preference information of decision makers. We apply our approaches to two real examples in a post-hoc way for illustration purpose. The proposed method may easily be modified for other pre and post market settings, and thus be an important complement to the current structured benefit-risk assessment (sBRA) framework to improve the transparent and consistency of the decision-making process. PMID:29505866

  10. Periodic benefit-risk assessment using Bayesian stochastic multi-criteria acceptability analysis.

    PubMed

    Li, Kan; Yuan, Shuai Sammy; Wang, William; Wan, Shuyan Sabrina; Ceesay, Paulette; Heyse, Joseph F; Mt-Isa, Shahrul; Luo, Sheng

    2018-04-01

    Benefit-risk (BR) assessment is essential to ensure the best decisions are made for a medical product in the clinical development process, regulatory marketing authorization, post-market surveillance, and coverage and reimbursement decisions. One challenge of BR assessment in practice is that the benefit and risk profile may keep evolving while new evidence is accumulating. Regulators and the International Conference on Harmonization (ICH) recommend performing periodic benefit-risk evaluation report (PBRER) through the product's lifecycle. In this paper, we propose a general statistical framework for periodic benefit-risk assessment, in which Bayesian meta-analysis and stochastic multi-criteria acceptability analysis (SMAA) will be combined to synthesize the accumulating evidence. The proposed approach allows us to compare the acceptability of different drugs dynamically and effectively and accounts for the uncertainty of clinical measurements and imprecise or incomplete preference information of decision makers. We apply our approaches to two real examples in a post-hoc way for illustration purpose. The proposed method may easily be modified for other pre and post market settings, and thus be an important complement to the current structured benefit-risk assessment (sBRA) framework to improve the transparent and consistency of the decision-making process. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. USGS to accept private funds

    NASA Astrophysics Data System (ADS)

    The U.S. Geological Survey (USGS), the federal government's largest earth science research agency, is now authorized to accept contributions from private sources and to collaborate with such sources in projects that support the agency's scientific research and its development of technology and data systems.Before the USGS can accept outside contributions, however, the proposed project must be deemed to be in the public interest and must be deemed compatible with the basic USGS mission. Among the responsibilities of the USGS, are assessing the nation's land, water, energy, and mineral resources and developing methods to define and mitigate hazards associated with earthquakes, volcanic eruptions, and landslides. Details on criteria and procedures for making contributions and entering into collaborative projects are outlined in the June 2 Federal Register.

  12. SU-E-T-60: A Plan Quality Index in IMRT QA That Is Independent of the Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, D; Kang, S; Kim, T

    2015-06-15

    Purpose: In IMRT QA, plan quality evaluation is made based on pass rate under preset acceptance criteria, mostly using gamma-values. This method is convenient but, its Result highly depends on what the acceptance criteria are and suffers from the lack of sensitivity in judging how good the plan is. In this study, we introduced a simple but effective plan quality index of IMRT QA based on dose difference only to supplement such shortcomings, and investigated its validity. Methods: The proposed index is a single value which is calculated mainly based on point-by-point comparison between planned and measured dose distributions, andmore » it becomes “1” in an ideal case. A systematic evaluation was performed with one-dimensional test dose distributions. For 3 hypothetical dose profiles, various displacements (in both dose and space) were introduced, the proposed index was calculated for each case, and the behavior of obtained indices was analyzed and compared with that of gamma evaluation. In addition, the feasibility of the index was assessed with clinical IMRT/VMAT/SBRT QA cases for different sites (prostate, head & neck, liver, lung, spine, and abdomen). Results: The proposed index showed more robust correlation with the amount of induced displacement compared to the gamma evaluation method. No matter what the acceptance criteria are (e.g., whether 3%/3mm or 2%/2mm), it was possible to clearly rank every case with the proposed index while it was difficult to do with the gamma evaluation method. Conclusion: IMRT plan quality can be evaluated quantitatively by the proposed index. It is considered that the proposed index would provide useful information for better judging the level of goodness of each plan and its Result is independent of the acceptance criteria. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded

  13. Acceptability and Efficacy of Locally Produced Ready-to-Use Therapeutic Food Nutreal in the Management of Severe Acute Malnutrition in Comparison With Defined Food.

    PubMed

    Thapa, Babu Ram; Goyal, Pooja; Menon, Jagadeesh; Sharma, Ajay

    2017-01-01

    Severe acute malnutrition (SAM) is a salient health problem in India. Federation of Indian Chamber of Commerce and Industry (FICCI) Research and Analysis Centre, New Delhi, prepared nutreal equivalent to ready-to-use therapeutic food by World Health Organization (WHO) for the management of SAM and defined food like homemade diet. To compare acceptability and efficacy of nutreal over defined food for the management of SAM. One hundred twelve children aged less than 5 years with SAM were enrolled as per the standard of WHO. Children were randomized into 2 groups to receive nutreal (n = 56) and defined food (n = 56) in unlimited amounts for 42 consecutive days and extended by 2 weeks as per demand. Calorie and protein intake, weight, and mid-upper arm circumference (MUAC) were recorded daily. Age range was 8 to 45 months. Ninety-three percent of children eagerly accepted nutreal but 7% does not. Whereas in the defined food group, 68% accepted eagerly, 30% did not accept eagerly, and 1.8% accepted poorly ( P = .004). At enrollment, mean weight in the nutreal group was 6.44 ± 1.60 kg and in the defined food group was 8.69 ± 1.76 kg, with MUAC in the nutreal group being 11.12 ± 0.47 cm and in the defined food group being 11.54 ± 0.34 cm. Mean weight in the nutreal and defined food groups at eighth week of intervention was 7.97 ± 1.8 kg and 9.71 ± 1.8 kg ( P < .001), respectively. Mid-upper arm circumference at eighth week was 12.10 ± 0.29 cm in the nutreal group and 12.49 ± 0.50 cm in the defined group ( P < .001). Acceptability, mean weight gain, and MUAC in the nutreal group are greater than the defined food.

  14. Improving Estimates of Acceptable Growiing Stock in Young Upland Oak Forests in the Missouri Ozarks

    Treesearch

    Daniel C. Dey; Paul S. Johnson; H.E. Garrett

    1998-01-01

    Estimates of regeneration or growing stock in young oak forests may be too high unless criteria are established that define explicitly acceptable growing stock. In young hardwood stands, crown class can be used to identify acceptable growing stock because it is related to the future growth and survival of reproduction. A method is presented for assigning crown class...

  15. The challenge of defining risk-based metrics to improve food safety: inputs from the BASELINE project.

    PubMed

    Manfreda, Gerardo; De Cesare, Alessandra

    2014-08-01

    In 2002, the Regulation (EC) 178 of the European Parliament and of the Council states that, in order to achieve the general objective of a high level of protection of human health and life, food law shall be based on risk analysis. However, the Commission Regulation No 2073/2005 on microbiological criteria for foodstuffs requires that food business operators ensure that foodstuffs comply with the relevant microbiological criteria. Such criteria define the acceptability of a product, a batch of foodstuffs or a process, based on the absence, presence or number of micro-organisms, and/or on the quantity of their toxins/metabolites, per unit(s) of mass, volume, area or batch. The same Regulation describes a food safety criterion as a mean to define the acceptability of a product or a batch of foodstuff applicable to products placed on the market; moreover, it states a process hygiene criterion as a mean indicating the acceptable functioning of the production process. Both food safety criteria and process hygiene criteria are not based on risk analysis. On the contrary, the metrics formulated by the Codex Alimentarius Commission in 2004, named Food Safety Objective (FSO) and Performance Objective (PO), are risk-based and fit the indications of Regulation 178/2002. The main aims of this review are to illustrate the key differences between microbiological criteria and the risk-based metrics defined by the Codex Alimentarius Commission and to explore the opportunity and also the possibility to implement future European Regulations including PO and FSO as supporting parameters to microbiological criteria. This review clarifies also the implications of defining an appropriate level of human protection, how to establish FSO and PO and how to implement them in practice linked to each other through quantitative risk assessment models. The contents of this review should clarify the context for application of the results collected during the EU funded project named BASELINE (www

  16. 46 CFR 12.03-1 - Coast Guard-accepted training other than approved courses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Guard-accepted training other than approved courses. (a) When the training and assessment of competence... assessment must meet the following requirements: (1) The training and assessment must have written, clearly defined objectives that emphasize specific knowledge, skills, and abilities, and that include criteria to...

  17. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  18. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  19. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  20. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  1. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  2. Industry Application Emergency Core Cooling System Cladding Acceptance Criteria Early Demonstration

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Szilard, Ronaldo H.; Youngblood, Robert W.; Zhang, Hongbin

    2015-09-01

    The U. S. NRC is currently proposing rulemaking designated as “10 CFR 50.46c” to revise the loss-of-coolant-accident (LOCA)/emergency core cooling system (ECCS) acceptance criteria to include the effects of higher burnup on cladding performance as well as to address other technical issues. The NRC is also currently resolving the public comments with the final rule expected to be issued in April 2016. The impact of the final 50.46c rule on the industry may involve updating of fuel vendor LOCA evaluation models, NRC review and approval, and licensee submittal of new LOCA evaluations or re-analyses and associated technical specification revisions formore » NRC review and approval. The rule implementation process, both industry and NRC activities, is expected to take 4-6 years following the rule effective date. As motivated by the new rule, the need to use advanced cladding designs may be a result. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee cost as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. Consequently, there will be an increased focus on licensee decision making related to LOCA analysis to minimize cost and impact, and to manage margin. The proposed rule would apply to a light water reactor and to all cladding types.« less

  3. [Criteria for the classification as a "domestic-setting corpse"--a literature search and review to define the term].

    PubMed

    Merz, Marius; Birngruber, Christoph G; Heidorn, Frank; Ramsthaler, Frank; Risse, Manfred; Kreutz, Kerstin; Krähahn, Jonathan; Verhoff, Marcel A

    2011-01-01

    In German medical and media circles (daily routine, specialist literature, press, novels), the term "domestic-setting corpse" is frequently used, but the term is only vaguely defined. The authors thus decided to perform an in-depth study of the literature, including historic textbooks and all German- and English-language medicolegal journals, going as far back as their first issues, in an attempt to more clearly define the term. Inclusion criteria used in the search were a post-mortem interval of at least 24 hours prior to discovery and discovery of the corpse in a domestic setting. In the literature, 37 cases that complied with the above-mentioned inclusion criteria were found. These cases frequently described "advanced decomposition", often "unclear cause of death" and "problems in identification". These characteristics can thus be considered as being additional pointers in the definition. However, we suggest that the two general defining characteristics of a "domestic-setting corpse" are a post-mortem interval of more than 24 hours before discovery and the discovery of the corpse in a domestic setting.

  4. [Organization of socially acceptable working hours in nursing].

    PubMed

    Büssing, A; Glaser, J

    1994-05-01

    Three dimensions in the structure of the working hour system of nurses, rendering them socially acceptable, are becoming important: duration of the working day, the time of day which is being worked and the distribution of working hours. The latter two are of particular importance because flexible shift is becoming the dominant pattern in nursing. Six indicators are discussed as criteria for social acceptability: security of employment which includes access to the labour-market, level of income, health, opportunity for social relationships, social participation, and autonomy. Responses of 297 nurses in one General Hospital taking part in a study, were analysed to examine empirically the concept of 'socially acceptable structure of the working hours'. Ideal and factual patterns are considered first. Secondly aspects of autonomy are considered and the way this depends on time, thirdly the criteria used to define 'social acceptability' are examined for validity. Results show firstly the cross contrast between the hospital's expectation and the nurses' wishes with regard to working hours. Furthermore, inspite of the demand for flexibility, staff have very little choice and there is little sign of joint decision making. Thirdly results show that health, interpersonal and social aspects are of special importance and that, correspondingly, in the view of nurses, financial and practical problems are of lesser importance in their every day life.

  5. Non Destructive Test Dye Penetrant and Ultrasonic on Welding SMAW Butt Joint with Acceptance Criteria ASME Standard

    NASA Astrophysics Data System (ADS)

    Endramawan, T.; Sifa, A.

    2018-02-01

    The purpose of this research is to know the type of discontinuity of SMAW welding result and to determine acceptance criteria based on American Society of Mechanical Engineer (ASME) standard. Material used is mild steel 98,71% Fe and 0,212% C with hardness 230 VHN with specimen diameter 20 cm and thickness 1.2 cm which is welded use SMAW butt joint with electrode for rooting LB 52U diameter 2.6 mm, current 70 Ampere and voltage 380 volt, filler used LB 5218 electrode diameter 3.2 mm with current 80 Ampere and 380 volt. The method used to analyze the welded with non destructive test dye penetrant (PT) method to see indication on the surface of the object and Ultrasonic (UT) to see indication on the sub and inner the surface of the object, the result is discontinuity recorded and analyzed and then the discontinuity is determine acceptance criteria based on the American Society of Mechanical Engineer (ASME) standards. The result show the discontinuity of porosity on the surface of the welded and inclusion on sub material used ultrasonic test, all indication on dye penetrant or ultrasonic test if there were rejected of result of welded that there must be gouging on part which rejected and then re-welding.

  6. Defining quality criteria for online continuing medical education modules using modified nominal group technique.

    PubMed

    Shortt, S E D; Guillemette, Jean-Marc; Duncan, Anne Marie; Kirby, Frances

    2010-01-01

    The rapid increase in the use of the Internet for continuing education by physicians suggests the need to define quality criteria for accredited online modules. Continuing medical education (CME) directors from Canadian medical schools and academic researchers participated in a consensus process, Modified Nominal Group Technique, to develop agreement on the most important quality criteria to guide module development. Rankings were compared to responses to a survey of a subset of Canadian Medical Association (CMA) members. A list of 17 items was developed, of which 10 were deemed by experts to be important and 7 were considered secondary. A quality module would: be needs-based; presented in a clinical format; utilize evidence-based information; permit interaction with content and experts; facilitate and attempt to document practice change; be accessible for later review; and include a robust course evaluation. There was less agreement among CMA members on criteria ranking, with consensus on ranking reached on only 12 of 17 items. In contrast to experts, members agreed that the need to assess performance change as a result of an educational experience was not important. This project identified 10 quality criteria for accredited online CME modules that representatives of Canadian organizations involved in continuing education believe should be taken into account when developing learning products. The lack of practitioner support for documentation of change in clinical behavior may suggest that they favor traditional attendance- or completion-based CME; this finding requires further research.

  7. Clinical outcome comparison of patients with septic shock defined by the new sepsis-3 criteria and by previous criteria

    PubMed Central

    Ryoo, Seung Mok; Kang, Gu Hyun; Shin, Tae Gun; Hwang, Sung Yeon; Kim, Kyuseok; Jo, You Hwan; Park, Yoo Seok; Choi, Sung-Hyuk; Yoon, Young Hoon; Kwon, Woon Yong; Suh, Gil Joon; Lim, Tae Ho; Han, Kap Su; Choi, Han Sung; Chung, Sung Phil

    2018-01-01

    Background We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected. The patients were divided into a sepsis-3 defined septic shock group, made up of those who met the new criteria for refractory hypotension with hyperlactatemia, and a group of those who met only the 1991 definition for septic shock. The primary outcome was 90-day mortality, and secondary outcomes were 28-day mortality and in-hospital mortality. Results Of all 1,028 included patients, 574 (55.8%) met the septic shock criteria for sepsis-3, leaving 454 patients who met only the previous definition. Those who met the sepsis-3 criteria demonstrated higher comorbidity than those who met the previous definition (83.1% vs. 75.3%, P<0.01), but there was no difference in infection focus. The sequential organ failure assessment (SOFA) (initial/maximal), the acute physiology, and the chronic health evaluation II scores were significantly higher in for those who met the sepsis-3 criteria [6.5±3.1 vs. 5.0±2.9, 9.3±3.8 vs. 6.6±3.4, and 20.0 (15.0–26.0) vs. 15.0 (10.0–20.3), respectively; P<0.01]. The 90-day mortality was significantly higher in the sepsis-3 group (32.1% vs. 23.3%; P<0.01). In-hospital and 28-day mortality were also higher in the sepsis-3 group (26.8% vs. 17.1% and 25.1% vs. 16.5%, respectively; P<0.01). Conclusions The new definition of septic shock successfully selected patients with greater severities and worse outcomes. PMID:29607156

  8. Needed: Guidelines for defining acceptable advance regeneration

    Treesearch

    Dennis E. Ferguson

    1984-01-01

    Advance regeneration is an important component in many stands scheduled for harvesting. Properly managed, such regeneration can contribute to a healthy, new stand, but too often trees do not quickly respond to the new environment or take too long to adjust. Definitions of acceptable advance regeneration are needed for pre- and postharvest inventories. The author...

  9. Quality by design for herbal drugs: a feedforward control strategy and an approach to define the acceptable ranges of critical quality attributes.

    PubMed

    Yan, Binjun; Li, Yao; Guo, Zhengtai; Qu, Haibin

    2014-01-01

    The concept of quality by design (QbD) has been widely accepted and applied in the pharmaceutical manufacturing industry. There are still two key issues to be addressed in the implementation of QbD for herbal drugs. The first issue is the quality variation of herbal raw materials and the second issue is the difficulty in defining the acceptable ranges of critical quality attributes (CQAs). To propose a feedforward control strategy and a method for defining the acceptable ranges of CQAs for the two issues. In the case study of the ethanol precipitation process of Danshen (Radix Salvia miltiorrhiza) injection, regression models linking input material attributes and process parameters to CQAs were built first and an optimisation model for calculating the best process parameters according to the input materials was established. Then, the feasible material space was defined and the acceptable ranges of CQAs for the previous process were determined. In the case study, satisfactory regression models were built with cross-validated regression coefficients (Q(2) ) all above 91 %. The feedforward control strategy was applied successfully to compensate the quality variation of the input materials, which was able to control the CQAs in the 90-110 % ranges of the desired values. In addition, the feasible material space for the ethanol precipitation process was built successfully, which showed the acceptable ranges of the CQAs for the concentration process. The proposed methodology can help to promote the implementation of QbD for herbal drugs. Copyright © 2013 John Wiley & Sons, Ltd.

  10. Reinforced concrete pipe cracks : acceptance criteria [summary].

    DOT National Transportation Integrated Search

    2011-01-01

    Reinforced concrete pipe (RCP) is widely used by the Florida Department of Transportation (FDOT) in installations expected to serve for periods of decades before replacement, and extremely slow deterioration of RCP can be accepted. However, cracks in...

  11. Establishing endangered species recovery criteria using predictive simulation modeling

    USGS Publications Warehouse

    McGowan, Conor P.; Catlin, Daniel H.; Shaffer, Terry L.; Gratto-Trevor, Cheri L.; Aron, Carol

    2014-01-01

    Listing a species under the Endangered Species Act (ESA) and developing a recovery plan requires U.S. Fish and Wildlife Service to establish specific and measurable criteria for delisting. Generally, species are listed because they face (or are perceived to face) elevated risk of extinction due to issues such as habitat loss, invasive species, or other factors. Recovery plans identify recovery criteria that reduce extinction risk to an acceptable level. It logically follows that the recovery criteria, the defined conditions for removing a species from ESA protections, need to be closely related to extinction risk. Extinction probability is a population parameter estimated with a model that uses current demographic information to project the population into the future over a number of replicates, calculating the proportion of replicated populations that go extinct. We simulated extinction probabilities of piping plovers in the Great Plains and estimated the relationship between extinction probability and various demographic parameters. We tested the fit of regression models linking initial abundance, productivity, or population growth rate to extinction risk, and then, using the regression parameter estimates, determined the conditions required to reduce extinction probability to some pre-defined acceptable threshold. Binomial regression models with mean population growth rate and the natural log of initial abundance were the best predictors of extinction probability 50 years into the future. For example, based on our regression models, an initial abundance of approximately 2400 females with an expected mean population growth rate of 1.0 will limit extinction risk for piping plovers in the Great Plains to less than 0.048. Our method provides a straightforward way of developing specific and measurable recovery criteria linked directly to the core issue of extinction risk. Published by Elsevier Ltd.

  12. 7 CFR 42.133 - Portion of production acceptance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CONTAINER REGULATIONS STANDARDS FOR CONDITION OF FOOD CONTAINERS On-Line Sampling and Inspection Procedures... determined by comparing the calculated CuSum value with the acceptance limit (“L”) for the specified AQL. (b) A portion of production is acceptable if the CuSum value, calculated from the subgroup representing...

  13. Acceptability of Health Care-Related Risks: A Literature Review.

    PubMed

    Quintard, Bruno; Roberts, Tamara; Nitaro, Léa; Quenon, Jean-Luc; Michel, Philippe

    2016-03-01

    Risk management aims at reducing risks associated with hospital care to an acceptable level, both in their frequency and their impact on health. The social acceptability of risk on the part of the general population and of the health-care professionals, faced with regular information about adverse events, is undoubtedly evolving rapidly.In contrast to risk acceptability, the concept of risk perception is of limited interest to risk managers because it does not inform on the behaviors and actions resulting from these perceptions. The aim of this work was to define the concept of social acceptability of risk through an in-depth examination of a wide-ranging and multidisciplinary literature. A 1990-2010 English and French literature review was carried out in medical, epidemiological, and human and social sciences online databases, gray literature, and books. Of the 5931 references retrieved, 203 met the inclusion criteria. We identified contributions from 5 major research fields: economic, sociocognitive, psychometric, sociological/anthropological, and interactionist. When assessing risks, individuals use a variety of psychological and social processes that include their perception not only of a given risk but also of their own personal and social resources. This global perception has a direct impact on the responses and actual behavior of individuals and groups, enabling them to cope with the risk and/or manage it. Social acceptability includes perceptions related to risks and the stated intentions of individual behavior. This concept may therefore be relevant for defining local and national patient safety priorities.

  14. Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the "Borda" Method: a Pilot Study.

    PubMed

    Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

    2015-01-01

    Decision-making for medicines to be accepted in Iran's public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called "Borda" in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software "Math-lab"7, "SPSS" 17 and Excel 2007 were used in this study. "Borda" estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance decision making.

  15. Prototypicality ratings of DSM-III criteria for personality disorders.

    PubMed

    Livesley, W J; Reiffer, L I; Sheldon, A E; West, M

    1987-07-01

    Although DSM-III personality disorder criteria have demonstrated acceptable reliability, the question of validity has not been adequately addressed. A first step in establishing the validity of diagnoses is to establish the validity of the criteria used to assess each diagnosis. The content validity of diagnostic criteria was investigated in relation to the larger set of potential criteria culled from the psychiatric literature. For each DSM-III axis II diagnosis, a panel of clinicians rated how prototypical each potential criterion was of the diagnosis in question. The results reveal problems with the organization and content of the criteria for most diagnoses. Many DSM-III criteria are composed of several statements linked by conjunctions or disjunctions. These component statements often received markedly different ratings, suggesting that criteria should be single statements. For most diagnoses, traits not included in DSM-III received higher ratings than did some DSM-III criteria. Suggestions are made to improve the distinctiveness and content validity of paranoid, schizoid, antisocial, borderline, avoidant, dependent, and compulsive personality disorders. The results for schizotypal personality disorder suggest that many clinicians are uncertain about this diagnosis. These findings provide a systematic way to modify definitions that contrasts with the more arbitrary ways in which diagnoses have previously been defined and redefined.

  16. Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the “Borda” Method: a Pilot Study

    PubMed Central

    Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

    2015-01-01

    Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called “Borda” in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software “Math-lab”7, “SPSS” 17 and Excel 2007 were used in this study. “Borda” estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance

  17. Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study.

    PubMed

    Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Meagher, David J; Palma, José; Viñuelas, Eva; Grau, Imma; Vilella, Elisabet; de Pablo, Joan

    2016-05-26

    Information on validity and reliability of delirium criteria is necessary for clinicians, researchers, and further developments of DSM or ICD. We compare four DSM and ICD delirium diagnostic criteria versions, which were developed by consensus of experts, with a phenomenology-based natural diagnosis delineated using cluster analysis of delirium features in a sample with a high prevalence of dementia. We also measured inter-rater reliability of each system when applied by two evaluators from distinct disciplines. Cross-sectional analysis of 200 consecutive patients admitted to a skilled nursing facility, independently assessed within 24-48 h after admission with the Delirium Rating Scale-Revised-98 (DRS-R98) and for DSM-III-R, DSM-IV, DSM-5, and ICD-10 criteria for delirium. Cluster analysis (CA) delineated natural delirium and nondelirium reference groups using DRS-R98 items and then diagnostic systems' performance were evaluated against the CA-defined groups using logistic regression and crosstabs for discriminant analysis (sensitivity, specificity, percentage of subjects correctly classified by each diagnostic system and their individual criteria, and performance for each system when excluding each individual criterion are reported). Kappa Index (K) was used to report inter-rater reliability for delirium diagnostic systems and their individual criteria. 117 (58.5 %) patients had preexisting dementia according to the Informant Questionnaire on Cognitive Decline in the Elderly. CA delineated 49 delirium subjects and 151 nondelirium. Against these CA groups, delirium diagnosis accuracy was highest using DSM-III-R (87.5 %) followed closely by DSM-IV (86.0 %), ICD-10 (85.5 %) and DSM-5 (84.5 %). ICD-10 had the highest specificity (96.0 %) but lowest sensitivity (53.1 %). DSM-III-R had the best sensitivity (81.6 %) and the best sensitivity-specificity balance. DSM-5 had the highest inter-rater reliability (K =0.73) while DSM-III-R criteria were the least

  18. Adaptive evolutionary conservation: towards a unified concept for defining conservation units.

    PubMed

    Fraser, D J; Bernatchez, L

    2001-12-01

    Recent years have seen a debate over various methods that could objectively prioritize conservation value below the species level. Most prominent among these has been the evolutionarily significant unit (ESU). We reviewed ESU concepts with the aim of proposing a more unified concept that would reconcile opposing views. Like species concepts, conflicting ESU concepts are all essentially aiming to define the same thing: segments of species whose divergence can be measured or evaluated by putting differential emphasis on the role of evolutionary forces at varied temporal scales. Thus, differences between ESU concepts lie more in the criteria used to define the ESUs themselves rather than in their fundamental essence. We provide a context-based framework for delineating ESUs which circumvents much of this situation. Rather than embroil in a befuddled debate over an optimal criterion, the key to a solution is accepting that differing criteria will work more dynamically than others and can be used alone or in combination depending on the situation. These assertions constitute the impetus behind adaptive evolutionary conservation.

  19. A FRAMEWORK TO DEVELOP FLAW ACCEPTANCE CRITERIA FOR STRUCTURAL INTEGRITY ASSESSMENT OF MULTIPURPOSE CANISTERS FOR EXTENDED STORAGE OF USED NUCLEAR FUEL

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lam, P.; Sindelar, R.; Duncan, A.

    2014-04-07

    A multipurpose canister (MPC) made of austenitic stainless steel is loaded with used nuclear fuel assemblies and is part of the transfer cask system to move the fuel from the spent fuel pool to prepare for storage, and is part of the storage cask system for on-site dry storage. This weld-sealed canister is also expected to be part of the transportation package following storage. The canister may be subject to service-induced degradation especially if exposed to aggressive environments during possible very long-term storage period if the permanent repository is yet to be identified and readied. Stress corrosion cracking may bemore » initiated on the canister surface in the welds or in the heat affected zone because the construction of MPC does not require heat treatment for stress relief. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defects be detected by periodic Inservice Inspection. The external loading cases include thermal accident scenarios and cask drop conditions with the contribution from the welding residual stresses. The determination of acceptable flaw size is based on the procedure to evaluate flaw stability provided by American Petroleum Institute (API) 579 Fitness-for-Service (Second Edition). The material mechanical and fracture properties for base and weld metals and the stress analysis results are obtained from the open literature such as NUREG-1864. Subcritical crack growth from stress corrosion cracking (SCC), and its impact on inspection intervals and acceptance criteria, is not addressed.« less

  20. Content validity of the DSM-IV borderline and narcissistic personality disorder criteria sets.

    PubMed

    Blais, M A; Hilsenroth, M J; Castlebury, F D

    1997-01-01

    This study sought to empirically evaluate the content validity of the newly revised DSM-IV narcissistic personality disorder (NPD) and borderline personality disorder (BPD) criteria sets. Using the essential features of each disorder as construct definitions, factor analysis was used to determine how adequately the criteria sets covered the constructs. In addition, this empirical investigation sought to: 1) help define the dimensions underlying these polythetic disorders; 2) identify core features of each diagnosis; and 3) highlight the characteristics that may be most useful in diagnosing these two disorders. Ninety-one outpatients meeting DSM-IV criteria for a personality disorder (PD) were identified through a retrospective analysis of chart information. Records of these 91 patients were independently rated on all of the BPD and NPD symptom criteria for the DSM-IV. Acceptable interrater reliability (kappa estimates) was obtained for both presence or absence of a PD and symptom criteria for BPD and NPD. The factor analysis, performed separately for each disorder, identified a three-factor solution for both the DSM-IV BPD and NPD criteria sets. The results of this study provide strong support for the content validity of the NPD criteria set and moderate support for the content validly of the BPD criteria set. Three domains were found to comprise the BPD criteria set, with the essential features of interpersonal and identity instability forming one domain, and impulsivity and affective instability each identified as separate domains. Factor analysis of the NPD criteria set found three factors basically corresponding to the essential features of grandiosity, lack of empathy, and need for admiration. Therefore, the NPD criteria set adequately covers the essential or defining features of the disorder.

  1. Relationship between colorimetric (instrumental) evaluation and consumer-defined beef colour acceptability.

    PubMed

    Holman, Benjamin W B; Mao, Yanwei; Coombs, Cassius E O; van de Ven, Remy J; Hopkins, David L

    2016-11-01

    The relationship between instrumental colorimetric values (L*, a*, b*, the ratio of reflectance at 630nm and 580nm) and consumer perception of acceptable beef colour was evaluated using a web-based survey and standardised photographs of beef m. longissimus lumborum with known colorimetrics. Only L* and b* were found to relate to average consumer opinions of beef colour acceptability. Respondent nationality was also identified as a source of variation in beef colour acceptability score. Although this is a preliminary study with the findings necessitating additional investigation, these results suggest L* and b* as candidates for developing instrumental thresholds for consumer beef colour expectations. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  2. Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria.

    PubMed

    Noctor, Eoin; Crowe, Catherine; Carmody, Louise A; Saunders, Jean A; Kirwan, Breda; O'Dea, Angela; Gillespie, Paddy; Glynn, Liam G; McGuire, Brian E; O'Neill, Ciarán; O'Shea, P M; Dunne, F P

    2016-10-01

    An increase in gestational diabetes mellitus (GDM) prevalence has been demonstrated across many countries with adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Here, we determine the cumulative incidence of abnormal glucose tolerance among women with previous GDM, and identify clinical risk factors predicting this. Two hundred and seventy women with previous IADPSG-defined GDM were prospectively followed up for 5years (mean 2.6) post-index pregnancy, and compared with 388 women with normal glucose tolerance (NGT) in pregnancy. Cumulative incidence of abnormal glucose tolerance (using American Diabetes Association criteria for impaired fasting glucose, impaired glucose tolerance and diabetes) was determined using the Kaplan-Meier method of survival analysis. Cox regression models were constructed to test for factors predicting abnormal glucose tolerance. Twenty-six percent of women with previous GDM had abnormal glucose tolerance vs 4% with NGT, with the log-rank test demonstrating significantly different survival curves (P<0.001). Women meeting IADPSG, but not the World Health Organization (WHO) 1999 criteria, had a lower cumulative incidence than women meeting both sets of criteria, both in the early post-partum period (4.2% vs 21.7%, P<0.001) and at longer-term follow-up (13.7% vs 32.6%, P<0.001). Predictive factors were glucose levels on the pregnancy oral glucose tolerance test, family history of diabetes, gestational week at testing, and BMI at follow-up. The proportion of women developing abnormal glucose tolerance remains high among those with IADPSG-defined GDM. This demonstrates the need for continued close follow-up, although the optimal frequency and method needs further study. © 2016 European Society of Endocrinology.

  3. CERISE, a French radioprotection code, to assess the radiological impact and acceptance criteria of installations for material handling, and recycling or disposal of very low-level radioactive waste

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Santucci, P.; Guetat, P.

    1993-12-31

    This document describes the code CERISE, Code d`Evaluations Radiologiques Individuelles pour des Situations en Enterprise et dans l`Environnement. This code has been developed in the frame of European studies to establish acceptance criteria of very low-level radioactive waste and materials. This code is written in Fortran and runs on PC. It calculates doses received by the different pathways: external exposure, ingestion, inhalation and skin contamination. Twenty basic scenarios are already elaborated, which have been determined from previous studies. Calculations establish the relation between surface, specific and/or total activities, and doses. Results can be expressed as doses for an average activitymore » unit, or as average activity limits for a set of reference doses (defined for each scenario analyzed). In this last case, the minimal activity values and the corresponding limiting scenarios, are selected and summarized in a final table.« less

  4. Photovoltaic system criteria documents. Volume 6: Criteria for auditing photovoltaic system applications and experiments. Revision A

    NASA Technical Reports Server (NTRS)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1980-01-01

    The criteria is defined for auditing photovoltaic system applications and experiments. The purpose of the audit is twofold: to see if the application is meeting its stated objectives and to measure the application's progress in terms of the National Photovoltaic Program's goals of performance, cost, reliability, safety, and socio-environmental acceptance. The information obtained from an audit will be used to assess the status of an application and to provide the Department of Energy with recommendations on the future conduct of the application. Those aspects are covered of a site audit necessary to produce a systematic method for the gathering of qualitative and quantitative data to measure the success of an application. A sequence of audit events and guidelines for obtaining the required information is presented.

  5. Association of prediabetes, defined by fasting glucose, HbA1c only, or combined criteria, with the risk of cardiovascular disease in Koreans.

    PubMed

    Kim, Hong-Kyu; Lee, Jung Bok; Kim, Seon Ha; Jo, Min-Woo; Kim, Eun Hee; Hwang, Jenie Yoonoo; Bae, Sung Jin; Jung, Chang Hee; Lee, Woo Je; Park, Joong-Yeol; Park, Gyung-Min; Kim, Young-Hak; Choe, Jaewon

    2016-09-01

    The aim of the present study was to compare the association between cardiovascular diseases (CVD) and prediabetes defined by either fasting plasma glucose (FPG), HbA1c, or their combination in a Korean population. In all, 76 434 South Koreans who voluntarily underwent a general health examination in the Health Screening & Promotion Center (Asan Medical Center) were analyzed after excluding patients with a previous history of CVD. Cardiovascular events and death due to CVD during a median follow-up period of 3.1 years (interquartile range 1.9-4.3 years) were identified from the Nationwide Health Insurance Claims Database and death certificates using ICD-10 codes. Age- and sex-adjusted hazard ratios (HRs) for overall CVD events were significantly greater for subjects with prediabetes defined by FPG only (HR 1.19; 95% confidence interval [CI] 1.08-1.31), HbA1c only (HR 1.28; 95% CI 1.16-1.42), and combined criteria (HR 1.20; 95% CI 1.09-1.32) compared with the normoglycemic group. After adjusting for multiple conventional risk factors (e.g. hypertension, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, smoking status, family history of CVD, and BMI), the HRs for overall CVD were significantly increased only for participants with prediabetes defined by HbA1c. Age- and sex-adjusted HRs for major ischemic heart disease events were significantly increased for subjects with prediabetes defined either by HbA1c or combined criteria. Similarly, age- and sex-adjusted HRs for percutaneous coronary intervention were significantly higher for subjects with prediabetes defined by HbA1c only. For diabetes, the multivariate-adjusted HRs for all outcomes were significantly increased by all three criteria. Adding an HbA1c criterion when defining prediabetes in Koreans can help identify individuals with an increased risk of CVD. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  6. Monitoring Reading Behavior: Criteria for Performance.

    ERIC Educational Resources Information Center

    Powell, William R.

    Effective use of the informal reading inventory (IRI) depends upon the criteria used in determining the functional reading levels and more specifically the word recognition criteria employed in describing acceptable limits of oral reading behavior. The author of this paper looks at the diverse sets of criteria commonly used, the problems…

  7. Photovoltaic system criteria documents. Volume 3: Environmental issues and evaluation criteria for photovoltaic applications

    NASA Technical Reports Server (NTRS)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1979-01-01

    The environmental issues and evaluation criteria relating to the suitability of sites proposed for photovoltaic (PV) system deployment are identified. The important issues are defined, briefly discussed and then developed into evaluation criteria. System designers are provided with information on the environmental sensitivity of PV systems in realistic applications, background material which indicates the applicability of the siting issues identified, and evaluation criteria are defined to facilitate the selection of sites that maximize PV system operation.

  8. Acceptance Probability (P a) Analysis for Process Validation Lifecycle Stages.

    PubMed

    Alsmeyer, Daniel; Pazhayattil, Ajay; Chen, Shu; Munaretto, Francesco; Hye, Maksuda; Sanghvi, Pradeep

    2016-04-01

    This paper introduces an innovative statistical approach towards understanding how variation impacts the acceptance criteria of quality attributes. Because of more complex stage-wise acceptance criteria, traditional process capability measures are inadequate for general application in the pharmaceutical industry. The probability of acceptance concept provides a clear measure, derived from specific acceptance criteria for each quality attribute. In line with the 2011 FDA Guidance, this approach systematically evaluates data and scientifically establishes evidence that a process is capable of consistently delivering quality product. The probability of acceptance provides a direct and readily understandable indication of product risk. As with traditional capability indices, the acceptance probability approach assumes that underlying data distributions are normal. The computational solutions for dosage uniformity and dissolution acceptance criteria are readily applicable. For dosage uniformity, the expected AV range may be determined using the s lo and s hi values along with the worst case estimates of the mean. This approach permits a risk-based assessment of future batch performance of the critical quality attributes. The concept is also readily applicable to sterile/non sterile liquid dose products. Quality attributes such as deliverable volume and assay per spray have stage-wise acceptance that can be converted into an acceptance probability. Accepted statistical guidelines indicate processes with C pk > 1.33 as performing well within statistical control and those with C pk < 1.0 as "incapable" (1). A C pk > 1.33 is associated with a centered process that will statistically produce less than 63 defective units per million. This is equivalent to an acceptance probability of >99.99%.

  9. 16 CFR Table 3 to Part 1512 - Minimum Acceptable Values for the Quantity A Defined in the Retroreflective Tire and Rim Test...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Minimum Acceptable Values for the Quantity A Defined in the Retroreflective Tire and Rim Test Procedure 3 Table 3 to Part 1512 Commercial Practices... Retroreflective Tire and Rim Test Procedure Observation angle (degrees) Entrance angle (degrees) Minimum...

  10. An alternative regionalization scheme for defining nutrient criteria for rivers and streams

    USGS Publications Warehouse

    Robertson, Dale M.; Saad, David A.; Wieben, Ann M.

    2001-01-01

    The environmental nutrient zone approach can be applied to specific states or nutrient ecoregions and used to develop criteria as a function of stream type. This approach can also be applied on the basis of environmental characteristics of the watershed alone rather than the general environmental characteristics from the region in which the site is located. The environmental nutrient zone approach will enable states to refine the basic nutrient criteria established by the USEPA by developing attainable criteria given the environmental characteristics where the streams are located.

  11. Definition of an Acceptable Glass composition Region (AGCR) via an Index System and a Partitioning Function

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Peeler, D. K.; Taylor, A. S.; Edwards, T.B.

    2005-06-26

    . A Type I error only reflects that the particular constraint system being used is overly conservative (i.e., its application restricts access to glasses that have an acceptable measured durability response). A Type II error results in a more serious misclassification that could result in allowing the transfer of a Slurry Mix Evaporator (SME) batch to the melter, which is predicted to produce a durable product based on the specific system applied but in reality does not meet the defined ''acceptability'' criteria. More specifically, a nondurable product could be produced in DWPF. Given the presence of Type II errors, the Index System approach was deemed inadequate for further implementation consideration at the DWPF. The second approach (the JMP partitioning process) was purely data driven and empirically derived--glass science was not a factor. In this approach, the collection of composition--durability data in ComPro was sequentially partitioned or split based on the best available specific criteria and variables. More specifically, the JMP software chose the oxide (Al{sub 2}O{sub 3} for this dataset) that most effectively partitions the PCT responses (NL [B]'s)--perhaps not 100% effective based on a single oxide. Based on this initial split, a second request was made to split a particular set of the ''Y'' values (good or bad PCTs based on the 10 g/L limit) based on the next most critical ''X'' variable. This ''splitting'' or ''partitioning'' process was repeated until an AGCR was defined based on the use of only 3 oxides (Al{sub 2}O{sub 3}, CaO, and MgO) and critical values of > 3.75 wt% Al{sub 2}O{sub 3}, {ge} 0.616 wt% CaO, and < 3.521 wt% MgO. Using this set of criteria, the ComPro database was partitioned in which no Type II errors were committed. The automated partitioning function screened or removed 978 of the 2406 ComPro glasses which did cause some initial concerns regarding excessive conservatism regardless of its ability to identify an AGCR. However, a

  12. Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and metabolic features.

    PubMed

    Welt, C K; Gudmundsson, J A; Arason, G; Adams, J; Palsdottir, H; Gudlaugsdottir, G; Ingadottir, G; Crowley, W F

    2006-12-01

    The Rotterdam criteria for polycystic ovary syndrome (PCOS) defines discrete subgroups whose phenotypes are not yet clear. The phenotypic characteristics of women in the PCOS subgroups defined by the Rotterdam criteria were compared. The study was observational. Subjects were studied in an outpatient setting in Boston and Reykjavik. Four subgroups of subjects with PCOS defined by 1) irregular menses (IM), hyperandrogenism (HA), and polycystic ovary morphology (PCOM, n = 298); 2) IM/HA (n = 7); 3) HA/PCOM (n = 77); and 4) IM/PCOM (n = 36) and a group of controls (n = 64), aged 18-45 yr, were examined. Subjects underwent a physical exam; fasting blood samples for androgens, gonadotropins, and metabolic parameters; and a transvaginal ultrasound. The phenotype was compared between groups. Ninety-seven percent of women with IM/HA had PCOM. Therefore, the groups with and without PCOM were combined. The Ferriman-Gallwey score and androgen levels were highest in the hyperandrogenic groups (IM/HA and HA/PCOM), whereas ovarian volume was higher in all PCOS subgroups compared with controls, as expected based on the definitions of the PCOS subgroups. Body mass index and insulin levels were highest in the IM/HA subgroup. Subjects with PCOS defined by IM/HA are the most severely affected women on the basis of androgen levels, ovarian volumes, and insulin levels. Their higher body mass index partially accounts for the increased insulin levels, suggesting that weight gain exacerbates the symptoms of PCOS.

  13. 49 CFR 173.57 - Acceptance criteria for new explosives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... must be subjected to the Drop Weight Impact Sensitivity Test (Test Method 3(a)(i)), the Friction... substance has a friction sensitiveness equal to or greater than that of dry pentaerythrite tetranitrate (PETN) when tested in the Friction Sensitivity Test; (4) The substance fails to pass the test criteria...

  14. TESTING AND ACCEPTANCE OF FUEL PLATES FOR RERTR FUEL DEVELOPMENT EXPERIMENTS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    J.M. Wight; G.A. Moore; S.C. Taylor

    2008-10-01

    This paper discusses how candidate fuel plates for RERTR Fuel Development experiments are examined and tested for acceptance prior to reactor insertion. These tests include destructive and nondestructive examinations (DE and NDE). The DE includes blister annealing for dispersion fuel plates, bend testing of adjacent cladding, and microscopic examination of archive fuel plates. The NDE includes Ultrasonic (UT) scanning and radiography. UT tests include an ultrasonic scan for areas of “debonds” and a high frequency ultrasonic scan to determine the "minimum cladding" over the fuel. Radiography inspections include identifying fuel outside of the maximum fuel zone and measurements and calculationsmore » for fuel density. Details of each test are provided and acceptance criteria are defined. These tests help to provide a high level of confidence the fuel plate will perform in the reactor without a breach in the cladding.« less

  15. Defining the drivers for accepting decision making automation in air traffic management.

    PubMed

    Bekier, Marek; Molesworth, Brett R C; Williamson, Ann

    2011-04-01

    Air Traffic Management (ATM) operators are under increasing pressure to improve the efficiency of their operation to cater for forecasted increases in air traffic movements. One solution involves increasing the utilisation of automation within the ATM system. The success of this approach is contingent on Air Traffic Control Operators' (ATCOs) willingness to accept increased levels of automation. The main aim of the present research was to examine the drivers underpinning ATCOs' willingness to accept increased utilisation of automation within their role. Two fictitious scenarios involving the application of two new automated decision-making tools were created. The results of an online survey revealed traditional predictors of automation acceptance such as age, trust and job satisfaction explain between 4 and 7% of the variance. Furthermore, these predictors varied depending on the purpose in which the automation was to be employed. These results are discussed from an applied and theoretical perspective. STATEMENT OF RELEVANCE: Efficiency improvements in ATM are required to cater for forecasted increases in air traffic movements. One solution is to increase the utilisation of automation within Air Traffic Control. The present research examines the drivers underpinning air traffic controllers' willingness to accept increased levels of automation in their role.

  16. Minimum training criteria for police traffic accident reconstruction.

    DOT National Transportation Integrated Search

    1987-03-01

    This report summarizes the development of a set of minimum training criteria for police accident reconstructionists. Prior to this effort, no nationally accepted standards or criteria were recognized for evaluating the qualifications of police engage...

  17. Final waste forms project: Performance criteria for phase I treatability studies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gilliam, T.M.; Hutchins, D.A.; Chodak, P. III

    1994-06-01

    This document defines the product performance criteria to be used in Phase I of the Final Waste Forms Project. In Phase I, treatability studies will be performed to provide {open_quotes}proof-of-principle{close_quotes} data to establish the viability of stabilization/solidification (S/S) technologies. This information is required by March 1995. In Phase II, further treatability studies, some at the pilot scale, will be performed to provide sufficient data to allow treatment alternatives identified in Phase I to be more fully developed and evaluated, as well as to reduce performance uncertainties for those methods chosen to treat a specific waste. Three main factors influence themore » development and selection of an optimum waste form formulation and hence affect selection of performance criteria. These factors are regulatory, process-specific, and site-specific waste form standards or requirements. Clearly, the optimum waste form formulation will require consideration of performance criteria constraints from each of the three categories. Phase I will focus only on the regulatory criteria. These criteria may be considered the minimum criteria for an acceptable waste form. In other words, a S/S technology is considered viable only if it meet applicable regulatory criteria. The criteria to be utilized in the Phase I treatability studies were primarily taken from Environmental Protection Agency regulations addressed in 40 CFR 260 through 265 and 268; and Nuclear Regulatory Commission regulations addressed in 10 CFR 61. Thus the majority of the identified criteria are independent of waste form matrix composition (i.e., applicable to cement, glass, organic binders etc.).« less

  18. Sediment quality criteria: A review with recommendations for developing criteria for the Hanford Site

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Driver, C.J.

    1994-05-01

    Criteria for determining the quality of liver sediment are necessary to ensure that concentrations of contaminants in aquatic systems are within acceptable limits for the protection of aquatic and human life. Such criteria should facilitate decision-making about remediation, handling, and disposal of contaminants. Several approaches to the development of sediment quality criteria (SQC) have been described and include both descriptive and numerical methods. However, no single method measures all impacts at all times to all organisms (U.S. EPA 1992b). The U.S. EPA`s interest is primarily in establishing chemically based, numerical SQC that are applicable nation-wide (Shea 1988). Of the approachesmore » proposed for SQC development, only three are being considered for numerical SQC on a national level. These approaches include an Equilibrium Partitioning Approach, a site-specific method using bioassays (the Apparent Effects Threshold Approach), and an approach similar to EPA`s water quality criteria (Pavlou and Weston 1984). Although national (or even regional) criteria address a number of political, litigative, and engineering needs, some researchers feel that protection of benthic communities require site-specific, biologically based criteria (Baudo et al. 1990). This is particularly true for areas where complex mixtures of contaminants are present in sediments. Other scientifically valid and accepted procedures for freshwater SQC include a background concentration approach, methods using field or spiked bioassays, a screening level concentration approach, the Apparent Effects Threshold Approach, the Sediment Quality Triad, the International Joint Commission Sediment Assessment Strategy, and the National Status and Trends Program Approach. The various sediment assessment approaches are evaluated for application to the Hanford Reach and recommendations for Hanford Site sediment quality criteria are discussed.« less

  19. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All gifts...

  20. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All gifts...

  1. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All gifts...

  2. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All gifts...

  3. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All gifts...

  4. 16 CFR 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  5. 16 CFR 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  6. 16 CFR 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  7. Outcome-based anatomic criteria for defining the hostile aortic neck.

    PubMed

    Jordan, William D; Ouriel, Kenneth; Mehta, Manish; Varnagy, David; Moore, William M; Arko, Frank R; Joye, James; de Vries, Jean-Paul P M

    2015-06-01

    There is abundant evidence linking hostile proximal aortic neck anatomy to poor outcome after endovascular aortic aneurysm repair (EVAR), yet the definition of hostile anatomy varies from study to study. This current analysis was undertaken to identify anatomic criteria that are most predictive of success or failure at the aortic neck after EVAR. The study group comprised 221 patients in the Aneurysm Treatment using the Heli-FX Aortic Securement System Global Registry (ANCHOR) clinical trial, a population enriched with patients with challenging aortic neck anatomy and failure of sealing. Imaging protocols were not protocol specified but were performed according to the institution's standard of care. Core laboratory analysis assessed the three-dimensional centerline-reformatted computed tomography scans. Failure at the aortic neck was defined by type Ia endoleak occurring at the time of the initial endograft implantation or during follow-up. Receiver operating characteristic curve analysis was used to assess the value of each anatomic measure in the classification of aortic neck success and failure and to identify optimal thresholds of discrimination. Binary logistic regression was performed after excluding highly intercorrelated variables, creating a final model with significant predictors of outcome after EVAR. Among the 221 patients, 121 (54.8%) remained free of type Ia endoleak and 100 (45.2%) did not. Type Ia endoleaks presented immediately after endograft deployment in 58 (58.0%) or during follow-up in 42 (42.0%). Receiver operating characteristic curve analysis identified 12 variables where the classification of patients with type Ia endoleak was significantly more accurate than chance alone. Increased aortic neck diameter at the lowest renal artery (P = .013) and at 5 mm (P = .008), 10 mm (P = .008), and 15 mm (P = .010) distally; aneurysm sac diameter (P = .001), common iliac artery diameters (right, P = .012; left, P = .032), and a conical (P = .049) neck

  8. EU landfill waste acceptance criteria and EU Hazardous Waste Directive compliance testing of incinerated sewage sludge ash.

    PubMed

    Donatello, S; Tyrer, M; Cheeseman, C R

    2010-01-01

    A hazardous waste assessment has been completed on ash samples obtained from seven sewage sludge incinerators operating in the UK, using the methods recommended in the EU Hazardous Waste Directive. Using these methods, the assumed speciation of zinc (Zn) ultimately determines if the samples are hazardous due to ecotoxicity hazard. Leaching test results showed that two of the seven sewage sludge ash samples would require disposal in a hazardous waste landfill because they exceed EU landfill waste acceptance criteria for stabilised non-reactive hazardous waste cells for soluble selenium (Se). Because Zn cannot be proven to exist predominantly as a phosphate or oxide in the ashes, it is recommended they be considered as non-hazardous waste. However leaching test results demonstrate that these ashes cannot be considered as inert waste, and this has significant implications for the management, disposal and re-use of sewage sludge ash.

  9. Defining pediatric sepsis by different criteria: discrepancies in populations and implications for clinical practice.

    PubMed

    Weiss, Scott L; Parker, Brandon; Bullock, Maria E; Swartz, Sheila; Price, Carolynn; Wainwright, Mark S; Goodman, Denise M

    2012-07-01

    Pediatric patients with sepsis are identified using related but distinct criteria for clinical, research, and administrative purposes. The overlap between these criteria will affect the validity of extrapolating data across settings. We sought to quantify the extent of agreement among different criteria for pediatric severe sepsis/septic shock and to detect systematic differences between these cohorts. Observational cohort study. Forty-two bed pediatric intensive care unit at an academic medical center. A total of 1,729 patients ≤ 18 yrs-old. None. All patients were screened for severe sepsis or septic shock using consensus guidelines (research criteria), diagnosis by healthcare professionals (clinical criteria), and International Classification of Diseases, Ninth Revision, Clinical Modification codes (administrative criteria). Cohen's κ determined the level of agreement among criteria, and patient characteristics were compared between cohorts. Ninety (5.2%) patients were identified by research, 96 (5.6%) by clinical, and 103 (6.0%) by administrative criteria. The κ ± standard error for pair-wise comparisons was 0.67 ± 0.04 for research-clinical, 0.52 ± 0.05 for research-administrative, and 0.55 ± 0.04 for clinical-administrative. Of the patients in the clinical cohort, 67% met research and 58% met administrative criteria. The research cohort exhibited a higher Pediatric Index of Mortality-2 score (median, interquartile range 5.2, 1.6-13.3) than the clinical (3.6, 1.1-6.2) and administrative (3.9, 1.0-6.0) cohorts (p = .005), an increased requirement for vasoactive infusions (74%, 57%, and 45%, p < .001), and a potential bias toward an increased proportion with respiratory dysfunction compared with clinical practice. Although research, clinical, and administrative criteria yielded a similar incidence (5%-6%) for pediatric severe sepsis/septic shock, there was only a moderate level of agreement in the patients identified by different criteria. One third of

  10. Crew Transportation Technical Standards and Design Evaluation Criteria

    NASA Technical Reports Server (NTRS)

    Lueders, Kathryn L.; Thomas, Rayelle E. (Compiler)

    2015-01-01

    Crew Transportation Technical Standards and Design Evaluation Criteria contains descriptions of technical, safety, and crew health medical processes and specifications, and the criteria which will be used to evaluate the acceptability of the Commercial Providers' proposed processes and specifications.

  11. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies.

    PubMed

    Diamond, Ivan R; Grant, Robert C; Feldman, Brian M; Pencharz, Paul B; Ling, Simon C; Moore, Aideen M; Wales, Paul W

    2014-04-01

    To investigate how consensus is operationalized in Delphi studies and to explore the role of consensus in determining the results of these studies. Systematic review of a random sample of 100 English language Delphi studies, from two large multidisciplinary databases [ISI Web of Science (Thompson Reuters, New York, NY) and Scopus (Elsevier, Amsterdam, NL)], published between 2000 and 2009. About 98 of the Delphi studies purported to assess consensus, although a definition for consensus was only provided in 72 of the studies (64 a priori). The most common definition for consensus was percent agreement (25 studies), with 75% being the median threshold to define consensus. Although the authors concluded in 86 of the studies that consensus was achieved, consensus was only specified a priori (with a threshold value) in 42 of these studies. Achievement of consensus was related to the decision to stop the Delphi study in only 23 studies, with 70 studies terminating after a specified number of rounds. Although consensus generally is felt to be of primary importance to the Delphi process, definitions of consensus vary widely and are poorly reported. Improved criteria for reporting of methods of Delphi studies are required. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. 15 CFR 768.6 - Criteria.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... DETERMINATION PROCEDURES AND CRITERIA § 768.6 Criteria. BIS will evaluate the evidence contained in a FAS or TAC... defined in § 768.1(d) of this part. In order to initiate an assessment, each FAS and TAC certification...

  13. 15 CFR 768.6 - Criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... DETERMINATION PROCEDURES AND CRITERIA § 768.6 Criteria. BIS will evaluate the evidence contained in a FAS or TAC... defined in § 768.1(d) of this part. In order to initiate an assessment, each FAS and TAC certification...

  14. 15 CFR 768.6 - Criteria.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... DETERMINATION PROCEDURES AND CRITERIA § 768.6 Criteria. BIS will evaluate the evidence contained in a FAS or TAC... defined in § 768.1(d) of this part. In order to initiate an assessment, each FAS and TAC certification...

  15. 15 CFR 768.6 - Criteria.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... DETERMINATION PROCEDURES AND CRITERIA § 768.6 Criteria. BIS will evaluate the evidence contained in a FAS or TAC... defined in § 768.1(d) of this part. In order to initiate an assessment, each FAS and TAC certification...

  16. 15 CFR 768.6 - Criteria.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... DETERMINATION PROCEDURES AND CRITERIA § 768.6 Criteria. BIS will evaluate the evidence contained in a FAS or TAC... defined in § 768.1(d) of this part. In order to initiate an assessment, each FAS and TAC certification...

  17. Impact of hospital and surgeon case volume on morbidity in colorectal endometriosis management: a plea to define criteria for expert centers.

    PubMed

    Bendifallah, Sofiane; Roman, Horace; Rubod, Chrystel; Leguevaque, Pierre; Watrelot, Antoine; Bourdel, Nicolas; Ballester, Marcos; Darai, Emile

    2018-04-01

    National and international guidelines recommend referring patients with severe forms of endometriosis to expert centers. However, there is a lack of clear criteria to define an expert center. We examined the roles of surgeon and hospital procedure volumes as determinants of morbidity in deep infiltrating endometriosis of the rectum and sigmoid colon (DIERS). We conducted a French retrospective multicenter study of hospital facilities performing colorectal surgery for DIERS in 2015. The primary end point was to analyze the relation between case volume and the incidence of complications. We estimated the optimal cut-off (OCO) determined by a minimal p-value approach. The study included 56 hospital facilities and collected data of 1135 cases of surgical management of colorectal endometriosis. The mean and median number of procedures per year and per surgeon were 9.17 and 5.58, respectively. The overall rate of grade III-V complication was 7.6% (82/1135). One grade V complication occurred. The rates of rectovaginal fistula, anastomotic leakage, pelvic abscess, and ureteral fistula were: 2.7% (31/1135), 0.79% (9/1135), 3.4% (39/1135), and 0.70% (8/1135), respectively. An OCO of 20 procedures per center and per year (p < 0.001) was defined. The OCO per surgeon and per year varied between seven (p = 0.007) and 13 procedures (p = 0.03). In a multivariate analysis, we found that only the volume of activity was independently correlated to complication outcomes (p = 0.0013). Our results contribute to providing objective morbidity data to determine criteria for defining expert centers for colorectal surgery for endometriosis.

  18. 16 CFR § 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  19. How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

    PubMed Central

    Simpson, Eric L.; Keck, Laura E.; Chalmers, Joanne R.; Williams, Hywel C.

    2012-01-01

    Background Eczema prevention is now an active area of dermatologic and allergic research. Defining an incident case is therefore a prerequisite for such as study. Objective We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. Methods We conducted a systematic review of controlled interventional atopic dermatitis prevention studies using searches of Medline and Cochrane databases from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. Results One hundred and two (102) studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. Conclusions The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. PMID:22424882

  20. Risk of progression to diabetes from prediabetes defined by HbA1c or fasting plasma glucose criteria in Koreans.

    PubMed

    Kim, Chul-Hee; Kim, Hong-Kyu; Kim, Eun-Hee; Bae, Sung-Jin; Choe, Jaewon; Park, Joong-Yeol

    2016-08-01

    To examine the abilities of HbA1c and fasting plasma glucose (FPG) criteria predicting 5-year progression rate to diabetes in Korean adults with prediabetes. Participants included 17,971 Koreans (aged 20-79years) who underwent routine medical check-ups at a mean interval of 5.2years (3.1-6.7years). Prediabetes was defined as FPG 5.6-6.9mmol/l or HbA1c 5.7-6.4% (39-46mmol/mol). Incident diabetes was defined as FPG⩾7.0mmol/l, HbA1c⩾6.5% (48mmol/mol), or initiation of antidiabetic medications. At baseline, the prevalence of prediabetes was 30.6% (n=5495) by FPG and 20.4% (n=3664) by HbA1c criteria. The 5-year progression rate to diabetes was significantly higher in prediabetes identified by HbA1c than by FPG tests (14.7% vs. 10.4%, P<0.001). Of individuals diagnosed with prediabetes by only one test, those by HbA1c alone had a higher risk of progression to diabetes than those diagnosed by FPG alone (6.0% vs. 3.9%, P<0.001). Receiver operating characteristic curve analysis showed that area under the curve was greater for HbA1c (0.855, 95% CI 0.840-0.870) than for FPG (0.830, 0.813-0.846) (P=0.016). After adjustment for conventional risk factors, the odds ratio (OR) of developing diabetes was higher in participants with prediabetes identified by HbA1c (OR 9.91, 8.24-11.9) than by FPG (OR 7.29, 5.97-8.89) (P=0.026). Although fewer individuals with prediabetes were identified by HbA1c than by FPG criteria, the ability to predict progression to diabetes was stronger for HbA1c than for FPG in Koreans. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Defining "Acceptable Risk" for Earthquakes Worldwide

    NASA Astrophysics Data System (ADS)

    Tucker, B.

    2001-05-01

    The greatest and most rapidly growing earthquake risk for mortality is in developing countries. Further, earthquake risk management actions of the last 50 years have reduced the average lethality of earthquakes in earthquake-threatened industrialized countries. (This is separate from the trend of the increasing fiscal cost of earthquakes there.) Despite these clear trends, every new earthquake in developing countries is described in the media as a "wake up" call, announcing the risk these countries face. GeoHazards International (GHI) works at both the community and the policy levels to try to reduce earthquake risk. GHI reduces death and injury by helping vulnerable communities recognize their risk and the methods to manage it, by raising awareness of its risk, building local institutions to manage that risk, and strengthening schools to protect and train the community's future generations. At the policy level, GHI, in collaboration with research partners, is examining whether "acceptance" of these large risks by people in these countries and by international aid and development organizations explains the lack of activity in reducing these risks. The goal of this pilot project - The Global Earthquake Safety Initiative (GESI) - is to develop and evaluate a means of measuring the risk and the effectiveness of risk mitigation actions in the world's largest, most vulnerable cities: in short, to develop an earthquake risk index. One application of this index is to compare the risk and the risk mitigation effort of "comparable" cities. By this means, Lima, for example, can compare the risk of its citizens dying due to earthquakes with the risk of citizens in Santiago and Guayaquil. The authorities of Delhi and Islamabad can compare the relative risk from earthquakes of their school children. This index can be used to measure the effectiveness of alternate mitigation projects, to set goals for mitigation projects, and to plot progress meeting those goals. The preliminary

  2. Criteria for structural test

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The results of a study to define criteria and techniques of design, analysis and test which permit the use of a single major structural test article for performing dynamic, fatigue, and static testing are presented. The criteria developed is applicable to both space vehicles and aircraft structures operating in the subsonic or supersonic regime. The feasibility of such an approach was demonstrated by defining test interactions, compatibilities and incompatibilities between the three different types of tests. The results of the study indicate that the single test article concept is feasible with a testing sequence of dynamic test followed by a fatigue and static test.

  3. Assessing health status and quality-of-life instruments: attributes and review criteria.

    PubMed

    Aaronson, Neil; Alonso, Jordi; Burnam, Audrey; Lohr, Kathleen N; Patrick, Donald L; Perrin, Edward; Stein, Ruth E

    2002-05-01

    The field of health status and quality of life (QoL) measurement - as a formal discipline with a cohesive theoretical framework, accepted methods, and diverse applications--has been evolving for the better part of 30 years. To identify health status and QoL instruments and review them against rigorous criteria as a precursor to creating an instrument library for later dissemination, the Medical Outcomes Trust in 1994 created an independently functioning Scientific Advisory Committee (SAC). In the mid-1990s, the SAC defined a set of attributes and criteria to carry out instrument assessments; 5 years later, it updated and revised these materials to take account of the expanding theories and technologies upon which such instruments were being developed. This paper offers the SAC's current conceptualization of eight key attributes of health status and QoL instruments (i.e., conceptual and measurement model; reliability; validity; responsiveness; interpretability; respondent and administrative burden; alternate forms; and cultural and language adaptations) and the criteria by which instruments would be reviewed on each of those attributes. These are suggested guidelines for the field to consider and debate; as measurement techniques become both more familiar and more sophisticated, we expect that experts will wish to update and refine these criteria accordingly.

  4. Defining new criteria for selection of cell-based intestinal models using publicly available databases

    PubMed Central

    2012-01-01

    Background The criteria for choosing relevant cell lines among a vast panel of available intestinal-derived lines exhibiting a wide range of functional properties are still ill-defined. The objective of this study was, therefore, to establish objective criteria for choosing relevant cell lines to assess their appropriateness as tumor models as well as for drug absorption studies. Results We made use of publicly available expression signatures and cell based functional assays to delineate differences between various intestinal colon carcinoma cell lines and normal intestinal epithelium. We have compared a panel of intestinal cell lines with patient-derived normal and tumor epithelium and classified them according to traits relating to oncogenic pathway activity, epithelial-mesenchymal transition (EMT) and stemness, migratory properties, proliferative activity, transporter expression profiles and chemosensitivity. For example, SW480 represent an EMT-high, migratory phenotype and scored highest in terms of signatures associated to worse overall survival and higher risk of recurrence based on patient derived databases. On the other hand, differentiated HT29 and T84 cells showed gene expression patterns closest to tumor bulk derived cells. Regarding drug absorption, we confirmed that differentiated Caco-2 cells are the model of choice for active uptake studies in the small intestine. Regarding chemosensitivity we were unable to confirm a recently proposed association of chemo-resistance with EMT traits. However, a novel signature was identified through mining of NCI60 GI50 values that allowed to rank the panel of intestinal cell lines according to their drug responsiveness to commonly used chemotherapeutics. Conclusions This study presents a straightforward strategy to exploit publicly available gene expression data to guide the choice of cell-based models. While this approach does not overcome the major limitations of such models, introducing a rank order of selected

  5. Developing social standards for wilderness encounters in Mount Rainier National Park: Manager-defined versus visitor-defined standards

    Treesearch

    Kristopher J. Lah

    2000-01-01

    This research compared the differences found between manager-defined and visitor-defined social standards for wilderness encounters in Mount Rainier National Park. Social standards in recreation areas of public land are defined by what is acceptable to the public, in addition to the area’s management. Social standards for the encounter indicator in Mount Rainier’s...

  6. A Distributive Model of Treatment Acceptability

    ERIC Educational Resources Information Center

    Carter, Stacy L.

    2008-01-01

    A model of treatment acceptability is proposed that distributes overall treatment acceptability into three separate categories of influence. The categories are comprised of societal influences, consultant influences, and influences associated with consumers of treatments. Each of these categories are defined and their inter-relationships within…

  7. 2017 Draft Aquatic Life Criteria for Aluminum in Freshwater

    EPA Pesticide Factsheets

    EPA has released draft updated aluminum aquatic life ambient water quality criteria for freshwater under Section 304(a)(1) of the Clean Water Act. EPA will accept public comments on the draft criteria for 60 days upon publication in the Federal Register.

  8. General contamination criteria for optical surfaces. [instrument performance losses in spaceborne conditions

    NASA Technical Reports Server (NTRS)

    Bremer, J. C.

    1982-01-01

    Physical models are developed for establishing criteria to decide on the acceptable contamination level of optical devices in space-borne conditions. Optical systems can be degraded in terms of decreased throughput, i.e., transmissivity or reflectivity, or increases in the total integrated scatter (TIS). Performance losses can be caused by particulate accretion, molecular film accretion, and impact cratering. A quantitative relationship is defined for film thickness and loss of throughput. Formulas are also developed for cases where induced surface defects are larger than the desired viewing wavelengths, or smaller or of the same order of the observed wavelengths. The techniques are used to quantify the degradation of a VUV solar coronagraph, a VUV stellar telescope, and a solar cell due to TIS. Applications are projected for estimating the contamination sensitivity of specific instruments, assessing the contamination hazard from known particulates, or to define clean room standards.

  9. Defining Mental Health in Later Life.

    ERIC Educational Resources Information Center

    Qualls, Sara Honn

    2002-01-01

    Traditional models for defining mental health have used statistical definitions and symptom-based definitions. In a lifespan psychological approach, mental health in later life is defined as acceptance of the aging self as an active being who creates meaning, maintains maximum autonomy, and sustains positive relationships. (Contains 12…

  10. 21 CFR 820.80 - Receiving, in-process, and finished device acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Receiving, in-process, and finished device acceptance. 820.80 Section 820.80 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... acceptance to ensure that each production run, lot, or batch of finished devices meets acceptance criteria...

  11. 21 CFR 820.80 - Receiving, in-process, and finished device acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Receiving, in-process, and finished device acceptance. 820.80 Section 820.80 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... acceptance to ensure that each production run, lot, or batch of finished devices meets acceptance criteria...

  12. [The assesment of cranio-cerebral injuries in the aspect of neurological, psychiatric and certification criteria].

    PubMed

    Maksymowicz, Krzysztof; Piechocki, Dariusz; Drozd, Radosław

    2005-01-01

    In this paper an effort has been made to explain and systemize the notions of encephalopathy, psycho organic syndrome, characteropathy, seen as consequences of cranio-cerebral injuries, and regarding neurological, psychiatric and certificating criteria. The main aim of this classification is to define the necessary conditions needed to confirm or exclude the presence of neurological changes mentioned above. The conditions should be acceptable from the neurological, psychiatric and certificating points of view. The certificating experience of the authors shows that there are vast differences among criteria applied by neurologists, psychiatrists and certificating doctors in assessing the consequences of cranio-cerebral injuries. Moreover, in the above paper various injury and disease factors have been presented and discussed. Although they do not remain in any causal connection with the assessed event, they have a significant influence on the final result of the medical certification.

  13. A systematic review of patient acceptance of consumer health information technology.

    PubMed

    Or, Calvin K L; Karsh, Ben-Tzion

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation.

  14. Improved exposure estimation in soil screening and cleanup criteria for volatile organic chemicals.

    PubMed

    DeVaull, George E

    2017-09-01

    Soil cleanup criteria define acceptable concentrations of organic chemical constituents for exposed humans. These criteria sum the estimated soil exposure over multiple pathways. Assumptions for ingestion, dermal contact, and dust exposure generally presume a chemical persists in surface soils at a constant concentration level for the entire exposure duration. For volatile chemicals, this is an unrealistic assumption. A calculation method is presented for surficial soil criteria that include volatile depletion of chemical for these uptake pathways. The depletion estimates compare favorably with measured concentration profiles and with field measurements of soil concentration. Corresponding volatilization estimates compare favorably with measured data for a wide range of volatile and semivolatile chemicals, including instances with and without the presence of a mixed-chemical residual phase. Selected examples show application of the revised factors in estimating screening levels for benzene in surficial soils. Integr Environ Assess Manag 2017;13:861-869. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  15. Negotiable Acceptability: Reflections on the Interactions between Language Professionals in Europe and NNS Scientists Wishing to Publish in English

    ERIC Educational Resources Information Center

    Burrough-Boenisch, Joy

    2006-01-01

    Prior to submitting a paper to a science journal, many European scientists employ language professionals to check that the English is acceptable. What influences these language professionals' criteria of acceptability? How do they interact with the authors for whom they work? And how do journals' criteria of acceptability affect their work? In…

  16. User-Defined Material Model for Progressive Failure Analysis

    NASA Technical Reports Server (NTRS)

    Knight, Norman F. Jr.; Reeder, James R. (Technical Monitor)

    2006-01-01

    An overview of different types of composite material system architectures and a brief review of progressive failure material modeling methods used for structural analysis including failure initiation and material degradation are presented. Different failure initiation criteria and material degradation models are described that define progressive failure formulations. These progressive failure formulations are implemented in a user-defined material model (or UMAT) for use with the ABAQUS/Standard1 nonlinear finite element analysis tool. The failure initiation criteria include the maximum stress criteria, maximum strain criteria, the Tsai-Wu failure polynomial, and the Hashin criteria. The material degradation model is based on the ply-discounting approach where the local material constitutive coefficients are degraded. Applications and extensions of the progressive failure analysis material model address two-dimensional plate and shell finite elements and three-dimensional solid finite elements. Implementation details and use of the UMAT subroutine are described in the present paper. Parametric studies for composite structures are discussed to illustrate the features of the progressive failure modeling methods that have been implemented.

  17. Revisiting Bioaccumulation Criteria

    EPA Science Inventory

    The objective of workgroup 5 was to revisit the B(ioaccumulation) criteria that are currently being used to identify POPs under the Stockholm Convention and PBTs under CEPA, TSCA, REACh and other programs. Despite the lack of a recognized definition for a B substance, we defined ...

  18. A research for Class II defect Bored Pile’s Accept Criteria: A case of Penang Second Marine bridge

    NASA Astrophysics Data System (ADS)

    Huang, Kang

    2018-03-01

    The aim of this preliminary research is to study the accept criteria of class II bored pile with subtle defect. According to a detailed comparison of the existed different standards, Chinese ones are more applicable especially for the large diameter bored piles. Through the concrete coring at pile No P25-03 of this case and the comparison to the actual calculation, the Class II pile’s defects were very minor. Comparison was also made for the effects on pile structural capacities before and after repair of the defects. the feasible repair proposal may bring forward to more defects to the piles. The Class II piles don’t need any further repairation when piles have typical of similar character and sonic logging test result with P25-03‘s one. For other Class II piles with some differences in characters, verification is needed through further concrete coring on the pile. The recommendation of this research could be adopted for the similar huge marine structures which installed large diameter bored piles.

  19. Design criteria for maglev structures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandberg, H.R.; Williams, J.R.

    1997-05-01

    Maglev systems represent an entirely new concept in transportation. They will not operate on nor share the right-of-way with any other system. It is important, therefore, that the guideways be designed and constructed so as to be economical, constructable, durable, adaptable, reliable, and readily maintained. Comparisons should be made with the current transportation systems, especially highways and railroads. Since most of the guideway will be elevated, the comparison should be with the bridges. The object of the comparisons should be to avoid the shortcomings of the other systems while building on their strengths. This paper develops in some detail designmore » and construction criteria that will ensure a good, long-lived performance of the maglev guideway. The importance of beauty should have a low priority in comparison to the other design criteria. Clean, simple details meeting other criteria will ensure an acceptable appearance. These criteria were used in evaluating the four maglev concepts developed for the National Maglev Initiative.« less

  20. The Indicator Performance Estimate (IPE) Approach to Defining Acceptable Conditions in Wilderness

    Treesearch

    Steven Hollenhorst; Lisa Stull-Gardner

    1992-01-01

    Using data from a study conducted in the Cranberry Wilderness area, this paper describes how the Importance-Performance approach can be used to prioritize wilderness indicators and determine how much change from the pristine is acceptable. The approach uses two key types of information: (1) indicator importance, or visitor opinion as to which wilderness indicators have...

  1. Alternative microbial methods: An overview and selection criteria.

    PubMed

    Jasson, Vicky; Jacxsens, Liesbeth; Luning, Pieternel; Rajkovic, Andreja; Uyttendaele, Mieke

    2010-09-01

    This study provides an overview and criteria for the selection of a method, other than the reference method, for microbial analysis of foods. In a first part an overview of the general characteristics of rapid methods available, both for enumeration and detection, is given with reference to relevant bibliography. Perspectives on future development and the potential of the rapid method for routine application in food diagnostics are discussed. As various alternative "rapid" methods in different formats are available on the market, it can be very difficult for a food business operator or for a control authority to select the most appropriate method which fits its purpose. Validation of a method by a third party, according to international accepted protocol based upon ISO 16140, may increase the confidence in the performance of a method. A list of at the moment validated methods for enumeration of both utility indicators (aerobic plate count) and hygiene indicators (Enterobacteriaceae, Escherichia coli, coagulase positive Staphylococcus) as well as for detection of the four major pathogens (Salmonella spp., Listeria monocytogenes, E. coli O157 and Campylobacter spp.) is included with reference to relevant websites to check for updates. In a second part of this study, selection criteria are introduced to underpin the choice of the appropriate method(s) for a defined application. The selection criteria link the definition of the context in which the user of the method functions - and thus the prospective use of the microbial test results - with the technical information on the method and its operational requirements and sustainability. The selection criteria can help the end user of the method to obtain a systematic insight into all relevant factors to be taken into account for selection of a method for microbial analysis. Copyright 2010 Elsevier Ltd. All rights reserved.

  2. Development of flaw acceptance criteria for aging management of spent nuclear fuel multiple-purpose canisters

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lam, P.; Sindelar, R.

    2015-03-09

    A typical multipurpose canister (MPC) is made of austenitic stainless steel and is loaded with spent nuclear fuel assemblies. The canister may be subject to service-induced degradation when it is exposed to aggressive atmospheric environments during a possibly long-term storage period if the permanent repository is yet to be identified and readied. Because heat treatment for stress relief is not required for the construction of an MPC, stress corrosion cracking may be initiated on the canister surface in the welds or in the heat affected zone. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defectsmore » be detected by periodic In-service Inspection. The first-order instability flaw sizes has been determined with bounding flaw configurations, that is, through-wall axial or circumferential cracks, and part-through-wall long axial flaw or 360° circumferential crack. The procedure recommended by the American Petroleum Institute (API) 579 Fitness-for-Service code (Second Edition) is used to estimate the instability crack length or depth by implementing the failure assessment diagram (FAD) methodology. The welding residual stresses are mostly unknown and are therefore estimated with the API 579 procedure. It is demonstrated in this paper that the residual stress has significant impact on the instability length or depth of the crack. The findings will limit the applicability of the flaw tolerance obtained from limit load approach where residual stress is ignored and only ligament yielding is considered.« less

  3. Development of flaw acceptance criteria for aging management of spent nuclear fuel multi-purpose canisters

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lam, Poh -Sang; Sindelar, Robert L.

    2015-03-09

    A typical multipurpose canister (MPC) is made of austenitic stainless steel and is loaded with spent nuclear fuel assemblies. The canister may be subject to service-induced degradation when it is exposed to aggressive atmospheric environments during a possibly long-term storage period if the permanent repository is yet to be identified and readied. Because heat treatment for stress relief is not required for the construction of an MPC, stress corrosion cracking may be initiated on the canister surface in the welds or in the heat affected zone. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defectsmore » be detected by periodic in-service Inspection. The first-order instability flaw sizes has been determined with bounding flaw configurations, that is, through-wall axial or circumferential cracks, and part-through-wall long axial flaw or 360° circumferential crack. The procedure recommended by the American Petroleum Institute (API) 579 Fitness-for-Service code (Second Edition) is used to estimate the instability crack length or depth by implementing the failure assessment diagram (FAD) methodology. The welding residual stresses are mostly unknown and are therefore estimated with the API 579 procedure. It is demonstrated in this paper that the residual stress has significant impact on the instability length or depth of the crack. The findings will limit the applicability of the flaw tolerance obtained from limit load approach where residual stress is ignored and only ligament yielding is considered.« less

  4. Evaluation of Flagging Criteria of United States Kidney Transplant Center Performance: How to Best Define Outliers?

    PubMed

    Schold, Jesse D; Miller, Charles M; Henry, Mitchell L; Buccini, Laura D; Flechner, Stuart M; Goldfarb, David A; Poggio, Emilio D; Andreoni, Kenneth A

    2017-06-01

    Scientific Registry of Transplant Recipients report cards of US organ transplant center performance are publicly available and used for quality oversight. Low center performance (LP) evaluations are associated with changes in practice including reduced transplant rates and increased waitlist removals. In 2014, Scientific Registry of Transplant Recipients implemented new Bayesian methodology to evaluate performance which was not adopted by Center for Medicare and Medicaid Services (CMS). In May 2016, CMS altered their performance criteria, reducing the likelihood of LP evaluations. Our aims were to evaluate incidence, survival rates, and volume of LP centers with Bayesian, historical (old-CMS) and new-CMS criteria using 6 consecutive program-specific reports (PSR), January 2013 to July 2015 among adult kidney transplant centers. Bayesian, old-CMS and new-CMS criteria identified 13.4%, 8.3%, and 6.1% LP PSRs, respectively. Over the 3-year period, 31.9% (Bayesian), 23.4% (old-CMS), and 19.8% (new-CMS) of centers had 1 or more LP evaluation. For small centers (<83 transplants/PSR), there were 4-fold additional LP evaluations (52 vs 13 PSRs) for 1-year mortality with Bayesian versus new-CMS criteria. For large centers (>183 transplants/PSR), there were 3-fold additional LP evaluations for 1-year mortality with Bayesian versus new-CMS criteria with median differences in observed and expected patient survival of -1.6% and -2.2%, respectively. A significant proportion of kidney transplant centers are identified as low performing with relatively small survival differences compared with expected. Bayesian criteria have significantly higher flagging rates and new-CMS criteria modestly reduce flagging. Critical appraisal of performance criteria is needed to assess whether quality oversight is meeting intended goals and whether further modifications could reduce risk aversion, more efficiently allocate resources, and increase transplant opportunities.

  5. Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

    PubMed Central

    McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

    2014-01-01

    Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there

  6. Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans.

    PubMed

    McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F

    2014-12-01

    The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference

  7. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography.

    PubMed

    Bredenoord, A J; Fox, M; Kahrilas, P J; Pandolfino, J E; Schwizer, W; Smout, A J P M

    2012-03-01

    The Chicago Classification of esophageal motility was developed to facilitate the interpretation of clinical high resolution esophageal pressure topography (EPT) studies, concurrent with the widespread adoption of this technology into clinical practice. The Chicago Classification has been an evolutionary process, molded first by published evidence pertinent to the clinical interpretation of high resolution manometry (HRM) studies and secondarily by group experience when suitable evidence is lacking. This publication summarizes the state of our knowledge as of the most recent meeting of the International High Resolution Manometry Working Group in Ascona, Switzerland in April 2011. The prior iteration of the Chicago Classification was updated through a process of literature analysis and discussion. The major changes in this document from the prior iteration are largely attributable to research studies published since the prior iteration, in many cases research conducted in response to prior deliberations of the International High Resolution Manometry Working Group. The classification now includes criteria for subtyping achalasia, EGJ outflow obstruction, motility disorders not observed in normal subjects (Distal esophageal spasm, Hypercontractile esophagus, and Absent peristalsis), and statistically defined peristaltic abnormalities (Weak peristalsis, Frequent failed peristalsis, Rapid contractions with normal latency, and Hypertensive peristalsis). The Chicago Classification is an algorithmic scheme for diagnosis of esophageal motility disorders from clinical EPT studies. Moving forward, we anticipate continuing this process with increased emphasis placed on natural history studies and outcome data based on the classification. © 2012 Blackwell Publishing Ltd.

  8. 76 FR 82201 - General Site Suitability Criteria for Nuclear Power Stations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ..., and 52 [NRC-2011-0297] General Site Suitability Criteria for Nuclear Power Stations AGENCY: Nuclear... Suitability Criteria for Nuclear Power Stations.'' This guide describes a method that the NRC staff considers acceptable to implement the site suitability requirements for nuclear power stations. DATES: Submit comments...

  9. Problems in Defining the Field of Distance Education.

    ERIC Educational Resources Information Center

    Keegan, Desmond

    1988-01-01

    This discussion of definitions of distance education responds to previous articles attempting to define the field. Topics discussed include distance education versus conventional education; group-based distance education; differences between open learning and distance education; and criteria to define distance education. (13 references) (LRW)

  10. Pros and cons of conjoint analysis of discrete choice experiments to define classification and response criteria in rheumatology.

    PubMed

    Taylor, William J

    2016-03-01

    Conjoint analysis of choice or preference data has been used in marketing for over 40 years but has appeared in healthcare settings much more recently. It may be a useful technique for applications within the rheumatology field. Conjoint analysis in rheumatology contexts has mainly used the approaches implemented in 1000Minds Ltd, Dunedin, New Zealand, Sawtooth Software, Orem UT, USA. Examples include classification criteria, composite response criteria, service prioritization tools and utilities assessment. Limitations imposed by very many attributes can be managed using new techniques. Conjoint analysis studies of classification and response criteria suggest that the assumption of equal weighting of attributes cannot be met, which challenges traditional approaches to composite criteria construction. Weights elicited through choice experiments with experts can derive more accurate classification criteria, than unweighted criteria. Studies that find significant variation in attribute weights for composite response criteria for gout make construction of such criteria problematic. Better understanding of various multiattribute phenomena is likely to increase with increased use of conjoint analysis, especially when the attributes concern individual perceptions or opinions. In addition to classification criteria, some applications for conjoint analysis that are emerging in rheumatology include prioritization tools, remission criteria, and utilities for life areas.

  11. Defining recovery in adult bulimia nervosa.

    PubMed

    Yu, Jessica; Agras, W Stewart; Bryson, Susan

    2013-01-01

    To examine how different definitions of recovery lead to varying rates of recovery, maintenance of recovery, and relapse in bulimia nervosa (BN), end-of-treatment (EOT) and follow-up data were obtained from 96 adults with BN. Combining behavioral, physical, and psychological criteria led to recovery rates between 15.5% and 34.4% at EOT, though relapse was approximately 50%. Combining these criteria and requiring abstinence from binge eating and purging when defining recovery may lead to lower recovery rates than those found in previous studies; however, a strength of this definition is that individuals who meet this criteria have no remaining disordered behaviors or symptoms.

  12. Determination of criteria weights in solving multi-criteria problems

    NASA Astrophysics Data System (ADS)

    Kasim, Maznah Mat

    2014-12-01

    A multi-criteria (MC) problem comprises of units to be analyzed under a set of evaluation criteria. Solving a MC problem is basically the process of finding the overall performance or overall quality of the units of analysis by using certain aggregation method. Based on these overall measures of each unit, a decision can be made whether to sort them, to select the best or to group them according to certain ranges. Prior to solving the MC problems, the weights of the related criteria have to be determined with the assumption that the weights represent the degree of importance or the degree of contribution towards the overall performance of the units. This paper presents two main approaches which are called as subjective and objective approaches, where the first one involves evaluator(s) while the latter approach depends on the intrinsic information contained in each criterion. The subjective and objective weights are defined if the criteria are assumed to be independent with each other, but if they are dependent, there is another type of weight, which is called as monotone measure weight or compound weights which represent degree of interaction among the criteria. The measure of individual weights or compound weights must be addressed in solving multi-criteria problems so that the solutions are more reliable since in the real world, evaluation criteria always come with different degree of importance or are dependent with each other. As the real MC problems have their own uniqueness, it is up to the decision maker(s) to decide which type of weights and which method are the most applicable ones for the problem under study.

  13. Remarks on the Acceptance of Proofs: The Case of Some Recently Tackled Major Theorems.

    ERIC Educational Resources Information Center

    Neubrand, Michael

    1989-01-01

    Lists five criteria in the acceptance of mathematical theorems, such as understanding, significance, compatibility, reputation, and convincing argument. Concludes that social and language factors are involved in the process of the acceptance. (YP)

  14. [Acceptance of lot sampling: its applicability to the evaluation of the primary care services portfolio].

    PubMed

    López-Picazo Ferrer, J

    2001-05-15

    To determine the applicability of the acceptance of lot quality assurance sampling (LQAS) in the primary care service portfolio, comparing its results with those given by classic evaluation. Compliance with the minimum technical norms (MTN) of the service of diabetic care was evaluated through the classic methodology (confidence 95%, accuracy 5%, representativeness of area, sample of 376 histories) and by LQAS (confidence 95%, power 80%, representativeness of primary care team (PCT), defining a lot by MTN and PCT, sample of 13 histories/PCT). Effort, information obtained and its operative nature were assessed. 44 PCTs from Murcia Primary Care Region. Classic methodology: compliance with MTN ranged between 91.1% (diagnosis, 95% CI, 84.2-94.0) and 30% (repercussion in viscera, 95% CI, 25.4-34.6). Objectives in three MTN were reached (diagnosis, history and EKG). LQAS: no MTN was accepted in all the PCTs, <01-diagnosis> being the most accepted (42 PCT, 95.6%) and <07-Funduscopy> the least accepted (24 PCT, 55.6%). In 9 PCT all were accepted (20.4%), and in 2 none were accepted (4.5%). Data were analysed through Pareto charts. Classic methodology offered accurate results, but did not identify which centres were those that did not comply (general focus). LQAS was preferable for evaluating MTN and probably coverage because: 1) it uses small samples, which foment internal quality-improvement initiatives; 2) it is easy and rapid to execute; 3) it identifies the PCT and criteria where there is an opportunity for improvement (specific focus), and 4) it can be used operatively for monitoring.

  15. Selection criteria of residents for residency programs in Kuwait

    PubMed Central

    2013-01-01

    Background In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. Methods A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Results Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. Conclusions This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training. PMID:23331670

  16. Establishment of design criteria for acceptable failure modes and fail safe considerations for the space shuttle structural system

    NASA Technical Reports Server (NTRS)

    Westrup, R. W.

    1972-01-01

    Investigations of fatigue life, and safe-life and fail-safe design concepts as applied to space shuttle structure are summarized. The results are evaluated to select recommended structural design criteria to provide assurance that premature failure due to propagation of undetected crack-like defects will not occur during shuttle operational service. The space shuttle booster, GDC configuration B-9U, is selected as the reference vehicle. Structural elements used as basis of detail analyses include wing spar caps, vertical stabilizer skins, crew compartment skin, orbiter support frame, and propellant tank shell structure. Fatigue life analyses of structural elements are performed to define potential problem areas and establish upper limits of operating stresses. Flaw growth analyses are summarized in parametric form over a range of initial flaw types and sizes, operating stresses and service life requirements. Service life of 100 to 500 missions is considered.

  17. 78 FR 64030 - Monitoring Criteria and Methods To Calculate Occupational Radiation Doses

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... NUCLEAR REGULATORY COMMISSION [NRC-2013-0234] Monitoring Criteria and Methods To Calculate... regulatory guide (DG), DG-8031, ``Monitoring Criteria and Methods to Calculate Occupational Radiation Doses.'' This guide describes methods that the NRC staff considers acceptable for licensees to use to determine...

  18. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework.

    PubMed

    Sekhon, Mandeep; Cartwright, Martin; Francis, Jill J

    2017-01-26

    It is increasingly acknowledged that 'acceptability' should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients. Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators. From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews). From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Despite frequent claims that healthcare interventions have assessed acceptability, it is

  19. [Revision of McDonald's new diagnostic criteria for multiple sclerosis].

    PubMed

    Wiendl, H; Kieseier, B C; Gold, R; Hohlfeld, R; Bendszus, M; Hartung, H-P

    2006-10-01

    In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.

  20. Defining and understanding healthy lifestyles choices for adolescents.

    PubMed

    He, Ka; Kramer, Ellen; Houser, Robert F; Chomitz, Virginia R; Hacker, Karen A

    2004-07-01

    To: (a) establish criteria for defining positive health behaviors and lifestyle; and (b) identify characteristics of adolescents who practice a healthy lifestyle. Responses from a 1998 survey via questionnaire, of 1487 students, from a public high school, Cambridge, Massachusetts, were used to assess correlates of healthy lifestyle choices. Strict and broad assessments of healthy behaviors were defined for students: use of alcohol, tobacco, and illegal drugs; sexual behavior; attempted suicide. Whereas the "strict" criteria included only those adolescents who did not practice any of the behaviors in question, the broad criteria reflected experimentation and moderate risk-taking. The prevalence of positive behaviors was assessed by demographic and student characteristics. In addition, logistic regression models were created to predict determinants of teenagers' healthy lifestyles using both strict and broad definitions. Using strict criteria of healthy lifestyle, significant predictors were being female, born outside the United States, higher academic performance, and fewer stressful life events. Using a broad definition of a healthy lifestyle, significant predictors were being non-Caucasian, in the lower grade levels at the school, higher academic performance, and fewer stressful life events. In both models, peers' approval of risky behaviors negatively influenced teens' lifestyles, whereas parents' disapproval of risky behaviors was a positive influence. These results reinforce the importance of school, peer, and parent support of positive behaviors. It is important for public health workers and families to understand and define healthy lifestyles choices for adolescents.

  1. Development of responder criteria for multicomponent non-pharmacological treatment in fibromyalgia.

    PubMed

    Vervoort, Vera M; Vriezekolk, Johanna E; van den Ende, Cornelia H

    2017-01-01

    There is a need to identify individual treatment success in patients with fibromyalgia (FM) who received non-pharmacological treatment. The present study described responder criteria for multicomponent non-pharmacological treatment in FM, and estimated and compared their sensitivity and specificity. Candidate responder sets were 1) identified in literature; and 2) formulated by expert group consensus. All candidate responder sets were tested in a cohort of 129 patients with FM receiving multicomponent non-pharmacological treatment. We used two gold standards (both therapist's and patient's perspective), assessed at six months after the start of treatment. Seven responder sets were defined (three identified in literature and four formulated by expert group consensus), and comprised combinations of domains of 1) pain; 2) fatigue; 3) patient global assessment (PGA); 4) illness perceptions; 5) limitations in activities of daily living (ADL); and 6) sleep. The sensitivity and specificity of literature-based responder sets (n=3) ranged between 17%-99% and 15%-95% respectively, whereas the expert-based responder sets (n=4) performed slightly better with regard to sensitivity (range 41%-81%) and specificity (range 50%-96%). Of the literature-based responder sets the OMERACT-OARSI responder set with patient's gold standard performed best (sensitivity 63%, specificity 75% and ROC area = 0.69). Overall, the expert-based responder set comprising the domains illness perceptions and limitations in ADL with patient's gold standard performed best (sensitivity 47%, specificity 96% and ROC area = 0.71). We defined sets of responder criteria for multicomponent non-pharmacological treatment in fibromyalgia. Further research should focus on the validation of those sets with acceptable performance.

  2. Application criteria of enteral nutrition in patients with anorexia nervosa: correlation between clinical and psychological data in a "lifesaving" treatment.

    PubMed

    Paccagnella, Agostino; Mauri, Alessandra; Baruffi, Carla; Berto, Rita; Zago, Raffaella; Marcon, Maria Lisa; Pizzolato, Daniela; Fontana, Francesca; Rizzo, Lenio; Bisetto, Mario; Agostini, Silvana; Foscolo, Giancarlo

    2006-01-01

    Data and research increasingly point to multiple factors in the genesis of eating-behavior disorders, but the lack of a clear etiological definition prevents a unique therapeutic or prognostic approach from being defined. Therapeutic approaches, as well as scientific research, have separately analyzed the psychological aspects and the clinical-nutrition aspects without integrating the variables or correlating clinical and psychological data. This work has several goals because it aims at considering the problem from the 2 different perspectives. Psychological and clinical variables are analyzed both separately and together in order to assess (a) the minimal criteria to define a cure as "lifesaving" and submit a patient to artificial nutrition; (b) the kind of implementation artificial nutrition should follow; (c) which indicators of the efficacy of artificial nutrition must be taken into account; (d) the results in nutrition terms that may be obtained during the follow-up; (e) if artificial nutrition may be used as a therapeutic tool; (f) if there are any psychological effects after artificial nutrition; (g) if there are any effects due to the patients' age; and (h) the correlation between the psychological profile of a patient and the acceptance of the nutrition treatment. Several psychological and pharmacologic variables, together with clinical and anthropometric data and blood chemical values, were all considered. Besides defining minimal criteria for a "lifesaving" cure and proposing 2 ad hoc scales for the assessment of patients' subjective willingness toward feeding and for the objective measurement of feeding itself, clinical data and correlations with psychological data evidenced the importance of artificial nutrition and specifically of enteral nutrition as a therapeutic tool, allowing us to define the modalities of implementation of enteral nutrition. Results show that, because enteral nutrition did not deteriorate the psychological state of the patients

  3. Scientific Issues Relevant to Setting Regulatory Criteria to Identify Endocrine-Disrupting Substances in the European Union.

    PubMed

    Slama, Rémy; Bourguignon, Jean-Pierre; Demeneix, Barbara; Ivell, Richard; Panzica, Giancarlo; Kortenkamp, Andreas; Zoeller, R Thomas

    2016-10-01

    Endocrine disruptors (EDs) are defined by the World Health Organization (WHO) as exogenous compounds or mixtures that alter function(s) of the endocrine system and consequently cause adverse effects in an intact organism, or its progeny, or (sub)populations. European regulations on pesticides, biocides, cosmetics, and industrial chemicals require the European Commission to establish scientific criteria to define EDs. We address the scientific relevance of four options for the identification of EDs proposed by the European Commission. Option 1, which does not define EDs and leads to using interim criteria unrelated to the WHO definition of EDs, is not relevant. Options 2 and 3 rely on the WHO definition of EDs, which is widely accepted by the scientific community, with option 3 introducing additional categories based on the strength of evidence (suspected EDs and endocrine-active substances). Option 4 adds potency to the WHO definition, as a decision criterion. We argue that potency is dependent on the adverse effect considered and is scientifically ambiguous, and note that potency is not used as a criterion to define other particularly hazardous substances such as carcinogens and reproductive toxicants. The use of potency requires a context that goes beyond hazard identification and corresponds to risk characterization, in which potency (or, more relevantly, the dose-response function) is combined with exposure levels. There is scientific agreement regarding the adequacy of the WHO definition of EDs. The potency concept is not relevant to the identification of particularly serious hazards such as EDs. As is common practice for carcinogens, mutagens, and reproductive toxicants, a multi-level classification of ED based on the WHO definition, and not considering potency, would be relevant (corresponding to option 3 proposed by the European Commission). Slama R, Bourguignon JP, Demeneix B, Ivell R, Panzica G, Kortenkamp A, Zoeller RT. 2016. Scientific issues relevant

  4. Scientific Issues Relevant to Setting Regulatory Criteria to Identify Endocrine-Disrupting Substances in the European Union

    PubMed Central

    Slama, Rémy; Bourguignon, Jean-Pierre; Demeneix, Barbara; Ivell, Richard; Panzica, Giancarlo; Kortenkamp, Andreas; Zoeller, R. Thomas

    2016-01-01

    Background: Endocrine disruptors (EDs) are defined by the World Health Organization (WHO) as exogenous compounds or mixtures that alter function(s) of the endocrine system and consequently cause adverse effects in an intact organism, or its progeny, or (sub)populations. European regulations on pesticides, biocides, cosmetics, and industrial chemicals require the European Commission to establish scientific criteria to define EDs. Objectives: We address the scientific relevance of four options for the identification of EDs proposed by the European Commission. Discussion: Option 1, which does not define EDs and leads to using interim criteria unrelated to the WHO definition of EDs, is not relevant. Options 2 and 3 rely on the WHO definition of EDs, which is widely accepted by the scientific community, with option 3 introducing additional categories based on the strength of evidence (suspected EDs and endocrine-active substances). Option 4 adds potency to the WHO definition, as a decision criterion. We argue that potency is dependent on the adverse effect considered and is scientifically ambiguous, and note that potency is not used as a criterion to define other particularly hazardous substances such as carcinogens and reproductive toxicants. The use of potency requires a context that goes beyond hazard identification and corresponds to risk characterization, in which potency (or, more relevantly, the dose–response function) is combined with exposure levels. Conclusions: There is scientific agreement regarding the adequacy of the WHO definition of EDs. The potency concept is not relevant to the identification of particularly serious hazards such as EDs. As is common practice for carcinogens, mutagens, and reproductive toxicants, a multi-level classification of ED based on the WHO definition, and not considering potency, would be relevant (corresponding to option 3 proposed by the European Commission). Citation: Slama R, Bourguignon JP, Demeneix B, Ivell R, Panzica G

  5. Defining the end-point of mastication: A conceptual model.

    PubMed

    Gray-Stuart, Eli M; Jones, Jim R; Bronlund, John E

    2017-10-01

    The great risks of swallowing are choking and aspiration of food into the lungs. Both are rare in normal functioning humans, which is remarkable given the diversity of foods and the estimated 10 million swallows performed in a lifetime. Nevertheless, it remains a major challenge to define the food properties that are necessary to ensure a safe swallow. Here, the mouth is viewed as a well-controlled processor where mechanical sensory assessment occurs throughout the occlusion-circulation cycle of mastication. Swallowing is a subsequent action. It is proposed here that, during mastication, temporal maps of interfacial property data are generated, which the central nervous system compares against a series of criteria in order to be sure that the bolus is safe to swallow. To determine these criteria, an engineering hazard analysis tool, alongside an understanding of fluid and particle mechanics, is used to deduce the mechanisms by which food may deposit or become stranded during swallowing. These mechanisms define the food properties that must be avoided. By inverting the thinking, from hazards to ensuring safety, six criteria arise which are necessary for a safe-to-swallow bolus. A new conceptual model is proposed to define when food is safe to swallow during mastication. This significantly advances earlier mouth models. The conceptual model proposed in this work provides a framework of decision-making to define when food is safe to swallow. This will be of interest to designers of dietary foods, foods for dysphagia sufferers and will aid the further development of mastication robots for preparation of artificial boluses for digestion research. It enables food designers to influence the swallow-point properties of their products. For example, a product may be designed to satisfy five of the criteria for a safe-to-swallow bolus, which means the sixth criterion and its attendant food properties define the swallow-point. Alongside other organoleptic factors, these

  6. Modified criteria for carotid sinus hypersensitivity are associated with increased mortality in a population-based study

    PubMed Central

    McDonald, Claire; Pearce, Mark S.; Newton, Julia L.; Kerr, Simon R.J.

    2016-01-01

    Abstract Aims Carotid sinus hypersensitivity (CSH) is arbitrarily defined as ≥3 s asystole or vasodepression of ≥50 mmHg in response to carotid sinus massage (CSM). Using this definition, 39% of older people meet the criteria for CSH. It has been suggested that current criteria are too sensitive. Krediet et al. [The history of diagnosing carotid sinus hypersensitivity: why are the current criteria too sensitive? Europace 2011;13:14–22] and Kerr et al. [Carotid sinus hypersensitivity in asymptomatic older persons: implications for diagnosis of syncope and falls. Arch Intern Med 2006;166:515–20] have proposed modified criteria. This population-based study aimed to compare the prevalence of CSH defined according to standard, Krediet and Kerr criteria, and to establish if CSH defined according these criteria is associated with all-cause mortality. Methods and results A total of 272 community-dwelling people aged ≥65 were recruited at random. Carotid sinus massage was performed for 5 s in supine and head-up positions. Heart rate and blood pressure response were recorded using an electrocardiogram and photoplethysmography. Cox regression analysis was used to examine the association between each definition of CSH and all-cause mortality. The prevalence of CSH defined according to standard, Krediet, and Kerr criteria was 39, 52, and 10%, respectively. Seventy-one participants died over a mean follow-up of 8.6 years (SD 2.1). Carotid sinus hypersensitivity defined according to standard and Krediet criteria was not associated with survival. Carotid sinus hypersensitivity defined according to Kerr criteria was associated with all-cause mortality independent of age and sex [hazard ratio (HR) 2.023 (95% confidence interval (95% CI) 1.131–3.618) P = 0.018)]. This remained significant after adjusting for cardiovascular risk factors [HR 2.174 (1.075–3.900) P = 0.009]. Conclusion Carotid sinus hypersensitivity defined according to Kerr criteria is associated with

  7. Quantum cryptography: Security criteria reexamined

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kaszlikowski, Dagomir; Liang, Y.C.; Englert, Berthold-Georg

    2004-09-01

    We find that the generally accepted security criteria are flawed for a whole class of protocols for quantum cryptography. This is so because a standard assumption of the security analysis, namely that the so-called square-root measurement is optimal for eavesdropping purposes, is not true in general. There are rather large parameter regimes in which the optimal measurement extracts substantially more information than the square-root measurement.

  8. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  9. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  10. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  11. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  12. Regulatory acceptance and use of 3R models for pharmaceuticals and chemicals: expert opinions on the state of affairs and the way forward.

    PubMed

    Schiffelers, Marie-Jeanne W A; Blaauboer, Bas J; Bakker, Wieger E; Beken, Sonja; Hendriksen, Coenraad F M; Koëter, Herman B W M; Krul, Cyrille

    2014-06-01

    Pharmaceuticals and chemicals are subjected to regulatory safety testing accounting for approximately 25% of laboratory animal use in Europe. This testing meets various objections and has led to the development of a range of 3R models to Replace, Reduce or Refine the animal models. However, these models must overcome many barriers before being accepted for regulatory risk management purposes. This paper describes the barriers and drivers and options to optimize this acceptance process as identified by two expert panels, one on pharmaceuticals and one on chemicals. To untangle the complex acceptance process, the multilevel perspective on technology transitions is applied. This perspective defines influences at the micro-, meso- and macro level which need alignment to induce regulatory acceptance of a 3R model. This paper displays that there are many similar mechanisms within both sectors that prevent 3R models from becoming accepted for regulatory risk assessment and management. Shared barriers include the uncertainty about the value of the new 3R models (micro level), the lack of harmonization of regulatory requirements and acceptance criteria (meso level) and the high levels of risk aversion (macro level). In optimizing the process commitment, communication, cooperation and coordination are identified as critical drivers. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Determining the Criteria and Their Weights for Medical Schools' Ranking: A National Consensus.

    PubMed

    Mojtahedzadeh, Rita; Mohammadi, Aeen; Kohan, Noushin; Gharib, Mitra; Zolfaghari, Mitra

    2016-06-01

    Delphi as a consensus development technique enables anonymous, systematic refinement of expert opinion with the aim of arriving at a combined or consensual position. In this study, we determined the criteria and their weights for Iranian Medical Schools' ranking through a Delphi process. An expert committee devised 13 proposed criteria with 32 indicators with their weights, which were arranged hierarchically in the form of a tree diagram. We used the Delphi technique to reach a consensus on these criteria and weights among the deans of 38 public Iranian medical schools. For this purpose, we devised and sent a questionnaire to schools and asked them to suggest or correct the criteria and their weights. We repeated this process in two rounds till all the schools reached an acceptable consensus on them. All schools reached a consensus on the set of 13 criteria and 30 indicators and their weights in three main contexts of education, research and facilities, and equipment which were used for Medical Schools' ranking. Using Delphi technique for devising the criteria and their weights in evaluation processes such as ranking makes their results more acceptable among universities.

  14. Diffusion of Educational Knowledge Through Journals: Gatekeepers' Selection Criteria

    ERIC Educational Resources Information Center

    Silverman, Robert J.

    1978-01-01

    Report is made of a survey of 248 editors representing scholarly, professional, association, and research journals in regard to their editorial role, criteria for accepting or rejecting manuscripts, and selection of editorial boards and reviewers. (Author/MJB)

  15. Stabilized Approach Criteria: Bridging the Gap Between Theory and Practice

    NASA Technical Reports Server (NTRS)

    Zaal, Petrus M.

    2018-01-01

    Approach and landing is the most common phase of flight for aviation accidents, accounting annually for approximately 65 percent of all accidents. A Flight Safety Foundation study of 16 years of runway excursions determined that 83 percent could have been avoided with a decision to go around. In other words, 54 percent of all accidents could potentially be prevented by going around. A critical industry policy designed to help prevent such accidents is the go-around policy. However, the collective industry performance of complying with go-around policies is extremely poor and only about three percent of unstable approaches result in a go-around. Improving the go-around compliance rate holds tremendous potential in reducing approach and landing accidents. There are many reasons for flight crews ignoring go-around policies related to pilot judgement and company policies. Examples are the collective industry norm to accept the noncompliance of go-around policies, management being disengaged from go-around noncompliance, and pilot fatigue and lack of situational awareness. One of the biggest factors is that pilots see current stabilized-approach criteria as too complex and restrictive for the operational environment. Following the American Airlines 1420 accident (Little Rock, 1999), where the aircraft overran the runway upon landing and crashed, the National Transportation Safety Board (NTSB) recommended that the Federal Aviation Administration (FAA) define detailed parameters for a stabilized approach, and develop detailed criteria indicating when a go-around should be performed. The experiment discussed in this presentation is the first step towards developing these go-around criteria for commercial transport aircraft.

  16. 49 CFR 611.11 - Local financial commitment criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Local financial commitment criteria. 611.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MAJOR CAPITAL INVESTMENT PROJECTS § 611.11 Local financial... proposed project is supported by an acceptable degree of local financial commitment, as required by section...

  17. 49 CFR 611.11 - Local financial commitment criteria.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Local financial commitment criteria. 611.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MAJOR CAPITAL INVESTMENT PROJECTS § 611.11 Local financial... proposed project is supported by an acceptable degree of local financial commitment, as required by section...

  18. [Permanent essential defacement--remarks on the possibilities of verification of the accepted criteria in medico-legal certification in criminal and civil law proceedings].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Jabłoński, Christian; Neniczka, Stanisława

    2007-01-01

    Despite the fact that some criteria of medico-legal certification in criminal and civil proceedings have been established, there are still some topics which are controversial and thus require modification. This is also true of the notion of "permanent essential defacement". In the opinion of the authors, changes in social conventions that are occurring nowadays, as well as a highly diversified, subjective perception of esthetic values indicate the need for discussing a possible modification of the presently obligatory criteria. Apart from the assessment of posttraumatic changes, an important problem is posed by defining the notion of "a part of the body customarily open to the view ". Additionally, the authors bring up for discussion the issue of experts taking into consideration the age and sex of the victims while assessing damages. A separate problem lies in difficulties in assessing the degree of detriment to health because of defacement due to the fact that official tables for evaluating permanent or long-term detriment to health do not include relevant information.

  19. Center-defined unacceptable HLA antigens facilitate transplants for sensitized patients in a multi-center kidney exchange program.

    PubMed

    Baxter-Lowe, L A; Cecka, M; Kamoun, M; Sinacore, J; Melcher, M L

    2014-07-01

    Multi-center kidney paired donation (KPD) is an exciting new transplant option that has not yet approached its full potential. One barrier to progress is accurate virtual crossmatching for KPD waitlists with many highly sensitized patients. Virtual crossmatch results from a large multi-center consortium, the National Kidney Registry (NKR), were analyzed to determine the effectiveness of flexible center-specific criteria for virtual crossmatching. Approximately two-thirds of the patients on the NKR waitlist are highly sensitized (>80% CPRA). These patients have antibodies against HLA-A (63%), HLA-B (66%), HLA-C (41%), HLA-DRB1 (60%), HLA-DRB3/4/5 (18-22%), HLA-DQB1 (54%) and HLA-DPB1 (26%). With donors typed for these loci before activation, 91% of virtual crossmatches accurately predicted an acceptable cell-based donor crossmatch. Failed virtual crossmatches were attributed to equivocal virtual crossmatches (46%), changes in HLA antibodies (21%), antibodies against HLA-DQA (6%), transcription errors (6%), suspected non-HLA antibodies (5%), allele-specific antibodies (1%) and unknown causes (15%). Some failed crossmatches could be prevented by modifiable factors such as more frequent assessment of HLA antibodies, DQA1 typing of donors and auditing data entry. Importantly, when transplant centers have flexibility to define crossmatch criteria, it is currently feasible to use virtual crossmatching for highly sensitized patients to reliably predict acceptable cell-based crossmatches. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  20. Donor understanding and attitudes about current and potential deferral criteria for high-risk sexual behavior.

    PubMed

    Goldman, Mindy; Yi, Qi-Long; Ye, Xibiao; Tessier, Lorna; O'Brien, Sheila F

    2011-08-01

    Few donor criteria are as contentious as the deferral of men who have had sex with men (MSM). We performed an anonymous donor survey to determine attitudes toward current screening and the feasibility and acceptability of adoption of alternate donor criteria for MSM. Donors who had successfully donated to Canadian Blood Services were randomly mailed an anonymous questionnaire several weeks after donation; there were 40,000 donors sampled, evenly split between first-time and repeat donors. The response rate was 45.5%. The vast majority of donors found the current screening questions and clinic environment acceptable. Attention to clinic educational materials was poor. A total of 53% felt that the MSM criteria should be changed; many were supportive of criteria based on specific behaviors rather than a period of abstinence. Gender-neutral questions such as number of sexual partners would result in deferral of large numbers of donors. Many donors would support a change in MSM deferral policy. Implementation of strategies based on donor attention to additional material would be challenging. Universal use of simple gender-neutral questions would result in very high donor loss and are therefore not an acceptable option. The acceptability and feasibility of various screening approaches should be explored further with both donors and advocacy groups. © 2011 American Association of Blood Banks.

  1. Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: a national study.

    PubMed

    Simpson, Alexander I F; Skipworth, Jeremy; McKenna, Brian; Moskowitz, Andrew; Barry-Walsh, Justin

    2006-09-01

    Homicides by people with mental illness have been studied using either clinical or legal categorization of the homicide as abnormal. No previous study has employed both definitions in the same population. A retrospective study of all homicides in New Zealand between 1988 and 2000 considered mentally abnormal homicide using a legal definition (when the courts deemed a contribution of mental illness was present) and a clinical definition (defined as the presence of a discharge diagnosis from inpatient mental health treatment) of 'mentally abnormal'. Rates, characteristics and time trends were investigated. Of the 844 cases, 7.1% met legal criteria for being mentally abnormal, while 7.7% had ever received a diagnosis for a psychotic illness, and a further 14.5% had been admitted to a psychiatric hospital for any other reason. The majority (60%) of perpetrators with a psychotic diagnosis received a mental health disposition from the court. Of these, 60% were first diagnosed with their psychotic illness prior to the homicide, while 28% were first diagnosed at the time of the offence and a further 12% after imprisonment. Of all those who received a psychotic diagnosis, 89% had post-conviction admissions or a mental health disposition. Legal and clinical definitions of mentally abnormal homicide detect similar rates of mentally abnormal homicide, but illustrate somewhat different dimensions of the relationship between mental illness and homicide.

  2. The need for pediatric-specific triage criteria: results from the Florida Trauma Triage Study.

    PubMed

    Phillips, S; Rond, P C; Kelly, S M; Swartz, P D

    1996-12-01

    The objective of the Florida Trauma Triage Study was to assess the performance of state-adopted field triage criteria. The study addressed three specific age groups: pediatric (age < 15 years), adult (age 15-54 years), and geriatric (age 55+ years). Since 1990, Florida has used a uniform set of eight triage criteria, known as the trauma scorecard, for triaging adult trauma patients to state-approved trauma centers. However, only five of the criteria are recommended for use with pediatric patients. This article presents the findings regarding the performance of the scorecard when applied to a pediatric population. We used state trauma registry data linked to state hospital discharge data in a retrospective analysis of trauma patients transported by prehospital providers to any acute care hospital within nine selected Florida counties between July 1, 1991, and December 31, 1991. We used cross-table and logistic regression analysis to determine the ability of triage criteria to correctly identify patients who were retrospectively defined as major trauma. We applied the field criteria to physiologic and anatomy/mechanism of injury data contained in the trauma registry to "score" the patient as major or minor trauma. To make our retrospective determination of major or minor trauma we used the protocols developed by an expert medical panel as described by E. J. MacKenzie et al. (1990). We calculated sensitivity, specificity, and the corresponding over- and undertriage rates by comparing patient classifications (major or minor trauma) produced by the triage criteria and the retrospective algorithm. We used logistic regression to identify which triage criteria were statistically significant in predicting major trauma. Pediatric cases accounted for 9.2% of the total study population, 6.0% of all hospitalized cases, and 6.8% of all trauma deaths. Of the 1505 pediatric cases available for analysis, the triage criteria classified 269 cases as expected major trauma and 1236

  3. Acceptability of willingness to pay techniques to consumers.

    PubMed

    Taylor, Susan J; Armour, Carol L

    2002-12-01

    The purpose of this study was to assess and compare the proportion of usable responses and protest votes obtained with two willingness to pay (WTP) techniques, contingent valuation (CV) and discrete choice experiment (DCE) and to assess the acceptability of the techniques to respondents. Pregnant women attending the public antenatal clinics of a Sydney teaching hospital were surveyed. Preference for either Treatment A (artificial rupture of the membranes followed by intravenous oxytocin) or Treatment B (prostaglandin E2 gel followed by oxytocin if necessary) was assessed. Then WTP for the preferred treatments was assessed using CV and WTP for specific attributes of the treatments in the DCE. In addition, the acceptability of the two techniques was compared in terms of responses deemed to be valid according to defined criteria, protest votes and comments recorded by consumers. With the CV, 74% of respondents chose gel and their maximum WTP was Aus$178 compared with $133 for the alternative. A total of 68% of responses were deemed to be valid including 5% who may have been expressing a protest vote. With the DCE, respondents were WTP $55 for every 1 h reduction in the length of time from induction to delivery. A total of 72% of responses were deemed valid and only two of these 258 women were considered to have expressed a protest vote. Only a small number of women expressed objections to the use of WTP questions in health-care and the majority of women completed both questions successfully.

  4. Acceptability of willingness to pay techniques to consumers

    PubMed Central

    Taylor, Susan J.; Armour, Carol L.

    2002-01-01

    Abstract Objective The purpose of this study was to assess and compare the proportion of usable responses and protest votes obtained with two willingness to pay (WTP) techniques, contingent valuation (CV) and discrete choice experiment (DCE) and to assess the acceptability of the techniques to respondents. Setting and participants Pregnant women attending the public antenatal clinics of a Sydney teaching hospital were surveyed. Main variables studied Preference for either Treatment A (artificial rupture of the membranes followed by intravenous oxytocin) or Treatment B (prostaglandin E2 gel followed by oxytocin if necessary) was assessed. Then WTP for the preferred treatments was assessed using CV and WTP for specific attributes of the treatments in the DCE. In addition, the acceptability of the two techniques was compared in terms of responses deemed to be valid according to defined criteria, protest votes and comments recorded by consumers. Results With the CV, 74% of respondents chose gel and their maximum WTP was Aus$178 compared with $133 for the alternative. A total of 68% of responses were deemed to be valid including 5% who may have been expressing a protest vote. With the DCE, respondents were WTP $55 for every 1 h reduction in the length of time from induction to delivery. A total of 72% of responses were deemed valid and only two of these 258 women were considered to have expressed a protest vote. Conclusions Only a small number of women expressed objections to the use of WTP questions in health‐care and the majority of women completed both questions successfully. PMID:12460223

  5. Preliminary vibration, acoustic, and shock design and test criteria for components on the SRB, ET, and SSME

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Specifications for vibration, acoustic and shock design for components and subassemblies on the External Tank (ET), Solid Rocket Booster (SRB), and Space Shuttle Main Engine (SSME). Included are vibration, acoustic, shock, transportation, handling, and acceptance test requirements and procedures. The space shuttle ET, SRB, and SSME have been divided into zones and subzones. Zones are designated primarily to assist in determining the applicable specifications. A subzone (General Specification) is available for use when the location of the component is known but component design and weight are not well defined. When the location, weight, and mounting configuration of the component are known, specifications for appropriate subzone weight ranges are available. Criteria for some specific components are also presented.

  6. Clinical criteria for psychiatric diagnosis and DSM-III.

    PubMed

    Spitzer, R L; Endicott, J; Robins, E

    1975-11-01

    The authors identify the differences in formal inclusion and exclusion criteria used to classify patient data into diagnoses as the largest source of diagnostic unreliability in psychiatry. They describe the efforts that have been made to reduce these differences, particularly the specified criteria approach to defining diagnostic categories, which was developed for research purposes. On the basis of studies showing that the use of specified criteria increases the reliability of diagnostic judgments, they suggest that including such criteria in the next edition of APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) would improve the reliability and validity of routine psychiatric diagnosis.

  7. CisLunar Habitat Internal Architecture Design Criteria

    NASA Technical Reports Server (NTRS)

    Jones, R.; Kennedy, K.; Howard, R.; Whitmore, M.; Martin, C.; Garate, J.

    2017-01-01

    BACKGROUND: In preparation for human exploration to Mars, there is a need to define the development and test program that will validate deep space operations and systems. In that context, a Proving Grounds CisLunar habitat spacecraft is being defined as the next step towards this goal. This spacecraft will operate differently from the ISS or other spacecraft in human history. The performance envelope of this spacecraft (mass, volume, power, specifications, etc.) is being defined by the Future Capabilities Study Team. This team has recognized the need for a human-centered approach for the internal architecture of this spacecraft and has commissioned a CisLunar Phase-1 Habitat Internal Architecture Study Team to develop a NASA reference configuration, providing the Agency with a "smart buyer" approach for future acquisition. THE CISLUNAR HABITAT INTERNAL ARCHITECTURE STUDY: Overall, the CisLunar Habitat Internal Architecture study will address the most significant questions and risks in the current CisLunar architecture, habitation, and operations concept development. This effort is achieved through definition of design criteria, evaluation criteria and process, design of the CisLunar Habitat Phase-1 internal architecture, and the development and fabrication of internal architecture concepts combined with rigorous and methodical Human-in-the-Loop (HITL) evaluations and testing of the conceptual innovations in a controlled test environment. The vision of the CisLunar Habitat Internal Architecture Study is to design, build, and test a CisLunar Phase-1 Habitat Internal Architecture that will be used for habitation (e.g. habitability and human factors) evaluations. The evaluations will mature CisLunar habitat evaluation tools, guidelines, and standards, and will interface with other projects such as the Advanced Exploration Systems (AES) Program integrated Power, Avionics, Software (iPAS), and Logistics for integrated human-in-the-loop testing. The mission of the Cis

  8. The number of lung transplants can be safely doubled using extended criteria donors; a single-center review.

    PubMed

    Meers, Caroline; Van Raemdonck, Dirk; Verleden, Geert M; Coosemans, Willy; Decaluwe, Herbert; De Leyn, Paul; Nafteux, Philippe; Lerut, Toni

    2010-06-01

    Relaxing the standard lung donor criteria may significantly increase the reported 15% organ yield but post-transplant recipient outcome should be carefully monitored. Charts from all consecutive deceased organ donors within our hospital network were reviewed over a 2-year period. Reasons for lung refusals and number of lungs transplanted were analysed. Hospital outcome including early recipient survival was compared between standard- and extended criteria donors. Out of 283 referrals, 164 (58%) qualified as donor of any organ. The majority (65.9%) of these effective donors were declined for lung donation because of chest X-ray abnormalities (20%), age >70 years (13%), poor oxygenation (10%), or aspiration (9%). Out of 56 (34.1%) accepted lung donors, 50 transplants were performed at our center, 23 from standard criteria donors versus 27 from extended criteria donors. There were no significant differences in hospital outcome and in early survival between lung recipients from both donor groups. Lung acceptance rate (34.1%) in our donor network is 10-20% higher than reported figures. The number of lung transplants in our center doubled by accepting extended criteria donors. This policy did not negatively influence our results after lung transplantation.

  9. Criteria for High Quality Biology Teaching: An Analysis

    ERIC Educational Resources Information Center

    Tasci, Guntay

    2015-01-01

    This study aims to analyze the process under which biology lessons are taught in terms of teaching quality criteria (TQC). Teaching quality is defined as the properties of efficient teaching and is considered to be the criteria used to measure teaching quality both in general and specific to a field. The data were collected through classroom…

  10. Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation.

    PubMed

    Lafranca, Jeffrey A; Spoon, Emerentia Q W; van de Wetering, Jacqueline; IJzermans, Jan N M; Dor, Frank J M F

    2017-01-01

    The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based.

  11. Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation

    PubMed Central

    Spoon, Emerentia Q. W.; van de Wetering, Jacqueline; IJzermans, Jan N. M.; Dor, Frank J. M. F.

    2017-01-01

    Background The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. Methods An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. Results 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Conclusions Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based. PMID:28732093

  12. Automated identification of social interaction criteria in Drosophila melanogaster.

    PubMed

    Schneider, J; Levine, J D

    2014-10-01

    The study of social behaviour within groups has relied on fixed definitions of an 'interaction'. Criteria used in these definitions often involve a subjectively defined cut-off value for proximity, orientation and time (e.g. courtship, aggression and social interaction networks) and the same numerical values for these criteria are applied to all of the treatment groups within an experiment. One universal definition of an interaction could misidentify interactions within groups that differ in life histories, study treatments and/or genetic mutations. Here, we present an automated method for determining the values of interaction criteria using a pre-defined rule set rather than pre-defined values. We use this approach and show changing social behaviours in different manipulations of Drosophila melanogaster. We also show that chemosensory cues are an important modality of social spacing and interaction. This method will allow a more robust analysis of the properties of interacting groups, while helping us understand how specific groups regulate their social interaction space. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  13. Wheelclimb Derailment Processes and Derailment Criteria

    DOT National Transportation Integrated Search

    1984-06-01

    The most widely accepted criterion for wheelclimb derailment defines an upper limit for safe operation on wheel/rail contact forces on the climbing wheel, with the limit varying with time duration of the forces. For dynamic wheelclimb processes with ...

  14. American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis.

    PubMed

    Wallace, Carol A; Giannini, Edward H; Huang, Bin; Itert, Lukasz; Ruperto, Nicolino

    2011-07-01

    To prospectively validate the preliminary criteria for clinical inactive disease (CID) in patients with select categories of juvenile idiopathic arthritis (JIA). We used the process for development of classification and response criteria recommended by the American College of Rheumatology Quality of Care Committee. Patient-visit profiles were extracted from the phase III randomized controlled trial of infliximab in polyarticular-course JIA (i.e., patients considered to resemble those with select categories of JIA) and sent to an international group of expert physician raters. Using the physician ratings as the gold standard, the sensitivity and specificity were calculated using the preliminary criteria. Modifications to the criteria were made, and these were sent to a larger group of pediatric rheumatologists to determine quantitative, face, and content validity. Variables weighted heaviest by physicians when making their judgment were the number of joints with active arthritis, erythrocyte sedimentation rate (ESR), physician's global assessment, and duration of morning stiffness. Three modifications were made: the definition of uveitis, the definition of abnormal ESR, and the addition of morning stiffness. These changes did not alter the accuracy of the preliminary set. The modified criteria, termed the "criteria for CID in select categories of JIA," have excellent feasibility and face, content, criterion, and discriminant validity to detect CID in select categories of JIA. The small changes made to the preliminary criteria set did not alter the area under the receiver operating characteristic curve (0.954) or accuracy (91%), but have increased face and content validity. Copyright © 2011 by the American College of Rheumatology.

  15. Chicago Classification Criteria of Esophageal Motility Disorders Defined in High Resolution Esophageal Pressure Topography (EPT)†

    PubMed Central

    Bredenoord, Albert J; Fox, Mark; Kahrilas, Peter J; Pandolfino, John E; Schwizer, Werner; Smout, AJPM; Conklin, Jeffrey L; Cook, Ian J; Gyawali, Prakash; Hebbard, Geoffrey; Holloway, Richard H; Ke, Meiyun; Keller, Jutta; Mittal, Ravinder K; Peters, Jeff; Richter, Joel; Roman, Sabine; Rommel, Nathalie; Sifrim, Daniel; Tutuian, Radu; Valdovinos, Miguel; Vela, Marcelo F; Zerbib, Frank

    2011-01-01

    Background The Chicago Classification of esophageal motility was developed to facilitate the interpretation of clinical high resolution esophageal pressure topography (EPT) studies, concurrent with the widespread adoption of this technology into clinical practice. The Chicago Classification has been, and will continue to be, an evolutionary process, molded first by published evidence pertinent to the clinical interpretation of high resolution manometry (HRM) studies and secondarily by group experience when suitable evidence is lacking. Methods This publication summarizes the state of our knowledge as of the most recent meeting of the International High Resolution Manometry Working Group in Ascona, Switzerland in April 2011. The prior iteration of the Chicago Classification was updated through a process of literature analysis and discussion. Key Results The major changes in this document from the prior iteration are largely attributable to research studies published since the prior iteration, in many cases research conducted in response to prior deliberations of the International High Resolution Manometry Working Group. The classification now includes criteria for subtyping achalasia, EGJ outflow obstruction, motility disorders not observed in normal subjects (Distal esophageal spasm, Hypercontractile esophagus, and Absent peristalsis), and statistically defined peristaltic abnormalities (Weak peristalsis, Frequent failed peristalsis, Rapid contractions with normal latency, and Hypertensive peristalsis). Conclusions & Inferences The Chicago Classification is an algorithmic scheme for diagnosis of esophageal motility disorders from clinical EPT studies. Moving forward, we anticipate continuing this process with increased emphasis placed on natural history studies and outcome data based on the classification. PMID:22248109

  16. Dysplastic naevus: histological criteria and their inter-observer reproducibility.

    PubMed

    Hastrup, N; Clemmensen, O J; Spaun, E; Søndergaard, K

    1994-06-01

    Forty melanocytic lesions were examined in a pilot study, which was followed by a final series of 100 consecutive melanocytic lesions, in order to evaluate the inter-observer reproducibility of the histological criteria proposed for the dysplastic naevus. The specimens were examined in a blind fashion by four observers. Analysis by kappa statistics showed poor reproducibility of nuclear features, while reproducibility of architectural features was acceptable, improving in the final series. Consequently, we cannot apply the combined criteria of cytological and architectural features with any confidence in the diagnosis of dysplastic naevus, and, until further studies have documented that architectural criteria alone will suffice in the diagnosis of dysplastic naevus, we, as pathologists, shall avoid this term.

  17. Severe community-acquired pneumonia. Assessment of severity criteria.

    PubMed

    Ewig, S; Ruiz, M; Mensa, J; Marcos, M A; Martinez, J A; Arancibia, F; Niederman, M S; Torres, A

    1998-10-01

    The purpose of the study was to validate the criteria used in the guidelines of the American Thoracic Society (ATS) for severe community-acquired pneumonia (CAP). Severe pneumonia was defined as admission to the intensive care unit (ICU). Overall 331 nonsevere (84%) and 64 severe cases (16%) of CAP were prospectively studied. Mortality was 19 of 395 (5%) and 19 of 64 (30%), respectively. Single severity criteria as well as the ATS definition of severe pneumonia were assessed calculating the operative indices. A modified prediction rule including minor (baseline) and major (baseline or evolutionary) criteria was derived. Single minor criteria at admission had a low sensitivity and positive predictive value. Defining severe pneumonia according to the ATS guidelines had a high sensitivity (98%). However, specificity and positive predictive value were low (32% and 24%, respectively). A modified prediction rule (presence of two or three minor criteria [systolic blood pressure < 90 mm Hg, multilobar involvement, PaO2/FIO2 < 250] or one of two major criteria [requirement of mechanical ventilation, presence of septic shock]) had a sensitivity of 78%, a specificity of 94%, a positive predictive value of 75%, and a negative predictive value of 95%. The ATS definition of severe pneumonia was highly sensitive but insufficiently specific and had a low positive predictive value. Our suggested modified rule had a more balanced performance and, if validated in an independent population, may represent a more accurate definition of severe CAP.

  18. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline.

    PubMed

    Azziz, Ricardo; Carmina, Enrico; Dewailly, Didier; Diamanti-Kandarakis, Evanthia; Escobar-Morreale, Hector F; Futterweit, Walter; Janssen, Onno E; Legro, Richard S; Norman, Robert J; Taylor, Ann E; Witchel, Selma F

    2006-11-01

    The Androgen Excess Society (AES) charged a task force to review all available data and recommend an evidence-based definition for polycystic ovary syndrome (PCOS), whether already in use or not, to guide clinical diagnosis and future research. Participants included expert investigators in the field. Based on a systematic review of the published peer-reviewed medical literature, by querying MEDLINE databases, we tried to identify studies evaluating the epidemiology or phenotypic aspects of PCOS. The task force drafted the initial report, following a consensus process via electronic communication, which was then reviewed and critiqued by the AES Board of Directors. No section was finalized until all members were satisfied with the contents and minority opinions noted. Statements that were not supported by peer-reviewed evidence were not included. Based on the available data, it is the view of the AES Task Force on the Phenotype of PCOS that there should be acceptance of the original 1990 National Institutes of Health criteria with some modifications, taking into consideration the concerns expressed in the proceedings of the 2003 Rotterdam conference. A principal conclusion was that PCOS should be first considered a disorder of androgen excess or hyperandrogenism, although a minority considered the possibility that there may be forms of PCOS without overt evidence of hyperandrogenism but recognized that more data are required before validating this supposition. Finally, the task force recognized, and fully expects, that the definition of this syndrome will evolve over time to incorporate new research findings.

  19. Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods.

    PubMed

    Dibari, Filippo; Bahwere, Paluku; Huerga, Helena; Irena, Abel Hailu; Owino, Victor; Collins, Steve; Seal, Andrew

    2013-01-01

    To develop a method for determining the acceptability and safety of ready-to-use therapeutic foods (RUTF) before clinical trialing. Acceptability was defined using a combination of three consumption, nine safety, and six preference criteria. These were used to compare a soy/maize/sorghum RUTF (SMS-RUTFh), designed for the rehabilitation of human immunodeficiency virus/tuberculosis (HIV/TB) wasted adults, with a peanut-butter/milk-powder paste (P-RUTF; brand: Plumpy'nut) designed for pediatric treatment. A cross-over, randomized, controlled trial was conducted in Kenya. Ten days of repeated measures of product intake by 41 HIV/TB patients, >18 y old, body mass index (BMI) 18-24 kg · m(-2), 250 g were offered daily under direct observation as a replacement lunch meal. Consumption, comorbidity, and preferences were recorded. The study arms had similar age, sex, marital status, initial BMI, and middle upper-arm circumference. No carryover effect or serious adverse events were found. SMS-RUTFh energy intake was not statistically different from the control, when adjusted for BMI on day 1, and the presence of throat sores. General preference, taste, and sweetness scores were higher for SMS-RUTFh compared to the control (P < 0.05). Most consumption, safety, and preference criteria for SMS-RUTFh were satisfied except for the average number of days of nausea (0.16 versus 0.09 d) and vomiting (0.04 versus 0.02 d), which occurred with a higher frequency (P < 0.05). SMS-RUTFh appears to be acceptable and can be safely clinically trialed, if close monitoring of vomiting and nausea is included. The method reported here is a useful and feasible approach for testing the acceptability of ready-to-use foods in low income countries. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Defining human death: an intersection of bioethics and metaphysics.

    PubMed

    Manninen, Bertha Alvarez

    2009-01-01

    For many years now, bioethicists, physicians, and others in the medical field have disagreed concerning how to best define human death. Different theories range from the Harvard Criteria of Brain Death, which defines death as the cessation of all brain activity, to the Cognitive Criteria, which is based on the loss of almost all core mental properties, e.g., memory, self-consciousness, moral agency, and the capacity for reason. A middle ground is the Irreversibility Standard, which defines death as occurring when the capacity for consciousness is forever lost. Given all these different theories, how can we begin to approach solving the issue of how to define death? I propose that a necessary starting point is discussing an even more fundamental question that properly belongs in the philosophical field of metaphysics: we must first address the issue of diachronic identity over time, and the persistence conditions of personal identity. In this paper, I illustrate the interdependent relationship between this metaphysical question and questions concerning the definition of death. I also illustrate how it is necessary to antecedently attend to the metaphysical issue of defining death before addressing certain issues in medical ethics, e.g., whether it is morally permissible to euthanize patients in persistent vegetative states or procure organs from anencephalic infants.

  1. Recurrent Pregnancy Loss: Generally Accepted Causes and Their Management.

    PubMed

    Kaiser, Jennifer; Branch, D Ware

    2016-09-01

    Recurrent pregnancy loss (RPL), commonly defined as 3 consecutive losses <10 weeks gestation, affects up to 5% of couples. Well-accepted causes include uterine malformation, antiphospholipid syndrome, and parental chromosomal abnormalities; however, the majority of RPL cases are idiopathic (up to 75%). This chapter covers these accepted causes of RPL and provides diagnosis and management strategies for patients falling within the above categories.

  2. Detection methods and performance criteria for genetically modified organisms.

    PubMed

    Bertheau, Yves; Diolez, Annick; Kobilinsky, André; Magin, Kimberly

    2002-01-01

    Detection methods for genetically modified organisms (GMOs) are necessary for many applications, from seed purity assessment to compliance of food labeling in several countries. Numerous analytical methods are currently used or under development to support these needs. The currently used methods are bioassays and protein- and DNA-based detection protocols. To avoid discrepancy of results between such largely different methods and, for instance, the potential resulting legal actions, compatibility of the methods is urgently needed. Performance criteria of methods allow evaluation against a common standard. The more-common performance criteria for detection methods are precision, accuracy, sensitivity, and specificity, which together specifically address other terms used to describe the performance of a method, such as applicability, selectivity, calibration, trueness, precision, recovery, operating range, limit of quantitation, limit of detection, and ruggedness. Performance criteria should provide objective tools to accept or reject specific methods, to validate them, to ensure compatibility between validated methods, and be used on a routine basis to reject data outside an acceptable range of variability. When selecting a method of detection, it is also important to consider its applicability, its field of applications, and its limitations, by including factors such as its ability to detect the target analyte in a given matrix, the duration of the analyses, its cost effectiveness, and the necessary sample sizes for testing. Thus, the current GMO detection methods should be evaluated against a common set of performance criteria.

  3. Criteria for Evaluating the Performance of Compilers

    DTIC Science & Technology

    1974-10-01

    cannot be made to fit, then an auxiliary mechanism outside the parser might be used . Finally, changing the choice of parsing tech - nique to a...was not useful in providing a basic for compiler evaluation. The study of the first question eztablished criteria and methodb for assigning four...program. The study of the second question estab- lished criteria for defining a "compiler Gibson mix", and established methods for using this "mix" to

  4. Defining Multiple Chronic Conditions for Quality Measurement.

    PubMed

    Drye, Elizabeth E; Altaf, Faseeha K; Lipska, Kasia J; Spatz, Erica S; Montague, Julia A; Bao, Haikun; Parzynski, Craig S; Ross, Joseph S; Bernheim, Susannah M; Krumholz, Harlan M; Lin, Zhenqiu

    2018-02-01

    Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized rates of unplanned admissions for Accountable Care Organizations. To define the MCC cohort we: (1) identified potential chronic conditions; (2) set criteria for cohort conditions based on MCC framework and measure concept; (3) applied the criteria informed by empirical analysis, experts, and the public; (4) described "broader" and "narrower" cohorts; and (5) selected final cohort with stakeholder input. Subjects were patients with chronic conditions. Participants included 21.8 million Medicare fee-for-service beneficiaries in 2012 aged 65 years and above with ≥1 of 27 Medicare Chronic Condition Warehouse condition(s). In total, 10 chronic conditions were identified based on our criteria; 8 of these 10 were associated with notably increased admission risk when co-occurring. A broader cohort (2+ of the 8 conditions) included 4.9 million beneficiaries (23% of total cohort) with an admission rate of 70 per 100 person-years. It captured 53% of total admissions. The narrower cohort (3+ conditions) had 2.2 million beneficiaries (10%) with 100 admissions per 100 person-years and captured 32% of admissions. Most stakeholders viewed the broader cohort as best aligned with the measure concept. By systematically narrowing chronic conditions to those most relevant to the outcome and incorporating stakeholder input, we defined an MCC admission measure cohort supported by stakeholders. This approach can be used as a model for other MCC outcome measures.

  5. 14 CFR 170.23 - LORAN-C establishment criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ratio of the present value of the LORAN-C life-cycle benefits (PVB) to the present value of LORAN-C life-cycle costs (PVC): PVB/PVC ≥ 1.0 (c) The criteria do not cover all situations that may arise and are not... acceptable for instrument flight rules operations as a result of an airport airspace analysis conducted in...

  6. Screening criteria for increased susceptibility to heat stress during work or leisure in hot environments in healthy individuals aged 31-70 years.

    PubMed

    Flouris, Andreas D; McGinn, Ryan; Poirier, Martin P; Louie, Jeffrey C; Ioannou, Leonidas G; Tsoutsoubi, Lydia; Sigal, Ronald J; Boulay, Pierre; Hardcastle, Stephen G; Kenny, Glen P

    2018-01-01

    Population aging and global warming generate important public health risks, as older adults have increased susceptibility to heat stress (SHS). We defined and validated sex-specific screening criteria for SHS during work and leisure activities in hot environments in individuals aged 31-70 years using age, anthropometry, and cardiorespiratory fitness. A total of 123 males and 44 females [44 ± 14 years; 22.9 ± 7.4% body fat; 40.3 ± 8.6 peak oxygen uptake (mlO 2 /kg/min)] participated, separated into the Analysis (n = 111) and Validation (n = 56) groups. Within these groups, participants were categorized into YOUNG (19-30 years; n = 47) and OLDER (31-70 years; n = 120). All participants performed exercise in the heat inside a direct calorimeter. Screening criteria for OLDER participants were defined from the Analysis group and were cross-validated in the Validation group. Results showed that 30% of OLDER individuals in the Analysis group were screened as SHS positive. A total of 274 statistically valid (p < 0.05) criteria were identified suggesting that OLDER participants were at risk for SHS when demonstrating two or more of the following (males/females): age ≥ 53.0/55.8 years; body mass index ≥29.5/25.7 kg/m 2 ; body fat percentage ≥ 28.8/34.9; body surface area ≤2.0/1.7 m 2 ; peak oxygen uptake ≤48.3/41.4 mlO 2 /kg fat free mass/min. In the Validation group, McNemar χ 2 comparisons confirmed acceptable validity for the developed criteria. We conclude that the developed criteria can effectively screen individuals 31-70 years who are at risk for SHS during work and leisure activities in hot environments and can provide simple and effective means to mitigate the public health risks caused by heat exposure.

  7. Diagnostic assignment of criteria: clinicians and DSM-IV.

    PubMed

    Linde, J A; Clark, L A

    1998-01-01

    The study examined clinician matching of diagnostic criteria to selected DSM-IV Axis I and II disorders. A national sample of clinical psychologists and psychiatrists assigned symptom criteria, presented in scrambled order by axis, to DSM-IV diagnoses with which they believed the criteria belonged, without using the DSM. On average, clinicians assigned 69% of Axis I criteria and 75% of Axis II criteria to the designated DSM-IV diagnosis. The Axis II data represent increased agreement over the 66% found for DSM-III-R. Reasons for the increase are discussed, focusing on modifications made in DSM-IV and increased familiarity with personality disorders. The significantly higher rate of agreement for Axis II over Axis I contrasts with typical reliability data which suggests that Axis I disorders are better defined. Specific points of disagreement between clinician criteria assignments and the DSM-IV are discussed.

  8. Analysis of existing work-zone devices with MASH safety performance criteria.

    DOT National Transportation Integrated Search

    2009-02-01

    Crashworthy, work-zone, portable sign support systems accepted under NCHRP Report No. 350 were analyzed to : predict their safety peformance according to the TL-3 MASH evaluation criteria. An analysis was conducted to determine : which hardware param...

  9. 7 CFR 3401.17 - Review criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... RESEARCH GRANTS PROGRAM Scientific Peer Review of Research Applications for Funding § 3401.17 Review criteria. (a) Federally funded research supported under these provisions shall be designed to, among other... revegetation and/or rehabilitation of rangelands; (4) Examine the health of rangelands; and (5) Define economic...

  10. Regulatory Acceptance of Alternative Methods in the Development and Approval of Pharmaceuticals.

    PubMed

    Beken, Sonja; Kasper, Peter; van der Laan, Jan-Willem

    Animal studies may be carried out to support first administration of a new medicinal product to either humans or the target animal species, or before performing clinical trials in even larger populations, or before marketing authorisation, or to control quality during production. Ethical and animal welfare considerations require that animal use is limited as much as possible. Directive 2010/63/EU on the protection of animals used for scientific purposes unambiguously fosters the application of the principle of the 3Rs when considering the choice of methods to be used.As such, today, the 3Rs are embedded in the relevant regulatory guidance both at the European (European Medicines Agency (EMA)) and (Veterinary) International Conference on Harmonization ((V)ICH) levels. With respect to non-clinical testing requirements for human medicinal products, reduction and replacement of animal testing has been achieved by the regulatory acceptance of new in vitro methods, either as pivotal, supportive or exploratory mechanistic studies. Whilst replacement of animal studies remains the ultimate goal, approaches aimed at reducing or refining animal studies have also been routinely implemented in regulatory guidelines, where applicable. The chapter provides an overview of the implementation of 3Rs in the drafting of non-clinical testing guidelines for human medicinal products at the level of the ICH. In addition, the revision of the ICH S2 guideline on genotoxicity testing and data interpretation for pharmaceuticals intended for human use is discussed as a case study.In October 2010, the EMA established a Joint ad hoc Expert Group (JEG 3Rs) with the mandate to improve and foster the application of 3Rs principles to the regulatory testing of medicinal products throughout their lifecycle. As such, a Guideline on regulatory acceptance of 3R testing approaches was drafted that defines regulatory acceptance and provides guidance on the scientific and technical criteria for regulatory

  11. Ventilator-Associated Pneumonia in Trauma Patients: Different Criteria, Different Rates.

    PubMed

    Leonard, Kenji L; Borst, Gregory M; Davies, Stephen W; Coogan, Michael; Waibel, Brett H; Poulin, Nathaniel R; Bard, Michael R; Goettler, Claudia E; Rinehart, Shane M; Toschlog, Eric A

    2016-06-01

    No consensus exists regarding the definition of ventilator-associated pneumonia (VAP). Even within a single institution, inconsistent diagnostic criteria result in conflicting rates of VAP. As a Level 1 trauma center participating in the Trauma Quality Improvement Project (TQIP) and the National Healthcare Safety Network (NHSN), our institution showed inconsistencies in VAP rates depending on which criteria was applied. The purpose of this study was to compare VAP definitions, defined by culture-based criteria, National Trauma Data Bank (NTDB) and NHSN, using incidence in trauma patients. A retrospective chart review of consecutive trauma patients who were diagnosed with VAP and met pre-determined inclusion and exclusion criteria admitted to our rural, 861-bed, Level 1 trauma and tertiary care center between January 2008 and December 2011 was performed. These patients were identified from the National Trauma Registry of the American College of Surgeons (NTRACS) database and an in-house infection control database. Ventilator-associated pneumonia diagnosis criteria defined by the U.S. Center for Disease Control and Prevention (used by the NHSN), the NTDB, and our institutional, culture-based criteria gold standard were compared among patients. Two hundred seventy-nine patients were diagnosed with VAP (25.4% met NHSN criteria, 88.2% met NTDB, and 76.3% met culture-based criteria). Only 58 (20.1%) patients met all three criteria. When NHSN criteria were compared with culture-based criteria, NHSN showed a high specificity (92.5%) and low sensitivity (28.2%). The positive predictive value (PPV) was 84.5%, but the negative predictive value (NPV) was 47.1%. The agreement between the NHSN and the culture-based criteria was poor (κ = 0.18). Conversely, the NTDB showed a lower specificity (57.8%), but greater sensitivity (86.4%) compared with culture-based criteria. The PPV and NPV were both 74% and the two criteria showed fair agreement (κ = 0.41). The lack of

  12. Defining Responses to Therapy and Study Outcomes in Clinical Trials of Invasive Fungal Diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer Consensus Criteria

    PubMed Central

    Segal, Brahm H.; Herbrecht, Raoul; Stevens, David A.; Ostrosky-Zeichner, Luis; Sobel, Jack; Viscoli, Claudio; Walsh, Thomas J.; Maertens, Johan; Patterson, Thomas F.; Perfect, John R.; Dupont, Bertrand; Wingard, John R.; Calandra, Thierry; Kauffman, Carol A.; Graybill, John R.; Baden, Lindsey R.; Pappas, Peter G.; Bennett, John E.; Kontoyiannis, Dimitrios P.; Cordonnier, Catherine; Viviani, Maria Anna; Bille, Jacques; Almyroudis, Nikolaos G.; Wheat, L. Joseph; Graninger, Wolfgang; Bow, Eric J.; Holland, Steven M.; Kullberg, Bart-Jan; Dismukes, William E.; De Pauw, Ben E.

    2009-01-01

    Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There is an important need for generation of consensus definitions of outcomes of IFD that will form a standard for evaluating treatment success and failure in clinical trials. Therefore, an expert international panel consisting of the Mycoses Study Group and the European Organization for Research and Treatment of Cancer was convened to propose guidelines for assessing treatment responses in clinical trials of IFDs and for defining study outcomes. Major fungal diseases that are discussed include invasive disease due to Candida species, Aspergillus species and other molds, Cryptococcus neoformans, Histoplasma capsulatum, and Coccidioides immitis. We also discuss potential pitfalls in assessing outcome, such as conflicting clinical, radiological, and/or mycological data and gaps in knowledge. PMID:18637757

  13. Quantification of Methane and Ammonia Emissions in a Naturally Ventilated Barn by Using Defined Criteria to Calculate Emission Rates.

    PubMed

    Schmithausen, Alexander J; Schiefler, Inga; Trimborn, Manfred; Gerlach, Katrin; Südekum, Karl-Heinz; Pries, Martin; Büscher, Wolfgang

    2018-05-16

    Extensive experimentation on individual animals in respiration chambers has already been carried out to evaluate the potential of dietary changes and opportunities to mitigate CH₄ emissions from ruminants. Although it is difficult to determine the air exchange rate of open barn spaces, measurements at the herd level should provide similarly reliable and robust results. The primary objective of this study was (1) to define a validity range (data classification criteria (DCC)) for the variables of wind velocity and wind direction during long-term measurements at barn level; and (2) to apply this validity range to a feeding trial in a naturally cross-flow ventilated dairy barn. The application of the DCC permitted quantification of CH₄ and NH₃ emissions during a feeding trial consisting of four periods. Differences between the control group (no supplement) and the experimental group fed a ration supplemented with condensed Acacia mearnsii tannins (CT) became apparent. Notably, CT concentrations of 1% and 3% of ration dry matter did not reduce CH₄ emissions. In contrast, NH₃ emissions decreased 34.5% when 3% CT was supplemented. The data confirm that quantification of trace gases in a naturally ventilated barn at the herd level is possible.

  14. Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence.

    PubMed

    Carolan, C M; Smith, A; Davies, G R; Forbat, L

    2018-03-01

    Many individuals affected by cancer who experience emotional distress report not wanting help. This review aims to understand why individuals affected by cancer seek, accept or decline help for emotional distress and what influences these actions. A systematic review and thematic synthesis of the qualitative literature was conducted. Using pre-defined search terms, four electronic databases were searched from January 2000 to May 2016. Pre-determined inclusion and exclusion criteria were then applied. Identified papers were quality appraised. In total, 32 papers were included in the synthesis. Four themes emerged from data synthesis: attaining normality-the normality paradox; being emotionally literate; perceptions of help; needs-support gap. Attaining normality is ideographic, context dependent and temporally situated; some individuals maintain normality by not seeking/declining help whereas others seek/accept help to achieve a new normality. Thus, attaining normality paradoxically functions to explain both why individuals sought/accepted help or did not seek/declined help. Data indicate that a context dependent, systems thinking approach is merited to enhance psychosocial care. In particular, clinicians must actively explore the personal context of an individual's distress to ensure that help desired and help offered are mutually understood. Further research must address the limitations of the current evidence base to advance theoretical understanding. © 2017 John Wiley & Sons Ltd.

  15. Development of parallel line analysis criteria for recombinant adenovirus potency assay and definition of a unit of potency.

    PubMed

    Ogawa, Yasushi; Fawaz, Farah; Reyes, Candice; Lai, Julie; Pungor, Erno

    2007-01-01

    Parameter settings of a parallel line analysis procedure were defined by applying statistical analysis procedures to the absorbance data from a cell-based potency bioassay for a recombinant adenovirus, Adenovirus 5 Fibroblast Growth Factor-4 (Ad5FGF-4). The parallel line analysis was performed with a commercially available software, PLA 1.2. The software performs Dixon outlier test on replicates of the absorbance data, performs linear regression analysis to define linear region of the absorbance data, and tests parallelism between the linear regions of standard and sample. Width of Fiducial limit, expressed as a percent of the measured potency, was developed as a criterion for rejection of the assay data and to significantly improve the reliability of the assay results. With the linear range-finding criteria of the software set to a minimum of 5 consecutive dilutions and best statistical outcome, and in combination with the Fiducial limit width acceptance criterion of <135%, 13% of the assay results were rejected. With these criteria applied, the assay was found to be linear over the range of 0.25 to 4 relative potency units, defined as the potency of the sample normalized to the potency of Ad5FGF-4 standard containing 6 x 10(6) adenovirus particles/mL. The overall precision of the assay was estimated to be 52%. Without the application of Fiducial limit width criterion, the assay results were not linear over the range, and an overall precision of 76% was calculated from the data. An absolute unit of potency for the assay was defined by using the parallel line analysis procedure as the amount of Ad5FGF-4 that results in an absorbance value that is 121% of the average absorbance readings of the wells containing cells not infected with the adenovirus.

  16. Evaluating the impacts of reducing the number of hot mix asphalt plant testing acceptance criteria on mix variability.

    DOT National Transportation Integrated Search

    2012-11-01

    The acceptance testing of Hot Mix Asphalt (HMA) conducted at the HMA production facility is an : important portion of the overall acceptance process used by the Connecticut Department of : Transportation (ConnDOT) for paving projects. In 2004, ConnDO...

  17. A proposed rationale and test methodology for establishment of acceptance criteria for vacuum integrity testing of pharmaceutical freeze dryers.

    PubMed

    Hardwick, Lisa M; Nail, Steven L; Jarman, James; Hasler, Kai; Hense, Thomas

    2013-10-01

    A scientific rationale is proposed for the establishment of acceptance criteria for leak rates in pharmaceutical freeze dryers. A method was developed to determine the quantity of air that could leak into any lyophilizer from the outside while still maintaining Class 100/Grade A microbial conditions. A lyophilizing product is assumed most vulnerable to microbial contamination during secondary drying, when mass transfer of water vapor from product to condenser is minimal. Using the void volume of the dryer, calculated from change in internal pressure when a known volume of air is introduced, and the potential maximum bioburden of the leaked air (based on measured values), calculations can determine the allowable leaked volume of air, the flow rate required to admit that volume in a given time frame, and the pressure rise that would result from the leak over a given testing period. For the dryers in this study, using worst-case air quality conditions, it was determined that a leak resulting in a pressure rise of 0.027 mbar over a 30 min period would allow the dryers to remain in secondary drying conditions for 62 h before the established action level of one colony forming unit for each cubic meter of air space would be reached. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Study of helicopterroll control effectiveness criteria

    NASA Technical Reports Server (NTRS)

    Heffley, Robert K.; Bourne, Simon M.; Curtiss, Howard C., Jr.; Hindson, William S.; Hess, Ronald A.

    1986-01-01

    A study of helicopter roll control effectiveness based on closed-loop task performance measurement and modeling is presented. Roll control critieria are based on task margin, the excess of vehicle task performance capability over the pilot's task performance demand. Appropriate helicopter roll axis dynamic models are defined for use with analytic models for task performance. Both near-earth and up-and-away large-amplitude maneuvering phases are considered. The results of in-flight and moving-base simulation measurements are presented to support the roll control effectiveness criteria offered. This Volume contains the theoretical analysis, simulation results and criteria development.

  19. A framework for developing objective and measurable recovery criteria for threatened and endangered species.

    PubMed

    Himes Boor, Gina K

    2014-02-01

    For species listed under the U.S. Endangered Species Act (ESA), the U.S. Fish and Wildlife Service and National Marine Fisheries Service are tasked with writing recovery plans that include "objective, measurable criteria" that define when a species is no longer at risk of extinction, but neither the act itself nor agency guidelines provide an explicit definition of objective, measurable criteria. Past reviews of recovery plans, including one published in 2012, show that many criteria lack quantitative metrics with clear biological rationale and are not meeting the measureable and objective mandate. I reviewed how objective, measureable criteria have been defined implicitly and explicitly in peer-reviewed literature, the ESA, other U.S. statutes, and legal decisions. Based on a synthesis of these sources, I propose the following 6 standards be used as minimum requirements for objective, measurable criteria: contain a quantitative threshold with calculable units, stipulate a timeframe over which they must be met, explicitly define the spatial extent or population to which they apply, specify a sampling procedure that includes sample size, specify a statistical significance level, and include justification by providing scientific evidence that the criteria define a species whose extinction risk has been reduced to the desired level. To meet these 6 standards, I suggest that recovery plans be explicitly guided by and organized around a population viability modeling framework even if data or agency resources are too limited to complete a viability model. When data and resources are available, recovery criteria can be developed from the population viability model results, but when data and resources are insufficient for model implementation, extinction risk thresholds can be used as criteria. A recovery-planning approach centered on viability modeling will also yield appropriately focused data-acquisition and monitoring plans and will facilitate a seamless transition

  20. A systematic review of the Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence.

    PubMed

    DiFranza, Joseph; Ursprung, W W Sanouri; Lauzon, Béatrice; Bancej, Christina; Wellman, Robert J; Ziedonis, Douglas; Kim, Sun S; Gervais, André; Meltzer, Bruce; McKay, Colleen E; O'Loughlin, Jennifer; Okoli, Chizimuzo T C; Fortuna, Lisa R; Tremblay, Michèle

    2010-05-01

    The Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence (DSM-ND) are based on the proposition that dependence is a syndrome that can be diagnosed only when a minimum of 3 of the 7 proscribed features are present. The DSM-ND criteria are an accepted research measure, but the validity of these criteria has not been subjected to a systematic evaluation. To systematically review evidence of validity and reliability for the DSM-ND criteria, a literature search was conducted of 16 national and international databases. Each article with original data was independently reviewed by two or more reviewers. In total, 380 potentially relevant articles were examined and 169 were reviewed in depth. The DSM-ND criteria have seen wide use in research settings, but sensitivity and specificity are well below the accepted standards for clinical applications. Predictive validity is generally poor. The 7 DSM-ND criteria are regarded as having face validity, but no data support a 3-symptom ND diagnostic threshold, or a 4-symptom withdrawal syndrome threshold. The DSM incorrectly states that daily smoking is a prerequisite for withdrawal symptoms. The DSM shows poor to modest concurrence with all other measures of nicotine dependence, smoking behaviors and biological measures of tobacco use. The data support the DSM-ND criteria as a valid measure of nicotine dependence severity for research applications. However, the data do not support the central premise of a 3-symptom diagnostic threshold, and no data establish that the DSM-ND criteria provide an accurate diagnosis of nicotine dependence. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  1. 42 CFR 505.5 - Loan criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population density... prioritized beginning with the State with the lowest population density. Population density is determined...

  2. 42 CFR 505.5 - Loan criteria.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... that meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population... prioritized beginning with the State with the lowest population density. Population density is determined...

  3. 42 CFR 505.5 - Loan criteria.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... that meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population... prioritized beginning with the State with the lowest population density. Population density is determined...

  4. 42 CFR 505.5 - Loan criteria.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... that meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population... prioritized beginning with the State with the lowest population density. Population density is determined...

  5. 42 CFR 505.5 - Loan criteria.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population density... prioritized beginning with the State with the lowest population density. Population density is determined...

  6. Non-Scientific Criteria for Belief Sustain Counter-Scientific Beliefs.

    PubMed

    Metz, S Emlen; Weisberg, Deena S; Weisberg, Michael

    2018-02-01

    Why is evolutionary theory controversial among members of the American public? We propose a novel explanation: allegiance to different criteria for belief. In one interview study, two online surveys, and one nationally representative phone poll, we found that evolutionists and creationists take different justifications for belief as legitimate. Those who accept evolution emphasize empirical evidence and scientific consensus. Creationists emphasize not only the Bible and religious authority, but also knowledge of the heart. These criteria for belief remain predictive of views about evolution even when taking into account other related factors like religion, political affiliation, and education. Each view is supported by its own internally specified criteria for what constitutes a justified belief. Changing minds may thus require changing epistemic norms. Copyright © 2018 Cognitive Science Society, Inc.

  7. Preliminary Rotary Wing Full Spectrum Crashworthiness Criteria

    DTIC Science & Technology

    2010-01-01

    6.2.1 Injury Risk Due to Occupant Loads Cervical forces and moments are to be used to evaluate injury to the head/neck, torso acceleration is used to...injury) for dynamic neck tension (lifting forces) at the occipital condyles (C0-C1, upper neck) and cervical vertebrae (C7-T1, lower neck) are defined...Neck Compression and Shear Force Limits The maximum acceptable cervical compression and shear force limits are defined in the following table

  8. Defining harm reduction.

    PubMed

    Single, E

    1995-01-01

    Harm reduction attempts to reduce the adverse consequences of drug use among persons who continue to use drugs. It developed in response to the excesses of a "zero tolerance approach". Harm reduction emphasizes practical rather than idealized goals. It has been expanded from illicit drugs to legal drugs and is grounded in the evolving public health and advocacy movements. Harm reduction has proved to be effective and it has gained increasing official acceptance; for example, it is now the basis of Canada's Drug Strategy. However, the concept is still poorly defined, as virtually any drug policy or programme, even abstinence-oriented programmes, attempt to reduce drug-related harm. The principle feature of harm reduction is the acceptance of the fact that some drug users cannot be expected to cease their drug use at the present time. Harm reduction is neutral about the long term goals of intervention while according a high priority to short-term realizable goals. Harm reduction should be neutral about legalization. The essence of the concept is to ameliorate adverse consequences of drug use while, at least in the short term, drug use continues.

  9. Indication Criteria for Total Knee Arthroplasty in Patients with Osteoarthritis - A Multi-perspective Consensus Study.

    PubMed

    Schmitt, Jochen; Lange, Toni; Günther, Klaus-Peter; Kopkow, Christian; Rataj, Elisabeth; Apfelbacher, Christian; Aringer, Martin; Böhle, Eckhardt; Bork, Hartmut; Dreinhöfer, Karsten; Friederich, Niklaus; Frosch, Karl-Heinz; Gravius, Sascha; Gromnica-Ihle, Erika; Heller, Karl-Dieter; Kirschner, Stephan; Kladny, Bernd; Kohlhof, Hendrik; Kremer, Michael; Leuchten, Nicolai; Lippmann, Maike; Malzahn, Jürgen; Meyer, Heiko; Sabatowski, Rainer; Scharf, Hanns-Peter; Stoeve, Johannes; Wagner, Richard; Lützner, Jörg

    2017-10-01

    Background and Objectives Knee osteoarthritis (OA) is a significant public health burden. Rates of total knee arthroplasty (TKA) in OA vary substantially between geographical regions, most likely due to the lack of standardised indication criteria. We set out to define indication criteria for the German healthcare system for TKA in patients with knee OA, on the basis of best evidence and transparent multi-stakeholder consensus. Methods We undertook a complex mixed methods study, including an iterative process of systematic appraisal of existing evidence, Delphi consensus methods and stakeholder conferences. We established a consensus panel representing key German national societies of healthcare providers (orthopaedic surgeons, rheumatologists, pain physicians, psychologists, physiotherapists), payers, and patient representatives. A priori defined consensus criteria were at least 70% agreement and less than 20% disagreement among the consensus panel. Agreement was sought for (1) core indication criteria defined as criteria that must be met to consider TKA in a normal patient with knee OA, (2) additional (not obligatory) indication criteria, (3) absolute contraindication criteria that generally prohibit TKA, and (4) risk factors that do not prohibit TKA, but usually do not lead to a recommendation for TKA. Results The following 5 core indication criteria were agreed within the panel: 1. intermittent (several times per week) or constant knee pain for at least 3 - 6 months; 2. radiological confirmation of structural knee damage (osteoarthritis, osteonecrosis); 3. inadequate response to conservative treatment, including pharmacological and non-pharmacological treatment for at least 3 - 6 months; 4. adverse impact of knee disease on patient's quality of life for at least 3 - 6 months; 5. patient-reported suffering/impairment due to knee disease. Additional indication criteria, contraindication criteria, and risk factors for adverse outcome were also agreed

  10. Learning Intentions and Success Criteria: Learners' and Teachers' Views

    ERIC Educational Resources Information Center

    Crichton, Hazel; McDaid, Ann

    2016-01-01

    It is generally accepted that Assessment for Learning (AfL) strategies are effective in teaching and learning. Approaches within this framework include the use of formative feedback, self and peer assessment and setting and discussion of learning intentions (LIs) and success criteria (SC). There has been a great deal of research into AfL…

  11. Assessing Non-Technical Site Suitability Criteria for Stormwater Capture, Treatment and Recharge

    NASA Astrophysics Data System (ADS)

    Eisenstein, W.

    2016-12-01

    This presentation will describe a new method for assessing non-technical site suitability criteria for the siting of stormwater capture, treatment and recharge (or stormwater CTR) facilities in Sonoma County, California, USA. "Non-technical site suitability criteria" include issues such as community acceptance, aesthetics, nuisances and hazards, and compatibility with neighboring land uses, and are distinguished from "technical criteria" such as hydrology and soil characteristics that are the traditional subject of suitability analyses. Non-technical criteria are rarely, if ever, considered in formal siting suitability studies conducted by agencies and municipalities, yet can be fatal to the prospects of a given project's construction if not identified and mitigated. The researchers developed a new method for identifying and spatially characterizing relevant non-technical criteria through interviews and questionnaires with community stakeholders, and introducing those criteria into a spatial multi-criteria decision analysis framework that assesses site suitabilty across a study watershed (the Upper Petaluma River watershed in Sonoma County).

  12. Emotional and Spiritual Quotient Approach Improve Biology Education Students’ Acceptance of Evolution Theory

    NASA Astrophysics Data System (ADS)

    Darussyamsu, R.; Fadilah, M.; Putri, D. H.

    2018-04-01

    Emotional and spiritual aspect is one of main factors that influence students’ acceptance of a theory. This study aim to measure university students’ acceptance of evolution by learns evolution using emotional and spiritual quotient (ESQ) approach. This is a quasi-experimental research using one shot case study design with the subject 36 biology educational students at Biology Department, Faculty of Mathematics and Natural Science, Universitas Negeri Padang. Data collected using the MATE instrument by Rutledge and Warden (2000) after the students learn evolution for eight meetings since January until March 2017. The result showed that by learning evolution theory combine with ESQ aspects increase students acceptance from very low become moderate acceptance. It concluded that ESQ aspects can improve students’ acceptance of evolution. Any criteria depend on it are discussed.

  13. An Open Trial of Acceptance-based Separated Family Treatment (ASFT) for Adolescents with Anorexia Nervosa

    PubMed Central

    Timko, C. Alix; Zucker, Nancy L.; Herbert, James D.; Rodriguez, Daniel; Merwin, Rhonda M.

    2016-01-01

    Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12–18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed. PMID:25898341

  14. Defining social acceptability in ecosystem management: a workshop proceedings; 1992 June 23-25; Kelso, WA.

    Treesearch

    Mark W. Brunson; Linda E. Kruger; Catherine B. Tyler; Susan A. Schroeder

    1996-01-01

    This compendium of papers was developed in response to the assumption that implementing an ecological approach to forest management requires an understanding of socially acceptable forestry—what it is and the implications of doing it. The papers in this collection bring to bear perspectives from a variety of social science disciplines and question whether the...

  15. UPDATE ON PEC ACTIVITIES INCLUDING NEW EVALUATION CRITERIA, THE APPLICATION COMPLETENESS CHECKLIST, AND STATUS OF THE WEBSITE DEVELOPMENT

    EPA Science Inventory

    US EPA's Pathogen Equivalency Committee (PEC) has updated the evaluation criteria it uses to make recommendations of equivalency (to processes acceptable under 40CFR503) on innovative or alternative sludge pathogen reduction processes. These criteria will be presented along with ...

  16. DEFINING ELIGIBILITY CRITERIA FOR FUNDING POLICIES AROUND IN VITRO FERTILIZATION.

    PubMed

    Menon, Devidas; Nardelli, Alexa A; Motan, Tarek; Klein, Kristin; Stafinski, Tania

    2015-01-01

    This review aims to assess the state of the science around the potential impact of certain patient characteristics on the safety and effectiveness of in vitro fertilization (IVF). Following Cochrane Collaboration guidelines and the PRISMA statement, a comprehensive systematic review of reviews and recent primary studies examining the impact of paternal age and maternal age, smoking, and body mass index (BMI) on the safety and effectiveness of IVF was performed. Papers, published between January 2007 and June 2014, were independently reviewed and critically appraised by two researchers using published quality assessment tools for reviews and primary studies. Due to heterogeneity across papers (different study designs and patient selection criteria), a qualitative analysis of extracted information was performed. Seventeen papers (ten systematic reviews and seven primary studies) were included. They comprised evidence from retrospective observational studies in which maternal age, BMI, and smoking status were explored as part of secondary analyses of larger studies. The majority of papers found that the likelihood of achieving a pregnancy was lower among women who were >40 years, had a BMI ≥ 25 and smoked. Advanced maternal age and BMI were also associated with higher rates of preterm birth and low birth weight. Based on available evidence, it may be appropriate to consider "maternal age" and "morbid obesity" in public funding policies that aim to maximize the effectiveness of IVF. However, given inconsistencies in the effect of smoking across different pregnancy-related outcomes, support for incorporating it into funding conditions appears weak.

  17. Usefulness of Urine Output Criteria for Early Detection of Acute Kidney Injury after Transcatheter Aortic Valve Implantation

    PubMed Central

    Shacham, Yacov; Rofe, Maytal; Leshem-Rubinow, Eran; Gal-Oz, Amir; Arbel, Yaron; Keren, Gad; Roth, Arie; Ben-Assa, Eyal; Halkin, Amir; Finkelstein, Ariel; Banai, Shmuel; Steinvil, Arie

    2014-01-01

    Background Previous studies demonstrated that acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI) is frequent and associated with adverse outcomes. However, these studies only applied the serum creatinine (sCr) criteria while ignoring the urine output criteria. We hypothesized that adding the urine output criteria might contribute to an earlier diagnosis of AKI. Methods We included 143 patients with severe aortic stenosis who underwent transfemoral TAVI between December 2012 and April 2014. Urine output was assessed hourly for at least 24 h following TAVI, and sCr was assessed at least daily until discharge. Based on the Valve Academic Research Consortium-2 (VARC-2), AKI was determined using both sCr and urine output criteria. We compared the incidence of AKI and time to AKI diagnosis based on these two methods. Results The mean age was 81 ± 6 years (range 61-94) and 56% were male. AKI occurred in 27 (19%) patients, 13 (9%) of whom had AKI defined by sCr criteria. Twenty (14%) patients had AKI defined by urine output criteria, only 6 of whom had AKI also defined by sCr criteria. The use of urine output criteria resulted in earlier identification of AKI (18 ± 4 vs. 64 ± 57 h, p = 0.02) and was associated with lower sCr elevation in patients having AKI defined by only urine output criteria (0.03 ± 0.12 vs. 0.37 ± 0.06 mg/dl, p < 0.001). Conclusion The use of the VARC-2 urine output criteria significantly increased the incidence of AKI and shortened the time to AKI diagnosis. PMID:25737679

  18. Tolerance, Acceptance and the Virtue of Orthonomy: A Reply to Lawrence Blum and Brenda Almond

    ERIC Educational Resources Information Center

    Ciurria, Michelle

    2011-01-01

    In the "Journal of Moral Education," 39(2), Brenda Almond and Lawrence Blum debate the importance of tolerance versus acceptance in sex education. Blum defines acceptance as "positive regard", in contradistinction to mere tolerance, "a live and let live attitude toward others, an acceptance of coexistence, but with a…

  19. 5 CFR 551.205 - Executive exemption criteria.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Section 551.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... criteria. (a) An executive employee is an employee whose primary duty is management (as defined in § 551... takes into consideration those organizations that use matrix management, i.e., a system of “shared...

  20. Space shuttle program: Lightning protection criteria document

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The lightning environment for space shuttle design is defined and requirements that the design must satisfy to insure protection of the vehicle system from direct and indirect effects of lightning are imposed. Specifications, criteria, and guidelines included provide a practical and logical approach to protection problems.

  1. The Use and Abuse of Diagnostic/Classification Criteria

    PubMed Central

    June, Rayford R.; Aggarwal, Rohit

    2015-01-01

    In rheumatic diseases, classification criteria have been developed to identify well-defined homogenous cohorts for clinical research. Although, they are commonly used in clinical practice, their use may not be appropriate for routine diagnostic clinical care. Classification criteria are being revised with improved methodology and further understanding of disease pathophysiology, but still may not encompass all unique clinical situations to be applied for diagnosis of heterogeneous, rare, evolving rheumatic diseases. Diagnostic criteria development is challenging primarily due to difficulty for universal application given significant differences in prevalence of rheumatic diseases based on geographical area and clinic settings. Despite these shortcomings, the clinician can still use classification criteria for understanding the disease as well as a guide for diagnosis with a few caveats. We present the limits of current classification criteria, describe their use and abuse in clinical practice, and how they should be used with caution when applied in clinics. PMID:26096094

  2. Self-defining as sexually abused and adult sexual risk behavior: Results from a cross-sectional survey of women attending an STD clinic

    PubMed Central

    Carey, Michael P.; Coury-Doniger, Patricia

    2011-01-01

    Objective Childhood sexual abuse (CSA) is associated with increased sexual risk behavior in adulthood, and this association may be mediated by traumagenic dynamics constructs (i.e., traumatic sexualization, trust, guilt, and powerlessness). However, few studies have investigated whether such relationships hold for women who do not identify as having experienced CSA despite meeting objective criteria that CSA occurred. This study sought to determine whether individuals who met research criteria for CSA and who self-defined as sexually abused differed on traumagenic dynamics constructs and current sexual risk behavior from individuals who met research criteria for CSA and who did not self-define as sexually abused. Methods Participants were 481 women recruited from a publicly-funded STD clinic. Participants completed a computerized survey assessing childhood sexual experiences and adult sexual risk behavior. Results Of the total sample, 206 (43%) met research criteria for CSA. Of the women meeting research criteria for CSA, 142 (69%) self-defined as sexually abused. Women who met research criteria for CSA reported more traumatic sexualization, more trust of a partner, more powerlessness, less sexual guilt, more episodes of unprotected sex, more sex partners, and greater likelihood of sex trading, compared to women who did not meet research criteria for CSA. Among women meeting research criteria, those who self-defined as sexually abused did not differ from those who did not self-define on any of the traumagenic dynamics constructs or on current sexual risk behavior, controlling for CSA characteristics. Conclusions Individuals who were sexually abused as children by behavioral research criteria are at risk for engaging in sexual risk behavior as adults, regardless of whether or not they perceive the experience to be CSA. Future research is needed to understand how non-definers perceive these childhood sexual experiences. PMID:21620162

  3. Results with cochlear implantation in adults with speech recognition scores exceeding current criteria.

    PubMed

    Amoodi, Hosam A; Mick, Paul T; Shipp, David B; Friesen, Lendra M; Nedzelski, Julian M; Chen, Joseph M; Lin, Vincent Y W

    2012-01-01

    The primary purpose of this study was to evaluate a group of postlingually deafened adults, whose aided speech recognition exceeded commonly accepted candidacy criteria for implantation. The study aimed to define performance and qualitative outcomes of cochlear implants in these individuals compared with their optimally fitted hearing aid(s). Retrospective case series. Tertiary referral center. All postlingually deafened subjects (N = 27), who were unsuccessful hearing aid users implanted between 2000 and 2010 with a preimplantation Hearing in Noise Test (HINT) score of 60% or more were included. We compared patients' preoperative performance (HINT score) with hearing aids to postoperative performance with the cochlear implant after 12 months of device use. In addition, the Hearing Handicap Inventory questionnaire was used to quantify the hearing-related handicap change perceived after the implantation. The study group demonstrated significant postoperative improvement on all outcome measures; most notably, the mean HINT score improved from 68.4% (standard deviation, 8.3) to 91.9% (standard deviation, 9.7). Additionally, there was a significant improvement in hearing-related handicap perceived by all patients. The envelope of implantation candidacy criteria continues to expand as shown by this study's cohort. Patient satisfaction and speech recognition results are very encouraging in support of treating those who currently perform at a level above the conventional candidacy threshold but struggle with optimally fitted hearing aids.

  4. Study on Influencing Factor Analysis and Application of Consumer Mobile Commerce Acceptance

    NASA Astrophysics Data System (ADS)

    Li, Gaoguang; Lv, Tingjie

    Mobile commerce (MC) refers to e-commerce activities carried out using a mobile device such as a phone or PDA. With new technology, MC will be rapidly growing in the near future. At the present time, what factors making consumer accept MC and what MC applications are acceptable by consumers are two of hot issues both for MC providers and f or MC researchers. This study presents a proposed MC acceptance model that integrates perceived playfulness, perceived risk and cost into the TAM to study which factors affect consumer MC acceptance. The proposed model includes five variables, namely perceived risk, cost, perceived usefulness, perceived playfulness, perceived ease of use, perceived playfulness. Then, using analytic hierarchy process (AHP) to calculate weight of criteria involved in proposed model. Finally, the study utilizes fuzzy comprehensive evaluation method to evaluate MC applications accepted possibility, and then a MC application is empirically tested using data collected from a survey of MC consumers.

  5. Hot mix asphalt voids acceptance review of QC/QA data 2000 through 2004.

    DOT National Transportation Integrated Search

    2006-07-01

    This report analyzes the Quality Control/Quality Assurance (QC/QA) data for hot mix asphalt using voids acceptance as : the testing criteria for the years 2000 through 2004. Analysis of the overall quality of the HMA is accomplished by : reviewing th...

  6. Hot mix asphalt voids acceptance review of QC/QA data 2000 through 2010.

    DOT National Transportation Integrated Search

    2011-10-01

    This report analyzes the quality control/quality assurance (QC/QA) data for hot mix asphalt (HMA) using : voids acceptance as the testing criteria awarded in the years 2000 through 2010. Analysis of the overall : performance of the projects is accomp...

  7. Compiler Acceptance Criteria Guidebook

    DTIC Science & Technology

    1977-05-01

    further delineated in subseuent sub-charts. P.11 items in the sub-charts are discussed as to their relative merit...object modules) enafles cor’niler systers to rinirize their resource requirerents. Usually there is no major benefit in having the entire comnpiler core...system and for their reasonable specification to the vendina organization. The specification charts developed in Part 1 also provide a meaningful

  8. Accuracy of Carotid Duplex Criteria in Diagnosis of Significant Carotid Stenosis in Asian Patients.

    PubMed

    Dharmasaroja, Pornpatr A; Uransilp, Nattaphol; Watcharakorn, Arvemas; Piyabhan, Pritsana

    2018-03-01

    Extracranial carotid stenosis can be diagnosed by velocity criteria of carotid duplex. Whether they are accurately applied to define severity of internal carotid artery (ICA) stenosis in Asian patients needs to be proved. The purpose of this study was to evaluate the accuracy of 2 carotid duplex velocity criteria in defining significant carotid stenosis. Carotid duplex studies and magnetic resonance angiography were reviewed. Criteria 1 was recommended by the Society of Radiologists in Ultrasound; moderate stenosis (50%-69%): peak systolic velocity (PSV) 125-230 cm/s, diastolic velocity (DV) 40-100 cm/s; severe stenosis (>70%): PSV greater than 230 cm/s, DV greater than 100 cm/s. Criteria 2 used PSV greater than 140 cm/s, DV less than 110 cm/s to define moderate stenosis (50%-75%) and PSV greater than 140 cm/s, DV greater than 110 cm/s for severe stenosis (76%-95%). A total of 854 ICA segments were reviewed. There was moderate stenosis in 72 ICAs, severe stenosis in 50 ICAs, and occlusion in 78 ICAs. Criteria 2 had slightly lower sensitivity, whereas higher specificity and accuracy than criteria 1 were observed in detecting moderate stenosis (criteria 1: sensitivity 95%, specificity 83%, accuracy 84%; criteria 2: sensitivity 92%, specificity 92%, and accuracy 92%). However, in detection of severe ICA stenosis, no significant difference in sensitivity, specificity, and accuracy was found (criteria 1: sensitivity 82%, specificity 99.57%, accuracy 98%; criteria 2: sensitivity 86%, specificity 99.68%, and accuracy 99%). In the subgroup of moderate stenosis, the criteria using ICA PSV greater than 140 cm/s had higher specificity and accuracy than the criteria using ICA PSV 125-230 cm/s. However, there was no significant difference in detection of severe stenosis or occlusion of ICA. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. State-of-Science Approaches to Determine Sensitive Taxa for Water Quality Criteria Derivation

    EPA Science Inventory

    Current Ambient Water Quality Criteria (AWQC) guidelines specify pre-defined taxa diversity requirements, which has limited chemical-specific criteria development in the U.S. to less than 100 chemicals. A priori knowledge of sensitive taxa to toxicologically similar groups of che...

  10. An open trial of Acceptance-based Separated Family Treatment (ASFT) for adolescents with anorexia nervosa.

    PubMed

    Timko, C Alix; Zucker, Nancy L; Herbert, James D; Rodriguez, Daniel; Merwin, Rhonda M

    2015-06-01

    Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12-18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. caBIG compatibility review system: software to support the evaluation of applications using defined interoperability criteria.

    PubMed

    Freimuth, Robert R; Schauer, Michael W; Lodha, Preeti; Govindrao, Poornima; Nagarajan, Rakesh; Chute, Christopher G

    2008-11-06

    The caBIG Compatibility Review System (CRS) is a web-based application to support compatibility reviews, which certify that software applications that pass the review meet a specific set of criteria that allow them to interoperate. The CRS contains workflows that support both semantic and syntactic reviews, which are performed by the caBIG Vocabularies and Common Data Elements (VCDE) and Architecture workspaces, respectively. The CRS increases the efficiency of compatibility reviews by reducing administrative overhead and it improves uniformity by ensuring that each review is conducted according to a standard process. The CRS provides metrics that allow the review team to evaluate the level of data element reuse in an application, a first step towards quantifying the extent of harmonization between applications. Finally, functionality is being added that will provide automated validation of checklist criteria, which will further simplify the review process.

  12. [Prognostic criteria of efficacy of programmed laparoscopic sanitation of the abdominal cavity in peritonitis].

    PubMed

    Salakhov, E K; Vlasov, A P; Bolotskyh, V A

    To define prognostic criteria of efficacy of programmed laparoscopic sanitation of the abdominal cavity in peritonitis. There were 32 patients after programmed laparoscopic sanitation of abdominal cavity for peritonitis due to different acute surgical diseases. Subsequently 12 of them required relaparotomy due to poor effectiveness of laparoscopic sanitation. Comprehensive clinical examination and laboratory assessment of some indexes of homeostasis and oxidative status were conducted. Prognostic clinical and laboratory criteria of efficacy of laparoscopic abdominal sanitation were suggested after analysis of intraoperative data during primary surgery and laboratory values in the 1st postoperative day. The offered prognostic criteria allow to define further management of peritonitis patients after primary laparotomy.

  13. Increasing the Automation and Autonomy for Spacecraft Operations with Criteria Action Table

    NASA Technical Reports Server (NTRS)

    Li, Zhen-Ping; Savki, Cetin

    2005-01-01

    The Criteria Action Table (CAT) is an automation tool developed for monitoring real time system messages for specific events and processes in order to take user defined actions based on a set of user-defined rules. CAT was developed by Lockheed Martin Space Operations as a part of a larger NASA effort at the Goddard Space Flight Center (GSFC) to create a component-based, middleware-based, and standard-based general purpose ground system architecture referred as GMSEC - the GSFC Mission Services Evolution Center. CAT has been integrated into the upgraded ground systems for Tropical Rainfall Measuring Mission (TRMM) and Small Explorer (SMEX) satellites and it plays the central role in their automation effort to reduce the cost and increase the reliability for spacecraft operations. The GMSEC architecture provides a standard communication interface and protocol for components to publish/describe messages to an information bus. It also provides a standard message definition so components can send and receive messages to the bus interface rather than each other, thus reducing the component-to-component coupling, interface, protocols, and link (socket) management. With the GMSEC architecture, components can publish standard event messages to the bus for all nominal, significant, and surprising events in regard to satellite, celestial, ground system, or any other activity. In addition to sending standard event messages, each GMSEC compliant component is required to accept and process GMSEC directive request messages.

  14. The Predictive Value of Selection Criteria in an Urban Magnet School

    ERIC Educational Resources Information Center

    Lohmeier, Jill Hendrickson; Raad, Jennifer

    2012-01-01

    The predictive value of selection criteria on outcome data from two cohorts of students (Total N = 525) accepted to an urban magnet high school were evaluated. Regression analyses of typical screening variables (suspensions, absences, metropolitan achievement tests, middle school grade point averages [GPAs], Matrix Analogies test scores, and…

  15. The Acceptability of Online Courses as Criteria for Admission to Medical School

    PubMed Central

    Adams, Jonathan

    2009-01-01

    A national survey of medical school admissions administrators was used to assess the acceptability of applicants' qualifications that included degrees earned partly online, partly in a community college, or in a traditional program. A questionnaire was sent from The Florida State University in 2007 to admissions administrators in the 125 accredited allopathic medical schools in the United States. In each of three situations, the respondents were asked to select one of two hypothetical applicants to invite for an interview. The applicants with their coursework taken in a traditional-residential setting were overwhelmingly preferred over the applicant holding the degree earned partly online. Further analysis indicated that online courses were perceived as not presenting sufficient opportunity for students to develop important social skills through interaction with other students and mentors. PMID:21603401

  16. Wind/tornado design criteria, development to achieve required probabilistic performance goals

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ng, D.S.

    1991-06-01

    This paper describes the strategy for developing new design criteria for a critical facility to withstand loading induced by the wind/tornado hazard. The proposed design requirements for resisting wind/tornado loads are based on probabilistic performance goals. The proposed design criteria were prepared by a Working Group consisting of six experts in wind/tornado engineering and meteorology. Utilizing their best technical knowledge and judgment in the wind/tornado field, they met and discussed the methodologies and reviewed available data. A review of the available wind/tornado hazard model for the site, structural response evaluation methods, and conservative acceptance criteria lead to proposed design criteriamore » that has a high probability of achieving the required performance goals.« less

  17. Wind/tornado design criteria, development to achieve required probabilistic performance goals

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ng, D.S.

    This paper describes the strategy for developing new design criteria for a critical facility to withstand loading induced by the wind/tornado hazard. The proposed design requirements for resisting wind/tornado loads are based on probabilistic performance goals. The proposed design criteria were prepared by a Working Group consisting of six experts in wind/tornado engineering and meteorology. Utilizing their best technical knowledge and judgment in the wind/tornado field, they met and discussed the methodologies and reviewed available data. A review of the available wind/tornado hazard model for the site, structural response evaluation methods, and conservative acceptance criteria lead to proposed design criteriamore » that has a high probability of achieving the required performance goals.« less

  18. Common Risk Criteria for National Test Ranges

    DTIC Science & Technology

    2010-12-01

    AFSPCMAN 91 - 710 . See footnote on previous page. Common Risk Criteria Standards For National Test Ranges, RCC Standard 321-10, December 2010 2-10...choice of 1/ 3 is consistent with the recommendation in Air Force Space Command (AFSPC) Manual 91 - 710VI, 1 July 2004, which uses 30×10 -6 as the...acceptability criterion for casualty expectation. In the range between 10 and 30×10 -6 (equivalent to one third of the risk criterion), AFSPCMAN 91 -710V1

  19. Implicitly defined criteria for vector optimization in technological process of hydroponic germination of wheat grain

    NASA Astrophysics Data System (ADS)

    Koneva, M. S.; Rudenko, O. V.; Usatikov, S. V.; Bugaets, N. A.; Tereshchenko, I. V.

    2018-05-01

    To reduce the duration of the process and to ensure the microbiological purity of the germinated material, an improved method of germination has been developed based on the complex use of physical factors: electrochemically activated water (ECHA-water), electromagnetic field of extremely low frequencies (EMF ELF) with round-the-clock artificial illumination by LED lamps. The increase in the efficiency of the "numerical" technology for solving computational problems of parametric optimization of the technological process of hydroponic germination of wheat grains is considered. In this situation, the quality criteria are contradictory and part of them is given by implicit functions of many variables. A solution algorithm is offered without the construction of a Pareto set in which a relatively small number of elements of a set of alternatives is used to obtain a linear convolution of the criteria with given weights, normalized to their "ideal" values from the solution of the problems of single-criterion private optimizations. The use of the proposed mathematical models describing the processes of hydroponic germination of wheat grains made it possible to intensify the germination process and to shorten the time of obtaining wheat sprouts "Altayskaya 105" for 27 hours.

  20. Diagnostic criteria, severity classification and guidelines of localized scleroderma.

    PubMed

    Asano, Yoshihide; Fujimoto, Manabu; Ishikawa, Osamu; Sato, Shinichi; Jinnin, Masatoshi; Takehara, Kazuhiko; Hasegawa, Minoru; Yamamoto, Toshiyuki; Ihn, Hironobu

    2018-04-23

    We established diagnostic criteria and severity classification of localized scleroderma because there is no established diagnostic criteria or widely accepted severity classification of the disease. Also, there has been no clinical guideline for localized scleroderma, so we established its clinical guideline ahead of all over the world. In particular, the clinical guideline was established by clinical questions based on evidence-based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1.0). We aimed to make the guideline easy to use and reliable based on the newest evidence, and to present guidance as specific as possible for various clinical problems in treatment of localized scleroderma. © 2018 Japanese Dermatological Association.

  1. Demographic monitoring of wild muriqui populations: Criteria for defining priority areas and monitoring intensity.

    PubMed

    Strier, Karen B; Possamai, Carla B; Tabacow, Fernanda P; Pissinatti, Alcides; Lanna, Andre M; Rodrigues de Melo, Fabiano; Moreira, Leandro; Talebi, Maurício; Breves, Paula; Mendes, Sérgio L; Jerusalinsky, Leandro

    2017-01-01

    Demographic data are essential to assessments of the status of endangered species. However, establishing an integrated monitoring program to obtain useful data on contemporary and future population trends requires both the identification of priority areas and populations and realistic evaluations of the kinds of data that can be obtained under different monitoring regimes. We analyzed all known populations of a critically endangered primate, the muriqui (genus: Brachyteles) using population size, genetic uniqueness, geographic importance (including potential importance in corridor programs) and implementability scores to define monitoring priorities. Our analyses revealed nine priority populations for the northern muriqui (B. hypoxanthus) and nine for the southern muriqui (B. arachnoides). In addition, we employed knowledge of muriqui developmental and life history characteristics to define the minimum monitoring intensity needed to evaluate demographic trends along a continuum ranging from simple descriptive changes in population size to predictions of population changes derived from individual based life histories. Our study, stimulated by the Brazilian government's National Action Plan for the Conservation of Muriquis, is fundamental to meeting the conservation goals for this genus, and also provides a model for defining priorities and methods for the implementation of integrated demographic monitoring programs for other endangered and critically endangered species of primates.

  2. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  3. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  4. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  5. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  6. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  7. Analyses related to the development of DSM-5 criteria for substance use related disorders: 3. An assessment of Pathological Gambling criteria.

    PubMed

    Denis, Cécile; Fatséas, Mélina; Auriacombe, Marc

    2012-04-01

    The DSM-5 Substance-Related Disorders Work Group proposed to include Pathological Gambling within the current Substance-Related Disorders section. The objective of the current report was to assess four possible sets of diagnostic criteria for Pathological Gambling. Gamblers (N=161) were defined as either Pathological or Non-Pathological according to four classification methods. (a) Option 1: the current DSM-IV criteria for Pathological Gambling; (b) Option 2: dropping the "Illegal Acts" criterion, while keeping the threshold at 5 required criteria endorsed; (c) Option 3: the proposed DSM-5 approach, i.e., deleting "Illegal Acts" and lowering the threshold of required criteria from 5 to 4; (d) Option 4: to use a set of Pathological Gambling criteria modeled on the DSM-IV Substance Dependence criteria. Cronbach's alpha and eigenvalues were calculated for reliability, Phi, discriminant function analyses, correlations and multivariate regression models were performed for validity and kappa coefficients were calculated for diagnostic consistency of each option. All criteria sets were reliable and valid. Some criteria had higher discriminant properties than others. The proposed DSM-5 criteria in Options 2 and 3 performed well and did not appear to alter the meanings of the diagnoses of Pathological Gambling from DSM-IV. Future work should further explore if Pathological Gambling might be assessed using the same criteria as those used for Substance Use Disorders. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Most Scottish neurologists do not apply the 2010 McDonald criteria when diagnosing multiple sclerosis.

    PubMed

    Lumley, R; Davenport, R; Williams, A

    2015-03-01

    The diagnostic criteria for multiple sclerosis have evolved over time and currently the 2010 McDonald criteria are the most widely accepted. These criteria allow the diagnosis of multiple sclerosis to be made at the clinically isolated syndrome stage provided certain criteria are met on a single magnetic resonance brain scan. Our hypothesis was that neurologists in Scotland did not use these criteria routinely. We sent a SurveyMonkey questionnaire to all Scottish neurologists (consultants and trainees) regarding the diagnosis of multiple sclerosis. Our questionnaire response rate was 65/99 (66%). Most Scottish neurologists were aware of the criteria and 31/58 (53%) felt that they were using these routinely. However, in a clinical vignette designed to test the application of these criteria, only 5/57 (9%) of neurologists appeared to use them. Scottish neurologists' use of the 2010 McDonald criteria for diagnosis of multiple sclerosis varies from practitioners' perception of their use of these criteria.

  9. 45 CFR 1308.17 - Eligibility criteria: Other impairments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... State Education Agency eligibility criteria for preschool children include an additional category which... of special education,” “educationally handicapped,” and “non-categorically handicapped.” (c) Children ages three to five, inclusive, who are experiencing developmental delays, as defined by their State and...

  10. 45 CFR 1308.17 - Eligibility criteria: Other impairments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... State Education Agency eligibility criteria for preschool children include an additional category which... of special education,” “educationally handicapped,” and “non-categorically handicapped.” (c) Children ages three to five, inclusive, who are experiencing developmental delays, as defined by their State and...

  11. Reproducibility of the World Health Organization 2008 criteria for myelodysplastic syndromes

    PubMed Central

    Senent, Leonor; Arenillas, Leonor; Luño, Elisa; Ruiz, Juan C.; Sanz, Guillermo; Florensa, Lourdes

    2013-01-01

    The reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is uncertain and its assessment was the major aim of this study. The different peripheral blood and bone marrow variables required for an adequate morphological classification were blindly evaluated by four cytomorphologists in samples from 50 patients with myelodysplastic syndromes. The degree of agreement among observers was calculated using intraclass correlation coefficient and the generalized kappa statistic for multiple raters. The degree of agreement for the percentages of blasts in bone marrow and peripheral blood, ring sideroblasts in bone marrow, and erythroid, granulocytic and megakaryocytic dysplastic cells was strong (P<0.001 in all instances). After stratifying the percentages according to the categories required for the assignment of World Health Organization subtypes, the degree of agreement was not statistically significant for cases with 5-9% blasts in bone marrow (P=0.07), 0.1-1% blasts in peripheral blood (P=0.47), or percentage of erythroid dysplastic cells (P=0.49). Finally, the interobserver concordance for World Health Organization-defined subtypes showed a moderate overall agreement (P<0.001), the reproducibility being lower for cases with refractory anemia with excess of blasts type 1 (P=0.05) and refractory anemia with ring sideroblasts (P=0.09). In conclusion, the reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is acceptable but the defining criteria for blast cells and features of erythroid dysplasia need to be refined. PMID:23065505

  12. Reproducibility of the World Health Organization 2008 criteria for myelodysplastic syndromes.

    PubMed

    Senent, Leonor; Arenillas, Leonor; Luño, Elisa; Ruiz, Juan C; Sanz, Guillermo; Florensa, Lourdes

    2013-04-01

    The reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is uncertain and its assessment was the major aim of this study. The different peripheral blood and bone marrow variables required for an adequate morphological classification were blindly evaluated by four cytomorphologists in samples from 50 patients with myelodysplastic syndromes. The degree of agreement among observers was calculated using intraclass correlation coefficient and the generalized kappa statistic for multiple raters. The degree of agreement for the percentages of blasts in bone marrow and peripheral blood, ring sideroblasts in bone marrow, and erythroid, granulocytic and megakaryocytic dysplastic cells was strong (P<0.001 in all instances). After stratifying the percentages according to the categories required for the assignment of World Health Organization subtypes, the degree of agreement was not statistically significant for cases with 5-9% blasts in bone marrow (P=0.07), 0.1-1% blasts in peripheral blood (P=0.47), or percentage of erythroid dysplastic cells (P=0.49). Finally, the interobserver concordance for World Health Organization-defined subtypes showed a moderate overall agreement (P<0.001), the reproducibility being lower for cases with refractory anemia with excess of blasts type 1 (P=0.05) and refractory anemia with ring sideroblasts (P=0.09). In conclusion, the reproducibility of the World Health Organization 2008 classification for myelodysplastic syndromes is acceptable but the defining criteria for blast cells and features of erythroid dysplasia need to be refined.

  13. Criteria to define a more relevant reference sample of titanium dioxide in the context of food: a multiscale approach.

    PubMed

    Dudefoi, William; Terrisse, Hélène; Richard-Plouet, Mireille; Gautron, Eric; Popa, Florin; Humbert, Bernard; Ropers, Marie-Hélène

    2017-05-01

    Titanium dioxide (TiO 2 ) is a transition metal oxide widely used as a white pigment in various applications, including food. Due to the classification of TiO 2 nanoparticles by the International Agency for Research on Cancer as potentially harmful for humans by inhalation, the presence of nanoparticles in food products needed to be confirmed by a set of independent studies. Seven samples of food-grade TiO 2 (E171) were extensively characterised for their size distribution, crystallinity and surface properties by the currently recommended methods. All investigated E171 samples contained a fraction of nanoparticles, however, below the threshold defining the labelling of nanomaterial. On the basis of these results and a statistical analysis, E171 food-grade TiO 2 totally differs from the reference material P25, confirming the few published data on this kind of particle. Therefore, the reference material P25 does not appear to be the most suitable model to study the fate of food-grade TiO 2 in the gastrointestinal tract. The criteria currently to obtain a representative food-grade sample of TiO 2 are the following: (1) crystalline-phase anatase, (2) a powder with an isoelectric point very close to 4.1, (3) a fraction of nanoparticles comprised between 15% and 45%, and (4) a low specific surface area around 10 m 2  g - 1 .

  14. Predicting nurses' use of healthcare technology using the technology acceptance model: an integrative review.

    PubMed

    Strudwick, Gillian

    2015-05-01

    The benefits of healthcare technologies can only be attained if nurses accept and intend to fully use them. One of the most common models utilized to understand user acceptance of technology is the Technology Acceptance Model. This model and modified versions of it have only recently been applied in the healthcare literature among nurse participants. An integrative literature review was conducted on this topic. Ovid/MEDLINE, PubMed, Google Scholar, and CINAHL were searched yielding a total of 982 references. Upon eliminating duplicates and applying the inclusion and exclusion criteria, the review included a total of four dissertations, three symposium proceedings, and 13 peer-reviewed journal articles. These documents were appraised and reviewed. The results show that a modified Technology Acceptance Model with added variables could provide a better explanation of nurses' acceptance of healthcare technology. These added variables to modified versions of the Technology Acceptance Model are discussed, and the studies' methodologies are critiqued. Limitations of the studies included in the integrative review are also examined.

  15. Duplex evaluation following femoropopliteal angioplasty and stenting: criteria and utility of surveillance.

    PubMed

    Baril, Donald T; Marone, Luke K

    2012-07-01

    Surveillance following lower extremity bypass, carotid endarterectomy, and endovascular aortic aneurysm repair has become the standard of care at most institutions. Conversely, surveillance following lower extremity endovascular interventions is performed somewhat sporadically in part because the duplex criteria for recurrent stenoses have been ill defined. It appears that duplex surveillance after peripheral endovascular interventions, as with conventional bypass, is beneficial in identifying recurrent lesions which may preclude failure and occlusion. In-stent stenosis following superficial femoral artery angioplasty and stenting can be predicted by both peak systolic velocity and velocity ratio data as measured by duplex ultrasound. Duplex criteria have been defined to determine both ≥50% in-stent stenosis and ≥80% in-stent stenosis. Although not yet well studied, it appears that applying these criteria during routine surveillance may assist in preventing failure of endovascular interventions.

  16. Environmental Criteria in the Spanish Public Works Procurement Process

    PubMed Central

    Fuentes-Bargues, José Luis; González-Cruz, Mª Carmen; González-Gaya, Cristina

    2017-01-01

    Green Public Procurement (GPP) is defined as a process of contracting products, services, and works with the least possible damage to the environment during their life cycle. In order to improve the knowledge about GPP, a study of the use of environmental tendering criteria in the Spanish public construction sector has been performed. The results of this study show that the use of environmental criteria in Spanish public sector construction procurement is low in comparison to a certain group of countries, known as “Green 7”, in the European Union. Environmental criteria is the fourth criterion in importance, but its weight in the global of the process is much lower than other criteria such as price, memory of the construction process and the delivery time. National administrations use environmental criteria more frequently because they have more resources and staff training about environmental issues. Environmental criteria are more used in the tendering of civil projects and works whose budget exceeds ten million euro due to the environmental impact of these kind and/or size of projects. PMID:28218706

  17. Environmental Criteria in the Spanish Public Works Procurement Process.

    PubMed

    Fuentes-Bargues, José Luis; González-Cruz, Mª Carmen; González-Gaya, Cristina

    2017-02-18

    Green Public Procurement (GPP) is defined as a process of contracting products, services, and works with the least possible damage to the environment during their life cycle. In order to improve the knowledge about GPP, a study of the use of environmental tendering criteria in the Spanish public construction sector has been performed. The results of this study show that the use of environmental criteria in Spanish public sector construction procurement is low in comparison to a certain group of countries, known as "Green 7", in the European Union. Environmental criteria is the fourth criterion in importance, but its weight in the global of the process is much lower than other criteria such as price, memory of the construction process and the delivery time. National administrations use environmental criteria more frequently because they have more resources and staff training about environmental issues. Environmental criteria are more used in the tendering of civil projects and works whose budget exceeds ten million euro due to the environmental impact of these kind and/or size of projects.

  18. Criteria for software modularization

    NASA Technical Reports Server (NTRS)

    Card, David N.; Page, Gerald T.; Mcgarry, Frank E.

    1985-01-01

    A central issue in programming practice involves determining the appropriate size and information content of a software module. This study attempted to determine the effectiveness of two widely used criteria for software modularization, strength and size, in reducing fault rate and development cost. Data from 453 FORTRAN modules developed by professional programmers were analyzed. The results indicated that module strength is a good criterion with respect to fault rate, whereas arbitrary module size limitations inhibit programmer productivity. This analysis is a first step toward defining empirically based standards for software modularization.

  19. Variability amongst radiographers in the categorization of clinical acceptability for digital trauma radiography

    NASA Astrophysics Data System (ADS)

    Decoster, Robin; Toomey, Rachel; Smits, Dirk; Mol, Harrie; Verhelle, Filip; Butler, Marie-Louise

    2016-03-01

    Introduction: Radiographers evaluate anatomical structures to judge clinical acceptability of a radiograph. Whether a radiograph is deemed acceptable for diagnosis or not depends on the individual decision of the radiographer. Individual decisions cause variation in the accepted image quality. To minimise these variations definitions of acceptability, such as in RadLex, were developed. On which criteria radiographers attribute a RadLex categories to radiographs is unknown. Insight into these criteria helps to further optimise definitions and reduce variability in acceptance between radiographers. Therefore, this work aims the evaluation of the correlation between the RadLex classification and the evaluation of anatomical structures, using a Visual Grading Analysis (VGA) Methods: Four radiographers evaluated the visibility of five anatomical structures of 25 lateral cervical spine radiographs on a secondary class display with a VGA. They judged clinical acceptability of each radiograph using RadLex. Relations between VGAS and RadLex category were analysed with Kendall's Tau correlation and Nagelkerke pseudo-R². Results: The overall VGA score (VGAS) and the RadLex score correlate (rτ= 0.62, p<0.01, R2=0.72) strongly. The observers' evaluation of contrast between bone, air (trachea) and soft tissue has low value in predicting (rτ=0.55, p<0.01, R2=0.03) the RadLex score. The reproduction of spinous processes (rτ=0.67, p<0.01, R2=0.31) and the evaluation of the exposure (rτ=0.65, p<0.01, R2=0.56) have a strong correlation with high predictive value for the RadLex score. Conclusion: RadLex scores and VGAS correlate positively, strongly and significantly. The predictive value of bony structures may support the use of these in the judgement of clinical acceptability. Considerable inter-observer variations in the VGAS within a certain RadLex category, suggest that observers use of observer specific cut

  20. Examining QRS amplitude criteria for electrocardiographic left ventricular hypertrophy in recommendations for screening criteria in athletes.

    PubMed

    Singla, Varun; Jindal, Akash; Pargaonkar, Vedant; Soofi, Muhammad; Wheeler, Matthew; Froelicher, Victor

    2015-01-01

    Current guidelines for interpretation of the ECGs of athletes recommend that isolated R and S wave amplitudes that exceed traditional criteria for left ventricular hypertrophy be accepted as a physiological response to exercise training. This is based on training and echocardiographic studies but not on long term follow up. Demonstration of the prognostic characteristics of the amplitude criteria in a non-athletic population could support the current guidelines. To evaluate the prognostic value of the R and S wave voltage criteria for electrocardiographic left ventricular hypertrophy (ECG-LVH) in an ambulatory clinical population. The target population consisted of 20,903 ambulatory subjects who had ECGs recorded between 1987 and 1999 and were followed for cardiovascular death until 2013. During the mean follow up of 17 years, there were 881 cardiovascular deaths. The mean age was 43 ± 10, 91% were male and 16% were African American. Of the 2482 (12%) subjects who met the Sokolow-Lyon criteria, 241 (1.2%) subjects with left ventricular (LV) strain had an HR of 5.4 (95% CI 4.1-7.2, p<0.001), while 2241 (11%) subjects without strain had an HR of 1.4 (95% CI 1.2-1.8, p<0.001). Of the 4836 (23%) subjects who met the Framingham voltage criteria, 350 (2%) subjects with LV strain had an HR of 5.1 (95% CI 4.0-6.5, p<0.001), while 4486 (22%) subjects without strain had an HR of 1.1 (95% CI 0.9-1.3, p=0.26). The individual components of the Romhilt-Estes had HRs ranging from 1.4 to 3.6, with only the voltage component not being significant (HR 1.1, 95% CI 0.9-1.5, p=0.35). This study demonstrates that the R and S wave voltage criteria components of most of the original classification schema for electrocardiographic left ventricular hypertrophy are not predictive of CV mortality. Our findings support the current guidelines for electrocardiographic screening of athletes. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Basis for application of criteria for definition of Global Heritage Stone

    NASA Astrophysics Data System (ADS)

    Marker, Brian

    2013-04-01

    The Global Heritage Stone designation has been proposed to assist geoscientists, planners and the industry in explaining the importance of some types of stone in repair and maintenance of historic structures, new buildings and objects such as sculptures. The designation will have value only if rigorous criteria are used in accepting proposals and the designation is not used too liberally. Criteria proposed by the Heritage Stone Task Group relate, in brief, to wide use of stone either internationally or for major cultural monuments for a period of at least 50 years. However it is not always easy to determine what is truly international or what is of sufficient cultural or artistic merit. This contribution provides some examples of possible problems as a basis for discussion on the refinement of application of the criteria.

  2. Radioactive waste management: review on clearance levels and acceptance criteria legislation, requirements and standards.

    PubMed

    Maringer, F J; Suráň, J; Kovář, P; Chauvenet, B; Peyres, V; García-Toraño, E; Cozzella, M L; De Felice, P; Vodenik, B; Hult, M; Rosengård, U; Merimaa, M; Szücs, L; Jeffery, C; Dean, J C J; Tymiński, Z; Arnold, D; Hinca, R; Mirescu, G

    2013-11-01

    In 2011 the joint research project Metrology for Radioactive Waste Management (MetroRWM)(1) of the European Metrology Research Programme (EMRP) started with a total duration of three years. Within this project, new metrological resources for the assessment of radioactive waste, including their calibration with new reference materials traceable to national standards will be developed. This paper gives a review on national, European and international strategies as basis for science-based metrological requirements in clearance and acceptance of radioactive waste. © 2013 Elsevier Ltd. All rights reserved.

  3. [Self-acceptance as adaptively resigning the self to low self-evaluation].

    PubMed

    Ueda, T

    1996-10-01

    In past studies, the concept of self-acceptance has often been confused with self-evaluation or self-esteem. The purpose of this study was to distinguish these concepts, and operationally define self-acceptance as Carl Rogers proposed: feeling all right toward the self when self-evaluation was low. Self-acceptance as adaptive resignation, a moderating variable, therefore should raise self-esteem of only those people with low self-evaluation. Self-acceptance was measured in the study as affirmative evaluation of own self-evaluation. Two hundred and forty college students, 120 each for men and women, completed a questionnaire of self-evaluative consciousness and self-esteem scales. Results of statistical analyses showed that among subjects with low self-evaluation, the higher self-acceptance, the higher the person's self-esteem. The same relation was not observed among those with high self-evaluation. Thus, it may be concluded that self-acceptance was adaptive resignation, and therefore meaningful to only those with low self-evaluation.

  4. On the Acceptability of Funding from Fossil Energy Companies

    NASA Astrophysics Data System (ADS)

    Frumhoff, P. C.; Goldman, G. T.

    2016-12-01

    Vigorous debates within the American Geophysical Union over the acceptability of funding from ExxonMobil sit within a broader societal debate over the climate responsibilities of fossil energy companies in a carbon constrained world. This has been fueled by recent evidence that leading companies have invested heavily in efforts to sow doubt about climate science in order to avoid regulation of their products. This talk examines the nature of this evidence and the ethical stances that AGU and other scientific societies and organizations might take toward acceptability of funding from fossil energy companies in light of it. The results of a climate responsibility scorecard, assessing a sample of leading oil, gas and coal companies against specific criteria for a more responsible fossil energy company, also will be presented.

  5. Guidelines for the acceptance of peroxide-containing oral hygiene products. American Dental Association Council on Dental Therapeutics.

    PubMed

    1994-08-01

    Safety and efficacy criteria are defined for oral products containing various forms of peroxides. The guidelines ask for safety and efficacy studies plus observation criteria that include long-term follow-up.

  6. Historical development of limits of acceptable change: conceptual clarifications and possible extensions

    Treesearch

    David N. Cole; George H. Stankey

    1997-01-01

    The Limits of Acceptable Change (LAC) process was developed to deal with the issue of recreational carrying capacity. For that purpose, the LAC process sought to explicitly define a compromise between resource/visitor experience protection and recreation use goals. The most critical and unique element of the process is the specification of LAC standards that define...

  7. Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT).

    PubMed

    Lindsay, Emily K; Creswell, J David

    2017-02-01

    Despite evidence linking trait mindfulness and mindfulness training with a broad range of effects, still little is known about its underlying active mechanisms. Mindfulness is commonly defined as (1) the ongoing monitoring of present-moment experience (2) with an orientation of acceptance. Building on conceptual, clinical, and empirical work, we describe a testable theoretical account to help explain mindfulness effects on cognition, affect, stress, and health outcomes. Specifically, Monitor and Acceptance Theory (MAT) posits that (1), by enhancing awareness of one's experiences, the skill of attention monitoring explains how mindfulness improves cognitive functioning outcomes, yet this same skill can increase affective reactivity. Second (2), by modifying one's relation to monitored experience, acceptance is necessary for reducing affective reactivity, such that attention monitoring and acceptance skills together explain how mindfulness improves negative affectivity, stress, and stress-related health outcomes. We discuss how MAT contributes to mindfulness science, suggest plausible alternatives to the account, and offer specific predictions for future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Quality of laboratory studies assessing effects of Bt-proteins on non-target organisms: minimal criteria for acceptability.

    PubMed

    De Schrijver, Adinda; Devos, Yann; De Clercq, Patrick; Gathmann, Achim; Romeis, Jörg

    2016-08-01

    The potential risks that genetically modified plants may pose to non-target organisms and the ecosystem services they contribute to are assessed as part of pre-market risk assessments. This paper reviews the early tier studies testing the hypothesis whether exposure to plant-produced Cry34/35Ab1 proteins as a result of cultivation of maize 59122 is harmful to valued non-target organisms, in particular Arthropoda and Annelida. The available studies were assessed for their scientific quality by considering a set of criteria determining their relevance and reliability. As a case-study, this exercise revealed that when not all quality criteria are met, weighing the robustness of the study and its relevance for risk assessment is not obvious. Applying a worst-case expected environmental concentration of bioactive toxins equivalent to that present in the transgenic crop, confirming exposure of the test species to the test substance, and the use of a negative control were identified as minimum criteria to be met to guarantee sufficiently reliable data. This exercise stresses the importance of conducting studies meeting certain quality standards as this minimises the probability of erroneous or inconclusive results and increases confidence in the results and adds certainty to the conclusions drawn.

  9. Micro-CT imaging: Developing criteria for examining fetal skeletons in regulatory developmental toxicology studies - A workshop report.

    PubMed

    Solomon, Howard M; Makris, Susan L; Alsaid, Hasan; Bermudez, Oscar; Beyer, Bruce K; Chen, Antong; Chen, Connie L; Chen, Zhou; Chmielewski, Gary; DeLise, Anthony M; de Schaepdrijver, Luc; Dogdas, Belma; French, Julian; Harrouk, Wafa; Helfgott, Jonathan; Henkelman, R Mark; Hesterman, Jacob; Hew, Kok-Wah; Hoberman, Alan; Lo, Cecilia W; McDougal, Andrew; Minck, Daniel R; Scott, Lelia; Stewart, Jane; Sutherland, Vicki; Tatiparthi, Arun K; Winkelmann, Christopher T; Wise, L David; Wood, Sandra L; Ying, Xiaoyou

    2016-06-01

    During the past two decades the use and refinements of imaging modalities have markedly increased making it possible to image embryos and fetuses used in pivotal nonclinical studies submitted to regulatory agencies. Implementing these technologies into the Good Laboratory Practice environment requires rigorous testing, validation, and documentation to ensure the reproducibility of data. A workshop on current practices and regulatory requirements was held with the goal of defining minimal criteria for the proper implementation of these technologies and subsequent submission to regulatory agencies. Micro-computed tomography (micro-CT) is especially well suited for high-throughput evaluations, and is gaining popularity to evaluate fetal skeletons to assess the potential developmental toxicity of test agents. This workshop was convened to help scientists in the developmental toxicology field understand and apply micro-CT technology to nonclinical toxicology studies and facilitate the regulatory acceptance of imaging data. Presentations and workshop discussions covered: (1) principles of micro-CT fetal imaging; (2) concordance of findings with conventional skeletal evaluations; and (3) regulatory requirements for validating the system. Establishing these requirements for micro-CT examination can provide a path forward for laboratories considering implementing this technology and provide regulatory agencies with a basis to consider the acceptability of data generated via this technology. Published by Elsevier Inc.

  10. IMPORTANCE OF MULTIPLE CRITERIA FOR PRIORITY SETTING OF HIV/AIDS INTERVENTIONS.

    PubMed

    Tromp, Noor; Prawiranegara, Rozar; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-01-01

    This study describes the views of various stakeholders on the importance of different criteria for priority setting of HIV/AIDS interventions in Indonesia. Based on a general list of criteria and a focus group discussion with stakeholders (n = 6), a list was developed of thirty-two criteria that play a role in priority setting in HIV/AIDS control in West-Java province. Criteria were categorized according to the World Health Organization's health system goals and building block frameworks. People living with HIV/AIDS (n = 49), healthcare workers (HCW) (n = 41), the general population (n = 43), and policy makers (n = 22) rated the importance of thirty-two criteria on a 5-point Likert-scale. Thereafter, respondents ranked the highest rated criteria to express more detailed preferences. Stakeholders valued the following criteria as most important for the priority setting of HIV/AIDS interventions: an intervention's impact on the HIV/AIDS epidemic, reduction of stigma, quality of care, effectiveness on individual level, and feasibility in terms of current capacity of the health system (i.e., HCW, product, information, and service requirements), financial sustainability, and acceptance by donors. Overall, stakeholders' preferences for the importance of criteria are similar. Our study design outlines an approach for other settings to identify which criteria are important for priority setting of health interventions. For Indonesia, these study results may be used in priority setting processes for HIV/AIDS control and may contribute to more transparent and systematic allocation of resources.

  11. The diagnosis of PCOS in young infertile women according to different diagnostic criteria: the role of serum anti-Müllerian hormone.

    PubMed

    Casadei, Luisa; Fanisio, Francesca; Sorge, Roberto Pietro; Collamarini, Matteo; Piccolo, Eleonora; Piccione, Emilio

    2018-07-01

    To diagnose polycystic ovary syndrome (PCOS) in young infertile women using different diagnostic criteria. To define serum anti-Müllerian hormone (AMH) cutoff values for PCOS definition. To investigate the correlation between AMH and body mass index (BMI). Retrospective case-control study. A total of 140 infertile women (age 21-35 years) were enrolled. PCOS was defined according to the National Institutes of Health (NIH) criteria, the Rotterdam consensus criteria and the Androgen Excess and PCOS Society (AE-PCOS) criteria. ROC curve analysis was performed to define AMH thresholds for PCOS definition according to the three different diagnostic criteria. Correlation between AMH and BMI was investigated. The prevalence of PCOS under the NIH criteria, the Rotterdam criteria and the AE-PCOS criteria was 27.1, 40 and 29.3%, respectively. The optimal thresholds of AMH to distinguish NIH PCOS from infertile controls was 5.20 ng/ml (AUC = 0.86, sensitivity 79%, specificity 80%); the best cutoff to detect Rotterdam PCOS was 4.57 ng/ml (AUC = 0.85, sensitivity 78%, specificity 81%); a cutoff of 4.85 ng/ml (AUC = 0.85, sensitivity 80%, specificity 78%) defined PCOS women according to AE-PCOS criteria. The prevalence of the syndrome became 37.1, 44.3 and 39.2% according to the three criteria, respectively, using AMH threshold between 4.57 and 5.20 ng/ml as an alternative to antral follicle count and/or hyperandrogenism. Anti-Müllerian hormone may reconcile the three diagnostic criteria and allow the PCOS diagnosis in women with mild symptoms. No significant correlation was found between AMH and BMI in PCOS women and controls.

  12. Critiquing bachelor candidates' theses: are the criteria useful?

    PubMed

    Kapborg, I; Berterö, C

    2002-06-01

    Nursing education programmes should be at an academic level and connected to research. In Sweden, empirical studies are generally required in order to obtain a Bachelor's degree; hence, in some cases, these studies are replaced by a literature review. A study was conducted using 11 criteria. Thirteen theses produced in a department of nursing science were examined, elaborated and reproduced by reviewing international and national literature. Thereafter, the criteria themselves were scrutinized. Principal findings when critiquing the theses were that in eight theses the purpose was dearly identified and well defined in relation to the study accomplished; in three theses the purpose was indistinct and vague; and in two the definitions and research questions were lacking. The topic was relevant for the area of nursing in all theses. General problems identified were poor spelling and grammar, and unsatisfactory thesis structure. This article discusses whether criteria are useful when examining the Bachelor candidates' theses. The authors report that the criteria seemed to be useful, giving some guidance for scrutinizing theses and facilitating correspondence. Criteria could be appropriate guidelines for using to increase the quality of the theses as well as the quality of nursing.

  13. Criteria to determine food allergen priority.

    PubMed

    Yeung, J M; Applebaum, R S; Hildwine, R

    2000-07-01

    The emergent health issue of food allergens presents an important challenge to the food industry. More than 170 foods have been reported in the scientific literature as causing allergic reactions. Clearly, it would be impossible to deal with the presence of trace amounts of all these in the context of food labeling. If the decision to classify major allergens is based solely on the knowledge and experience of allergists and food scientists in the field, without scientifically defined criteria, it is likely to lead to a proliferation of lists. Such practices may lead to an unnecessary elimination of foods containing important nutrients. This paper defines food allergy, food intolerance, and food anaphylaxis and identifies criteria for classifying food allergens associated with frequent allergic reactions. A practical list of food allergens that may result in potentially life-threatening allergic reactions is provided. A mechanism-based (i.e., immunoglobulin E mediated), acute life-threatening anaphylaxis that is standardized and measurable and reflects the severity of health risk is proposed as the principal inclusion criterion for food allergen labeling. Where available, prevalence in the population and threshold levels of allergens should be used as an additional guide to identify possible future labeling needs.

  14. WAIS Performance in Unincarcerated Groups of MMPI-Defined Sociopaths and Normal Controls

    ERIC Educational Resources Information Center

    Allain, Albert N.

    1974-01-01

    This investigation examines WAIS performance in groups of 32 sociopaths and 33 normal controls defined by Minnesota Multiphasic Personality Inventory criteria. Sociopaths and normal controls show no differences in overall level of intellectual functioning. (Author)

  15. Acceptance and expressed emotion in Mexican American caregivers of relatives with schizophrenia.

    PubMed

    Dorian, Marina; Ramírez García, Jorge I; López, Steven R; Hernández, Brenda

    2008-06-01

    The relation between Expressed Emotion (EE) and caregiver acceptance was tested with the use of video-recorded interactions between 31 Mexican American family caregivers and their relatives with schizophrenia. Borrowing the concept from Integrative Behavioral Couple Therapy, acceptance was defined as caregiver's engagement with the ill relative along with low levels of expectations for behavioral change. Three aspects of caregiver acceptance were measured: global acceptance of the patient, unified detachment (i.e., nonblaming but engaged problem discussion), and low aversive responses to patient behavior (e.g., criticisms and demanding change). Relative to high EE caregivers, low EE caregivers were consistently more accepting of their ill relatives across the three measures of acceptance. Unified detachment was negatively associated with emotional overinvolvement and aversive responses were positively related to criticism. Warmth was not related to acceptance. The findings suggest that the study of acceptance in family caregivers is a heuristic avenue for future research due to its potential to shed light on specifically what family members do in caring for their ill relatives with schizophrenia.

  16. NASA Lewis Wind Tunnel Model Systems Criteria

    NASA Technical Reports Server (NTRS)

    Soeder, Ronald H.; Haller, Henry C.

    1994-01-01

    This report describes criteria for the design, analysis, quality assurance, and documentation of models or test articles that are to be tested in the aeropropulsion facilities at the NASA Lewis Research Center. The report presents three methods for computing model allowable stresses on the basis of the yield stress or ultimate stress, and it gives quality assurance criteria for models tested in Lewis' aeropropulsion facilities. Both customer-furnished model systems and in-house model systems are discussed. The functions of the facility manager, project engineer, operations engineer, research engineer, and facility electrical engineer are defined. The format for pretest meetings, prerun safety meetings, and the model criteria review are outlined Then, the format for the model systems report (a requirement for each model that is to be tested at NASA Lewis) is described, the engineers that are responsible for developing the model systems report are listed, and the time table for its delivery to the facility manager is given.

  17. The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache.

    PubMed

    Day, Melissa A; Thorn, Beverly E

    2016-04-01

    This study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy). A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N=24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted. Pain acceptance emerged as a significant mediator of the group-interference relation (p<.05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p<.05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference. Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. 14 CFR 170.23 - LORAN-C establishment criteria.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) NAVIGATIONAL FACILITIES ESTABLISHMENT AND DISCONTINUANCE CRITERIA FOR AIR TRAFFIC CONTROL...-cost ratio equals or exceeds one). As defined in § 170.3 of this part, the benefit-cost ratio is the ratio of the present value of the LORAN-C life-cycle benefits (PVB) to the present value of LORAN-C life...

  19. Key acceptability attributes of orodispersible films.

    PubMed

    Scarpa, Mariagiovanna; Paudel, Amrit; Kloprogge, Frank; Hsiao, Wen Kai; Bresciani, Massimo; Gaisford, Simon; Orlu, Mine

    2018-04-01

    The features rendering orodispersible films (ODFs) patient-centric formulations are widely discussed in the scientific literature. However there is a lack of research studies exploring ODF characteristics with a potential impact on end-user acceptability. The aim of this study was to identify the key ODF characteristics affecting end-user acceptability by developing in vitro test methods for the prediction of ODFs acceptability and correlate these formulation characteristics with the data obtained from a human panel study. Four drug-free single-polymer films were prepared by solvent casting. Solutions of poly(vinyl) alcohol (PVOH) 39 KDa (P1), PVOH 197 KDa (P2), carboxymethylcellulose (CMC) 395 KDa (C1), and CMC 725 KDa (C2) were prepared. Texture analysis and Dynamic Mechanical Analysis (DMA) were used to assess film tack. Petri dish and drop methods were used to assess disintegration time. A human panel of 24 healthy young adults was employed to identify end-user acceptability criteria of the four study film samples. Texture analysis data of ODF tack were not found to be in agreement with the in vivo perceived stickiness in the mouth. However, measurement of the area under the adhesive force curve obtained by DMA correlated with in vivo perceived stickiness data for all samples. The disintegration times obtained by drop method were more comparable to human panel data than the petri dish method. Hence DMA and drop methods proved to be promising methodologies for the prediction of the end-user acceptability. The type and molecular weight of the film-forming polymer had a strong influence on stickiness perception, whereas only polymeric molecular weight influenced perceived disintegration time. The human panel study showed that Participant Reported Outcomes (PROs) for the perceived stickiness in the mouth and disintegration time of test films received significantly different scores between samples, and thus were identified as the key attributes with the

  20. Application fuzzy multi-attribute decision analysis method to prioritize project success criteria

    NASA Astrophysics Data System (ADS)

    Phong, Nguyen Thanh; Quyen, Nguyen Le Hoang Thuy To

    2017-11-01

    Project success is a foundation for project owner to manage and control not only for the current project but also for future potential projects in construction companies. However, identifying the key success criteria for evaluating a particular project in real practice is a challenging task. Normally, it depends on a lot of factors, such as the expectation of the project owner and stakeholders, triple constraints of the project (cost, time, quality), and company's mission, vision, and objectives. Traditional decision-making methods for measuring the project success are usually based on subjective opinions of panel experts, resulting in irrational and inappropriate decisions. Therefore, this paper introduces a multi-attribute decision analysis method (MADAM) for weighting project success criteria by using fuzzy Analytical Hierarchy Process approach. It is found that this method is useful when dealing with imprecise and uncertain human judgments in evaluating project success criteria. Moreover, this research also suggests that although cost, time, and quality are three project success criteria projects, the satisfaction of project owner and acceptance of project stakeholders with the completed project criteria is the most important criteria for project success evaluation in Vietnam.

  1. Trust, Isolation, and Presence: The Virtual Work Environment and Acceptance of Deep Organizational Change

    ERIC Educational Resources Information Center

    Rose, Laurence Michael

    2013-01-01

    The primary focus of this research was to explore through the use of a grounded theory methodology if the human perceptions of trust, isolation, and presence affected the virtual workers ability to accept deep organizational change. The study found that the virtual workers in the sample defined their acceptance of deep organizational change by…

  2. Criteria for the use of regression analysis for remote sensing of sediment and pollutants

    NASA Technical Reports Server (NTRS)

    Whitlock, C. H.; Kuo, C. Y.; Lecroy, S. R.

    1982-01-01

    An examination of limitations, requirements, and precision of the linear multiple-regression technique for quantification of marine environmental parameters is conducted. Both environmental and optical physics conditions have been defined for which an exact solution to the signal response equations is of the same form as the multiple regression equation. Various statistical parameters are examined to define a criteria for selection of an unbiased fit when upwelled radiance values contain error and are correlated with each other. Field experimental data are examined to define data smoothing requirements in order to satisfy the criteria of Daniel and Wood (1971). Recommendations are made concerning improved selection of ground-truth locations to maximize variance and to minimize physical errors associated with the remote sensing experiment.

  3. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement.

    PubMed

    Sachdev, Perminder; Kalaria, Raj; O'Brien, John; Skoog, Ingmar; Alladi, Suvarna; Black, Sandra E; Blacker, Deborah; Blazer, Dan G; Chen, Christopher; Chui, Helena; Ganguli, Mary; Jellinger, Kurt; Jeste, Dilip V; Pasquier, Florence; Paulsen, Jane; Prins, Niels; Rockwood, Kenneth; Roman, Gustavo; Scheltens, Philip

    2014-01-01

    Several sets of diagnostic criteria have been published for vascular dementia since the 1960s. The continuing ambiguity in vascular dementia definition warrants a critical reexamination. Participants at a special symposium of the International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2009 critiqued the current criteria. They drafted a proposal for a new set of criteria, later reviewed through multiple drafts by the group, including additional experts and the members of the Neurocognitive Disorders Work Group of the fifth revision of Diagnostic and Statistical Manual (DSM-5) Task Force. Cognitive disorders of vascular etiology are a heterogeneous group of disorders with diverse pathologies and clinical manifestations, discussed broadly under the rubric of vascular cognitive disorders (VCD). The continuum of vascular cognitive impairment is recognized by the categories of Mild Vascular Cognitive Disorder, and Vascular Dementia or Major Vascular Cognitive Disorder. Diagnostic thresholds are defined. Clinical and neuroimaging criteria are proposed for establishing vascular etiology. Subtypes of VCD are described, and the frequent cooccurrence of Alzheimer disease pathology emphasized. The proposed criteria for VCD provide a coherent approach to the diagnosis of this diverse group of disorders, with a view to stimulating clinical and pathologic validation studies. These criteria can be harmonized with the DSM-5 criteria such that an international consensus on the criteria for VCD may be achieved.

  4. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement

    PubMed Central

    Sachdev, Perminder; Kalaria, Raj; O’Brien, John; Skoog, Ingmar; Alladi, Suvarna; Black, Sandra E; Blacker, Deborah; Blazer, Dan; Chen, Christopher; Chui, Helena; Ganguli, Mary; Jellinger, Kurt; Jeste, Dilip V.; Pasquier, Florence; Paulsen, Jane; Prins, Niels; Rockwood, Kenneth; Roman, Gustavo; Scheltens, Philip

    2014-01-01

    Background Several sets of diagnostic criteria have been published for vascular dementia (VaD) since the 1960s. The continuing ambiguity in VaD definition warrants a critical re-examination. Methods Participants at a special symposium of the International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2009 critiqued the current criteria. They drafted a proposal for a new set of criteria, later reviewed through multiple drafts by the group, including additional experts and the members of the Neurocognitive Disorders Work Group of the DSM-5 Task Force. Results Cognitive disorders of vascular etiology are a heterogeneous group of disorders with diverse pathologies and clinical manifestations, discussed broadly under the rubric of vascular cognitive disorders (VCD). The continuum of vascular cognitive impairment is recognized by the categories of Mild Vascular Cognitive Disorder, and Vascular Dementia or Major Vascular Cognitive Disorder. Diagnostic thresholds are defined. Clinical and neuroimaging criteria are proposed for establishing vascular etiology. Subtypes of VCD are described, and the frequent co-occurrence of Alzheimer’s disease pathology emphasized. Conclusions The proposed criteria for VCD provide a coherent approach to the diagnosis of this diverse group of disorders, with a view to stimulating clinical and pathological validation studies. These criteria can be harmonized with the DSM-5 criteria such that an international consensus on the criteria for VCD may be achieved. PMID:24632990

  5. Defining active progressive multiple sclerosis.

    PubMed

    Sellebjerg, Finn; Börnsen, Lars; Ammitzbøll, Cecilie; Nielsen, Jørgen Erik; Vinther-Jensen, Tua; Hjermind, Lena Elisabeth; von Essen, Marina; Ratzer, Rikke Lenhard; Soelberg Sørensen, Per; Romme Christensen, Jeppe

    2017-11-01

    It is unknown whether disease activity according to consensus criteria (magnetic resonance imaging activity or clinical relapses) associate with cerebrospinal fluid (CSF) changes in progressive multiple sclerosis (MS). To compare CSF biomarkers in active and inactive progressive MS according to consensus criteria. Neurofilament light chain (NFL), myelin basic protein (MBP), IgG-index, chitinase-3-like-1 (CHI3L1), matrix metalloproteinase-9 (MMP-9), chemokine CXCL13, terminal complement complex, leukocyte counts and nitric oxide metabolites were measured in primary ( n = 26) and secondary progressive MS ( n = 26) and healthy controls ( n = 24). Progressive MS patients had higher CSF cell counts, IgG-index, CHI3L1, MMP-9, CXCL13, NFL and MBP concentrations. Active patients were younger and had higher NFL, CXCL13 and MMP-9 concentrations than inactive patients. Patients with active disease according to consensus criteria or detectable CXCL13 or MMP-9 in CSF were defined as having combined active progressive MS. These patients had increased CSF cell counts, IgG-index and MBP, NFL and CHI3L1 concentrations. Combined inactive patients only had increased IgG-index and MBP concentrations. Patients with combined active progressive MS show evidence of inflammation, demyelination and neuronal/axonal damage, whereas the remaining patients mainly show evidence of active demyelination. This challenges the idea that neurodegeneration independent of inflammation is crucial in disease progression.

  6. Medical device software: defining key terms.

    PubMed

    Pashkov, Vitalii; Gutorova, Nataliya; Harkusha, Andrii

    one of the areas of significant growth in medical devices has been the role of software - as an integral component of a medical device, as a standalone device and more recently as applications on mobile devices. The risk related to a malfunction of the standalone software used within healthcare is in itself not a criterion for its qualification or not as a medical device. It is therefore, necessary to clarify some criteria for the qualification of stand-alone software as medical devices Materials and methods: Ukrainian, European Union, United States of America legislation, Guidelines developed by European Commission and Food and Drug Administration's, recommendations represented by international voluntary group and scientific works. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. the legal regulation of software which is used for medical purpose in Ukraine limited to one definition. In European Union and United States of America were developed and applying special guidelines that help developers, manufactures and end users to difference software on types standing on medical purpose criteria. Software becomes more and more incorporated into medical devices. Developers and manufacturers may not have initially appreciated potential risks to patients and users such situation could have dangerous results for patients or users. It is necessary to develop and adopt the legislation that will intend to define the criteria for the qualification of medical device software and the application of the classification criteria to such software, provide some illustrative examples and step by step recommendations to qualify software as medical device.

  7. Identifying clinical criteria to predict Type 1 diabetes, as defined by absolute insulin deficiency: a systematic review protocol.

    PubMed

    Shields, Beverley M; Peters, Jaime L; Cooper, Chris; Powell, Roy J; Knight, Bridget A; Hyde, Christopher; Hattersley, Andrew T

    2012-01-01

    Management of a patient's diabetes is entirely dependent upon the type of diabetes they are deemed to have. Patients with Type 1 diabetes are insulin deficient so require multiple daily insulin injections, whereas patients with Type 2 diabetes still have some endogenous insulin production so insulin treatment is only required when diet and tablets do not establish good glycaemic control. Despite the importance of a correct diagnosis, classification of diabetes is based on aetiology and relies on clinical judgement. There are no clinical guidelines on how to determine whether a patient has Type 1 or Type 2 diabetes. We aim to systematically review the literature to derive evidence-based clinical criteria for the classification of the major subtypes of diabetes. We will perform a systematic review of diagnostic accuracy studies to establish clinical criteria that predict the subsequent development of absolute insulin deficiency seen in Type 1 diabetes. Insulin deficiency will be determined by reference standard C-peptide concentrations. Synthesis of criteria identified will be undertaken using hierarchical summary receiver operating characteristic curves. As this is a systematic review, there will be no ethical issues. We will disseminate results by writing up the final systematic review and synthesis for publication in a peer-reviewed journal and will present at national and international diabetes-related meetings.

  8. European public acceptance of euthanasia: socio-demographic and cultural factors associated with the acceptance of euthanasia in 33 European countries.

    PubMed

    Cohen, Joachim; Marcoux, Isabelle; Bilsen, Johan; Deboosere, Patrick; van der Wal, Gerrit; Deliens, Luc

    2006-08-01

    In many European countries, the last decade has been marked by an increasing debate about the acceptability and regulation of euthanasia and other end-of-life decisions in medical practice. Growing public sensibility to a 'right to die' for terminally ill patients has been one of the main constituents of these debates. Within this context, we sought to describe and compare acceptance of euthanasia among the general public in 33 European countries. We used the European Values Study data of 1999-2000 with a total of 41125 respondents (63% response rate) in 33 European countries. The main outcome measure concerned the acceptance of euthanasia (defined as 'terminating the life of the incurably sick', rated on a scale from 1 to 10). Results showed that the acceptance of euthanasia tended to be high in some countries (e.g. the Netherlands, Denmark, France, Sweden), while a markedly low acceptance was found in others (e.g. Romania, Malta and Turkey). A multivariate ordinal regression showed that weaker religious belief was the most important factor associated with a higher acceptance; however, there were also socio-demographic differences: younger cohorts, people from non-manual social classes, and people with a higher educational level tended to have a higher acceptance of euthanasia. While religious belief, socio-demographic factors, and also moral values (i.e. the belief in the right to self-determination) could largely explain the differences between countries, our findings suggest that perceptions regarding euthanasia are probably also influenced by national traditions and history (e.g. Germany). Thus, we demonstrated clear cross-national differences with regard to the acceptance of euthanasia, which can serve as an important basis for further debate and research in the specific countries.

  9. Extended Criteria Donors in Liver Transplantation.

    PubMed

    Vodkin, Irine; Kuo, Alexander

    2017-05-01

    Mortality rates on the liver transplant waiting list are increasing. The shortage of organs has resulted in higher utilization of extended criteria donors (ECDs), with centers pushing the limits of what is acceptable for transplantation. Donor quality is more appropriately represented as a continuum of risk, and careful selection and matching of ECD grafts with recipients may lead to excellent outcomes. Although there is no precise definition for what constitutes an ECD liver, this review focuses on frequently cited characteristics, including donor age, steatosis, donation after cardiac death, and donors with increased risk of disease transmission. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Design criteria for Reedy Creek Demonstration Project

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Felicione, F.S.; Logan, J.A.

    1980-11-01

    This document defines the basic criteria for the 100-ton/day pilot plant which will use the Andco-Torrax pyrolysis process at Walt Disney World in Orlando, Florida, to produce hot water. The waste will simulate transuranic wastes which are stored at INEL. The Andco-Torrax process is designed to convert mixed municipal refuse into energy and is called slagging pyrolysis solid waste conversion. (DLC)

  11. The Tritiated Water Skin Barrier Integrity Test: Considerations for Acceptance Criteria with and Without 14C-Octanol.

    PubMed

    Lehman, Paul A; Beatch, Kacie; Raney, Sam G; Franz, Thomas J

    2017-01-01

    A study was designed to assess barrier integrity simultaneously using separate compounds (probes) for polar and non-polar pathways through the skin, 3 H 2 O and 14 C-octanol, respectively; and to determine whether the two probe approach could better define barrier integrity. A 5-min dose of water containing 3 H 2 O and 14 C -octanol was applied to ex vivo human skin mounted in Franz diffusion cells. The receptor solution was sampled at 30 min, analyzed for 3 H and 14 C content, and the correlation between water and octanol absorption was determined by statistical tests suitable for non-normally distributed data. This study was conducted on skin from 37 donors with from 3 to 30 replicate skin sections per donor (a total of 426 sections). The correlation between 3 H 2 O and 14 C-octanol absorption was low (Pearson correlation coefficient = 0.3485). The 3 H 2 O absorption cutoff used in this study to select for a normal skin barrier rejected some sections in which 14 C-octanol absorption was within normal limits and accepted others in which 14 C-octanol absorption was abnormally high. The converse was true for 3 H 2 O absorption when the 14 C-octanol-based cutoff was used. The results of the 3 H 2 O test or of similar tests that primarily assess the permeability of polar pathways through the skin may not necessarily provide information relevant to the absorption of highly lipophilic compounds. Octanol, or another molecule that more closely matches the physicochemical attributes of the test compound, may characterize properties of the skin barrier that are more relevant to compounds of low water solubility.

  12. Acceptance and Avoidance Processes at Different Levels of Psychological Recovery from Enduring Mental Illness.

    PubMed

    Siqueira, Vinicius R; Oades, Lindsay G

    2015-01-01

    Objective. This study examined the use of psychological acceptance and experiential avoidance, two key concepts of Acceptance and Commitment Therapy (ACT), in the psychological recovery process of people with enduring mental illness. Method. Sixty-seven participants were recruited from the metropolitan, regional, and rural areas of New South Wales, Australia. They all presented some form of chronic mental illness (at least 12 months) as reflected in DSM-IV Axis I diagnostic criteria. The Acceptance and Action Questionnaire (AAQ-19) was used to measure the presence of psychological acceptance and experiential avoidance; the Recovery Assessment Scale (RAS) was used to examine the levels of psychological recovery; and the Scales of Psychological Well-Being was used to observe if there are benefits in utilizing psychological acceptance and experiential avoidance in the recovery process. Results. An analysis of objectively quantifiable measures found no clear correlation between the use of psychological acceptance and recovery in mental illness as measured by the RAS. The data, however, showed a relationship between psychological acceptance and some components of recovery, thereby demonstrating its possible value in the recovery process. Conclusion. The major contribution of this research was the emerging correlation that was observed between psychological acceptance and positive levels of psychological well-being among individuals with mental illness.

  13. Attitudes of belgian students of medicine, philosophy, and law toward euthanasia and the conditions for its acceptance.

    PubMed

    Roelands, Marc; Van den Block, Lieve; Geurts, Sylvie; Deliens, Luc; Cohen, Joachim

    2015-01-01

    Euthanasia is legal in Belgium if due care criteria are met, which is judged by committees including physicians, ethicists, and jurists. We examined whether students in these disciplines differ in how they judge euthanasia as an acceptable act. A cross-sectional, anonymous e-mail survey revealed that they have similar attitudes and accept its legalization. Therefore, joint decision-making of physicians, ethicists, and lawyers regarding euthanasia seems to have a common attitudinal base in Belgium. However, they differ to some extent regarding the conditions they put forward for euthanasia being acceptable. Philosophy of life (religion) was an independent predictor of these attitudes.

  14. Prototype Training Materials for Acceptance Criteria of Maintenance ASAP Events Occurring Within Social Context

    NASA Technical Reports Server (NTRS)

    Taylor, J. C.

    2004-01-01

    The aviation maintenance community is at a crossroads with respect to implementing the Aviation Safety Action Program (ASAP). While there is considerable interest, several key issues have emerged that cast doubt on how to assure a successful implementation, including buy-in from all levels of the company and training for key participants. There are two objectives for the present report. The first is to provide an examination of limits (or more properly, examples) of the degree of acceptability of more problematic events for risk-based decisions within the current ASAP guidelines. The second objective is to apply these limits of community standards to a set of further refined ASAP training scenarios.

  15. 77 FR 26048 - Notice of Availability for the Final Certification Criteria for Non-Federal Regional Information...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ...-Federal Regional Information Coordination Entities (RICE) as Approved by the Interagency Ocean Observing... final RICE certification criteria. These certification criteria establish eligibility for non-federal...) and are applicable to RICEs as defined in the Act, including Regional Associations. ADDRESSES: The...

  16. Stopping Criteria for Log-Domain Diffeomorphic Demons Registration: An Experimental Survey for Radiotherapy Application.

    PubMed

    Peroni, M; Golland, P; Sharp, G C; Baroni, G

    2016-02-01

    A crucial issue in deformable image registration is achieving a robust registration algorithm at a reasonable computational cost. Given the iterative nature of the optimization procedure an algorithm must automatically detect convergence, and stop the iterative process when most appropriate. This paper ranks the performances of three stopping criteria and six stopping value computation strategies for a Log-Domain Demons Deformable registration method simulating both a coarse and a fine registration. The analyzed stopping criteria are: (a) velocity field update magnitude, (b) mean squared error, and (c) harmonic energy. Each stoping condition is formulated so that the user defines a threshold ∊, which quantifies the residual error that is acceptable for the particular problem and calculation strategy. In this work, we did not aim at assigning a value to e, but to give insights in how to evaluate and to set the threshold on a given exit strategy in a very popular registration scheme. Experiments on phantom and patient data demonstrate that comparing the optimization metric minimum over the most recent three iterations with the minimum over the fourth to sixth most recent iterations can be an appropriate algorithm stopping strategy. The harmonic energy was found to provide best trade-off between robustness and speed of convergence for the analyzed registration method at coarse registration, but was outperformed by mean squared error when all the original pixel information is used. This suggests the need of developing mathematically sound new convergence criteria in which both image and vector field information could be used to detect the actual convergence, which could be especially useful when considering multi-resolution registrations. Further work should be also dedicated to study same strategies performances in other deformable registration methods and body districts. © The Author(s) 2014.

  17. Mechanisms of Mindfulness Training: Monitor and Acceptance Theory (MAT)1

    PubMed Central

    Lindsay, Emily K.; Creswell, J. David

    2016-01-01

    Despite evidence linking trait mindfulness and mindfulness training with a broad range of effects, still little is known about its underlying active mechanisms. Mindfulness is commonly defined as (1) the ongoing monitoring of present-moment experience (2) with an orientation of acceptance. Building on conceptual, clinical, and empirical work, we describe a testable theoretical account to help explain mindfulness effects on cognition, affect, stress, and health outcomes. Specifically, Monitor and Acceptance Theory (MAT) posits that (1), by enhancing awareness of one’s experiences, the skill of attention monitoring explains how mindfulness improves cognitive functioning outcomes, yet this same skill can increase affective reactivity. Second (2), by modifying one’s relation to monitored experience, acceptance is necessary for reducing affective reactivity, such that attention monitoring and acceptance skills together explain how mindfulness improves negative affectivity, stress, and stress-related health outcomes. We discuss how MAT contributes to mindfulness science, suggest plausible alternatives to the account, and offer specific predictions for future research. PMID:27835764

  18. Defining the paramedic process.

    PubMed

    Carter, Holly; Thompson, James

    2015-01-01

    The use of a 'process of care' is well established in several health professions, most evidently within the field of nursing. Now ingrained within methods of care delivery, it offers a logical approach to problem solving and ensures an appropriate delivery of interventions that are specifically suited to the individual patient. Paramedicine is a rapidly advancing profession despite a wide acknowledgement of limited research provisions. This frequently results in the borrowing of evidence from other disciplines. While this has often been useful, there are many concerns relating to the acceptable limit of evidence transcription between professions. To date, there is no formally recognised 'process of care'-defining activity within the pre-hospital arena. With much current focus on the professional classification of paramedic work, it is considered timely to formally define a formula that underpins other professional roles such as nursing. It is hypothesised that defined processes of care, particularly the nursing process, may have features that would readily translate to pre-hospital practice. The literature analysed was obtained through systematic searches of a range of databases, including Ovid MEDLINE, Cumulative Index to Nursing and Allied Health. The results demonstrated that the defined process of care provides nursing with more than just a structure for practice, but also has implications for education, clinical governance and professional standing. The current nursing process does not directly articulate to the complex and often unstructured role of the paramedic; however, it has many principles that offer value to the paramedic in their practice. Expanding the nursing process model to include the stages of Dispatch Considerations, Scene Assessment, First Impressions, Patient History, Physical Examination, Clinical Decision-Making, Interventions, Re-evaluation, Transport Decisions, Handover and Reflection would provide an appropriate model for pre

  19. 17 CFR Appendix A to Part 38 - Guidance on Compliance With Designation Criteria

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the criteria for designation. To the extent that compliance with, or satisfaction of, a criterion for designation is not self-explanatory from the face of the contract market's rules (as defined in § 40.1 of this... FACILITY—The board of trade shall—(A) establish and enforce rules defining, or specifications detailing...

  20. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    PubMed

    Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

    2015-01-01

    We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  1. FDI World Dental Federation - clinical criteria for the evaluation of direct and indirect restorations. Update and clinical examples.

    PubMed

    Hickel, Reinhard; Peschke, Arnd; Tyas, Martin; Mjör, Ivar; Bayne, Stephen; Peters, Mathilde; Hiller, Karl-Anton; Randall, Ross; Vanherle, Guido; Heintze, Siegward D

    2010-08-01

    In 2007, new clinical criteria were approved by the FDI World Dental Federation and simultaneously published in three dental journals. The criteria were categorized into three groups: esthetic parameters (four criteria), functional parameters (six criteria), and biological parameters (six criteria). Each criterion can be expressed with five scores, three for acceptable and two for non-acceptable (one for reparable and one for replacement). The criteria have been used in several clinical studies since 2007, and the resulting experience in their application has led to a requirement to modify some of the criteria and scores. The two major alterations involve staining and approximal contacts. As staining of the margins and the surface have different causes, both phenomena do not appear simultaneously. Thus, staining has been differentiated into marginal staining and surface staining. The approximal contact now appears under the name "approximal anatomic form" as the approximal contour is a specific, often non-esthetic issue that cannot be integrated into the criterion "esthetic anatomical form". In 2008, a web-based training and calibration tool called e-calib (www.e-calib.info) was made available. Clinical investigators and other research workers can train and calibrate themselves interactively by assessing clinical cases of posterior restorations, which are presented as high quality pictures. Currently, about 300 clinical cases are included in the database which is regularly updated. Training for 8 of the 16 clinical criteria is available in the program: "Surface luster"; "Staining (surface, margins)"; "Color match and translucency"; "Esthetic anatomical form"; "Fracture of material and retention"; "Marginal adaptation"; "Recurrence of caries, erosion, abfraction"; and "Tooth integrity (enamel cracks, tooth fractures)". Typical clinical cases are presented for each of these eight criteria and their corresponding five scores.

  2. The challenges of simulating wake vortex encounters and assessing separation criteria

    NASA Technical Reports Server (NTRS)

    Dunham, R. E.; Stuever, Robert A.; Vicroy, Dan D.

    1993-01-01

    During landings and take-offs, the longitudinal spacing between airplanes is in part determined by the safe separation required to avoid the trailing vortex wake of the preceding aircraft. Safe exploration of the feasibility of reducing longitudinal separation standards will require use of aircraft simulators. This paper discusses the approaches to vortex modeling, methods for modeling the aircraft/vortex interaction, some of the previous attempts of defining vortex hazard criteria, and current understanding of the development of vortex hazard criteria.

  3. Public Acceptability of E-Mental Health Treatment Services for Psychological Problems: A Scoping Review

    PubMed Central

    Kemper, Jessica; Stürmer, Carolina

    2017-01-01

    Background Over the past decades, the deficient provision of evidence-based interventions for the prevention and treatment of mental health problems has become a global challenge across health care systems. In view of the ongoing diffusion of new media and mobile technologies into everyday life, Web-delivered electronic mental health (e-mental health) treatment services have been suggested to expand the access to professional help. However, the large-scale dissemination and adoption of innovative e-mental health services is progressing slowly. This discrepancy between potential and actual impact in public health makes it essential to explore public acceptability of e-mental health treatment services across health care systems. Objective This scoping review aimed to identify and evaluate recent empirical evidence for public acceptability, service preferences, and attitudes toward e-mental health treatments. On the basis of both frameworks for technology adoption and previous research, we defined (1) perceived helpfulness and (2) intentions to use e-mental health treatment services as indicators for public acceptability in the respective general population of reviewed studies. This mapping should reduce heterogeneity and help derive implications for systematic reviews and public health strategies. Methods We systematically searched electronic databases (MEDLINE/PubMed, PsycINFO, Psyndex, PsycARTICLES, and Cochrane Library, using reference management software for parallel searches) to identify surveys published in English in peer-reviewed journals between January 2010 and December 2015, focusing on public perceptions about e-mental health treatments outside the context of clinical, psychosocial, or diagnostic interventions. Both indicators were obtained from previous review. Exclusion criteria further involved studies targeting specific groups or programs. Results The simultaneous database search identified 76 nonduplicate records. Four articles from Europe and

  4. The metabolic syndrome: a concept hard to define.

    PubMed

    Aguilar-Salinas, Carlos A; Rojas, Rosalba; Gómez-Pérez, Francisco J; Mehta, Roopa; Franco, Aurora; Olaiz, Gustavo; Rull, Juan A

    2005-01-01

    The metabolic syndrome integrates, in a single diagnosis, the manifestations of insulin resistance that may lead to increased cardiovascular morbidity and precedes type 2 diabetes. Here we discuss the strengths and limitations of the definitions of the metabolic syndrome and the epidemiology of the syndrome including information from non-Caucasian populations. The definitions proposed by the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) are the most frequently used. The relative risk of having long-term complications is greater for the WHO definition; this is explained by the inclusion of the insulin resistance criteria. The cut-off points used in these definitions should be, but are not, adjusted for ethnicity; as a result, in non-Caucasian subjects, there is lack of agreement among these criteria. In a Mexican population-based survey the prevalence was 13.61% using the WHO definition and 26.6% using the NCEP-III criteria. Cases identified by the WHO criteria had a more severe form of the disease. We propose that the metabolic syndrome should be viewed as a progressive long-term process that leads to major complications. Its definition should reflect the continuous nature of the disease; the categorical approach of the current criteria oversimplifies the complexity of the syndrome. The threshold for defining abnormality should be based on the associated risk of the identified phenotype. Refinement of the definition of both affected and nonaffected subjects is required. The available definitions include, in each of these categories, heterogeneous groups with a broad range of risk of future complications.

  5. Bridging the Gap between Social Acceptance and Ethical Acceptability.

    PubMed

    Taebi, Behnam

    2017-10-01

    New technology brings great benefits, but it can also create new and significant risks. When evaluating those risks in policymaking, there is a tendency to focus on social acceptance. By solely focusing on social acceptance, we could, however, overlook important ethical aspects of technological risk, particularly when we evaluate technologies with transnational and intergenerational risks. I argue that good governance of risky technology requires analyzing both social acceptance and ethical acceptability. Conceptually, these two notions are mostly complementary. Social acceptance studies are not capable of sufficiently capturing all the morally relevant features of risky technologies; ethical analyses do not typically include stakeholders' opinions, and they therefore lack the relevant empirical input for a thorough ethical evaluation. Only when carried out in conjunction are these two types of analysis relevant to national and international governance of risky technology. I discuss the Rawlsian wide reflective equilibrium as a method for marrying social acceptance and ethical acceptability. Although the rationale of my argument is broadly applicable, I will examine the case of multinational nuclear waste repositories in particular. This example will show how ethical issues may be overlooked if we focus only on social acceptance, and will provide a test case for demonstrating how the wide reflective equilibrium can help to bridge the proverbial acceptance-acceptability gap. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  6. Trends of Underweight and Overweight/Obesity Among Japanese Schoolchildren From 2003 to 2012, Defined by Body Mass Index and Percentage Overweight Cutoffs

    PubMed Central

    Shirasawa, Takako; Ochiai, Hirotaka; Nanri, Hinako; Nishimura, Rimei; Ohtsu, Tadahiro; Hoshino, Hiromi; Tajima, Naoko; Kokaze, Akatsuki

    2015-01-01

    Background We investigated the prevalence and trends of underweight and overweight/obesity in a population-based sample of Japanese schoolchildren from 2003 to 2012, defined by body mass index (BMI) and percentage overweight (POW). Methods Subjects comprised fourth and seventh graders from the town of Ina, Japan, from 2003 to 2012. The height and weight of each subject were measured. Children were classified as underweight, normal weight, or overweight/obese using two criteria: BMI cutoff points proposed by the International Obesity Task Force and cutoffs based on POW in Japan. Results Data from 4367 fourth graders and 3724 seventh graders were analyzed. The prevalence of underweight and overweight as defined by POW criteria were lower than those based on BMI criteria. There was a decrease in the prevalence of overweight among fourth-grade boys and girls and seventh-grade girls according to BMI; this decrease was also observed when POW criteria were used for the definition of overweight. Conclusions The prevalence and trends of both underweight and overweight as defined by POW were underestimated among Japanese schoolchildren compared to those determined using BMI. The results of this study also suggest that trends in underweight and overweight/obesity using POW criteria are similar to those based on BMI criteria among schoolchildren in Japan. PMID:25986154

  7. Trends of Underweight and Overweight/Obesity Among Japanese Schoolchildren From 2003 to 2012, Defined by Body Mass Index and Percentage Overweight Cutoffs.

    PubMed

    Shirasawa, Takako; Ochiai, Hirotaka; Nanri, Hinako; Nishimura, Rimei; Ohtsu, Tadahiro; Hoshino, Hiromi; Tajima, Naoko; Kokaze, Akatsuki

    2015-01-01

    We investigated the prevalence and trends of underweight and overweight/obesity in a population-based sample of Japanese schoolchildren from 2003 to 2012, defined by body mass index (BMI) and percentage overweight (POW). Subjects comprised fourth and seventh graders from the town of Ina, Japan, from 2003 to 2012. The height and weight of each subject were measured. Children were classified as underweight, normal weight, or overweight/obese using two criteria: BMI cutoff points proposed by the International Obesity Task Force and cutoffs based on POW in Japan. Data from 4367 fourth graders and 3724 seventh graders were analyzed. The prevalence of underweight and overweight as defined by POW criteria were lower than those based on BMI criteria. There was a decrease in the prevalence of overweight among fourth-grade boys and girls and seventh-grade girls according to BMI; this decrease was also observed when POW criteria were used for the definition of overweight. The prevalence and trends of both underweight and overweight as defined by POW were underestimated among Japanese schoolchildren compared to those determined using BMI. The results of this study also suggest that trends in underweight and overweight/obesity using POW criteria are similar to those based on BMI criteria among schoolchildren in Japan.

  8. Controversy in clinical endocrinology: diagnosis of polycystic ovarian syndrome: the Rotterdam criteria are premature.

    PubMed

    Azziz, Ricardo

    2006-03-01

    Polycystic ovary syndrome (PCOS) is defined most commonly according to the proceedings of an expert conference sponsored by the National Institutes of Health (NIH) in April 1990, which noted the disorder as having 1) hyperandrogenism and/or hyperandrogenemia, 2) oligoovulation, and 3) exclusion of known disorders. Alternatively, another expert conference held in Rotterdam in May 2003 defined PCOS, after the exclusion of related disorders, by two of the following three features: 1) oligo- or anovulation, 2) clinical and/or biochemical signs of hyperandrogenism, or 3) polycystic ovaries. In essence, the Rotterdam 2003 expanded the NIH 1990 definition creating two new phenotypes: 1) ovulatory women with polycystic ovaries and hyperandrogenism, and 2) oligoanovulatory women with polycystic ovaries, but without hyperandrogenism. The objective of this study was to ascertain the validity of using the Rotterdam 2003 criteria rather than the NIH 1991 criteria for the diagnosis of PCOS. Interventions included the use of the Rotterdam 2003 criteria for diagnosing PCOS and, in particular, the proposal to define two new phenotypes as PCOS. POSITIONS: Available data suggest that hyperandrogenic ovulatory women with polycystic ovaries tend to have mild insulin resistance and mild evidence of ovarian dysfunction, although significantly less than women with anovulatory PCOS. However, whether these women will have an increased risk of infertility or metabolic complications, such as type 2 diabetes, remains to be determined. Alternatively, the risk of insulin resistance and long-term metabolic risks of oligoovulatory women with polycystic ovaries is even less well characterized and may be nonexistent. Because of the paucity of data on the two new phenotypes and their long-term implications and the potential negative impact on research, clinical practice, and patient insurability, the adoption of the Rotterdam 2003 criteria for defining PCOS should be considered premature. However

  9. How the definition of acceptable antigens and epitope analysis can facilitate transplantation of highly sensitized patients with excellent long-term graft survival.

    PubMed

    Heidt, Sebastiaan; Haasnoot, Geert W; Claas, Frans H J

    2018-05-24

    Highly sensitized patients awaiting a renal transplant have a low chance of receiving an organ offer. Defining acceptable antigens and using this information for allocation purposes can vastly enhance transplantation of this subgroup of patients, which is the essence of the Eurotransplant Acceptable Mismatch program. Acceptable antigens can be determined by extensive laboratory testing, as well as on basis of human leukocyte antigen (HLA) epitope analyses. Within the Acceptable Mismatch program, there is no effect of HLA mismatches on long-term graft survival. Furthermore, patients transplanted through the Acceptable Mismatch program have similar long-term graft survival to nonsensitized patients transplanted through regular allocation. Although HLA epitope analysis is already being used for defining acceptable HLA antigens for highly sensitized patients in the Acceptable Mismatch program, increasing knowledge on HLA antibody - epitope interactions will pave the way toward the definition of acceptable epitopes for highly sensitized patients in the future. Allocation based on acceptable antigens can facilitate transplantation of highly sensitized patients with excellent long-term graft survival.

  10. Validation of criteria for the definition of transient lower esophageal sphincter relaxations using high-resolution manometry.

    PubMed

    Roman, S; Holloway, R; Keller, J; Herbella, F; Zerbib, F; Xiao, Y; Bernard, L; Bredenoord, A J; Bruley des Varannes, S; Chen, M; Fox, M; Kahrilas, P J; Mittal, R K; Penagini, R; Savarino, E; Sifrim, D; Wu, J; Decullier, E; Pandolfino, J E; Mion, F

    2017-02-01

    Criteria for transient lower esophageal sphincter relaxations (TLESRs) are well-defined for Dentsleeve manometry. As high-resolution manometry (HRM) is now the gold standard to assess esophageal motility, our aim was to propose a consensus definition of TLESRs using HRM. Postprandial esophageal HRM combined with impedance was performed in 10 patients with gastroesophageal reflux disease. Transient lower esophageal sphincter relaxations identification was performed by 17 experts using a Delphi process. Four investigators then characterized TLESR candidates that achieved 100% agreement (TLESR events) and those that achieved less than 25% agreement (non-events) after the third round. Logistic regression and decision tree analysis were used to define optimal diagnostic criteria. All diagnostic criteria were more frequently encountered in the 57 TLESR events than in the 52 non-events. Crural diaphragm (CD) inhibition and LES relaxation duration >10 seconds had the highest predictive value to identify TLESR. Based on decision tree analysis, reflux on impedance, esophageal shortening, common cavity, upper esophageal sphincter relaxation without swallow and secondary peristalsis were alternate diagnostic criteria. Using HRM, TLESR might be defined as LES relaxation occurring in absence of swallowing, lasting more than 10 seconds and associated with CD inhibition. © 2016 John Wiley & Sons Ltd.

  11. Selection of response criteria for clinical trials of sarcoma treatment.

    PubMed

    Schuetze, Scott M; Baker, Laurence H; Benjamin, Robert S; Canetta, Renzo

    2008-01-01

    Soft tissue sarcomas are a heterogeneous group of malignancies arising from mesenchymal tissues. A large number of new therapies are being evaluated in patients with sarcomas, and consensus criteria defining treatment responses are essential for comparison of results from studies completed by different research groups. The 1979 World Health Organization (WHO) handbook set forth operationally defined criteria for response evaluation in solid tumors that were updated in 2000 with the publication of the Response Evaluation Criteria in Solid Tumors (RECIST). There have been significant advances in tumor imaging, however, that are not reflected in the RECIST. For example, computed tomography (CT) slice thickness has been reduced from 10 mm to < or =2.5 mm, allowing for more reproducible and accurate measurement of smaller lesions. Combination of imaging techniques, such as positron emission tomography with fluorine-18-fluorodeoxyglucose (18FDG-PET) and CT can provide investigators and clinicians with both anatomical and functional information regarding tumors, and there is now a large body of evidence demonstrating the effectiveness of PET/CT and other newer imaging methods for the detection and staging of tumors as well as early determination of responses to therapy. The application of newer imaging methods has the potential to decrease both the sample sizes required for, and duration of, clinical trials by providing an early indication of therapeutic response that is well correlated with clinical outcomes, such as time to tumor progression or overall survival. The results summarized in this review support the conclusion that the RECIST and the WHO criteria for evaluation of response in solid tumors need to be modernized. In addition, there is a current need for prospective trials to compare new response criteria with established endpoints and to validate imaging-based response rates as surrogate endpoints for clinical trials of new agents for sarcoma and other solid

  12. Defining Scholarship in Physician Assistant Education.

    PubMed

    Opacic, Deborah A; Roessler, Elizabeth

    2017-09-01

    The goal of educational scholarship is to establish evidence that identifies excellence in teaching, curriculum design, student assessment, mentoring, advising, leadership, and administration. Our challenge as faculty is to determine what best defines this within our profession. Responsibilities of physician assistant (PA) educators include not only increasing evidence supporting quality in PA education but also outlining strategies that lead us to this success. As innovative scholars, we should focus on expanding the definition of educational scholarship by reevaluating criteria that define it. We then can explore new opportunities for faculty to develop a portfolio that endorses their academic advancement. The outcomes of this scholarship can be used to further advance PA education and clinical practice. Educational scholarship should satisfy the following: address a need, expand existing research, and be provocative, measurable, and reproducible. As innovative scholars, we should also consider analyzing existing evidence and determine whether what has been defined as best practices in the general areas of health care education are also effective in PA education. The outcomes of this research can be used to establish best practices within PA education. Cultivating a collaborative environment among programs will enable our profession to gather robust evidence supporting a quality education.

  13. Attitudes toward death criteria and organ donation among healthcare personnel and the general public.

    PubMed

    DuBois, James M; Anderson, Emily E

    2006-03-01

    To examine attitudes toward death criteria and their relation to attitudes and behaviors regarding organ donation. This article reviews empirical studies on the attitudes of healthcare personnel and the general public regarding death criteria and organ donation. The review was restricted to studies that had as a primary focus attitudes toward 1 or more of the following 3 specific criteria for determining death: (1) brain death, the irreversible loss of all functions of the entire brain; (2) higher brain death, the loss of cerebral cortex function alone; and (3) the circulatory-respiratory criteria commonly used in donation after cardiac death. Studies consistently show that the general public and some medical personnel are inadequately familiar with the legal and medical status of brain death; attitudes toward the dead donor rule are strong predictors of willingness to donate organs using controversial criteria; concerns about donation after cardiac death surround the withdrawal of life support more than the actual death criteria used; and concerns about death criteria correlate with less favorable attitudes toward organ donation. Both general and ethical education may serve to guide policy and facilitate family member requests and informed consent dialogues. Furthermore, helping families to understand and accept not only medical and legal criteria for determining death, but also ethical criteria for withdrawing life support may help them be more comfortable with their decisions.

  14. Metabolic Syndrome in Obese Thai Children: Defined Using Modified 'The National Cholesterol Education Program/Adult Treatment Panel III' Criteria.

    PubMed

    Rerksuppaphol, Sanguansak; Rerksuppaphol, Lakkana

    2015-11-01

    Obesity is considered to be a risk of metabolic syndrome; however, data on the prevalence of metabolic syndrome in Thai obese children are scarce. The present study aims to determine the prevalence of metabolic syndrome in Thai obese children. A cross-sectional study was conducted on 113 obese children who were students of a public elementary school in Ongkharak district, Thailand, in 2013. Anthropometric data, blood pressure and biochemical parameters were measured. Metabolic syndrome was defined using modified 'the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATPIII)' criteria. The prevalence of metabolic syndrome in obese children was 50.4%. Children with metabolic syndrome had significantly higher waist circumference (86.9 vs. 82.4 cm, p-value = 0.049), biceps skinfold thickness (17.2 vs. 14.9 mm, p-value = 0.017), suprailiac skinfold thickness (36.5 vs. 31.8 mm, p-value = 0.019), systolic blood pressure (119.7 vs. 112.6 mmHg, p-value = 0.007), diastolic blood pressure (73.7 vs. 69.0 mmHg, p-value = 0.022), fasting blood glucose (97.4 vs. 93.6 mg/dL, p-value = 0.009) and triglyceride levels (140.0 vs. 85.6 mg/dL, p-value < 0.001) than those without metabolic syndrome. HDL-cholesterol was significantly lower in children with metabolic syndrome than those in without metabolic syndrome (48.7 vs. 63.1 mg/dL, p-value < 0.001). Of the sample, approximately half of children with obesity had metabolic syndrome. The prevalence of metabolic syndrome appears to be on the increase. Strategies for childhood obesity and metabolic syndrome prevention are urgently needed for Thai children.

  15. [Early diagnosis of HIV in Primary Care in Spain. Results of a pilot study based on targeted screening based on indicator conditions, behavioral criteria and region of origin].

    PubMed

    Agustí, Cristina; Martín-Rabadán, María; Zarco, José; Aguado, Cristina; Carrillo, Ricard; Codinachs, Roger; Carmona, Jose Manuel; Casabona, Jordi

    2018-03-01

    To estimate the prevalence of HIV infection in patients diagnosed with an indicator condition (IC) for HIV and/or risk behavior for their acquisition and/or coming from high prevalence countries. To determine the acceptability and feasibility of offering HIV testing based on IC and behavioral and origin criteria in Primary Care (PC). Cross-sectional study in a convenience sample. Six PC centers in Spain. The inclusion criteria were: patients between 16 and 65years old who presented at least one of the proposed ICs and/or at least one of the proposed behavioral and/or origin criteria. A total of 388 patients participated. HIV serology was offered to all patients who met the inclusion criteria. Description of IC frequency, behavioral and origin criteria. Prevalence of HIV infection. Level of acceptability and feasibility of the HIV screening based on IC and behavioral and origin criteria. A total of 174 patients had an IC (44.84%). The most common behavioral criterion was: having unprotected sex at some time in life with people who did not know their HIV status (298; 76.8%). Four HIV+ patients (1.03%) were diagnosed. All had an IC and were men who had sex with men. The level of acceptability in PC was high. Offering HIV testing to patients with IC and behavioral criteria is feasible and effective in PC. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  16. Kindler syndrome: a case report and proposal for clinical diagnostic criteria.

    PubMed

    Fischer, Irena Angelova; Kazandjieva, Jana; Vassileva, Snejina; Dourmishev, Assen

    2005-06-01

    Kindler syndrome is a rare hereditary disorder characterized by acral blister formation in infancy and childhood, progressive poikiloderma, cutaneous atrophy and increased photosensitivity. Since it was first described in 1954, less than 100 cases have been reported worldwide. Recently it has been reported that Kindler syndrome is the first genodermatosis caused by a defect in the actin-extracellular matrix linkage, and the gene was mapped to chromosome 20p12.3. The clinical features of the syndrome have been annotated by different authors but the definite of criteria to confirm the diagnosis have not yet been generally accepted. We report a case of Kindler syndrome that presents a full spectrum of clinical manifestations, and we propose a set of clinical criteria for diagnosis.

  17. User Acceptance of Computerized Cognitive Behavioral Therapy for Depression: Systematic Review

    PubMed Central

    Rost, Theresia; Stein, Janine; Löbner, Margrit; Kersting, Anette; Luck-Sikorski, Claudia

    2017-01-01

    Background Computerized cognitive behavioral therapy (cCBT) has been proven to be effective in depression care. Moreover, cCBT packages are becoming increasingly popular. A central aspect concerning the take-up and success of any treatment is its user acceptance. Objective The aim of this study was to update and expand on earlier work on user acceptance of cCBT for depression. Methods This paper systematically reviewed quantitative and qualitative studies regarding the user acceptance of cCBT for depression. The initial search was conducted in January 2016 and involved the following databases: Web of Science, PubMed, the Cochrane Library, and PsycINFO. Studies were retained if they described the explicit examination of the user acceptance, experiences, or satisfaction related to a cCBT intervention, if they reported depression as a primary outcome, and if they were published in German or English from July 2007 onward. Results A total of 1736 studies were identified, of which 29 studies were eligible for review. User acceptance was operationalized and analyzed very heterogeneously. Eight studies reported a very high level of acceptance, 17 indicated a high level of acceptance, and one study showed a moderate level of acceptance. Two qualitative studies considered the positive and negative aspects concerning the user acceptance of cCBT. However, a substantial proportion of reviewed studies revealed several methodical shortcomings. Conclusions In general, people experience cCBT for depression as predominantly positive, which supports the potential role of these innovative treatments. However, methodological challenges do exist in terms of defining user acceptance, clear operationalization of concepts, and measurement. PMID:28903893

  18. Acceptability of HIV self-testing: a systematic literature review.

    PubMed

    Krause, Janne; Subklew-Sehume, Friederike; Kenyon, Chris; Colebunders, Robert

    2013-08-08

    The uptake of HIV testing and counselling services remains low in risk groups around the world. Fear of stigmatisation, discrimination and breach of confidentiality results in low service usage among risk groups. HIV self-testing (HST) is a confidential HIV testing option that enables people to find out their status in the privacy of their homes. We evaluated the acceptability of HST and the benefits and challenges linked to the introduction of HST. A literature review was conducted on the acceptability of HST in projects in which HST was offered to study participants. Besides acceptability rates of HST, accuracy rates of self-testing, referral rates of HIV-positive individuals into medical care, disclosure rates and rates of first-time testers were assessed. In addition, the utilisation rate of a telephone hotline for counselling issues and clients` attitudes towards HST were extracted. Eleven studies met the inclusion criteria (HST had been offered effectively to study participants and had been administered by participants themselves) and demonstrated universally high acceptability of HST among study populations. Studies included populations from resource poor settings (Kenya and Malawi) and from high-income countries (USA, Spain and Singapore). The majority of study participants were able to perform HST accurately with no or little support from trained staff. Participants appreciated the confidentiality and privacy but felt that the provision of adequate counselling services was inadequate. The review demonstrates that HST is an acceptable testing alternative for risk groups and can be performed accurately by the majority of self-testers. Clients especially value the privacy and confidentiality of HST. Linkage to counselling as well as to treatment and care services remain major challenges.

  19. The Relationship between Treatment Integrity and Acceptability of Reading Interventions for Children with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Mautone, Jennifer A.; DuPaul, George J.; Jitendra, Asha K.; Tresco, Katy E.; Junod, Rosemary Vile; Volpe, Robert J.

    2009-01-01

    This study examined the relationship between treatment integrity and acceptability for reading interventions across two consultation models, intensive data-based academic intervention (IDAI) and traditional data-based academic intervention (TDAI). Participants included 83 first- through fourth-grade students who met research criteria for…

  20. Developing acceptance limits for measured bearing wear of the Space Shuttle Main Engine high pressure oxidizer turbopump

    NASA Technical Reports Server (NTRS)

    Genge, Gary G.

    1991-01-01

    The probabilistic design approach currently receiving attention for structural failure modes has been adapted for obtaining measured bearing wear limits in the Space Shuttle Main Engine high-pressure oxidizer turbopump. With the development of the shaft microtravel measurements to determine bearing health, an acceptance limit was neeed that protects against all known faiure modes yet is not overly conservative. This acceptance criteria limit has been successfully determined using probabilistic descriptions of preflight hardware geometry, empirical bearing wear data, mission requirements, and measurement tool precision as an input for a Monte Carlo simulation. The result of the simulation is a frequency distribution of failures as a function of preflight acceptance limits. When the distribution is converted into a reliability curve, a conscious risk management decision is made concerning the acceptance limit.

  1. Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy

    PubMed Central

    Dobashi, Akira; Goda, Kenichi; Yoshimura, Noboru; Ohya, Tomohiko R; Kato, Masayuki; Sumiyama, Kazuki; Matsushima, Masato; Hirooka, Shinichi; Ikegami, Masahiro; Tajiri, Hisao

    2016-01-01

    AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma (SESCC) on Narrow Band Imaging combined with magnifying endoscopy (NBI-ME). METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopists detected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: “intervascular background coloration”; “proliferation of intrapapillary capillary loops (IPCL)”; and “dilation”, “tortuosity”, “change in caliber”, and “various shapes (VS)” of IPCLs (i.e., Inoue’s tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue’s criteria. RESULTS Fifty-four lesions (65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC (P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue’s tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified

  2. Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review.

    PubMed

    Chan, Vincy; Thurairajah, Pravheen; Colantonio, Angela

    2015-02-04

    Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and

  3. Defining the Anthropocene

    NASA Astrophysics Data System (ADS)

    Lewis, Simon; Maslin, Mark

    2016-04-01

    Time is divided by geologists according to marked shifts in Earth's state. Recent global environmental changes suggest that Earth may have entered a new human-dominated geological epoch, the Anthropocene. Should the Anthropocene - the idea that human activity is a force acting upon the Earth system in ways that mean that Earth will be altered for millions of years - be defined as a geological time-unit at the level of an Epoch? Here we appraise the data to assess such claims, first in terms of changes to the Earth system, with particular focus on very long-lived impacts, as Epochs typically last millions of years. Can Earth really be said to be in transition from one state to another? Secondly, we then consider the formal criteria used to define geological time-units and move forward through time examining whether currently available evidence passes typical geological time-unit evidence thresholds. We suggest two time periods likely fit the criteria (1) the aftermath of the interlinking of the Old and New Worlds, which moved species across continents and ocean basins worldwide, a geologically unprecedented and permanent change, which is also the globally synchronous coolest part of the Little Ice Age (in Earth system terms), and the beginning of global trade and a new socio-economic "world system" (in historical terms), marked as a golden spike by a temporary drop in atmospheric CO2, centred on 1610 CE; and (2) the aftermath of the Second World War, when many global environmental changes accelerated and novel long-lived materials were increasingly manufactured, known as the Great Acceleration (in Earth system terms) and the beginning of the Cold War (in historical terms), marked as a golden spike by the peak in radionuclide fallout in 1964. We finish by noting that the Anthropocene debate is politically loaded, thus transparency in the presentation of evidence is essential if a formal definition of the Anthropocene is to avoid becoming a debate about bias. The

  4. Freeform solar concentrator with a highly asymmetric acceptance cone

    NASA Astrophysics Data System (ADS)

    Wheelwright, Brian; Angel, J. Roger P.; Coughenour, Blake; Hammer, Kimberly

    2014-10-01

    A solar concentrator with a highly asymmetric acceptance cone is investigated. Concentrating photovoltaic systems require dual-axis sun tracking to maintain nominal concentration throughout the day. In addition to collecting direct rays from the solar disk, which subtends ~0.53 degrees, concentrating optics must allow for in-field tracking errors due to mechanical misalignment of the module, wind loading, and control loop biases. The angular range over which the concentrator maintains <90% of on-axis throughput is defined as the optical acceptance angle. Concentrators with substantial rotational symmetry likewise exhibit rotationally symmetric acceptance angles. In the field, this is sometimes a poor match with azimuth-elevation trackers, which have inherently asymmetric tracking performance. Pedestal-mounted trackers with low torsional stiffness about the vertical axis have better elevation tracking than azimuthal tracking. Conversely, trackers which rotate on large-footprint circular tracks are often limited by elevation tracking performance. We show that a line-focus concentrator, composed of a parabolic trough primary reflector and freeform refractive secondary, can be tailored to have a highly asymmetric acceptance angle. The design is suitable for a tracker with excellent tracking accuracy in the elevation direction, and poor accuracy in the azimuthal direction. In the 1000X design given, when trough optical errors (2mrad rms slope deviation) are accounted for, the azimuthal acceptance angle is +/- 1.65°, while the elevation acceptance angle is only +/-0.29°. This acceptance angle does not include the angular width of the sun, which consumes nearly all of the elevation tolerance at this concentration level. By decreasing the average concentration, the elevation acceptance angle can be increased. This is well-suited for a pedestal alt-azimuth tracker with a low cost slew bearing (without anti-backlash features).

  5. Influence of diagnostic criteria on the interpretation of adrenal vein sampling.

    PubMed

    Lethielleux, Gaëlle; Amar, Laurence; Raynaud, Alain; Plouin, Pierre-François; Steichen, Olivier

    2015-04-01

    Guidelines promote the use of adrenal vein sampling (AVS) to document lateralized aldosterone hypersecretion in primary aldosteronism. However, there are large discrepancies between institutions in the criteria used to interpret its results. This study evaluates the consequences of these differences on the classification and management of patients. The results of all 537 AVS procedures performed between January 2001 and July 2010 in our institution were interpreted with 4 diagnostic criteria used in experienced institutions where AVS is performed without cosyntropin (Brisbane, Padua, Paris, and Turin) and with criteria proposed by a recent consensus statement. AVS procedures were classified as unsuccessful, lateralized, or not lateralized according to each set of criteria. Almost 5× more AVS procedures were classified as unsuccessful with the strictest criteria than with the least strict criteria (18% versus 4%, respectively). Similarly, over 2× more AVS procedures were classified as lateralized with the least stringent criteria than with the most stringent criteria (60% versus 26%, respectively). Multiple samples were available from ≥1 side for 155 AVS procedures. These procedures were classified differently by ≥2 right-left sample pairs in 12% to 20% of cases. Thus, different sets of criteria used to interpret AVS in experienced institutions translate into heterogeneous classifications and hence management decisions, for patients with primary aldosteronism. Defining the most appropriate procedures and diagnostic criteria is needed for AVS to achieve optimal performance and fully justify its status as a gold standard. © 2015 American Heart Association, Inc.

  6. CORAL REEF BIOLOGICAL CRITERIA: USING THE CLEAN ...

    EPA Pesticide Factsheets

    Coral reefs are declining at unprecedented rates worldwide due to multiple interactive stressors including climate change and land-based sources of pollution. The Clean Water Act (CWA) can be a powerful legal instrument for protecting water resources, including the biological inhabitants of coral reefs. The objective of the CWA is to restore and maintain the chemical, physical and biological integrity of water resources. Coral reef protection and restoration under the Clean Water Act begins with water quality standards - provisions of state or Federal law that consist of a designated use(s) for the waters of the United States and water quality criteria sufficient to protect the uses. Aquatic life use is the designated use that is measured by biological criteria (biocriteria). Biocriteria are expectations set by a jurisdiction for the quality and quantity of living aquatic resources in a defined waterbody. Biocriteria are an important addition to existing management tools for coral reef ecosystems. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework to aid States and Territories in their development, adoption, and implementation of coral reef biocriteria in their respective water quality standards. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework for coral re

  7. Social science to improve fuels management: a synthesis of research on assessing social acceptability of fuels treatments

    Treesearch

    Terry C. Daniel; Michael Valdiserri; Carrie R. Daniel; Pamela Jakes; Pamela Jakes; Susan Barro

    2005-01-01

    A series of syntheses were commissioned by the USDA Forest Service to aid in fuels mitigation project planning. This synthesis focuses on research for assessing the social acceptability of fuels treatments. The synthesis is structured around six important considerations for any social acceptability assessment: defining the fuels treatments being assessed; representing...

  8. What makes up marginal lands and how can it be defined and classified?

    NASA Astrophysics Data System (ADS)

    Ivanina, Vadym

    2017-04-01

    Definitions of marginal lands are often not explicit. The term "marginal" is not supported by either a precise definition or research to determine which lands fall into this category. To identify marginal lands terminology/methodology is used which varies between physical characteristics and the current land use of a site as basic perspective. The term 'Marginal' is most commonly followed by 'degraded' lands, and other widely used terms such as 'abandoned', 'idle', 'pasture', 'surplus agricultural land', 'Conservation Reserve Programme' (CRP)', 'barren and carbon-poor land', etc. Some terms are used synonymously. To the category of "marginal" lands are predominantly included lands which are excluded from cultivation due to economic infeasibility or physical restriction for growing conventional crops. Such sites may still have potential to be used for alternative agricultural practice, e.g. bioenergy feedstock production. The existing categorizing of marginal lands does not allow evaluating soil fertility potential or to define type and level of constrains for growing crops as the reason of a low practical value with regards to land use planning. A new marginal land classification has to be established and developed. This classification should be built on criteria of soil biophysical properties, ecologic, environment and climate handicaps for growing crops, be easy in use and of high practical value. The SEEMLA consortium made steps to build such a marginal land classification which is based on direct criteria depicting soil properties and constrains, and defining their productivity potential. By this classification marginal lands are divided into eleven categories: shallow rooting, low fertility, stony texture, sandy texture, clay texture, salinic, sodicic, acidic, overwet, eroded, and contaminated. The basis of this classification was taken criteria modified after and adapted from Regulation EU (1305)2013. To define an area of marginal lands with climate and

  9. Diagnostic Criteria for Cannabis Withdrawal Syndrome

    PubMed Central

    Gorelick, David A.; Levin, Kenneth H.; Copersino, Marc L.; Heishman, Stephen J.; Liu, Fang; Boggs, Douglas L.; Kelly, Deanna L.

    2011-01-01

    Objective Cannabis withdrawal occurs in frequent users who quit, but there are no accepted diagnostic criteria for a cannabis withdrawal syndrome (CWS). This study evaluated diagnostic criteria for CWS proposed in DSM-V and two earlier proposals. Method A convenience sample of 384 adult, non-treatment-seeking lifetime cannabis smokers provided retrospective self-report data on their “most difficult” quit attempt without formal treatment, which was used in this secondary analysis. Prevalence, time of onset, and peak intensity (5-point Likert scale) for 39 withdrawal symptoms (drawn from the literature) were assessed via computer-administered questionnaire. Subject groups were compared using chi-square or ANOVA. Symptom clustering was evaluated with principal components analysis. Results 40.9% of subjects met the DSM-V criterion of ≥ 3 symptoms from a list of 7. There were no associations with sex, race, or type of cannabis preparation used. There were significant positive associations between duration or frequency of cannabis use prior to the quit attempt and experiencing CWS. Subjects with CWS had a significantly shorter duration of abstinence. Alternative syndromal criteria (dropping physical symptoms from DSM-V list; requiring ≥ 2or ≥ 4 symptoms from a list of 11) yielded a similar prevalence of CWS and similar associations with prior cannabis use and relapse. The PCA yielded 12 factors, including some symptom clusters not included in DSM-V. Conclusions Findings support the concurrent and predictive validity of the proposed DSM-V CWS, but suggest that the list of withdrawal symptoms and number required for diagnosis warrant further evaluation. PMID:22153944

  10. 25 CFR 13.12 - Criteria for approval of reassumption petitions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Section 13.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER TRIBAL REASSUMPTION OF JURISDICTION OVER CHILD CUSTODY PROCEEDINGS Reassumption § 13.12 Criteria for approval of... jurisdiction over Indian child custody matters if: (1) Any reservation, as defined in 25 U.S.C. 1903(10...

  11. Risk assessment in ginecology and obstetrics in Sicily: an approach based on Wolff's Criteria.

    PubMed

    Matranga, D; Marsala, M G L; Vadalà, M; Morici, M; Restivo, V; Ferrara, C; Vitale, F; Firenze, A

    2013-01-01

    To apply Wolff's Criteria to hospital discharge records (HDR) in order to detect adverse events worthy of further study. Gynecology and Obstetrics Units of three Sicilian hospitals were considered and HDR regarding ordinary and day hospital admissions in 2008 were collected. A matched case-control study was designed, by random selection of 10 controls at maximum for each case. Matching was performed on the variables age and speciality of admission (gynecology or obstetrics). Out of a total of 7011 HDR examined, 114 cases were identified with Wolff's Criteria. Multivariate analysis confirmed a statistically significant association with the origin of admission, diagnosis at the acceptance and length of stay: there was a decreased risk of Wolff's event in patients having urgent admission compared to elective (OR = 0.47, 95% CI = [0.28-0.78]), an increased risk in patients reporting tumor (OR = 5:41, 95 % CI [1.89-15.47]) and other causes (OR = 2.16, 95% CI [1.10-4.24]) compared to delivery diagnosis at acceptance and in patients whose length of stay was more than 6 days (OR = 23.17, 95% CI = [12.56-42.7]) compared to less or equal than 3 days Wolff's Criteria can be applied for the analysis of clinical risk in hospitals with different structural characteristics, on condition that the HDR database is complete and good quality.

  12. [Criteria for prioritising patients on surgical waiting lists in the National Health System].

    PubMed

    Allepuz, A; Espallargues, M; Martínez, O

    2009-01-01

    To survey the importance of previously proposed criteria for prioritising patients on surgical waiting lists and to analyse their use in daily practice. Cross-sectional study through a self-auto-administered postal questionnaire to hospital managers, medical directors, admissions managers, and department heads of general surgery, ophthalmology, orthopaedics and traumatology surgery and vascular surgery from 139 centres. The questionnaire comprised 3 sections: a) 3 to 5 of the most important criteria had to be selected and their use in daily practice had to be assessed; b) new criteria were proposed, c) socio-demographic data. The mean and its standard deviation of each criterion of importance were calculated. The proposed criteria were categorised and their frequency was calculated. The questionnaire was answered by the 22% of those surveyed. Disease severity, speed of progression, waiting time and pain were the criteria considered as most important and were the most used. The current clinical situation and the professional environment were the two most common categories defined from the criteria proposed by those surveyed. The surgical priority should be determined by other criteria related to surgery necessity besides waiting time. Establishing prioritisation criteria could enable current implicit criteria to be used explicitly.

  13. Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort.

    PubMed

    Cosio, Borja G; Soriano, Joan B; López-Campos, Jose Luis; Calle-Rubio, Myriam; Soler-Cataluna, Juan José; de-Torres, Juan P; Marín, Jose M; Martínez-Gonzalez, Cristina; de Lucas, Pilar; Mir, Isabel; Peces-Barba, Germán; Feu-Collado, Nuria; Solanes, Ingrid; Alfageme, Inmaculada; Casanova, Ciro

    2016-01-01

    Asthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult. To identify patients with ACOS, a cohort of well-characterized patients with COPD and up to 1 year of follow-up was analyzed. We evaluated the presence of specific characteristics associated with asthma in this COPD cohort, divided into major criteria (bronchodilator test > 400 mL and 15% and past medical history of asthma) and minor criteria (blood eosinophils > 5%, IgE > 100 IU/mL, or two separate bronchodilator tests > 200 mL and 12%). We defined ACOS by the presence of one major criterion or two minor criteria. Baseline characteristics, health status (COPD Assessment Test [CAT]), BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index, rate of exacerbations, and mortality up to 1 year of follow-up were compared between patients with and without criteria for ACOS. Of 831 patients with COPD included,125 (15%) fulfilled the criteria for ACOS, and 98.4% of them sustained these criteria after 1 year. Patients with ACOS were predominantly male (81.6%), with symptomatic mild to moderate disease (67%), who were receiving inhaled corticosteroids (63.2%). There were no significant differences in baseline characteristics, and only survival was worse in patients with non-ACOS COPD after 1 year of follow-up (P < .05). The proposed ACOS criteria are present in 15% of a cohort of patients with COPD and these patients show better 1-year prognosis than clinically similar patients with COPD with no ACOS criteria. ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  14. Defining Medical Capabilities for Exploration Missions

    NASA Technical Reports Server (NTRS)

    Hailey, M.; Antonsen, E.; Blue, R.; Reyes, D.; Mulcahy, R.; Kerstman, E.; Bayuse, T.

    2018-01-01

    Exploration-class missions to the moon, Mars and beyond will require a significant change in medical capability from today's low earth orbit centric paradigm. Significant increases in autonomy will be required due to differences in duration, distance and orbital mechanics. Aerospace medicine and systems engineering teams are working together within ExMC to meet these challenges. Identifying exploration medical system needs requires accounting for planned and unplanned medical care as defined in the concept of operations. In 2017, the ExMC Clinicians group identified medical capabilities to feed into the Systems Engineering process, including: determining what and how to address planned and preventive medical care; defining an Accepted Medical Condition List (AMCL) of conditions that may occur and a subset of those that can be treated effectively within the exploration environment; and listing the medical capabilities needed to treat those conditions in the AMCL. This presentation will discuss the team's approach to addressing these issues, as well as how the outputs of the clinical process impact the systems engineering effort.

  15. A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria

    PubMed Central

    Angus, Derek C.; Seymour, Christopher W.; Coopersmith, Craig M.; Deutschman, Clifford; Klompas, Michael; Levy, Mitchell M.; Martin, Greg S.; Osborn, Tiffany M.; Rhee, Chanu; Watson, R. Scott

    2016-01-01

    Although sepsis was described more than 2,000 years ago, and clinicians still struggle to define it, there is no “gold standard,” and multiple competing approaches and terms exist. Challenges include the ever-changing knowledge base that informs our understanding of sepsis, competing views on which aspects of any potential definition are most important, and the tendency of most potential criteria to be distributed in at-risk populations in such a way as to hinder separation into discrete sets of patients. We propose that the development and evaluation of any definition or diagnostic criteria should follow four steps: 1) define the epistemologic underpinning, 2) agree on all relevant terms used to frame the exercise, 3) state the intended purpose for any proposed set of criteria, and 4) adopt a scientific approach to inform on their usefulness with regard to the intended purpose. Usefulness can be measured across six domains: 1) reliability (stability of criteria during retesting, between raters, over time, and across settings), 2) content validity (similar to face validity), 3) construct validity (whether criteria measure what they purport to measure), 4) criterion validity (how new criteria fare compared to standards), 5) measurement burden (cost, safety, and complexity), and 6) timeliness (whether criteria are available concurrent with care decisions). The relative importance of these domains of usefulness depends on the intended purpose, of which there are four broad categories: 1) clinical care, 2) research, 3) surveillance, and 4) quality improvement and audit. This proposed methodologic framework is intended to aid understanding of the strengths and weaknesses of different approaches, provide a mechanism for explaining differences in epidemiologic estimates generated by different approaches, and guide the development of future definitions and diagnostic criteria. PMID:26901559

  16. A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria.

    PubMed

    Angus, Derek C; Seymour, Christopher W; Coopersmith, Craig M; Deutschman, Clifford S; Klompas, Michael; Levy, Mitchell M; Martin, Gregory S; Osborn, Tiffany M; Rhee, Chanu; Watson, R Scott

    2016-03-01

    Although sepsis was described more than 2,000 years ago, and clinicians still struggle to define it, there is no "gold standard," and multiple competing approaches and terms exist. Challenges include the ever-changing knowledge base that informs our understanding of sepsis, competing views on which aspects of any potential definition are most important, and the tendency of most potential criteria to be distributed in at-risk populations in such a way as to hinder separation into discrete sets of patients. We propose that the development and evaluation of any definition or diagnostic criteria should follow four steps: 1) define the epistemologic underpinning, 2) agree on all relevant terms used to frame the exercise, 3) state the intended purpose for any proposed set of criteria, and 4) adopt a scientific approach to inform on their usefulness with regard to the intended purpose. Usefulness can be measured across six domains: 1) reliability (stability of criteria during retesting, between raters, over time, and across settings), 2) content validity (similar to face validity), 3) construct validity (whether criteria measure what they purport to measure), 4) criterion validity (how new criteria fare compared to standards), 5) measurement burden (cost, safety, and complexity), and 6) timeliness (whether criteria are available concurrent with care decisions). The relative importance of these domains of usefulness depends on the intended purpose, of which there are four broad categories: 1) clinical care, 2) research, 3) surveillance, and 4) quality improvement and audit. This proposed methodologic framework is intended to aid understanding of the strengths and weaknesses of different approaches, provide a mechanism for explaining differences in epidemiologic estimates generated by different approaches, and guide the development of future definitions and diagnostic criteria.

  17. Adequacy of published screening criteria for retinopathy of prematurity.

    PubMed

    Taranath, Deepa A; Oh, Dickson D-S; Keane, Miriam C; Fabel, Helen; Marshall, Peter

    2016-03-01

    Criteria for screening preterm infants for retinopathy of prematurity vary around the world. We aimed to analyse the efficacy of alternative screening criteria. We collected retrospective data at a tertiary level neonatal nursery. Our participants were 1007 babies, born between 1997 and 2011, at <32 weeks gestational age or <1500 g birth weight (as recommended by the National Health and Medical Research Council in 1996), who had completed follow-up to full retinal vascularization, with defined presence or absence of retinopathy of prematurity. We determined whether disease would be detected using an alternative Australian screening model (gestational age <30 weeks or birth weight <1250 g) or screening criteria utilized in developed countries with similar standards of neonatal care. Detection of retinopathy of prematurity is our main outcome. Using several of the alternative criteria, two neonates with clinically significant retinopathy of prematurity, one of whom required laser treatment to preserve sight, would not have been screened, and their disease may have gone undetected. Use of <30 weeks gestational age or <1500 g birth weight as the criteria would still have screened these infants but would have reduced the number of infants screened by 24.9%. Some commonly utilized international screening criteria for retinopathy of prematurity may risk clinically significant cases being missed and others may screen babies unnecessarily. Alternative criteria should be considered and '<30 weeks gestational age and/or <1500 g birth weight' appears a viable option. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

  18. Laboratory study of effects of sonic boom shaping on subjective loudness and acceptability

    NASA Technical Reports Server (NTRS)

    Leatherwood, Jack D.; Sullivan, Brenda M.

    1992-01-01

    A laboratory study was conducted to determine the effects of sonic boom signature shaping on subjective loudness and acceptability. The study utilized the sonic boom simulator at the Langley Research Center. A wide range of symmetrical, front-shock-minimized signature shapes were investigated together with a limited number of asymmetrical signatures. Subjective loudness judgments were obtained from 60 test subjects by using an 11-point numerical category scale. Acceptability judgments were obtained using the method of constant stimuli. Results were used to assess the relative predictive ability of several noise metrics, determine the loudness benefits of detailed boom shaping, and derive laboratory sonic boom acceptability criteria. These results indicated that the A-weighted sound exposure level, the Stevens Mark 7 Perceived Level, and the Zwicker Loudness Level metrics all performed well. Significant reductions in loudness were obtained by increasing front-shock rise time and/or decreasing front-shock overpressure of the front-shock minimized signatures. In addition, the asymmetrical signatures were rated to be slightly quieter than the symmetrical front-shock-minimized signatures of equal A-weighted sound exposure level. However, this result was based on a limited number of asymmetric signatures. The comparison of laboratory acceptability results with acceptability data obtained in more realistic situations also indicated good agreement.

  19. 46 CFR 11.309 - Coast Guard-accepted training other than approved courses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Coast Guard-accepted training other than approved courses. (a) When the training and assessment of... qualify to hold an STCW endorsement, such training and assessment must meet the following requirements: (1) The training and assessment must have written, clearly defined objectives that emphasize specific...

  20. Development and validation of sustainability criteria of administrative green schools in Iran.

    PubMed

    Meiboudi, Hossein; Lahijanian, Akramolmolok; Shobeiri, Seyed Mohammad; Jozi, Seyed Ali; Azizinezhad, Reza

    2017-07-15

    Environmental responsibility in school has led to the emergence of a variety of criteria to administer green schools' contributions to sustainability. Sustainability criteria of administrative green schools need validity, reliability and norms. The aim of the current study was to develop and validate assessment criteria for green schools in Iran based on the role of academia. A national survey was conducted to obtain data on sustainability criteria initiatives for green schools and the Iranian profile was defined. An initial pool of 71 items was generated and after its first edition, 63 items were selected to comprise the sustainability criteria. Engineering-architectural and behavioral aspects of this sustainability criteria were evaluated through a sample of 1218 graduate students with environmental degrees from Iran's universities. Exploratory factor analysis using principal components and promax rotation method showed that these 9 criteria have simple structures and are consistent with the theoretical framework. The reliability coefficients of subscales ranged between 0.62 (participation) and 0.84 (building location and position). The study's survey of correlation coefficients between items and subscales illustrated that those coefficients varied between 0.24 and 0.68. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Establishment of design criteria for acceptable failure modes and fail safe considerations for the space shuttle structural system

    NASA Technical Reports Server (NTRS)

    Westrup, R. W.

    1971-01-01

    The application of general design approaches for preventing failures due to repeated load cycles is briefly discussed. Program objective, mission requirements, and structural design criteria are summarized. Discrete structural elements and associated sections were selected for detailed strength, fatigue, and fracture mechanics investigations.

  2. A Preliminary Investigation of Acceptance and Commitment Therapy as a Treatment for Marijuana Dependence in Adults

    ERIC Educational Resources Information Center

    Twohig, Michael P.; Shoenberger, Deacon; Hayes, Steven C.

    2007-01-01

    In this investigation, 3 adults who met criteria for marijuana dependence were treated using an abbreviated version of acceptance and commitment therapy (ACT). The treatment was delivered in eight weekly 90-min individual sessions. The effects of the intervention were assessed using a nonconcurrent multiple baseline across participants design.…

  3. Acceptable health and priority weighting: Discussing a reference-level approach using sufficientarian reasoning.

    PubMed

    Wouters, S; van Exel, N J A; Rohde, K I M; Vromen, J J; Brouwer, W B F

    2017-05-01

    Health care systems are challenged in allocating scarce health care resources, which are typically insufficient to fulfil all health care wants and needs. One criterion for priority setting may be the 'acceptable health' approach, which suggests that society may want to assign higher priority to health benefits in people with "unacceptable" than in people with "acceptable" health. A level of acceptable health then serves as a reference point for priority setting. Empirical research has indicated that people may be able and willing to define health states as "unacceptable" or "acceptable", but little attention has been given to the normative implications of evaluating health benefits in relation to a reference level of acceptable health. The current paper aims to address this gap by relating insights from the distributive justice literature, i.e. the sufficientarian literature, to the acceptable health approach, as we argue that these approaches are related. We specifically focus on the implications of an 'acceptability' approach for priority weighting of health benefits, derived from sufficientarian reasoning and debates, and assess the moral implications of such weighting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. 34 CFR 647.21 - What selection criteria does the Secretary use?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... uses the following criteria to evaluate an application for a new grant: (a) Need (16 Points). The... definitively demonstrate the need for a McNair project to serve the target population. In particular, the Secretary looks for information that clearly defines the target population; describes the academic...

  5. Tentative civil airworthiness flight criteria for powered-lift transports

    NASA Technical Reports Server (NTRS)

    Hynes, C. S.; Scott, B. C.

    1976-01-01

    Representatives of the U.S., British, French, and Canadian airworthiness authorities participated in a NASA/FAA program to formulate tentative civil airworthiness flight criteria for powered-lift transports. The ultimate limits of the flight envelope are defined by boundaries in the airspeed/path-angle plane. Angle of attack and airspeed margins applied to these ultimate limits provide protection against both atmospheric disturbances and disturbances resulting from pilot actions or system variability, but do not ensure maneuvering capability directly, as the 30% speed margin does for conventional transports. Separate criteria provide for direct demonstration of adequate capability for approach path control, flare and landing, and for go-around. Demonstration maneuvers are proposed, and appropriate abuses and failures are suggested. Taken together, these criteria should permit selection of appropriate operating points within the flight envelopes for the approach, landing, and go-around flight phases which are likely to be most critical for powered-lift aircraft.

  6. Implementation of Subjective Cognitive Decline criteria in research studies

    PubMed Central

    Molinuevo, José L; Rabin, Laura A.; Amariglio, Rebecca; Buckley, Rachel; Dubois, Bruno; Ellis, Kathryn A.; Ewers, Michael; Hampel, Harald; Klöppel, Stefan; Rami, Lorena; Reisberg, Barry; Saykin, Andrew J.; Sikkes, Sietske; Smart, Colette M.; Snitz, Beth E.; Sperling, Reisa; van der Flier, Wiesje M.; Wagner, Michael; Jessen, Frank

    2017-01-01

    INTRODUCTION Subjective Cognitive Decline (SCD) manifesting prior to clinical impairment could serve as a target population for early intervention trials in Alzheimer’s disease (AD). A working group, the Subjective Cognitive Decline Initiative (SCD-I), published SCD research criteria in the context of preclinical AD. To successfully apply them, a number of issues regarding assessment and implementation of SCD needed to be addressed. METHODS Members of the SCD-I met to identify and agree upon topics relevant to SCD criteria operationalization in research settings. Initial ideas and recommendations were discussed with other SCD-I working group members and modified accordingly. RESULTS Topics included SCD inclusion and exclusion criteria, together with the informant’s role in defining SCD presence and the impact of demographic factors. DISCUSSION Recommendations for the operationalization of SCD in differing research settings, with the aim of harmonization of SCD measurement across studies are proposed, to enhance comparability and generalizability across studies. PMID:27825022

  7. Preliminary Criteria for Global Flares in Childhood-Onset Systemic Lupus Erythematosus

    PubMed Central

    Brunner, Hermine I.; Mina, Rina; Pilkington, Clarissa; Beresford, Michael W.; Reiff, Andreas; Levy, Deborah M.; Tucker, Lori B.; Eberhard, B. Anne; Ravelli, Angelo; Schanberg, Laura E.; Saad-Magalhaes, Claudia; Higgins, Gloria C.; Onel, Karen; Singer, Nora G.; von Scheven, Emily; Itert, Lukasz; Klein-Gitelman, Marisa S.; Punaro, Marilynn; Ying, Jun; Giannini, Edward H.

    2011-01-01

    Objectives To develop widely acceptable preliminary criteria of global flare for childhood-onset SLE (cSLE). Methods Pediatric rheumatologists (n=138) rated a total of 358 unique patient profiles (PP) with information about the cSLE flare descriptors (cSLE-FD) from two consecutive visits: patient global assessment of well-being, physician global assessment of disease activity (MD-global), health-related quality of life, anti-dsDNA antibodies, disease activity index score, protein/creatinine (P/C) ratio, complement levels and ESR. Based on 2996 rater responses about the course of cSLE (baseline vs. follow-up) the accuracy (sensitivity, specificity, area under the receiver operating characteristic curve) of candidate flare criteria was assessed. An international consensus conference was held to rank these candidate flare criteria as per the ACR-recommendations for the development and validation of criteria sets. Results The highest ranked candidate criteria considered absolute changes (Δ) of the SLEDAI or BILAG, MD-global, P/C ratio, and ESR; Flare scores can be calculated [0.5 × ΔSLEDAI + 0.45 × ΔP/C ratio + 0.5 × ΔMD-global + 0.02 × ΔESR], where values ≥ 1.04 are reflective of a flare. Similarly, BILAG-based flare scores [0.4 × ΔBILAG + 0.65 × ΔP/C ratio + 0.5 × ΔMD-global + 0.02 × ΔESR] of ≥ 1.15 were diagnostic of a flare. Flare scores increase with flare severity. Conclusions Consensus has been reached on preliminary criteria for global flares in cSLE. Further validation studies are needed to confirm the usefulness of the cSLE flare criteria in research and for clinical care. PMID:21618452

  8. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys.

    PubMed

    Akamizu, Takashi; Satoh, Tetsurou; Isozaki, Osamu; Suzuki, Atsushi; Wakino, Shu; Iburi, Tadao; Tsuboi, Kumiko; Monden, Tsuyoshi; Kouki, Tsuyoshi; Otani, Hajime; Teramukai, Satoshi; Uehara, Ritei; Nakamura, Yosikazu; Nagai, Masaki; Mori, Masatomo

    2012-07-01

    Thyroid storm (TS) is life threatening. Its incidence is poorly defined, few series are available, and population-based diagnostic criteria have not been established. We surveyed TS in Japan, defined its characteristics, and formulated diagnostic criteria, FINAL-CRITERIA1 and FINAL-CRITERIA2, for two grades of TS, TS1, and TS2 respectively. We first developed diagnostic criteria based on 99 patients in the literature and 7 of our patients (LIT-CRITERIA1 for TS1 and LIT-CRITERIA2 for TS2). Thyrotoxicosis was a prerequisite for TS1 and TS2 as well as for combinations of the central nervous system manifestations, fever, tachycardia, congestive heart failure (CHF), and gastrointestinal (GI)/hepatic disturbances. We then conducted initial and follow-up surveys from 2004 through 2008, targeting all hospitals in Japan, with an eight-layered random extraction selection process to obtain and verify information on patients who met LIT-CRITERIA1 and LIT-CRITERIA2. We identified 282 patients with TS1 and 74 patients with TS2. Based on these data and information from the Ministry of Health, Labor, and Welfare of Japan, we estimated the incidence of TS in hospitalized patients in Japan to be 0.20 per 100,000 per year. Serum-free thyroxine and free triiodothyroine concentrations were similar among patients with TS in the literature, Japanese patients with TS1 or TS2, and a group of patients with thyrotoxicosis without TS (Tox-NoTS). The mortality rate was 11.0% in TS1, 9.5% in TS2, and 0% in Tox-NoTS patients. Multiple organ failure was the most common cause of death in TS1 and TS2, followed by CHF, respiratory failure, arrhythmia, disseminated intravascular coagulation, GI perforation, hypoxic brain syndrome, and sepsis. Glasgow Coma Scale results and blood urea nitrogen (BUN) were associated with irreversible damages in 22 survivors. The only change in our final diagnostic criteria for TS as compared with our initial criteria related to serum bilirubin concentration >3 mg

  9. Diagnostic Criteria, Clinical Features, and Incidence of Thyroid Storm Based on Nationwide Surveys

    PubMed Central

    Satoh, Tetsurou; Isozaki, Osamu; Suzuki, Atsushi; Wakino, Shu; Iburi, Tadao; Tsuboi, Kumiko; Monden, Tsuyoshi; Kouki, Tsuyoshi; Otani, Hajime; Teramukai, Satoshi; Uehara, Ritei; Nakamura, Yosikazu; Nagai, Masaki; Mori, Masatomo

    2012-01-01

    Background Thyroid storm (TS) is life threatening. Its incidence is poorly defined, few series are available, and population-based diagnostic criteria have not been established. We surveyed TS in Japan, defined its characteristics, and formulated diagnostic criteria, FINAL-CRITERIA1 and FINAL-CRITERIA2, for two grades of TS, TS1, and TS2 respectively. Methods We first developed diagnostic criteria based on 99 patients in the literature and 7 of our patients (LIT-CRITERIA1 for TS1 and LIT-CRITERIA2 for TS2). Thyrotoxicosis was a prerequisite for TS1 and TS2 as well as for combinations of the central nervous system manifestations, fever, tachycardia, congestive heart failure (CHF), and gastrointestinal (GI)/hepatic disturbances. We then conducted initial and follow-up surveys from 2004 through 2008, targeting all hospitals in Japan, with an eight-layered random extraction selection process to obtain and verify information on patients who met LIT-CRITERIA1 and LIT-CRITERIA2. Results We identified 282 patients with TS1 and 74 patients with TS2. Based on these data and information from the Ministry of Health, Labor, and Welfare of Japan, we estimated the incidence of TS in hospitalized patients in Japan to be 0.20 per 100,000 per year. Serum-free thyroxine and free triiodothyroine concentrations were similar among patients with TS in the literature, Japanese patients with TS1 or TS2, and a group of patients with thyrotoxicosis without TS (Tox-NoTS). The mortality rate was 11.0% in TS1, 9.5% in TS2, and 0% in Tox-NoTS patients. Multiple organ failure was the most common cause of death in TS1 and TS2, followed by CHF, respiratory failure, arrhythmia, disseminated intravascular coagulation, GI perforation, hypoxic brain syndrome, and sepsis. Glasgow Coma Scale results and blood urea nitrogen (BUN) were associated with irreversible damages in 22 survivors. The only change in our final diagnostic criteria for TS as compared with our initial criteria related to serum

  10. Establishment of an equivalence acceptance criterion for accelerated stability studies.

    PubMed

    Burdick, Richard K; Sidor, Leslie

    2013-01-01

    In this article, the use of statistical equivalence testing for providing evidence of process comparability in an accelerated stability study is advocated over the use of a test of differences. The objective of such a study is to demonstrate comparability by showing that the stability profiles under nonrecommended storage conditions of two processes are equivalent. Because it is difficult at accelerated conditions to find a direct link to product specifications, and hence product safety and efficacy, an equivalence acceptance criterion is proposed that is based on the statistical concept of effect size. As with all statistical tests of equivalence, it is important to collect input from appropriate subject-matter experts when defining the acceptance criterion.

  11. The DSM diagnostic criteria for hypoactive sexual desire disorder in women.

    PubMed

    Brotto, Lori A

    2010-04-01

    Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by the monosymptomatic criterion "persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity" that causes "marked distress or interpersonal difficulty." This article reviews the diagnosis of HSDD in prior and current (DSM-IV-TR) editions of the DSM, critiques the existing criteria, and proposes criteria for consideration in DSM-V. Problems in coming to a clear operational definition of desire, the fact that sexual activity often occurs in the absence of desire for women, conceptual issues in understanding untriggered versus responsive desire, the relative infrequency of unprovoked sexual fantasies in women, and the significant overlap between desire and arousal are reviewed and highlight the need for revised DSM criteria for HSDD that accurately reflect women's experiences. The article concludes with the recommendation that desire and arousal be combined into one disorder with polythetic criteria.

  12. Evaluation Criteria for Solid Waste Processing Research and Technology Development

    NASA Technical Reports Server (NTRS)

    Levri, Julie A.; Hogan, J. A.; Alazraki, M. P.

    2001-01-01

    A preliminary list of criteria is proposed for evaluation of solid waste processing technologies for research and technology development (R&TD) in the Advanced Life Support (ALS) Program. Completion of the proposed list by current and prospective ALS technology developers, with regard to specific missions of interest, may enable identification of appropriate technologies (or lack thereof) and guide future development efforts for the ALS Program solid waste processing area. An attempt is made to include criteria that capture information about the technology of interest as well as its system-wide impacts. Some of the criteria in the list are mission-independent, while the majority are mission-specific. In order for technology developers to respond to mission-specific criteria, critical information must be available on the quantity, composition and state of the waste stream, the wast processing requirements, as well as top-level mission scenario information (e.g. safety, resource recovery, planetary protection issues, and ESM equivalencies). The technology readiness level (TRL) determines the degree to which a technology developer is able to accurately report on the list of criteria. Thus, a criteria-specific minimum TRL for mandatory reporting has been identified for each criterion in the list. Although this list has been developed to define criteria that are needed to direct funding of solid waste processing technologies, this list processes significant overlap in criteria required for technology selection for inclusion in specific tests or missions. Additionally, this approach to technology evaluation may be adapted to other ALS subsystems.

  13. Nosographic analysis of osmophobia and field testing of diagnostic criteria including osmophobia.

    PubMed

    Chalmer, Mona Ameri; Hansen, Thomas Folkmann; Olesen, Jes

    2018-01-01

    Introduction Osmophobia has been suggested as an additional symptom of migraine without aura, and a high prevalence of osmophobia of up to 50% has been reported in the literature. We conducted a nosographic study of osmophobia in all migraineurs and tension-type headache patients and a field testing of suggested diagnostic criteria of osmophobia, presented in the appendix of the second edition of The International Classification of Headache Disorders and suggested by Silva-Néto et al. and Wang et al ., in migraine without aura and tension-type headache patients (n = 1934). Materials and methods Each patient received a validated semi-structured interview. All subjects fulfilled the diagnostic criteria of the second edition of The International Classification of Headache Disorders for migraine or tension-type headache. Statistical analyses were performed using statistical software R. The statistical R package "Caret" was used to construct a confusion matrix and retrieve sensitivity, which is defined as the suggested criteria's ability to correctly diagnose migraine without aura patients, and specificity, defined as the suggested criteria's ability to not wrongly diagnose tension-type headache patients. Results Osmophobia was present in 33.5% of patients with migraine with aura, in 36.0% of patients with migraine without aura, and in 1.2% of patients with tension-type headache. All migraineurs with osmophobia also fulfilled the current criteria for migraine by having nausea or photophobia and phonophobia. The appendix criteria had a sensitivity of 0.96 and a specificity of 0.99 for migraine without aura, and a sensitivity of 0.65 and a specificity of 0.99 for probable migraine without aura. Both the criteria by Silva-Néto et al. and Wang et al. had a sensitivity of 0.98 and a specificity of 0.99 for migraine without aura, and a sensitivity of 0.66 and a specificity of 0.99 for probable migraine without aura. Discussion This study demonstrates the remarkable

  14. How Researchers Define Vulnerable Populations in HIV/AIDS Clinical Trials

    PubMed Central

    Lo, Bernard; Strauss, Ronald P.; Eron, Joseph; Gifford, Allen L.

    2010-01-01

    In this study, we interviewed researchers, asking them to define vulnerable populations in HIV/AIDS clinical trials, and provide feedback on the federal regulations for three vulnerable populations. Interview data informed a conceptual framework, and were content analyzed to identify acceptability or disagreement with the regulations. Beginning with several characteristics of vulnerable enrollees identified by researchers, the conceptual framework illustrates possible scenarios of how enrollees could be considered vulnerable in clinical research. Content analysis identified barriers affecting HIV/AIDS researchers’ ability to conduct clinical trials with pregnant women, prisoners, and children, for which the regulations specify additional protections. This study challenges current thinking about federal regulations’ group-based approach to defining vulnerable populations. PMID:20721614

  15. A proposal of criteria for the classification of systemic sclerosis.

    PubMed

    Nadashkevich, Oleg; Davis, Paul; Fritzler, Marvin J

    2004-11-01

    Sensitive and specific criteria for the classification of systemic sclerosis are required by clinicians and investigators to achieve higher quality clinical studies and approaches to therapy. A clinical study of systemic sclerosis patients in Europe and Canada led to a set of criteria that achieve high sensitivity and specificity. Both clinical and laboratory investigations of patients with systemic sclerosis, related conditions and diseases with clinical features that can be mistaken as part of the systemic sclerosis spectrum were undertaken. Laboratory investigations included the detection of autoantibodies to centromere proteins, Scl-70 (topoisomerase I), and fibrillarin (U3-RNP). Based on the investigation of 269 systemic sclerosis patients and 720 patients presenting with related and confounding conditions, the following set of criteria for the classification of systemic sclerosis was proposed: 1) autoantibodies to: centromere proteins, Scl-70 (topo I), fibrillarin; 2) bibasilar pulmonary fibrosis; 3) contractures of the digital joints or prayer sign; 4) dermal thickening proximal to the wrists; 5) calcinosis cutis; 6) Raynaud's phenomenon; 7) esophageal distal hypomotility or reflux-esophagitis; 8) sclerodactyly or non-pitting digital edema; 9) teleangiectasias. The classification of definite SSc requires at least three of the above criteria. Criteria for the classification of systemic sclerosis have been proposed. Preliminary testing has defined the sensitivity and specificity of these criteria as high as 99% and 100%, respectively. Testing and validation of the proposed criteria by other clinical centers is required.

  16. Criteria for the evaluation and certification of long-term digital archives in the earth sciences

    NASA Astrophysics Data System (ADS)

    Klump, Jens

    2010-05-01

    Digital information has become an indispensable part of our cultural and scientific heritage. Scientific findings, historical documents and cultural achievements are to a rapidly increasing extent being presented in electronic form - in many cases exclusively so. However, besides the invaluable advantages offered by this form, it also carries a serious disadvantage: users need to invest a great deal of technical effort in accessing the information. Also, the underlying technology is still undergoing further development at an exceptionally fast pace. The rapid obsolescence of the technology required to read the information combined with the frequently imperceptible physical decay of the media themselves represents a serious threat to preservation of the information content. Many data sets in earth science research are from observations that cannot be repeated. This makes these digital assets particularly valuable. Therefore, these data should be kept and made available for re-use long after the end of the project from which they originated. Since research projects only run for a relatively short period of time, it is advisable to shift the burden of responsibility for long-term data curation from the individual researcher to a trusted data repository or archive. But what makes a trusted data repository? Each trusted digital repository has its own targets and specifications. The trustworthiness of digital repositories can be tested and assessed on the basis of a criteria catalogue. This is the main focus of the work of the nestor working group "Trusted repositories - Certification". It identifies criteria which permit the trustworthiness of a digital repository to be evaluated, both at the organisational and technical levels. The criteria are defined in close collaboration with a wide range of different memory organisations, producers of information, experts and other interested parties. This open approach ensures a high degree of universal validity, suitability for

  17. Coastal zone management with stochastic multi-criteria analysis.

    PubMed

    Félix, A; Baquerizo, A; Santiago, J M; Losada, M A

    2012-12-15

    The methodology for coastal management proposed in this study takes into account the physical processes of the coastal system and the stochastic nature of forcing agents. Simulation techniques are used to assess the uncertainty in the performance of a set of predefined management strategies based on different criteria representing the main concerns of interest groups. This statistical information as well as the distribution function that characterizes the uncertainty regarding the preferences of the decision makers is fed into a stochastic multi-criteria acceptability analysis that provides the probability of alternatives obtaining certain ranks and also calculates the preferences of a typical decision maker who supports an alternative. This methodology was applied as a management solution for Playa Granada in the Guadalfeo River Delta (Granada, Spain), where the construction of a dam in the river basin is causing severe erosion. The analysis of shoreline evolution took into account the coupled action of atmosphere, ocean, and land agents and their intrinsic stochastic character. This study considered five different management strategies. The criteria selected for the analysis were the economic benefits for three interest groups: (i) indirect beneficiaries of tourist activities; (ii) beach homeowners; and (iii) the administration. The strategies were ranked according to their effectiveness, and the relative importance given to each criterion was obtained. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Safe days in space with acceptable uncertainty from space radiation exposure.

    PubMed

    Cucinotta, Francis A; Alp, Murat; Rowedder, Blake; Kim, Myung-Hee Y

    2015-04-01

    The prediction of the risks of cancer and other late effects from space radiation exposure carries large uncertainties mostly due to the lack of information on the risks from high charge and energy (HZE) particles and other high linear energy transfer (LET) radiation. In our recent work new methods were used to consider NASA's requirement to protect against the acceptable risk of no more than 3% probability of cancer fatality estimated at the 95% confidence level. Because it is not possible that a zero-level of uncertainty could be achieved, we suggest that an acceptable uncertainty level should be defined in relationship to a probability distribution function (PDF) that only suffers from modest skewness with higher uncertainty allowed for a normal PDF. In this paper, we evaluate PDFs and the number or "safe days" in space, which are defined as the mission length where risk limits are not exceeded, for several mission scenarios at different acceptable levels of uncertainty. In addition, we briefly discuss several important issues in risk assessment including non-cancer effects, the distinct tumor spectra and lethality found in animal experiments for HZE particles compared to background or low LET radiation associated tumors, and the possibility of non-targeted effects (NTE) modifying low dose responses and increasing relative biological effectiveness (RBE) factors for tumor induction. Each of these issues skew uncertainty distributions to higher fatality probabilities with the potential to increase central values of risk estimates in the future. Therefore they will require significant research efforts to support space exploration within acceptable levels of risk and uncertainty. Copyright © 2015 The Committee on Space Research (COSPAR). Published by Elsevier Ltd. All rights reserved.

  19. The manned transportation system study - Defining human pathways into space

    NASA Technical Reports Server (NTRS)

    Lance, Nick; Geyer, Mark S.; Gaunce, Michael T.; Anson, H. W.; Bienhoff, D. G.; Carey, D. A.; Emmett, B. R.; Mccandless, B.; Wetzel, E. D.

    1992-01-01

    Substantiating data developed by a NASA-industry team (NIT) for subsequent NASA decisions on the 'right' set of manned transportation elements needed for human access to space are discussed. Attention is given to the framework for detailed definition of these manned transportation elements. Identifying and defining architecture evaluation criteria, i.e., attributes, specified the amount and type of data needed for each concept under consideration. Several architectures, each beginning with today's transportation systems, were defined using representative systems to explore future options and address specific questions currently being debated. The present solutions emphasize affordability, safety, routineness, and reliability. Key issues associated with current business practices were challenged and the impact associated with these practices quantified.

  20. Respondent-driven sampling to assess mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies in eastern Democratic Republic of Congo

    PubMed Central

    Scott, Jennifer; Rouhani, Shada; Greiner, Ashley; Albutt, Katherine; Kuwert, Philipp; Hacker, Michele R; VanRooyen, Michael; Bartels, Susan

    2015-01-01

    Objectives Assess mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in eastern Democratic Republic of Congo and stigma toward and acceptance of women and their children. Design Participants were recruited using respondent-driven sampling. Setting Bukavu, Democratic Republic of Congo in 2012. Participants 757 adult women raising children from SVRPs were interviewed. A woman aged 18 and older was eligible for the study if she self-identified as a sexual violence survivor since the start of the conflict (∼1996), conceived an SVRP, delivered a liveborn child and was currently raising the child. A woman was ineligible for the study if the SVRP ended with a spontaneous abortion or fetal demise or the child was not currently living or in the care of the biological mother. Intervention Trained female Congolese interviewers verbally administered a quantitative survey after obtaining verbal informed consent. Outcome measures Symptom criteria for major depressive disorder, post-traumatic stress disorder, anxiety and suicidality were assessed, as well as stigma toward the woman and her child. Acceptance of the woman and child from the spouse, family and community were analysed. Results 48.6% met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria. Conclusions Women raising children from SVRPs experience symptoms of mental health disorders. Programming addressing stigma and acceptance following sexual violence may

  1. Acceptance test report for portable exhauster POR-007/Skid E

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kriskovich, J.R.

    1998-07-24

    This document describes Acceptance Testing performed on Portable Exhauster POR-007/Skid E. It includes measurements of bearing vibration levels, pressure decay testing, programmable logic controller interlocks, high vacuum, flow and pressure control functional testing. The purpose of Acceptance testing documented by this report was to demonstrate compliance of the exhausters with the performance criteria established within HNF-0490, Rev. 1 following a repair and upgrade effort at Hanford. In addition, data obtained during this testing is required for the resolution of outstanding Non-conformance Reports (NCR), and finally, to demonstrate the functionality of the associated software for the pressure control and high vacuummore » exhauster operating modes provided for by W-320. Additional testing not required by the ATP was also performed to assist in the disposition and close out of receiving inspection report and for application design information (system curve). Results of this testing are also captured within this document.« less

  2. [Criteria of quality of structure in rehabilitation units with inpatient treatment].

    PubMed

    Klein, K; Farin, E; Jäckel, W H; Blatt, O; Schliehe, F

    2004-04-01

    The structure of a rehabilitation unit is an important feature of the quality of care. Adequate and qualitatively good structures provide the basis for appropriate therapy offers and treatment and eventually, a better health for rehabilitants. The quality of structures is generally recorded without any evaluation of the aspects in particular. The definition of standards is the basis for such an evaluation. The project presented is aimed at the definition of relevant structural standards for rehab units with inpatient treatment for musculoskeletal, cardiac, neurological, gastroenterological, oncological, pneumological and dermatological diseases. Here, the distinction between basal criteria which have to be fulfilled by every rehab unit with inpatient treatment and criteria important for a well-aimed assignment of patients with specific needs ("assignment criteria") should be made. Apart from the documentation of structural attributes, the structural quality of a rehab unit can be described individually as well as in comparison with other units. Relevant structural criteria were defined in expert meetings by means of a modified Delphi-technique with five inquiries. Overall, 199 "basal criteria" and "assignment criteria" were defined. All criteria can be assigned to the two domains general structural characteristics (general characteristics and equipment of rooms; medical/technical equipment; therapy, education, care; staff) and process-related structures (conceptual frames; internal quality management; internal communication and personnel development). The structural standards are applicable to units for musculoskeletal, cardiac, neurological, oncological, gastroenterological, dermatological and pneumological rehabilitation financed by the two main providers of rehabilitation, the statutory pension insurance scheme and the statutory health insurance scheme for all other five indications. The definition of structural standards agreed by experts in a formal consensus

  3. The changing purpose of Prader-Willi syndrome clinical diagnostic criteria and proposed revised criteria.

    PubMed

    Gunay-Aygun, M; Schwartz, S; Heeger, S; O'Riordan, M A; Cassidy, S B

    2001-11-01

    results indicate that the sensitivities of most of the published criteria are acceptable. However, 16.7% of patients with molecular diagnosis did not meet the 1993 clinical diagnostic criteria retrospectively, suggesting that the published criteria may be too exclusive. A less strict scoring system may ensure that all appropriate people are tested. Accordingly, we suggest revised clinical criteria to help identify the appropriate patients for DNA testing for PWS. The suggested age groupings are based on characteristic phases of the natural history of PWS. Some of the features (eg, neonatal hypotonia, feeding problems in infancy) serve to diagnose the syndrome in the first few years of life, whereas others (eg, excessive eating) are useful during early childhood. Similarly, hypogonadism is most useful during and after adolescence. Some of the features like neonatal hypotonia and infantile feeding problems are less likely to be missed, whereas others such as characteristic facial features and hypogonadism (especially in prepubertal females) may require more careful and/or expert examination. The issue of who should have diagnostic testing is distinct from the determination of features among confirmed patients. Based on the sensitivities of the published criteria and our experience, we suggest testing all newborns/infants with otherwise unexplained hypotonia with poor suck. For children between 2 and 6 years of age, we consider hypotonia with history of poor suck associated with global developmental delay sufficient criteria to prompt testing. Between 6 and 12 years of age, we suggest testing those with hypotonia (or history of hypotonia with poor suck), global developmental delay, and excessive eating with central obesity (if uncontrolled). At the ages of 13 years and above, we recommend testing patients with cognitive impairment, excessive eating with central obesity (if uncontrolled), and hypogonadotropic hypogonadism and/or typical behavior problems (including temper

  4. Polycystic ovary morphology: age-based ultrasound criteria.

    PubMed

    Kim, Hyun-Jun; Adams, Judith M; Gudmundsson, Jens A; Arason, Gudmundur; Pau, Cindy T; Welt, Corrine K

    2017-09-01

    To determine age-based criteria for polycystic ovary morphology. Cross-sectional, case-control design. Outpatient setting. Women with polycystic ovary syndrome (PCOS) defined by hyperandrogenism and irregular menses (n = 544) and controls with regular menses and no evidence of hyperandrogenism (n = 666) participated. Parameters were tested in a second cohort of women with PCOS (n = 105) and controls (n = 32) meeting the same criteria. Subjects underwent a pelvic ultrasound documenting ovarian volume and maximum follicle number in a single plane. A receiver operating characteristic curve was constructed to determine the ovarian volume and follicle number with the best sensitivity and specificity to define PCOS for age groups at approximately 5-year intervals from age 18 to >44 years. The best sensitivity and specificity were obtained using a threshold volume of 12 mL and 13 follicles for ages ≤24 years, 10 mL and 14 follicles for ages 25-29 years, 9 mL and 10 follicles for ages 30-34 years, 8 mL and 10 follicles for ages 35-39 years, 10 mL and 9 follicles for ages 40-44 years, and 6 mL and 7 follicles for ages >44 years. Data from a second cohort confirmed the need to decrease volume and follicle number with increasing age to diagnose PCOS. Polycystic ovary morphology was most accurate at predicting the PCOS diagnosis for women ages 30-39 years. The ovarian volume and follicle number threshold to define polycystic ovary morphology should be lowered starting at age 30. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Self Evaluation of Organizations.

    ERIC Educational Resources Information Center

    Pooley, Richard C.

    Evaluation within human service organizations is defined in terms of accepted evaluation criteria, with reasonable expectations shown and structured into a model of systematic evaluation practice. The evaluation criteria of program effort, performance, adequacy, efficiency and process mechanisms are discussed, along with measurement information…

  6. User Acceptance of Computerized Cognitive Behavioral Therapy for Depression: Systematic Review.

    PubMed

    Rost, Theresia; Stein, Janine; Löbner, Margrit; Kersting, Anette; Luck-Sikorski, Claudia; Riedel-Heller, Steffi G

    2017-09-13

    Computerized cognitive behavioral therapy (cCBT) has been proven to be effective in depression care. Moreover, cCBT packages are becoming increasingly popular. A central aspect concerning the take-up and success of any treatment is its user acceptance. The aim of this study was to update and expand on earlier work on user acceptance of cCBT for depression. This paper systematically reviewed quantitative and qualitative studies regarding the user acceptance of cCBT for depression. The initial search was conducted in January 2016 and involved the following databases: Web of Science, PubMed, the Cochrane Library, and PsycINFO. Studies were retained if they described the explicit examination of the user acceptance, experiences, or satisfaction related to a cCBT intervention, if they reported depression as a primary outcome, and if they were published in German or English from July 2007 onward. A total of 1736 studies were identified, of which 29 studies were eligible for review. User acceptance was operationalized and analyzed very heterogeneously. Eight studies reported a very high level of acceptance, 17 indicated a high level of acceptance, and one study showed a moderate level of acceptance. Two qualitative studies considered the positive and negative aspects concerning the user acceptance of cCBT. However, a substantial proportion of reviewed studies revealed several methodical shortcomings. In general, people experience cCBT for depression as predominantly positive, which supports the potential role of these innovative treatments. However, methodological challenges do exist in terms of defining user acceptance, clear operationalization of concepts, and measurement. ©Theresia Rost, Janine Stein, Margrit Löbner, Anette Kersting, Claudia Luck-Sikorski, Steffi G Riedel-Heller. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.09.2017.

  7. Identifying fundamental criteria for eating disorder recovery: a systematic review and qualitative meta-analysis.

    PubMed

    de Vos, Jan Alexander; LaMarre, Andrea; Radstaak, Mirjam; Bijkerk, Charlotte Ariane; Bohlmeijer, Ernst T; Westerhof, Gerben J

    2017-01-01

    Outcome studies for eating disorders regularly measure pathology change or remission as the only outcome. Researchers, patients and recovered individuals highlight the importance of using additional criteria for measuring eating disorder recovery. There is no clear consensus on which additional criteria are most fundamental. Studies focusing on the perspectives of recovered patients show criteria which are closely related to dimensions of positive functioning as conceptualized in the complete mental health model. The aim of this study was to identify fundamental criteria for eating disorder recovery according to recovered individuals. A systematic review and a qualitative meta-analytic approach were used. Eighteen studies with recovered individuals and meeting various quality criteria were included. The result sections of the included papers were searched for themes that were stated as criteria for recovery or 'being recovered'. All themes were analyzed using a meta-summary technique. Themes were labeled into criteria for recovery and the frequency of the found criteria was examined. In addition to the remission of eating disorder pathology, dimensions of psychological well-being and self-adaptability/resilience were found to be fundamental criteria for eating disorder recovery. The most frequently mentioned criteria were: self-acceptance, positive relationships, personal growth, decrease in eating disorder behavior/cognitions, self-adaptability/resilience and autonomy. People who have recovered rate psychological well-being as a central criterion for ED recovery in addition to the remission of eating disorder symptoms. Supplementary criteria, besides symptom remission, are needed to measure recovery. We recommend including measurements of psychological well-being and self-adaptability/resilience in future research, such as outcome studies and in routine outcome measurement.

  8. Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases.

    PubMed

    Pauer, Frédéric; Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas Of; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

    2016-08-25

    The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases

  9. Defining conditions where long-term glucocorticoid treatment has an acceptably low level of harm to facilitate implementation of existing recommendations: viewpoints from an EULAR task force.

    PubMed

    Strehl, Cindy; Bijlsma, Johannes W J; de Wit, Maarten; Boers, Maarten; Caeyers, Nele; Cutolo, Maurizio; Dasgupta, Bhaskar; Dixon, William G; Geenen, Rinie; Huizinga, Tom W J; Kent, Alison; de Thurah, Annette Ladefoged; Listing, Joachim; Mariette, Xavier; Ray, David W; Scherer, Hans U; Seror, Raphaèle; Spies, Cornelia M; Tarp, Simon; Wiek, Dieter; Winthrop, Kevin L; Buttgereit, Frank

    2016-06-01

    There is convincing evidence for the known and unambiguously accepted beneficial effects of glucocorticoids at low dosages. However, the implementation of existing recommendations and guidelines on the management of glucocorticoid therapy in rheumatic diseases is lagging behind. As a first step to improve implementation, we aimed at defining conditions under which long-term glucocorticoid therapy may have an acceptably low level of harm. A multidisciplinary European League Against Rheumatism task force group of experts including patients with rheumatic diseases was assembled. After a systematic literature search, breakout groups critically reviewed the evidence on the four most worrisome adverse effects of glucocorticoid therapy (osteoporosis, hyperglycaemia/diabetes mellitus, cardiovascular diseases and infections) and presented their results to the other group members following a structured questionnaire for final discussion and consensus finding. Robust evidence on the risk of harm of long-term glucocorticoid therapy was often lacking since relevant study results were often either missing, contradictory or carried a high risk of bias. The group agreed that the risk of harm is low for the majority of patients at long-term dosages of ≤5 mg prednisone equivalent per day, whereas at dosages of >10 mg/day the risk of harm is elevated. At dosages between >5 and ≤10 mg/day, patient-specific characteristics (protective and risk factors) determine the risk of harm. The level of harm of glucocorticoids depends on both dose and patient-specific parameters. General and glucocorticoid-associated risk factors and protective factors such as a healthy lifestyle should be taken into account when evaluating the actual and future risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Multi-Criteria Decision Making for a Spatial Decision Support System on the Analysis of Changing Risk

    NASA Astrophysics Data System (ADS)

    Olyazadeh, Roya; van Westen, Cees; Bakker, Wim H.; Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

    2014-05-01

    Natural hazard risk management requires decision making in several stages. Decision making on alternatives for risk reduction planning starts with an intelligence phase for recognition of the decision problems and identifying the objectives. Development of the alternatives and assigning the variable by decision makers to each alternative are employed to the design phase. Final phase evaluates the optimal choice by comparing the alternatives, defining indicators, assigning a weight to each and ranking them. This process is referred to as Multi-Criteria Decision Making analysis (MCDM), Multi-Criteria Evaluation (MCE) or Multi-Criteria Analysis (MCA). In the framework of the ongoing 7th Framework Program "CHANGES" (2011-2014, Grant Agreement No. 263953) of the European Commission, a Spatial Decision Support System is under development, that has the aim to analyse changes in hydro-meteorological risk and provide support to selecting the best risk reduction alternative. This paper describes the module for Multi-Criteria Decision Making analysis (MCDM) that incorporates monetary and non-monetary criteria in the analysis of the optimal alternative. The MCDM module consists of several components. The first step is to define criteria (or Indicators) which are subdivided into disadvantages (criteria that indicate the difficulty for implementing the risk reduction strategy, also referred to as Costs) and advantages (criteria that indicate the favorability, also referred to as benefits). In the next step the stakeholders can use the developed web-based tool for prioritizing criteria and decision matrix. Public participation plays a role in decision making and this is also planned through the use of a mobile web-version where the general local public can indicate their agreement on the proposed alternatives. The application is being tested through a case study related to risk reduction of a mountainous valley in the Alps affected by flooding. Four alternatives are evaluated in

  11. NASA Glenn Wind Tunnel Model Systems Criteria

    NASA Technical Reports Server (NTRS)

    Soeder, Ronald H.; Roeder, James W.; Stark, David E.; Linne, Alan A.

    2004-01-01

    This report describes criteria for the design, analysis, quality assurance, and documentation of models that are to be tested in the wind tunnel facilities at the NASA Glenn Research Center. This report presents two methods for computing model allowable stresses on the basis of the yield stress or ultimate stress, and it defines project procedures to test models in the NASA Glenn aeropropulsion facilities. Both customer-furnished and in-house model systems are discussed. The functions of the facility personnel and customers are defined. The format for the pretest meetings, safety permit process, and model reviews are outlined. The format for the model systems report (a requirement for each model that is to be tested at NASA Glenn) is described, the engineers responsible for developing the model systems report are listed, and the timetable for its delivery to the project engineer is given.

  12. Shifting from glucose diagnostic criteria to the new HbA(1c) criteria would have a profound impact on prevalence of diabetes among a high-risk Spanish population.

    PubMed

    Costa, B; Barrio, F; Cabré, J-J; Piñol, J-L; Cos, F-X; Solé, C; Bolibar, B; Castell, C; Lindström, J; Barengo, N; Tuomilehto, J

    2011-10-01

    To investigate changes in the prevalence of diabetes and pre-diabetes by shifting from 2-h plasma glucose and/or fasting plasma glucose diagnostic criteria to the proposed new HbA(1c) -based criteria when applied to a Mediterranean population detected to have a high risk of Type 2 diabetes. Individuals without diabetes aged 45-75 years (n = 2287) were screened using the Finnish Diabetes Risk Score questionnaire, a 2-h oral glucose tolerance test plus HbA(1c) test. Prevalence and degree of diagnostic overlap between three sets of criteria (2-h plasma glucose, fasting plasma glucose and HbA(1c) ) and three diagnostic categories (normal, pre-diabetes and diabetes) were calculated. Defining diabetes by a single HbA(1c) measurement resulted in a dramatic decrease in prevalence (1.3%), particularly in comparison with diabetes defined by 2-h plasma glucose (8.6%), but was also significant with regard to fasting plasma glucose (2.8%). A total of 201 screened subjects (8.8%) were classified as having diabetes and 1023 (44.7%) as having pre-diabetes based on at least one of these criteria; among these, the presence of all three criteria simultaneously classified only 21 and 110 individuals respectively, about ten percent of each group. The single overlap index between subjects diagnosed as having diabetes by 2-h plasma glucose/fasting plasma glucose vs. HbA(1c) was 13.9/28%. Similarly, the single overlap index regarding pre-diabetes was 19.2/27.1%. A shift from the glucose-based diagnosis to the HbA(1c) -based diagnosis for diabetes will reduce diabetes prevalence with a low overall or single degree of overlap between diagnostic categories in this high-risk Spanish population. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  13. Language-Related Criteria as Determinants of Ethnicity. Goals and Results of a Feasibility Study in the Netherlands.

    ERIC Educational Resources Information Center

    Broeder, Peter; And Others

    This paper addresses the potential value of language-related criteria for use in identifying ethnic minorities in the Netherlands. A description of the way the Dutch government defines ethnic minority groups is followed by a comparative outline of the use of language-related criteria in countries with a longer tradition of immigration (Australia,…

  14. Mindfulness- and Acceptance-based Interventions for Psychosis: A Systematic Review and Meta-analysis

    PubMed Central

    Lauche, Romy; Haller, Heidemarie; Langhorst, Jost; Dobos, Gustav

    2016-01-01

    Background: Mindfulness- and acceptance-based interventions are increasingly studied as a potential treatment for a variety of mental conditions. Objective: To assess the effects of mindfulness- and acceptance-based interventions on psychotic symptoms and hospitalization in patients with psychosis Methods: MEDLINE/PubMed, Embase, the Cochrane Library, and PsycINFO were screened from inception through April 2015. Randomized controlled trials (RCTs) were analyzed when they assessed psychotic symptoms or hospitalization in patients with psychosis; affect, acceptance, mindfulness, and safety were defined as secondary outcomes. Results: Eight RCTs with a total of 434 patients comparing mindfulness-based (4 RCTs) or acceptance-based interventions (4 RCTs) to treatment as usual or attention control were included. Six RCTs had low risk of bias. Moderate evidence was found for short-term effects on total psychotic symptoms, positive symptoms, hospitalization rates, duration of hospitalization, and mindfulness and for long-term effects on total psychotic symptoms and duration of hospitalization. No evidence was found for effects on negative symptoms, affect, or acceptance. No serious adverse events were reported. Conclusion: Mindfulness- and acceptance-based interventions can be recommended as an additional treatment for patients with psychosis. PMID:26937312

  15. Acceptance and adoption of biofortified crops in low- and middle-income countries: a systematic review

    PubMed Central

    Talsma, Elise F; Melse-Boonstra, Alida; Brouwer, Inge D

    2017-01-01

    Context: Biofortification of staple crops is a promising strategy for increasing the nutrient density of diets in order to improve human health. The willingness of consumers and producers to accept new crop varieties will determine whether biofortification can be successfully implemented. Objective: This review assessed sensory acceptance and adoption of biofortified crops and the determining factors for acceptance and adoption among consumers and producers in low- and middle-income countries. Data sources: PubMed, Scopus, and Web of Science were searched for published reports. Unpublished studies were identified using an internet search. Study selection: From a total of 1669 records found, 72 primary human research studies published in English or Spanish met the criteria for inclusion. Data extraction: Data were extracted from each identified study using a standardized form. Results: Sensory acceptability (n = 40) was the most common topic of the studies, followed by determinants of acceptance (n = 25) and adoption (n = 21). Of crops included in the studies, sweet potato and maize were the most studied, whereas rice and pearl-millet were the least investigated. Overall, sensory acceptance was good, and availability and information on health benefits of the crops were the most important determinants of acceptance and adoption. Conclusions: Changes to the sensory qualities of a crop, including changes in color, did not act as an obstacle to acceptance of biofortified crops. Future studies should look at acceptance of biofortified crops after they have been disseminated and introduced on a wide-scale. PMID:29028269

  16. Preliminary criteria for global flares in childhood-onset systemic lupus erythematosus.

    PubMed

    Brunner, Hermine I; Mina, Rina; Pilkington, Clarissa; Beresford, Michael W; Reiff, Andreas; Levy, Deborah M; Tucker, Lori B; Eberhard, B Anne; Ravelli, Angelo; Schanberg, Laura E; Saad-Magalhaes, Claudia; Higgins, Gloria C; Onel, Karen; Singer, Nora G; von Scheven, Emily; Itert, Lukasz; Klein-Gitelman, Marisa S; Punaro, Marilynn; Ying, Jun; Giannini, Edward H

    2011-09-01

    To develop widely acceptable preliminary criteria of global flare for childhood-onset systemic lupus erythematosus (cSLE). Pediatric rheumatologists (n = 138) rated a total of 358 unique patient profiles with information about the cSLE flare descriptors from 2 consecutive visits: patient global assessment of well-being, physician global assessment of disease activity (MD-global), health-related quality of life, anti-double-stranded DNA antibodies, disease activity index scores, protein:creatinine (P:C) ratio, complement levels, and erythrocyte sedimentation rate (ESR). Based on 2,996 rater responses about the course of cSLE (baseline versus followup), the accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) of candidate flare criteria was assessed. An international consensus conference was held to rank these candidate flare criteria as per the American College of Rheumatology recommendations for the development and validation of criteria sets. The highest-ranked candidate criteria considered absolute changes (Δ) of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) or British Isles Lupus Assessment Group (BILAG), MD-global, P:C ratio, and ESR; flare scores can be calculated (0.5 × ΔSLEDAI + 0.45 × ΔP:C ratio + 0.5 × ΔMD-global + 0.02 × ΔESR), where values of ≥1.04 are reflective of a flare. Similarly, BILAG-based flare scores (0.4 × ΔBILAG + 0.65 × ΔP:C ratio + 0.5 × ΔMD-global + 0.02 × ΔESR) of ≥1.15 were diagnostic of a flare. Flare scores increased with flare severity. Consensus has been reached on preliminary criteria for global flares in cSLE. Further validation studies are needed to confirm the usefulness of the cSLE flare criteria in research and for clinical care. Copyright © 2011 by the American College of Rheumatology.

  17. Opportunities and challenges of expanded criteria organs in liver and kidney transplantation as a response to organ shortage.

    PubMed

    Solomon, Harvey

    2011-01-01

    In 1989, there were 19,000 patients on the UNOS (United Network of Organ Sharing) wait list for organs compared to 110,000 today. Without an equivalent increase in donors, the patients awaiting these organs for transplant face increasing severity of illness and risk of dying without receiving a transplant. This disparity in supply and demand has led to acceptance of organs with lower than expected success rates compared to previous standard donors variously defined as extended criteria donors in order to increase transplantation. The reluctance to wider use of these types of organs is based on the less than expected transplant center graft and patient survival results associated with their use, as well as the increased resources required to care for the patients who receive these organs. The benefits need to be compared to the survival of not receiving a transplant and remaining on the waiting list rather than on outcomes of receiving a standard donor. A lack of a systematic risk outcomes adjustment is one of the most important factors preventing more extensive utilization as transplant centers are held to patient and graft survival statistics as a performance measure by multiple regulatory organizations and insurers. Newer classification systems of such donors may allow a more systematic approach to analyzing the specific risks to individualized patients. Due to changes in donor policies across the country, there has been an increase in Extended Criteria Donors (ECD) organs procured by organ procurement organizations (OPO) but their uneven acceptance by the transplant centers has contributed to an increase in discards and organs not being used. This is one of the reasons that wider sharing of organs is currently receiving much attention. Transplanting ECD organs presents unique challenges and innovative approaches to achieve satisfactory results. Improved logistics and information technology combined strategies for improving donor quality with may prevent discards

  18. Expanded criteria donor and donation after circulatory death renal allografts in the West of Scotland: Their place in the kidney allocation process.

    PubMed

    Hesse, Kerrick; Aitken, Emma; Clancy, Marc; Vesey, Alex

    2016-06-01

    Due to the rising disparity between demand and availability, organs from expanded criteria donors (ECD) and donors after determination of circulatory death (DCD) are increasingly used. The purpose of this study was to report outcomes in recipients of ECD and DCD renal allografts from a single centre. A retrospective analysis from a single centre for all renal transplants performed between 2001 and 2010 inclusive was undertaken. SCD (standard criteria donor) and ECD organs were compared, as were DCD and DBD (donation after determination of brain stem death) organs. Baseline data and predefined standard transplant outcomes were collected and compared using appropriate statistical tests. P < 0.05 was defined as significant. 729 renal transplants were performed. Comparing ECD to SCD organs, there was a significant difference in graft survival between groups (logrank for trend, p = 0.032) with ECD organs doing worse than SCD organs. Short-term outcomes showed a similar disparity with a higher 1-year post-transplant creatinine and delayed graft function (DGF) rate in ECD grafts. Nevertheless, outcomes were still clinically acceptable. When comparing DCD to DBD organs, no such differences were apparent, with DCD organs appearing to perform at least as well as DBD organs. In our cohort, unlike some previous studies, DGF rates were similar in both DCD and DBD groups. Although ECD organs perform less well than SCD organs, outcomes are still acceptable and our results support their continuing use. When considering DCD organs, our data support the view that they should no longer be necessarily regarded as marginal grafts. Our low DGF rates are perhaps explained by local factors contributing to a short CIT. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  19. Diagnostic criteria for Menière's disease.

    PubMed

    Lopez-Escamez, Jose A; Carey, John; Chung, Won-Ho; Goebel, Joel A; Magnusson, Måns; Mandalà, Marco; Newman-Toker, David E; Strupp, Michael; Suzuki, Mamoru; Trabalzini, Franco; Bisdorff, Alexandre

    2015-01-01

    This paper presents diagnostic criteria for Menière's disease jointly formulated by the Classification Committee of the Bárány Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. The classification includes two categories: definite Menière's disease and probable Menière's disease. The diagnosis of definite Menière's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable Menière's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

  20. Evaluation models and criteria of the quality of hospital websites: a systematic review study

    PubMed Central

    Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

    2017-01-01

    Introduction Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. Methods This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regional database such as Magiran, Scientific Information Database, Persian Journal Citation Report (PJCR) and IranMedex were searched. Suitable keywords including website, evaluation, and quality of website were used. Full text papers related to the research were included. The criteria and sub criteria of the evaluation of website quality were extracted and classified. Results To evaluate the quality of the websites, various models and criteria were presented. The WEB-Q-IM, Mile, Minerva, Seruni Luci, and Web-Qual models were the designed models. The criteria of accessibility, content and apparent features of the websites, the design procedure, the graphics applied in the website, and the page’s attractions have been mentioned in the majority of studies. Conclusion The criteria of accessibility, content, design method, security, and confidentiality of personal information are the essential criteria in the evaluation of all websites. It is suggested that the ease of use, graphics, attractiveness and other apparent properties of websites are considered as the user-friendliness sub criteria. Further, the criteria of speed and accessibility of the website should be considered as sub criterion of efficiency. When determining the evaluation criteria of the quality of websites, attention to major differences in the specific features of any website is essential. PMID:28465807

  1. Evaluation models and criteria of the quality of hospital websites: a systematic review study.

    PubMed

    Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

    2017-02-01

    Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regional database such as Magiran, Scientific Information Database, Persian Journal Citation Report (PJCR) and IranMedex were searched. Suitable keywords including website, evaluation, and quality of website were used. Full text papers related to the research were included. The criteria and sub criteria of the evaluation of website quality were extracted and classified. To evaluate the quality of the websites, various models and criteria were presented. The WEB-Q-IM, Mile, Minerva, Seruni Luci, and Web-Qual models were the designed models. The criteria of accessibility, content and apparent features of the websites, the design procedure, the graphics applied in the website, and the page's attractions have been mentioned in the majority of studies. The criteria of accessibility, content, design method, security, and confidentiality of personal information are the essential criteria in the evaluation of all websites. It is suggested that the ease of use, graphics, attractiveness and other apparent properties of websites are considered as the user-friendliness sub criteria. Further, the criteria of speed and accessibility of the website should be considered as sub criterion of efficiency. When determining the evaluation criteria of the quality of websites, attention to major differences in the specific features of any website is essential.

  2. Explicit criteria for prioritization of cataract surgery

    PubMed Central

    Ma Quintana, José; Escobar, Antonio; Bilbao, Amaia

    2006-01-01

    Background Consensus techniques have been used previously to create explicit criteria to prioritize cataract extraction; however, the appropriateness of the intervention was not included explicitly in previous studies. We developed a prioritization tool for cataract extraction according to the RAND method. Methods Criteria were developed using a modified Delphi panel judgment process. A panel of 11 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the effect of all variables on the final panel score using general linear and logistic regression models. Priority scoring systems were developed by means of optimal scaling and general linear models. The explicit criteria developed were summarized by means of regression tree analysis. Results Eight variables were considered to create the indications. Of the 310 indications that the panel evaluated, 22.6% were considered high priority, 52.3% intermediate priority, and 25.2% low priority. Agreement was reached for 31.9% of the indications and disagreement for 0.3%. Logistic regression and general linear models showed that the preoperative visual acuity of the cataractous eye, visual function, and anticipated visual acuity postoperatively were the most influential variables. Alternative and simple scoring systems were obtained by optimal scaling and general linear models where the previous variables were also the most important. The decision tree also shows the importance of the previous variables and the appropriateness of the intervention. Conclusion Our results showed acceptable validity as an evaluation and management tool for prioritizing cataract extraction. It also provides easy algorithms for use in clinical practice. PMID:16512893

  3. DSM disorders and their criteria: how should they inter-relate?

    PubMed

    Kendler, K S

    2017-09-01

    While the changes in psychiatric diagnosis introduced by Diagnostic and Statistical Manual third edition (DSM-III) have had major benefits to the field of psychiatry, the reification of its diagnostic criteria and the widespread adoption of diagnostic literalism have been problematic. I argue that, at root, these developments can be best understood by contrasting two approaches to the relationship between DSM disorders and their criteria. In a constitutive relationship, criteria definitively define the disorder. Having a disorder is nothing more than meeting the criteria. In an indexical relationship, the criteria are fallible indices of a disorder understood as a hypothetical, tentative diagnostic construct. I trace the origins of the constitutive model to the philosophical theory of operationalism. I then examine a range of historical and empirical results that favor the indexical over the constitutive position including (i) evidence that individual criteria for DSM-III were selected from a broader pool of possible symptoms/signs, (ii) revisions of DSM have implicitly assumed an indexical criteria-disorder relationship, (iii) the indexical position allows DSM criteria to be wrong and misdiagnose patients while such a result is incoherent for a constitutive model, an implausible position, (iv) we assume an indexical criteria-scale relationships for many personality and symptom measures commonly used in psychiatric practice and research, and (v) empirical studies suggesting similar performance for DSM and non-DSM symptoms for major depression. I then review four reasons for the rise of the constitutive position: (i) the 'official' nature of the DSM criteria, (ii) the strong investment psychiatry has had in the DSM manual and its widespread use and success, iii) lack of a clear pathophysiology for our disorders, and (iv) the absence of informative diagnostic signs of minimal clinical importance. I conclude that the constitutive position is premature and reflects a

  4. Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot Study

    ERIC Educational Resources Information Center

    Morton, Jane; Snowdon, Sharon; Gopold, Michelle; Guymer, Elise

    2012-01-01

    A pilot study of a brief group-based Acceptance and Commitment Therapy (ACT) intervention (12 two-hour sessions) was conducted with clients of public mental health services meeting four or more criteria for borderline personality disorder (BPD). Participants were randomly assigned to receive the ACT group intervention in addition to their current…

  5. Defining Peer-to-Peer Accountability From the Nurse's Perspective.

    PubMed

    Lockett, Jacqueline Jansen; Barkley, Leslie; Stichler, Jaynelle; Palomo, Jeanne; Kik, Bozena; Walker, Christopher; Donnelly, Janet; Willon, Judy; Sanborn, Julie; O'Byrne, Noeleen

    2015-11-01

    The aim of this study was to define and create a conceptual model for peer-to-peer accountability (P to PA). Many organizations cite the importance of peer accountability (PA) as essential in ensuring patient safety. Professionalism in nursing requires self-regulation of practice and PA. Although discussed in the literature, P to PA is not conceptually defined. A grounded theory study design with constant comparative data collection and analysis was used to explore nurses' definitions of P to PA and their perceptions of motivators and barriers to engaging in P to PA. Transcripts of digital recordings of all interviews were analyzed using line-by-line coding until identified themes emerged. P to PA was defined as the act of speaking up when one observes a peer not practicing to acceptable standards. A conceptual model illustrates the antecedents, attributes, and consequences of P to PA. P to PA is the professional responsibility of every nurse and healthcare provider and is essential for safe patient care. The conceptual definition facilitates actualization of P to PA in practice.

  6. [Reflections about the efficiency criteria for cancer treatments during marketing authorization application].

    PubMed

    Jeannin, Noémie; Blois-Da Conceição, Stéphanie; Protière, Christel

    2013-03-01

    Although clear and validated recommendations exist concerning the evaluation of cancer treatments at the international level, the criteria retained to obtain the marketing authorization (MA) are multiple and heterogeneous. This qualitative survey explores the opinion related to the assessment of cancer treatment among the several concerned population. By the way of semi-structured interviews, our aim was to elicit perceptions toward the criteria which should be retained during the process of MA, by patients, oncologists, members of the pharmaceutical industry, health decision-makers and general population. Our survey emphasizes the variability of the significations associated with the criteria of efficiency of cancer treatments according to the characteristics of the respondents. We also have observed some common expectations from patients and oncologists toward the economic and political aspect, but also from the whole respondents toward the importance of the comfort of the patients. Lastly, the necessity to define specific criteria related to clinical cases emerges.

  7. Collaborative Analysis of DRD4 and DAT Genotypes in Population-Defined ADHD Subtypes

    ERIC Educational Resources Information Center

    Todd, Richard D.; Huang, Hongyan; Smalley, Susan L.; Nelson, Stanley F.; Willcutt, Erik G.; Pennington, Bruce F.; Smith, Shelley D.; Faraone, Stephen V.; Neuman, Rosalind J.

    2005-01-01

    Background: It has been proposed that some of the variability in reporting of associations between attention deficit hyperactivity disorder (ADHD) and candidate genes may result from mixing of genetically heterogeneous forms of ADHD using DSM-IV criteria. The goal of the current study is to test whether population-based ADHD subtypes defined by…

  8. The generation of criteria for selecting analytical tools for landscape management

    Treesearch

    Marilyn Duffey-Armstrong

    1979-01-01

    This paper presents an approach to generating criteria for selecting the analytical tools used to assess visual resources for various landscape management tasks. The approach begins by first establishing the overall parameters for the visual assessment task, and follows by defining the primary requirements of the various sets of analytical tools to be used. Finally,...

  9. Defining how aging Pseudotsuga and Abies compensate for multiple stresses through multi-criteria assessment of a functional-structural model

    Treesearch

    Maureen C. Kennedy; E. David Ford; Thomas M. Hinckley

    2009-01-01

    Many hypotheses have been advanced about factors that control tree longevity. We use a simulation model with multi-criteria optimization and Pareto optimality to determine branch morphologies in the Pinaceae that minimize the effect of growth limitations due to water stress while simultaneously maximizing carbohydrate gain. Two distinct branch morphologies in the...

  10. Should We Reject Donated Organs on Moral Grounds or Permit Allocation Using Non‐Medical Criteria?: A Qualitative Study

    PubMed Central

    Moorlock, Greg; Ives, Jonathan; Bramhall, Simon

    2015-01-01

    Abstract Conditional and directed deceased organ donations occur when donors (or often their next of kin) attempt to influence the allocation of their donated organs. This can include asking that the organs are given to or withheld from certain types of people, or that they are given to specified individuals. Donations of these types have raised ethical concerns, and have been prohibited in many countries, including the UK. In this article we report the findings from a qualitative study involving interviews with potential donors (n = 20), potential recipients (n = 9) and transplant staff (n = 11), and use these results as a springboard for further ethical commentary. We argue that although participants favoured unconditional donation, this preference was grounded in a false distinction between ‘medical’ and ‘non‐medical’ allocation criteria. Although there are good reasons to maintain organ allocation based primarily upon the existing ‘medical’ criteria, it may be premature to reject all other potential criteria as being unacceptable. Part of participants' justification for allocating organs using ‘medical’ criteria was to make the best use of available organs and avoid wasting their potential benefit, but this can also justify accepting conditional donations in some circumstances. We draw a distinction between two types of waste – absolute and relative – and argue that accepting conditional donations may offer a balance between these forms of waste. PMID:26132802

  11. A Critique of Radical Innovation as a Solution to Contemporary Problems of Education.

    ERIC Educational Resources Information Center

    Baumrind, Diana

    Without well-defined criteria for success, all radical innovations are doomed to failure. To facilitate successful experimentation the following are necessary: an outside agency to conduct evaluation; criteria of success acceptable to innovators and critics; and, in control and comparison groups, assessment and accounting of the initial versus…

  12. Axial spondyloarthritis criteria and modified NY criteria: issues and controversies.

    PubMed

    Deodhar, Atul

    2014-06-01

    The Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axial spondyloarthritis (axSpA) developed in 2009 was a major step forward, since the 1984 modified New York (mNY) criteria for classification of ankylosing spondylitis (AS) were too insensitive to identify patients with early signs of axial inflammation. In the absence of "diagnostic" criteria for either axSpA or AS, both of these "classification" criteria are routinely used in clinical practice to diagnose patients. However, there is a real danger of "misdiagnosis" if classification criteria are applied erroneously by ticking "yes" or "no" boxes in an undiagnosed patient. This concern was raised and discussed at the FDA Arthritis Advisory Committee meeting in June 2013, and the committee warned that if TNF inhibitors are approved to treat axSpA, such misdiagnosis could lead to serious consequences. To gauge the SPARTAN members' familiarity with these criteria and these issues surrounding them, as well as to investigate how they are using these criteria in daily practice, two questionnaires (one each for mNY and ASAS axSpA criteria) were sent to the "full" members of SPARTAN before the annual meeting. The results showed that more than 60% of the responders used these criteria most of the time in practice to help them diagnose a patient, and nearly three fourth of responders agreed with the FDA Advisory Committee and would like to see some objective signs before prescribing TNF inhibitors to axSpA patients. A majority of responders looked at the sacroiliac joint x-rays themselves to diagnose sacroiliitis, even though they had difficulty in grading the x-rays. In a live vote at the meeting, 88% of the members suggested that SPARTAN should engage in either modifying the existing criteria or develop new diagnostic criteria for axial spondyloarthritis.

  13. The H-ATOMIC Criteria for the Etiologic Classification of Patients with Intracerebral Hemorrhage

    PubMed Central

    Prats-Sánchez, Luis; Martínez-Domeño, Alejandro; Camps-Renom, Pol; Marín, Rebeca; Jiménez-Xarrié, Elena; Fuentes, Blanca; Dorado, Laura; Purroy, Francisco; Arias-Rivas, Susana; Delgado-Mederos, Raquel

    2016-01-01

    Background and Purpose There are no generally accepted criteria for the etiologic classification of intracerebral hemorrhage (ICH). For this reason, we have developed a set of etiologic criteria and have applied them to a large number of patients to determine their utility. Methods The H-ATOMIC classification includes 7 etiologic categories: Hypertension, cerebral Amyloid angiopathy, Tumour, Oral anticoagulants, vascular Malformation, Infrequent causes and Cryptogenic. For each category, the etiology is scored with three degrees of certainty: Possible(3), Probable(2) and Definite(1). Our aim was to perform a basic study consisting of neuroimaging, blood tests, and CT-angio when a numerical score (SICH) suggested an underlying structural abnormality. Combinations of >1 etiologic category for an individual patient were acceptable. The criteria were evaluated in a multicenter and prospective study of consecutive patients with spontaneous ICH. Results Our study included 439 patients (age 70.8 ± 14.5 years; 61.3% were men). A definite etiology was achieved in 176 (40.1% of the patients: Hypertension 28.2%, cerebral Amyloid angiopathy 0.2%, Tumour 0.2%, Oral anticoagulants 2.2%, vascular Malformation 4.5%, Infrequent causes 4.5%). A total of 7 patients (1.6%) were cryptogenic. In the remaining 58.3% of the patients, ICH was attributable to a single (n = 56, 12.7%) or the combination of ≥2 (n = 200, 45.5%) possible/probable etiologies. The most frequent combinations of etiologies involved possible hypertension with possible CAA (H3A3, n = 38) or with probable CAA (H3A2, n = 29), and probable hypertension with probable OA (H2O2, n = 27). The most frequent category with any degree of certainty was hypertension (H1+2+3 = 80.6%) followed by cerebral amyloid angiopathy (A1+2+3 = 30.9%). Conclusions According to our etiologic criteria, only about 40% patients received a definite diagnosis, while in the remaining patients ICH was attributable to a single possible

  14. The challenges of modelling phosphorus in a headwater catchment: Applying a 'limits of acceptability' uncertainty framework to a water quality model

    NASA Astrophysics Data System (ADS)

    Hollaway, M. J.; Beven, K. J.; Benskin, C. McW. H.; Collins, A. L.; Evans, R.; Falloon, P. D.; Forber, K. J.; Hiscock, K. M.; Kahana, R.; Macleod, C. J. A.; Ockenden, M. C.; Villamizar, M. L.; Wearing, C.; Withers, P. J. A.; Zhou, J. G.; Barber, N. J.; Haygarth, P. M.

    2018-03-01

    There is a need to model and predict the transfer of phosphorus (P) from land to water, but this is challenging because of the large number of complex physical and biogeochemical processes involved. This study presents, for the first time, a 'limits of acceptability' approach of the Generalized Likelihood Uncertainty Estimation (GLUE) framework to the Soil and Water Assessment Tool (SWAT), in an application to a water quality problem in the Newby Beck catchment (12.5 km2), Cumbria, United Kingdom (UK). Using high frequency outlet data (discharge and P), individual evaluation criteria (limits of acceptability) were assigned to observed discharge and P loads for all evaluation time steps, identifying where the model was performing well/poorly and to infer which processes required improvement in the model structure. Initial limits of acceptability were required to be relaxed by a substantial amount (by factors of between 5.3 and 6.7 on a normalized scale depending on the evaluation criteria used) in order to gain a set of behavioral simulations (1001 and 1016, respectively out of 5,000,000). Of the 39 model parameters tested, the representation of subsurface processes and associated parameters, were consistently shown as critical to the model not meeting the evaluation criteria, irrespective of the chosen evaluation metric. It is therefore concluded that SWAT is not an appropriate model to guide P management in this catchment. This approach highlights the importance of high frequency monitoring data for setting robust model evaluation criteria. It also raises the question as to whether it is possible to have sufficient input data available to drive such models so that we can have confidence in their predictions and their ability to inform catchment management strategies to tackle the problem of diffuse pollution from agriculture.

  15. USING CFD TO ANALYZE NUCLEAR SYSTEMS BEHAVIOR: DEFINING THE VALIDATION REQUIREMENTS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Richard Schultz

    2012-09-01

    A recommended protocol to formulate numeric tool specifications and validation needs in concert with practices accepted by regulatory agencies for advanced reactors is described. The protocol is based on the plant type and perceived transient and accident envelopes that translates to boundary conditions for a process that gives the: (a) key phenomena and figures-of-merit which must be analyzed to ensure that the advanced plant can be licensed, (b) specification of the numeric tool capabilities necessary to perform the required analyses—including bounding calculational uncertainties, and (c) specification of the validation matrices and experiments--including the desired validation data. The result of applyingmore » the process enables a complete program to be defined, including costs, for creating and benchmarking transient and accident analysis methods for advanced reactors. By following a process that is in concert with regulatory agency licensing requirements from the start to finish, based on historical acceptance of past licensing submittals, the methods derived and validated have a high probability of regulatory agency acceptance.« less

  16. Gout Classification Criteria: Update and Implications

    PubMed Central

    Vargas-Santos, Ana Beatriz; Taylor, William J.

    2016-01-01

    Gout is the most common inflammatory arthritis, with a rising prevalence and incidence worldwide. There has been a resurgence in gout research, fueled, in part, by a number of advances in pharmacologic therapy for gout. The conduct of clinical trials and other observational research in gout requires a standardized and validated means of assembling well-defined groups of patients with gout for such research purposes. Recently, an international collaborative effort that involved a data-driven process with state-of-the art methodology supported by the American College of Rheumatology and the European League Against Rheumatism led to publication of new gout classification criteria. PMID:27342957

  17. Optimal Utilization of Donor Grafts With Extended Criteria

    PubMed Central

    Cameron, Andrew M.; Ghobrial, R Mark; Yersiz, Hasan; Farmer, Douglas G.; Lipshutz, Gerald S.; Gordon, Sherilyn A.; Zimmerman, Michael; Hong, Johnny; Collins, Thomas E.; Gornbein, Jeffery; Amersi, Farin; Weaver, Michael; Cao, Carlos; Chen, Tony; Hiatt, Jonathan R.; Busuttil, Ronald W.

    2006-01-01

    Objective: Severely limited organ resources mandate maximum utilization of donor allografts for orthotopic liver transplantation (OLT). This work aimed to identify factors that impact survival outcomes for extended criteria donors (ECD) and developed an ECD scoring system to facilitate graft-recipient matching and optimize utilization of ECDs. Methods: Retrospective analysis of over 1000 primary adult OLTs at UCLA. Extended criteria (EC) considered included donor age (>55 years), donor hospital stay (>5 days), cold ischemia time (>10 hours), and warm ischemia time (>40 minutes). One point was assigned for each extended criterion. Cox proportional hazard regression model was used for multivariate analysis. Results: Of 1153 allografts considered in the study, 568 organs exhibited no extended criteria (0 score), while 429, 135 and 21 donor allografts exhibited an EC score of 1, 2 and 3, respectively. Overall 1-year patient survival rates were 88%, 82%, 77% and 48% for recipients with EC scores of 0, 1, 2 and 3 respectively (P < 0.001). Adjusting for recipient age and urgency at the time of transplantation, multivariate analysis identified an ascending mortality risk ratio of 1.4 and 1.8 compared to a score of 0 for an EC score of 1, and 2 (P < 0.01) respectively. In contrast, an EC score of 3 was associated with a mortality risk ratio of 4.5 (P < 0.001). Further, advanced recipient age linearly increased the death hazard ratio, while an urgent recipient status increased the risk ratio of death by 50%. Conclusions: Extended criteria donors can be scored using readily available parameters. Optimizing perioperative variables and matching ECD allografts to appropriately selected recipients are crucial to maintain acceptable outcomes and represent a preferable alternative to both high waiting list mortality and to a potentially futile transplant that utilizes an ECD for a critically ill recipient. PMID:16772778

  18. How should we revise diagnostic criteria for substance use disorders in the DSM-V?

    PubMed

    Martin, Christopher S; Chung, Tammy; Langenbucher, James W

    2008-08-01

    This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. Copyright (c) 2008 APA, all rights reserved.

  19. How Should We Revise Diagnostic Criteria for Substance Use Disorders in the DSM—V?

    PubMed Central

    Martin, Christopher S.; Chung, Tammy; Langenbucher, James W.

    2009-01-01

    This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM—IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM—V). Substantial data indicate that DSM—IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM—V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM–V. The DSM–V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. PMID:18729609

  20. The J-2X Fuel Turbopump - Turbine Nozzle Low Cycle Fatigue Acceptance Rationale

    NASA Technical Reports Server (NTRS)

    Hawkins, Lakiesha V.; Duke, Gregory C.; Newman, Wesley R.; Reynolds, David C.

    2011-01-01

    The J-2X Fuel Turbopump (FTP) turbine, which drives the pump that feeds hydrogen to the J-2X engine for main combustion, is based on the J-2S design developed in the early 1970 s. Updated materials and manufacturing processes have been incorporated to meet current requirements. This paper addresses an analytical concern that the J-2X Fuel Turbine Nozzle Low Cycle Fatigue (LCF) analysis did not meet safety factor requirements per program structural assessment criteria. High strains in the nozzle airfoil during engine transients were predicted to be caused by thermally induced stresses between the vane hub, vane shroud, and airfoil. The heritage J-2 nozzle was of a similar design and experienced cracks in the same area where analysis predicted cracks in the J-2X design. Redesign options that did not significantly impact the overall turbine configuration were unsuccessful. An approach using component tests and displacement controlled fracture mechanics analysis to evaluate LCF crack initiation and growth rate was developed. The results of this testing and analysis were used to define the level of inspection on development engine test units. The programmatic impact of developing crack initiation/growth rate/arrest data was significant for the J-2X program. Final Design Certification Review acceptance logic will ultimately be developed utilizing this test and analytical data.

  1. Criteria for designation of clinical substage in canine lymphoma: a survey of veterinary oncologists.

    PubMed

    Barber, L G; Weishaar, K M

    2016-08-01

    Clinical substage is frequently reported to be prognostic in dogs with lymphoma, yet formal criteria for defining this parameter are lacking. The World Health Organization TNM Classification of Tumors of Domestic Animals simply defines substage as the absence or presence of systemic signs (substages a and b, respectively). We designed a survey to query veterinary oncologists on the criteria they use to determine clinical substage in practice. Gastrointestinal, constitutional and respiratory signs were the most commonly identified clinical factors, with greater than 90% respondents indicating that inappetence, vomiting, diarrhoea, changes in attitude, weakness and dyspnea were integral in assigning clinical substage. Nevertheless, more than three-quarters of respondents also considered metabolic, neurologic and nutritional parameters when making this determination. For most factors, respondents reported mild-to-moderate severity of clinical signs was sufficient for substage b designation. © 2014 John Wiley & Sons Ltd.

  2. Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases

    PubMed Central

    Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas OF; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

    2016-01-01

    Background The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. Objective The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. Methods First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. Results We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. Conclusions The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited

  3. Evaluation of facial attractiveness in black people according to the subjective facial analysis criteria.

    PubMed

    Melo, Andréa Reis de; Conti, Ana Cláudia de Castro Ferreira; Almeida-Pedrin, Renata Rodrigues; Didier, Victor; Valarelli, Danilo Pinelli; Capelozza Filho, Leopoldino

    2017-02-01

    The objective of this study was to evaluate the facial attractiveness in 30 black individuals, according to the Subjective Facial Analysis criteria. Frontal and profile view photographs of 30 black individuals were evaluated for facial attractiveness and classified as esthetically unpleasant, acceptable, or pleasant by 50 evaluators: the 30 individuals from the sample, 10 orthodontists, and 10 laymen. Besides assessing the facial attractiveness, the evaluators had to identify the structures responsible for the classification as unpleasant and pleasant. Intraexaminer agreement was assessed by using Spearman's correlation, correlation within each category using Kendall concordance coefficient, and correlation between the 3 categories using chi-square test and proportions. Most of the frontal (53. 5%) and profile view (54. 9%) photographs were classified as esthetically acceptable. The structures most identified as esthetically unpleasant were the mouth, lips, and face, in the frontal view; and nose and chin in the profile view. The structures most identified as esthetically pleasant were harmony, face, and mouth, in the frontal view; and harmony and nose in the profile view. The ratings by the examiners in the sample and laymen groups showed statistically significant correlation in both views. The orthodontists agreed with the laymen on the evaluation of the frontal view and disagreed on profile view, especially regarding whether the images were esthetically unpleasant or acceptable. Based on these results, the evaluation of facial attractiveness according to the Subjective Facial Analysis criteria proved to be applicable and to have a subjective influence; therefore, it is suggested that the patient's opinion regarding the facial esthetics should be considered in orthodontic treatmentplanning.

  4. Development of acceptance criteria for batches of silane primer for external tank thermal protection system bonding applications

    NASA Technical Reports Server (NTRS)

    Mikes, F.

    1985-01-01

    Fourier transform infrared spectroscopy is currently the best technique for observing hydrolytic changes in DC 1200 silane the primers caused by moisture in the atmosphere. To further prove that FTIR can be used as a criterion test for acceptance of silane primer lots, intensities of the FTIR OH- band are being compared with primer adhesive bond strength using a mechanical test suggested by NASA. Results of tests for shear strength and Oh-absorption are tabulated and compared with FTIR absorption intensities in the OH-region.

  5. Selecting essential information for biosurveillance--a multi-criteria decision analysis.

    PubMed

    Generous, Nicholas; Margevicius, Kristen J; Taylor-McCabe, Kirsten J; Brown, Mac; Daniel, W Brent; Castro, Lauren; Hengartner, Andrea; Deshpande, Alina

    2014-01-01

    The National Strategy for Biosurveillance defines biosurveillance as "the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels." However, the strategy does not specify how "essential information" is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being "essential". The question of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of "essential information" for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system.

  6. Harz/Vesper: Acceptance Research with Logical Relations and Pragma-Dialectics

    NASA Astrophysics Data System (ADS)

    Harz, M.

    2012-04-01

    of the new technology. Politics must focus on the majority's needs. Businesses must openly commit themselves to their interest in maximizing profit by using the new technologies. Science must contribute to the effective and independent function of the technologies and claim true statements about them. Using the pragma-dialectical theory of argumentation we define "acceptance" in terms of the "acceptance of a standpoint" as an outcome of the protagonist's attempt to justify the "acceptability of a standpoint". The pragma-dialectical ideal model of critical discussion provides a number of norms for a dialectical discussion process leading to the "acceptance of a standpoint". These norms make a systematic analysis of accomplishments and flaws within a critical exchange possible. One of these norms is the sound use of argument schemes which connect a standpoint with an argument. An arguer using the argument scheme of pragmatic argumentation presents the desirable or undesirable consequences of a certain action to back up the (un)acceptability of the standpoint. Critical questions are used to reveal the (in)correct use of pragmatic argumentation. We argue that accomplishments and flaws in the pragmatic argumentation of the four parties observed are closely related to the acceptance of the technology CCS.

  7. Acceptance test report for portable exhauster POR-008/Skid F

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kriskovich, J.R.

    1998-07-24

    Portable Exhauster POR-008 was procured via HNF-0490, Specification for a Portable Exhausted System for Waste Tank Ventilation. Prior to taking ownership, acceptance testing was performed at the vendors. However at the conclusion of testing a number of issues remained that required resolution before the exhausters could be used by Project W-320. The purpose of acceptance testing documented by this report was to demonstrate compliance of the exhausters with the performance criteria established within HNF-O49O, Rev. 1 following a repair and upgrade effort at Hanford. In addition, data obtained during this testing is required for the resolution of outstanding Non-conformance Reportsmore » (NCR), and finally, to demonstrate the functionality of the associated software for the pressure control and high vacuum exhauster operating modes provided for by W-320. Additional testing not required by the ATP was also performed to assist in the disposition and close out of receiving inspection report and for application design information (system curve). Results of this testing are also captured within this document.« less

  8. FAD: A full-acceptance detector for physics at the SSC

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bjorken, J.D.

    1992-09-01

    For high energy pp collisions, the concepts 4{pi}'' and full acceptance'' are distinct. At the SSC, the appropriate variables for describing phase space are the lego variables: pseudorapidity {eta} and azimuthal angle {phi}. While most of 4{pi} is covered by pseudorapidities less than 3 or 4 in magnitude, at the SSC there is very interesting physics out to {eta}'s of 9 to 12. For over a year I have been attempting to encourage an initiative at the SSC to provide a detector which could cover the missing acceptance of the two big detectors, which in particular have no appreciable chargedmore » particle tracking with good momentum resolution beyond rapidities of 2.5 or so. The nonnegotiable criteria for an FAD are for me the following: 1. All charged particles are seen and their momenta measured well, provided pt is not too large. 2. All photons are seen and their momenta are measured well. 3. The physics of rapidity-gaps is not compromised. This means angular coverage from 90{degrees} down to tens of microradians. The above criteria cannot be met on day one of SSC commissioning with the amount of funds available. But I believe a staged approach is feasible, with a lot of interesting physics available along the way. The basic philosophy underlying the FAD idea is that it should first and most be a survey instrument, sensitive to almost everything, but optimized for almost nothing. Its strength is in the perception of complex patterns individual events, used as a signature of new and/or interesting physics. Examples of such patterns will be given later.« less

  9. FAD: A full-acceptance detector for physics at the SSC

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bjorken, J.D.

    1992-09-01

    For high energy pp collisions, the concepts ``4{pi}`` and ``full acceptance`` are distinct. At the SSC, the appropriate variables for describing phase space are the lego variables: pseudorapidity {eta} and azimuthal angle {phi}. While most of 4{pi} is covered by pseudorapidities less than 3 or 4 in magnitude, at the SSC there is very interesting physics out to {eta}`s of 9 to 12. For over a year I have been attempting to encourage an initiative at the SSC to provide a detector which could cover the missing acceptance of the two big detectors, which in particular have no appreciable chargedmore » particle tracking with good momentum resolution beyond rapidities of 2.5 or so. The nonnegotiable criteria for an FAD are for me the following: 1. All charged particles are seen and their momenta measured well, provided pt is not too large. 2. All photons are seen and their momenta are measured well. 3. The physics of rapidity-gaps is not compromised. This means angular coverage from 90{degrees} down to tens of microradians. The above criteria cannot be met on day one of SSC commissioning with the amount of funds available. But I believe a staged approach is feasible, with a lot of interesting physics available along the way. The basic philosophy underlying the FAD idea is that it should first and most be a survey instrument, sensitive to almost everything, but optimized for almost nothing. Its strength is in the perception of complex patterns individual events, used as a signature of new and/or interesting physics. Examples of such patterns will be given later.« less

  10. Respondent-driven sampling to assess mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies in eastern Democratic Republic of Congo.

    PubMed

    Scott, Jennifer; Rouhani, Shada; Greiner, Ashley; Albutt, Katherine; Kuwert, Philipp; Hacker, Michele R; VanRooyen, Michael; Bartels, Susan

    2015-04-08

    Assess mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in eastern Democratic Republic of Congo and stigma toward and acceptance of women and their children. Participants were recruited using respondent-driven sampling. Bukavu, Democratic Republic of Congo in 2012. 757 adult women raising children from SVRPs were interviewed. A woman aged 18 and older was eligible for the study if she self-identified as a sexual violence survivor since the start of the conflict (∼1996), conceived an SVRP, delivered a liveborn child and was currently raising the child. A woman was ineligible for the study if the SVRP ended with a spontaneous abortion or fetal demise or the child was not currently living or in the care of the biological mother. Trained female Congolese interviewers verbally administered a quantitative survey after obtaining verbal informed consent. Symptom criteria for major depressive disorder, post-traumatic stress disorder, anxiety and suicidality were assessed, as well as stigma toward the woman and her child. Acceptance of the woman and child from the spouse, family and community were analysed. 48.6% met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria. Women raising children from SVRPs experience symptoms of mental health disorders. Programming addressing stigma and acceptance following sexual violence may improve mental health outcomes in this population. Published by the BMJ Publishing Group

  11. Human Research Program Unique Processes, Criteria, and Guidelines (UPCG). Revision C, July 28, 2011

    NASA Technical Reports Server (NTRS)

    Chin, Duane

    2011-01-01

    This document defines the processes, criteria, and guidelines exclusive to managing the Human Research Program (HRP). The intent of this document is to provide instruction to the reader in the form of processes, criteria, and guidelines. Of the three instructional categories, processes contain the most detail because of the need for a systematic series of actions directed to some end. In contrast, criteria have lesser detail than processes with the idea of creating a rule or principle structure for evaluating or testing something. Guidelines are a higher level indication of a course of action typically with the least amount of detail. The lack of detail in guidelines allows the reader flexibility when performing an action or actions.

  12. Sustainability criteria: their indicators, control, and monitoring (with examples from the biofuel sector).

    PubMed

    Pavlovskaia, Evgenia

    2014-01-01

    The purpose of the article is to research and analyze the notion of sustainability criteria in their function of an emerging tool to promote and safeguard sustainable products and their sustainable production. The article addresses critical issues, which are important for deeper understanding of sustainability criteria and their practical use. In this, the article examines the existing definitions of sustainability criteria, explores what indicators for sustainability criteria are, researches the issue of costs for following sustainability criteria, and discusses what groups of actors can be responsible for setting and supporting sustainability criteria. The research is done from a legal perspective, which involves much attention on how sustainability criteria can efficiently be implemented and used in legal constructions. Examples from the biofuel sector, which is regulated through a variety of legal frameworks and voluntary sustainability standards with sustainability criteria, are provided. The research results highlight that sustainability criteria is not a clearly defined concept. Their content should be linked to the understanding of what sustainable development and sustainability in each particular branch are. Purposes of sustainability criteria have to be explained and clarified so that it is easier to interpret and fulfill them. In some cases, sustainability criteria can set an upper limit to the use of natural resources and provide institutional guidance. It is desirable that sustainability criteria are applied at initial stages of an industry development. Control of how sustainability criteria are fulfilled and its quality are very important. Thoroughly elaborated regulations on control mechanisms and their components, such as monitoring, reporting, verification, and transparency, should be included into legal frameworks and voluntary sustainability standards. Different groups of actors at different levels can be responsible for setting and supporting

  13. Downstaging therapy followed by liver transplantation for hepatocellular carcinoma beyond Milan criteria.

    PubMed

    Kim, Young; Stahl, Christopher C; Makramalla, Abouelmagd; Olowokure, Olugbenga O; Ristagno, Ross L; Dhar, Vikrom K; Schoech, Michael R; Chadalavada, Seetharam; Latif, Tahir; Kharofa, Jordan; Bari, Khurram; Shah, Shimul A

    2017-12-01

    Orthotopic liver transplantation is a curative treatment for hepatocellular carcinoma within Milan criteria, but these criteria preclude many patients from transplant candidacy. Recent studies have demonstrated that downstaging therapy can reduce tumor burden to meet conventional criteria. The present study reports a single-center experience with tumor downstaging and its effects on post-orthotopic liver transplantation outcomes. All patients with hepatocellular carcinoma who were evaluated by our multidisciplinary liver services team from 2012 to 2016 were identified (N = 214). Orthotopic liver transplantation candidates presenting outside of Milan criteria at initial radiographic diagnosis and/or an initial alpha-fetoprotein >400 ng/mL were categorized as at high risk for tumor recurrence and post-transplant mortality. Of the 214 patients newly diagnosed with hepatocellular carcinoma, 73 (34.1%) eventually underwent orthotopic liver transplantation. The majority of patients who did not undergo orthotopic liver transplantation were deceased or lost to follow-up (47.5%), with 14 of 141 (9.9%) currently listed for transplantation. Among transplanted patients, 21 of 73 (28.8%) were considered high-risk candidates. All 21 patients were downstaged to within Milan criteria with an alpha-fetoprotein <400 ng/mL before orthotopic liver transplantation, through locoregional therapies. Recurrence of hepatocellular carcinoma was higher but acceptable between downstaged high-risk and traditional candidates (9.5% vs 1.9%; P > .05) at a median follow-up period of 17 months. Downstaged high-risk candidates had a similar overall survival compared with those transplanted within Milan criteria (log-rank P > .05). In highly selected cases, patients with hepatocellular carcinoma outside of traditional criteria for orthotopic liver transplantation may undergo downstaging therapy in a multidisciplinary fashion with excellent post-transplant outcomes. These data support an

  14. Exploring new classification criteria for the earliest type stars: the 3400 Aregion

    NASA Astrophysics Data System (ADS)

    Morrell, Nidia I.; Walborn, Nolan R.; Arias, Julia I.

    2002-02-01

    We propose spectroscopic observations of a sample of standard O2-O4 stars in the wavelength region containing the N IV 3479-83-85 Aand O IV 3381-85-3412 Alines, in order to analyze the behavior of these spectral features as a function of the spectral type. We aim to define new classification criteria for the hottest stars, evaluating these N IV and O IV lines near 3400 Aas possible temperature and luminosity discriminators. The former spectral class O3 has just been split into three different classes: O2, O3 and O3.5 (Walborn et al. 2001). The paucity of classification criteria at these types in the traditional wavelength domain (4000 - 4700 Å), makes clear the need to explore other spectral ranges in order to define additional constraints on the determination of spectral types and luminosity classes. The wavelength range around 3400 Ahas been observed in many faint, crowded early O-type stars by HST/FOS, the corresponding data being available from the HST archive. This enhances our interest in observing this spectral range in the classification standards for the early O-type stars in order to make these existing HST observations even more useful, allowing the determination of accurate spectral types for unknown objects from them, once the behavior of the new criteria in the standards has been charted.

  15. Design criteria for a self-actuated shutdown system to ensure limitation of core damage. [LMFBR

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Deane, N.A.; Atcheson, D.B.

    1981-09-01

    Safety-based functional requirements and design criteria for a self-actuated shutdown system (SASS) are derived in accordance with LOA-2 success criteria and reliability goals. The design basis transients have been defined and evaluated for the CDS Phase II design, which is a 2550 MWt mixed oxide heterogeneous core reactor. A partial set of reactor responses for selected transients is provided as a function of SASS characteristics such as reactivity worth, trip points, and insertion times.

  16. Criteria-based evaluation of group 3 level memory telefacsimile equipment for interlibrary loan.

    PubMed Central

    Bennett, V M; Wood, M S; Malcom, D L

    1990-01-01

    The Interlibrary Loan, Document Delivery, and Union List Task Force of the Health Sciences Libraries Consortium (HSLC)--with nineteen libraries located in Philadelphia, Pittsburgh, and Hershey, Pennsylvania, and Delaware--accepted the charge of evaluating and recommending for purchase telefacsimile hardware to further interlibrary loan among HSLC members. To allow a thorough and scientific evaluation of group 3 level telefacsimile equipment, the task force identified ninety-six hardware features, which were grouped into nine broad criteria. These features formed the basis of a weighted analysis that identified three final candidates, with one model recommended to the HSLC board. This article details each of the criteria and discusses features in terms of library applications. The evaluation grid developed in the weighted analysis process should aid librarians charged with the selection of level 3 telefacsimile equipment. PMID:2328361

  17. Optimal control theory for non-scalar-valued performance criteria. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Gerring, H. P.

    1971-01-01

    The theory of optimal control for nonscalar-valued performance criteria is discussed. In the space, where the performance criterion attains its value, the relations better than, worse than, not better than, and not worse than are defined by a partial order relation. The notion of optimality splits up into superiority and non-inferiority, because worse than is not the complement of better than, in general. A superior solution is better than every other solution. A noninferior solution is not worse than any other solution. Noninferior solutions have been investigated particularly for vector-valued performance criteria. Superior solutions for non-scalar-valued performance criteria attaining their values in abstract partially ordered spaces are emphasized. The main result is the infimum principle which constitutes necessary conditions for a control to be a superior solution to an optimal control problem.

  18. A Practical Clinical Approach to Diagnosis of Fetal Alcohol Spectrum Disorders: Clarification of the 1996 Institute of Medicine Criteria

    PubMed Central

    Eugene Hoyme, H.; May, Philip A.; Kalberg, Wendy O.; Kodituwakku, Piyadasa; Phillip Gossage, J.; Trujillo, Phyllis M.; Buckley, David G.; Miller, Joseph H.; Aragon, Alfredo S.; Khaole, Nathaniel; Viljoen, Denis L.; Jones, Kenneth Lyons; Robinson, Luther K.

    2006-01-01

    Background. The adverse effects of alcohol on the developing human represent a spectrum of structural anomalies and behavioral and neurocognitive disabilities, most accurately termed fetal alcohol spectrum disorders (FASD). The first descriptions in the modern medical literature of a distinctly recognizable pattern of malformations associated with maternal alcohol abuse were reported in 1968 and 1973. Since that time, substantial progress has been made in developing specific criteria for defining and diagnosing this condition. Two sets of diagnostic criteria are now used most widely for evaluation of children with potential diagnoses in the FASD continuum, ie, the 1996 Institute of Medicine (IOM) criteria and the Washington criteria. Although both approaches have improved the clinical delineation of FASD, both suffer from significant drawbacks in their practical application in pediatric practice. Objective. The purpose of this report is to present specific clarifications of the 1996 IOM criteria for the diagnosis of FASD, to facilitate their practical application in clinical pediatric practice. Methods. A large cohort of children who were prenatally exposed to alcohol were identified, through active case-ascertainment methods, in 6 Native American communities in the United States and 1 community in the Western Cape Province of South Africa. The children and their families underwent standardized multidisciplinary evaluations, including a dysmorphology examination, developmental and neuropsychologic testing, and a structured maternal interview, which gathered data about prenatal drinking practices and other demographic and family information. Data for these subjects were analyzed, and revisions and clarifications of the existing IOM FASD diagnostic categories were formulated on the basis of the results. Results. The revised IOM method defined accurately and completely the spectrum of disabilities among the children in our study. On the basis of this experience, we

  19. Project W-320 acceptance test report for AY-farm electrical distribution

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bevins, R.R.

    1998-04-02

    This Acceptance Test Procedure (ATP) has been prepared to demonstrate that the AY-Farm Electrical Distribution System functions as required by the design criteria. This test is divided into three parts to support the planned construction schedule; Section 8 tests Mini-Power Pane AY102-PPI and the EES; Section 9 tests the SSS support systems; Section 10 tests the SSS and the Multi-Pak Group Control Panel. This test does not include the operation of end-use components (loads) supplied from the distribution system. Tests of the end-use components (loads) will be performed by other W-320 ATPs.

  20. Quantitative appraisal of the Amyloid Imaging Taskforce appropriate use criteria for amyloid-PET.

    PubMed

    Altomare, Daniele; Ferrari, Clarissa; Festari, Cristina; Guerra, Ugo Paolo; Muscio, Cristina; Padovani, Alessandro; Frisoni, Giovanni B; Boccardi, Marina

    2018-04-18

    We test the hypothesis that amyloid-PET prescriptions, considered appropriate based on the Amyloid Imaging Taskforce (AIT) criteria, lead to greater clinical utility than AIT-inappropriate prescriptions. We compared the clinical utility between patients who underwent amyloid-PET appropriately or inappropriately and among the subgroups of patients defined by the AIT criteria. Finally, we performed logistic regressions to identify variables associated with clinical utility. We identified 171 AIT-appropriate and 67 AIT-inappropriate patients. AIT-appropriate and AIT-inappropriate cases did not differ in any outcomes of clinical utility (P > .05). Subgroup analysis denoted both expected and unexpected results. The logistic regressions outlined the primary role of clinical picture and clinical or neuropsychological profile in identifying patients benefitting from amyloid-PET. Contrary to our hypothesis, also AIT-inappropriate prescriptions were associated with clinical utility. Clinical or neuropsychological variables, not taken into account by the AIT criteria, may help further refine criteria for appropriateness. Copyright © 2018. Published by Elsevier Inc.

  1. When Progressive Disease Does Not Mean Treatment Failure: Reconsidering the Criteria for Progression

    PubMed Central

    2012-01-01

    Although progression-based endpoints, such as progression-free survival, are often key clinical trial endpoints for anticancer agents, the clinical meaning of “objective progression” is much less certain. As scrutiny of progression-based endpoints in clinical trials increases, it should be remembered that the Response Evaluation Criteria In Solid Tumors (RECIST) progression criteria were not developed as a surrogate for survival. Now that progression-free survival has come to be an increasingly important trial endpoint, the criteria that define progression deserve critical evaluation to determine whether alternate definitions of progression might facilitate the development of stronger surrogate endpoints and more meaningful trial results. In this commentary, we review the genesis of the criteria for progression, highlight recent data that question their value as a marker of treatment failure, and advocate for several research strategies that could lay the groundwork for a clinically validated definition of disease progression in solid tumor oncology. PMID:22927506

  2. Video Game Acceptance: A Meta-Analysis of the Extended Technology Acceptance Model.

    PubMed

    Wang, Xiaohui; Goh, Dion Hoe-Lian

    2017-11-01

    The current study systematically reviews and summarizes the existing literature of game acceptance, identifies the core determinants, and evaluates the strength of the relationships in the extended technology acceptance model. Moreover, this study segments video games into two categories: hedonic and utilitarian and examines player acceptance of these two types separately. Through a meta-analysis of 50 articles, we find that perceived ease of use (PEOU), perceived usefulness (PU), and perceived enjoyment (PE) significantly associate with attitude and behavioral intention. PE is the dominant predictor of hedonic game acceptance, while PEOU and PU are the main determinants of utilitarian game acceptance. Furthermore, we find that respondent type and game platform are significant moderators. Findings of this study provide critical insights into the phenomenon of game acceptance and suggest directions for future research.

  3. ACR Appropriateness Criteria® Chronic Ankle Pain.

    PubMed

    Chang, Eric Y; Tadros, Anthony S; Amini, Behrang; Bell, Angela M; Bernard, Stephanie A; Fox, Michael G; Gorbachova, Tetyana; Ha, Alice S; Lee, Kenneth S; Metter, Darlene F; Mooar, Pekka A; Shah, Nehal A; Singer, Adam D; Smith, Stacy E; Taljanovic, Mihra S; Thiele, Ralf; Kransdorf, Mark J

    2018-05-01

    Chronic ankle pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic ankle pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. ACR Appropriateness Criteria® Chronic Hip Pain.

    PubMed

    Mintz, Douglas N; Roberts, Catherine C; Bencardino, Jenny T; Baccei, Steven J; Caird, Michelle S; Cassidy, R Carter; Chang, Eric Y; Fox, Michael G; Gyftopoulos, Soterios; Kransdorf, Mark J; Metter, Darlene F; Morrison, William B; Rosenberg, Zehava S; Shah, Nehal A; Small, Kirstin M; Subhas, Naveen; Tambar, Siddharth; Towers, Jeffrey D; Yu, Joseph S; Weissman, Barbara N

    2017-05-01

    Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  5. Why do different criteria for 'cure' yield different conclusions in comparing two treatments for bacterial vaginosis?

    PubMed

    Thomas, Katherine K; Sanchez, Sixto; Garcia, Patricia J; Holmes, King K

    2005-09-01

    The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis (BV) led to markedly different conclusions about treatment efficacy in a randomized trial comparing metronidazole gel versus metronidazole/nystatin ovules. We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14, 42, and 104 days after initiating treatment. Compared with gel, ovules more effectively eliminated amines, clue cells, and Gardnerella, Prevotella, or Mobiluncus morphotypes from vaginal fluid, thus achieving cure based on "usual" criteria (absence of BV by Amsel or Nugent criteria), but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH, thus not meeting Federal Drug Administration (FDA) criteria for cure. Because early vaginal recolonization by lactobacilli was poor after both gel and ovules, FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella, clue cells, and amines. Cure defined more "usually" may give more useful information.

  6. Assessing the conceptual clarity and evidence base of quality criteria/standards developed for evaluating decision aids

    PubMed Central

    McDonald, Heather; Charles, Cathy; Gafni, Amiram

    2011-01-01

    Abstract Context  Promoting patient participation in treatment decision making is of increasing interest to researchers, clinicians and policy makers. Decision aids (DAs) are advocated as one way to help achieve this goal. Despite their proliferation, there has been little agreement on criteria or standards for evaluating these tools. To fill this gap, an international collaboration of researchers and others interested in the development, content and quality of DAs have worked over the past several years to develop a checklist and, based on this checklist, an instrument for determining whether any given DA meets a defined set of quality criteria. Objective/Methods  In this paper, we offer a framework for assessing the conceptual clarity and evidence base used to support the development of quality criteria/standards for evaluating DAs. We then apply this framework to assess the conceptual clarity and evidence base underlying the International Patient Decision Aids Standards (IPDAS) checklist criteria for one of the checklist domains: how best to present in DAs probability information to patients on treatment benefits and risks. Conclusion  We found that some of the central concepts underlying the presenting probabilities domain were not defined. We also found gaps in the empirical evidence and theoretical support for this domain and criteria within this domain. Finally, we offer suggestions for steps that should be undertaken for further development and refinement of quality standards for DAs in the future. PMID:22050440

  7. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease—an evidence-based guideline

    PubMed Central

    Reményi, Bo; Wilson, Nigel; Steer, Andrew; Ferreira, Beatriz; Kado, Joseph; Kumar, Krishna; Lawrenson, John; Maguire, Graeme; Marijon, Eloi; Mirabel, Mariana; Mocumbi, Ana Olga; Mota, Cleonice; Paar, John; Saxena, Anita; Scheel, Janet; Stirling, John; Viali, Satupaitea; Balekundri, Vijayalakshmi I.; Wheaton, Gavin; Zühlke, Liesl; Carapetis, Jonathan

    2017-01-01

    Over the past 5 years, the advent of echocardiographic screening for rheumatic heart disease (RHD) has revealed a higher RHD burden than previously thought. In light of this global experience, the development of new international echocardiographic guidelines that address the full spectrum of the rheumatic disease process is opportune. Systematic differences in the reporting of and diagnostic approach to RHD exist, reflecting differences in local experience and disease patterns. The World Heart Federation echocardiographic criteria for RHD have, therefore, been developed and are formulated on the basis of the best available evidence. Three categories are defined on the basis of assessment by 2D, continuous-wave, and color-Doppler echocardiography: ‘definite RHD’, ‘borderline RHD’, and ‘normal’. Four subcategories of ‘definite RHD’ and three subcategories of ‘borderline RHD’ exist, to reflect the various disease patterns. The morphological features of RHD and the criteria for pathological mitral and aortic regurgitation are also defined. The criteria are modified for those aged over 20 years on the basis of the available evidence. The standardized criteria aim to permit rapid and consistent identification of individuals with RHD without a clear history of acute rheumatic fever and hence allow enrollment into secondary prophylaxis programs. However, important unanswered questions remain about the importance of subclinical disease (borderline or definite RHD on echocardiography without a clinical pathological murmur), and about the practicalities of implementing screening programs. These standardized criteria will help enable new studies to be designed to evaluate the role of echocardiographic screening in RHD control. PMID:22371105

  8. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease--an evidence-based guideline.

    PubMed

    Reményi, Bo; Wilson, Nigel; Steer, Andrew; Ferreira, Beatriz; Kado, Joseph; Kumar, Krishna; Lawrenson, John; Maguire, Graeme; Marijon, Eloi; Mirabel, Mariana; Mocumbi, Ana Olga; Mota, Cleonice; Paar, John; Saxena, Anita; Scheel, Janet; Stirling, John; Viali, Satupaitea; Balekundri, Vijayalakshmi I; Wheaton, Gavin; Zühlke, Liesl; Carapetis, Jonathan

    2012-02-28

    Over the past 5 years, the advent of echocardiographic screening for rheumatic heart disease (RHD) has revealed a higher RHD burden than previously thought. In light of this global experience, the development of new international echocardiographic guidelines that address the full spectrum of the rheumatic disease process is opportune. Systematic differences in the reporting of and diagnostic approach to RHD exist, reflecting differences in local experience and disease patterns. The World Heart Federation echocardiographic criteria for RHD have, therefore, been developed and are formulated on the basis of the best available evidence. Three categories are defined on the basis of assessment by 2D, continuous-wave, and color-Doppler echocardiography: 'definite RHD', 'borderline RHD', and 'normal'. Four subcategories of 'definite RHD' and three subcategories of 'borderline RHD' exist, to reflect the various disease patterns. The morphological features of RHD and the criteria for pathological mitral and aortic regurgitation are also defined. The criteria are modified for those aged over 20 years on the basis of the available evidence. The standardized criteria aim to permit rapid and consistent identification of individuals with RHD without a clear history of acute rheumatic fever and hence allow enrollment into secondary prophylaxis programs. However, important unanswered questions remain about the importance of subclinical disease (borderline or definite RHD on echocardiography without a clinical pathological murmur), and about the practicalities of implementing screening programs. These standardized criteria will help enable new studies to be designed to evaluate the role of echocardiographic screening in RHD control.

  9. Potential Impact of DSM-5 Criteria on Autism Spectrum Disorder Prevalence Estimates

    PubMed Central

    Maenner, Matthew J.; Rice, Catherine E.; Arneson, Carrie L.; Cunniff, Christopher; Schieve, Laura A.; Carpenter, Laura A.; Van Naarden Braun, Kim; Kirby, Russell S.; Bakian, Amanda V.; Durkin, Maureen S.

    2014-01-01

    IMPORTANCE The DSM-5 contains revised diagnostic criteria for autism spectrum disorder (ASD) from the DSM-IV-TR. Potential impacts of the new criteria on ASD prevalence are unclear. OBJECTIVE To assess potential effects of the DSM-5 ASD criteria on ASD prevalence estimation by retrospectively applying the new criteria to population-based surveillance data collected for previous ASD prevalence estimation. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based ASD surveillance based on clinician review of coded behaviors documented in children’s medical and educational evaluations from 14 geographically defined areas in the United States participating in the Autism and Developmental Disabilities Monitoring (ADDM) Network in 2006 and 2008. This study included 8-year-old children living in ADDM Network study areas in 2006 or 2008, including 644 883 children under surveillance, of whom 6577 met surveillance ASD case status based on the DSM-IV-TR. MAIN OUTCOMES AND MEASURES Proportion of children meeting ADDM Network ASD criteria based on the DSM-IV-TR who also met DSM-5 criteria; overall prevalence of ASD using DSM-5 criteria. RESULTS Among the 6577 children classified by the ADDM Network as having ASD based on the DSM-IV-TR, 5339 (81.2%) met DSM-5 ASD criteria. This percentage was similar for boys and girls but higher for those with than without intellectual disability (86.6% and 72.5%, respectively; P < .001). A total of 304 children met DSM-5 ASD criteria but not current ADDM Network ASD case status. Based on these findings, ASD prevalence per 1000 for 2008 would have been 10.0 (95% CI, 9.6–10.3) using DSM-5 criteria compared with the reported prevalence based on DSM-IV-TR criteria of 11.3 (95% CI, 11.0–11.7). CONCLUSIONS AND RELEVANCE Autism spectrum disorder prevalence estimates will likely be lower under DSM-5 than under DSM-IV-TR diagnostic criteria, although this effect could be tempered by future adaptation of diagnostic practices and

  10. Criteria for assessing the quality of mHealth apps: a systematic review.

    PubMed

    Nouri, Rasool; R Niakan Kalhori, Sharareh; Ghazisaeedi, Marjan; Marchand, Guillaume; Yasini, Mobin

    2018-05-16

    Review the existing studies including an assessment tool/method to assess the quality of mHealth apps; extract their criteria; and provide a classification of the collected criteria. In accordance with the PRISMA statement, a literature search was conducted in MEDLINE, EMBase, ISI and Scopus for English language citations published from January 1, 2008 to December 22, 2016 for studies including tools or methods for quality assessment of mHealth apps. Two researchers screened the titles and abstracts of all retrieved citations against the inclusion and exclusion criteria. The full text of relevant papers was then individually examined by the same researchers. A senior researcher resolved eventual disagreements and confirmed the relevance of all included papers. The authors, date of publication, subject fields of target mHealth apps, development method, and assessment criteria were extracted from each paper. The extracted assessment criteria were then reviewed, compared, and classified by an expert panel of two medical informatics specialists and two health information management specialists. Twenty-three papers were included in the review. Thirty-eight main classes of assessment criteria were identified. These were reorganized by expert panel into 7 main classes (Design, Information/Content, Usability, Functionality, Ethical Issues, Security and Privacy, and User-perceived value) with 37 sub-classes of criteria. There is a wide heterogeneity in assessment criteria for mHealth apps. It is necessary to define the exact meanings and degree of distinctness of each criterion. This will help to improve the existing tools and may lead to achieve a better comprehensive mHealth app assessment tool.

  11. Wittgenstein's Contextualist Approach to Judging "Sound" Teaching: Escaping Enthrallment in Criteria-Based Assessments

    ERIC Educational Resources Information Center

    Stickney, Jeff Alan

    2009-01-01

    Comparing the early, analytic attempt to define "sound" teaching with the current use of criteria-based rating schemes, Jeff Stickney turns to Wittgenstein's holistic, contextualist approach to judging teaching against its complex "background" within our "form of life." To exemplify this approach, Stickney presents cases of classroom practice…

  12. Third Response to "The Teacher as a Service Professional," by Donald A. Myers: Defining "Professionalism" Does Not Make It So

    ERIC Educational Resources Information Center

    Houston, W. Robert

    2008-01-01

    It has been generally accepted that teaching does not meet the criteria of a profession, at least as exemplified by the more mature professions of medicine and law (Abbott, 1988; Darling-Hammond & Youngs, 2002; Etzioni, 1969; Howsam, Corrigan, Denemark, & Nash, 1976). Teaching is most often referred to as a semiprofession; Myers's (2008 [this…

  13. How valid are current diagnostic criteria for dental erosion?

    PubMed Central

    2008-01-01

    In principle, there is agreement about the clinical diagnostic criteria for dental erosion, basically defined as cupping and grooving of the occlusal/incisal surfaces, shallow defects on smooth surfaces located coronal from the enamel–cementum junction with an intact cervical enamel rim and restorations rising above the adjacent tooth surface. This lesion characteristic was established from clinical experience and from observations in a small group of subjects with known exposure to acids rather than from systematic research. Their prevalence is higher in risk groups for dental erosion compared to subjects not particularly exposed to acids, but analytical epidemiological studies on random or cluster samples often fail to find a relation between occurrence or severity of lesions and any aetiological factor. Besides other aspects, this finding might be due to lack of validity with respect to diagnostic criteria. In particular, cupping and grooving might be an effect of abrasion as well as of erosion and their value for the specific diagnosis of erosion must be doubted. Knowledge about the validity of current diagnostic criteria of different forms of tooth wear is incomplete, therefore further research is needed. PMID:18228062

  14. Sustainability assessment of alternative end-uses for disused areas based on multi-criteria decision-making method.

    PubMed

    De Feo, Giovanni; De Gisi, Sabino; De Vita, Sabato; Notarnicola, Michele

    2018-08-01

    The main aim of this study was to define and apply a multidisciplinary and multi-criteria approach to sustainability in evaluating alternative end-uses for disused areas. Taking into account the three pillars of sustainability (social, economic and environmental dimension) as well as the need for stakeholders to have new practical instruments, the innovative approach consists of four modules stated (i) sociological, (ii) economic, (iii) environmental and (iv) multi-criteria assessment. By means of a case study on a small Municipality in Southern Italy, three end-uses alternatives, representing three essential services for citizens, were selected: Municipal gym; Market area; Municipal Solid Waste (MSW) separate collection centre. The sociological module was useful to select the most socially sound alternative by means of a consultative referendum, simulated with the use of a structured questionnaire administered to a sample of the population. The economic evaluation was conducted defining the bill of quantities with regarding to six main items (soil handling, landfill disposal tax, public services, structure and services, completion work, equipment and furnishings). The environmental evaluation was performed applying the Delphi method with local technicians who were involved in a qualitative-quantitative evaluation of the three alternatives with regarding to eight possible environmental impacts (landscape impact, soil handling, odour, traffic, noise, atmospheric pollution, wastewater, waste). Finally, the Simple Additive Weighting was used as multi-criteria technique to define alternatives priorities. The obtained results showed how the multi-criteria analysis is a useful decision support tool able to identify transparently and efficiently the most sustainable solutions to a complex social problem. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Interpretation of standard leaching test BS EN 12457-2: is your sample hazardous or inert?

    PubMed

    Zandi, Mohammad; Russell, Nigel V; Edyvean, Robert G J; Hand, Russell J; Ward, Philip

    2007-12-01

    A slag sample from a lead refiner has been obtained and given to two analytical laboratories to determine the release of trace elements from the sample according to BS EN 12457-2. Samples analysed by one laboratory passed waste acceptance criteria, leading it to be classified as an inert material; samples of the same material analysed by the other laboratory failed waste acceptance criteria and were classified as hazardous. It was found that the sample preparation procedure is the critical step in the leaching analysis and that the effects of particle size on leachability should be taken into account when using this standard. The purpose of this paper is to open a debate on designing a better defined standard leaching test and making current waste acceptance criteria more flexible.

  16. Recommended test methods and pass/fail criteria for a respirator fit capability test of half-mask air-purifying respirators

    PubMed Central

    Zhuang, Ziqing; Bergman, Michael; Lei, Zhipeng; Niezgoda, George; Shaffer, Ronald

    2017-01-01

    This study assessed key test parameters and pass/fail criteria options for developing a respirator fit capability (RFC) test for half-mask air-purifying particulate respirators. Using a 25-subject test panel, benchmark RFC data were collected for 101 National Institute for Occupational Safety and Health-certified respirator models. These models were further grouped into 61 one-, two-, or three-size families. Fit testing was done using a PortaCount® Plus with N95-Companion accessory and an Occupational Safety and Health Administration-accepted quantitative fit test protocol. Three repeated tests (donnings) per subject/respirator model combination were performed. The panel passing rate (PPR) (number or percentage of the 25-subject panel achieving acceptable fit) was determined for each model using five different alternative criteria for determining acceptable fit. When the 101 models are evaluated individually (i.e., not grouped by families), the percentages of models capable of fitting >75% (19/25 subjects) of the panel were 29% and 32% for subjects achieving a fit factor ≥100 for at least one of the first two donnings and at least one of three donnings, respectively. When the models are evaluated grouped into families and using >75% of panel subjects achieving a fit factor ≥100 for at least one of two donnings as the PPR pass/fail criterion, 48% of all models can pass. When >50% (13/25 subjects) of panel subjects was the PPR criterion, the percentage of passing models increased to 70%. Testing respirators grouped into families and evaluating the first two donnings for each of two respirator sizes provided the best balance between meeting end user expectations and creating a performance bar for manufacturers. Specifying the test criterion for a subject obtaining acceptable fit as achieving a fit factor ≥100 on at least one out of the two donnings is reasonable because a majority of existing respirator families can achieve an PPR of >50% using this criterion

  17. Recommended test methods and pass/fail criteria for a respirator fit capability test of half-mask air-purifying respirators.

    PubMed

    Zhuang, Ziqing; Bergman, Michael; Lei, Zhipeng; Niezgoda, George; Shaffer, Ronald

    2017-06-01

    This study assessed key test parameters and pass/fail criteria options for developing a respirator fit capability (RFC) test for half-mask air-purifying particulate respirators. Using a 25-subject test panel, benchmark RFC data were collected for 101 National Institute for Occupational Safety and Health-certified respirator models. These models were further grouped into 61 one-, two-, or three-size families. Fit testing was done using a PortaCount® Plus with N95-Companion accessory and an Occupational Safety and Health Administration-accepted quantitative fit test protocol. Three repeated tests (donnings) per subject/respirator model combination were performed. The panel passing rate (PPR) (number or percentage of the 25-subject panel achieving acceptable fit) was determined for each model using five different alternative criteria for determining acceptable fit. When the 101 models are evaluated individually (i.e., not grouped by families), the percentages of models capable of fitting >75% (19/25 subjects) of the panel were 29% and 32% for subjects achieving a fit factor ≥100 for at least one of the first two donnings and at least one of three donnings, respectively. When the models are evaluated grouped into families and using >75% of panel subjects achieving a fit factor ≥100 for at least one of two donnings as the PPR pass/fail criterion, 48% of all models can pass. When >50% (13/25 subjects) of panel subjects was the PPR criterion, the percentage of passing models increased to 70%. Testing respirators grouped into families and evaluating the first two donnings for each of two respirator sizes provided the best balance between meeting end user expectations and creating a performance bar for manufacturers. Specifying the test criterion for a subject obtaining acceptable fit as achieving a fit factor ≥100 on at least one out of the two donnings is reasonable because a majority of existing respirator families can achieve an PPR of >50% using this criterion

  18. Consumer acceptance of insect-based foods in the Netherlands: Academic and commercial implications.

    PubMed

    House, Jonas

    2016-12-01

    Despite growing interest in the use of insects as food, uptake of insect-based foods in Europe is low. Existing research into Western consumer acceptance of insects as food tends to emphasise the role of individual cognition in food choice at the expense of social or contextual factors, and typically frames consumer acceptance as a general issue, rather than relevant only for relatively few early adopters. This paper outlines empirical work, theoretically and methodologically informed by a critical appraisal of previous research, with consumers of insect-based convenience foods in the Netherlands. Reported initial motivations for trying insect foods are shown to be substantially different from factors - such as price, taste, availability, and 'fit' with established eating practices - which affect repeat consumption. Such factors are congruent with those affecting routine consumption of more conventional foods, indicating that insect foods should be analysed according to similar criteria and should be designed with more practical considerations in mind. Further, a reorientation of consumer acceptance research is proposed. Research should shift from attempts to forecast acceptance and engage with 'actual' examples of insect consumption; social, practical and contextual factors affecting food consumption should be emphasised; and - following work on the establishment of other novel foods - early adopters, rather than general populations, should receive greater analytic attention. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  19. Acceptance test report, 241-SY-101 Flexible Receiver System, Phase 2 testing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ritter, G.A.

    1995-02-06

    This document summarizes the results of the Phase 2 acceptance test of the 241-SY-101 Flexible Receiver System (FRS). The FRS is one of six major components of the Equipment Removal System, which has been designed to retrieve, transport, and store the test mixer pump currently installed in Tank 241-SY-101. The purpose of this acceptance test is to verify the strength of the containment bag and bag bottom cinching mechanism. It is postulated that 68 gallons of waste could be trapped inside the pump internals. The bag must be capable of supporting this waste if it shakes loose and drains tomore » the bottom of the bag after the bag bottom has been cinched closed. This acceptance test was performed at the Maintenance and Storage Facility (MASF) Facility in the 400 area on January 23, 1995. The bag assembly supported the weight of 920 kg (2,020 lbs) of water with no leakage or damage to the bag. This value meets the acceptance criteria of 910 kg of water and therefore the results were found to be acceptable. The maximum volume of liquid expected to be held up in the pump internals is 258 L (68 gallons), which corresponds to 410 kg. This test weight gives just over a safety factor of 2. The bag also supported a small shock load while it was filled with water when the crane hoisted the bag assembly up and down. Based on the strength rating of the bag components, the bag assembly should support 2--3 times the test weight of 910 kg.« less

  20. Criteria for social media-based scholarship in health professions education.

    PubMed

    Sherbino, Jonathan; Arora, Vineet M; Van Melle, Elaine; Rogers, Robert; Frank, Jason R; Holmboe, Eric S

    2015-10-01

    Social media are increasingly used in health professions education. How can innovations and research that incorporate social media applications be adjudicated as scholarship? To define the criteria for social media-based scholarship in health professions education. In 2014 the International Conference on Residency Education hosted a consensus conference of health professions educators with expertise in social media. An expert working group drafted consensus statements based on a literature review. Draft consensus statements were posted on an open interactive online platform 2 weeks prior to the conference. In-person and virtual (via Twitter) participants modified, added or deleted draft consensus statements in an iterative fashion during a facilitated 2 h session. Final consensus statements were unanimously endorsed. A review of the literature demonstrated no existing criteria for social media-based scholarship. The consensus of 52 health professions educators from 20 organisations in four countries defined four key features of social media-based scholarship. It must (1) be original; (2) advance the field of health professions education by building on theory, research or best practice; (3) be archived and disseminated; and (4) provide the health professions education community with the ability to comment on and provide feedback in a transparent fashion that informs wider discussion. Not all social media activities meet the standard of education scholarship. This paper clarifies the criteria, championing social media-based scholarship as a legitimate academic activity in health professions education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.