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Sample records for imaging guidelines implementation

  1. Diagnostic Imaging Guidelines Implementation Study for Spinal Disorders

    PubMed Central

    Bussières, André E.; Laurencelle, Louis; Peterson, Cynthia

    2010-01-01

    Purpose: Implementation strategies of imaging guidelines can assist in reducing the number of radiographic examinations. This study aimed to compare the perceived need for diagnostic imaging before and after an educational intervention strategy. Methods: One hundred sixty Swiss chiropractors attending a conference were randomized to either receive a radiology workshop, reviewing appropriate indications for diagnostic imaging for adult spine disorders (n = 80), or be in a control group (CG). One group of 40 individuals dropped out from the CG due to logistic reasons. Participants in the intervention group were randomly assigned to three subgroups to evaluate the effect of an online reminder at midpoint. All participants underwent a pretest and a final test at 14–16 weeks. A posttest was administered to two subgroups at 8–10 weeks. Results: There was no difference between baseline scores, and overall scores for the pretest and the final tests for all four groups were not significantly different. However, the subgroup provided with access to a reminder performed significantly better than the subgroup with whom they were compared (F = 4.486; df = 1 and 30; p = .043). Guideline adherence was 50.5% (95% CI, 39.1–61.8) for the intervention group and 43.7% (95% CI, 23.7–63.6) for the CG at baseline. Adherence at follow-up was lower, but mean group differences remained insignificant. Conclusions: Online access to specific recommendations while making a clinical decision may favorably influence the intention to either order or not order imaging studies. However, a didactic presentation alone did not appear to change the perception for the need of diagnostic imaging studies. PMID:20480010

  2. Guideline Implementation: Preventing Hypothermia.

    PubMed

    Bashaw, Marie A

    2016-03-01

    The updated AORN "Guideline for prevention of unplanned patient hypothermia" provides guidance for identifying factors associated with intraoperative hypothermia, preventing hypothermia, educating perioperative personnel on this topic, and developing relevant policies and procedures. This article focuses on key points of the guideline, which addresses performing a preoperative assessment for factors that may contribute to hypothermia, measuring and monitoring the patient's temperature in all phases of perioperative care, and implementing interventions to prevent hypothermia. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:26924369

  3. Provisional Teacher Program: Implementation Guidelines.

    ERIC Educational Resources Information Center

    New Jersey State Dept. of Education, Trenton.

    These guidelines are offered to public school districts and nonpublic schools to assist in implementing the provisional certification requirements for first year teachers in New Jersey. The guidelines address: (1) membership of the Professional Support Team that provides the training, support, and supervision for provisional teachers; (2) roles…

  4. Guideline implementation: Surgical attire.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:25645036

  5. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  6. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  7. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  8. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  9. 10 CFR 960.3 - Implementation guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this...

  10. Guideline Implementation: Processing Flexible Endoscopes.

    PubMed

    Bashaw, Marie A

    2016-09-01

    The updated AORN "Guideline for processing flexible endoscopes" provides guidance to perioperative, endoscopy, and sterile processing personnel for processing all types of reusable flexible endoscopes and accessories in all procedural settings. This article focuses on key points of the guideline to help perioperative personnel safely and effectively process flexible endoscopes to prevent infection transmission. The key points address verification of manual cleaning, mechanical cleaning and processing, storage in a drying cabinet, determination of maximum storage time before reprocessing is needed, and considerations for implementing a microbiologic surveillance program. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:27568535

  11. GOSIP implementation guidelines

    SciTech Connect

    Van Norman, H.J.

    1996-07-01

    GOSIP (Government Open Systems Interconnection Profile) is a subset of ISO`s OSI protocol standards relevant to US Government operations. As a Federal Information Processing Standard (FIPS), GOSIP is required by law for all Federal agencies. Mandatory standards-based communications products are required when purchasing functionality equivalent to what is specified in GOSIP. This unprecedented requirement by the Federal government has caused considerable confusion concerning practical implementation of relatively immature and untested technologies. Many organizations already have substantial investment in one or more proprietary network architectures. This paper examines issues associated with conversion to the GOSIP system.

  12. Guideline implementation: surgical instrument cleaning.

    PubMed

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-05-01

    Cleaning, decontaminating, and handling instructions for instruments vary widely based on the type of instrument and the manufacturer. Processing instruments in accordance with the manufacturer's instructions can help prevent damage and keep devices in good working order. Most importantly, proper cleaning and disinfection may prevent transmission of pathogenic organisms from a contaminated device to a patient or health care worker. The updated AORN "Guideline for cleaning and care of surgical instruments" provides guidance on cleaning, decontaminating, transporting, inspecting, and storing instruments. This article focuses on key points of the guideline to help perioperative personnel implement appropriate instrument care protocols in their practice settings. The key points address timely cleaning and decontamination of instruments after use; appropriate heating, ventilation, and air conditioning parameters for the decontamination area; processing of ophthalmic instruments and laryngoscopes; and precautions to take with instruments used in cases of suspected prion disease. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:25946180

  13. An implementation framework for GEM encoded guidelines.

    PubMed Central

    Gershkovich, P.; Shiffman, R. N.

    2001-01-01

    Access to timely decision support information is critical for delivery of high-quality medical care. Transformation of clinical knowledge that is originally expressed in the form of a guideline to a computable format is one of the main obstacles to the integration of knowledge sharing functionality into computerized clinical systems. The Guideline Element Model (GEM) provides a methodology for such a transformation. Although the model has been used to store heterogeneous guideline knowledge, it is important to demonstrate that GEM markup facilitates guideline implementation. This report demonstrates the feasibility of implementation of GEM-encoded guideline recommendations using Apache Group s Cocoon Web Publishing Framework. We further demonstrate how XML-based programming allows for maintaining the separation of guideline content from processing logic and from presentation format. Finally, we analyze whether the guideline authors original intent has been sufficiently captured and conveyed to the end user. PMID:11825181

  14. Total quality management implementation guidelines

    SciTech Connect

    Not Available

    1993-12-01

    These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

  15. Guidelines for an effective SPDS implementation program

    SciTech Connect

    Blanch, P.M.; Wilkinson, C.D.

    1984-03-01

    Guidelines developed by the Nuclear Utility Task Action Committee for the implementation of a safety parameter display system (SPDS) are summarized. These guidelines reflect the consensus of nuclear utilities on how SPDS requirements, as set up by the Nuclear Regulatory Commission, could be met. This article includes a functional definition of SPDS and discussions of SPDS implementation plans, design bases, purchase specifications, training, integration and documentation, and verification and validation.

  16. Guidelines for Implementing Teletraining Systems.

    ERIC Educational Resources Information Center

    Chute, Alan G.

    Designed to provide change agents with a framework for planning and implementing successful teletraining systems, this paper discusses strategies for the introduction of sophisticated teletraining technology into corporate training programs without adversely affecting a client organization's social environment. Teletraining is defined as an…

  17. Implementation of Job Placement Services Guidelines.

    ERIC Educational Resources Information Center

    McGillicuddy (Shirley) & Associates, Sierra Madre, CA.

    The Implementation of Job Placement Services Guidelines Project was designed to strengthen placement programs and services for California community college vocational students, and for all students needing part-time employment to realize their educational goals. The project was designed to test the validity and relevance of quality indicators…

  18. Guideline Implementation: Prevention of Retained Surgical Items.

    PubMed

    Fencl, Jennifer L

    2016-07-01

    A surgical item unintentionally retained in a patient after an operative or other invasive procedure is a serious, preventable medical error with the potential to cause the patient great harm. Perioperative RNs play a key role in preventing retained surgical items (RSIs). The updated AORN "Guideline for prevention of retained surgical items" provides guidance for implementing a consistent, multidisciplinary approach to RSI prevention; accounting for surgical items; preventing retention of device fragments; reconciling count discrepancies; and using adjunct technologies to supplement manual count procedures. This article focuses on key points of the guideline to help perioperative personnel provide optimal care during a procedure. Key points addressed include taking responsibility for RSI prevention as a team; minimizing distractions, noise, and interruptions during counts; using consistent counting methods; reconciling discrepancies; and participating in performance-improvement activities. Perioperative RNs should review the complete guideline for additional information and for guidance in writing and updating policies and procedures. PMID:27350354

  19. Developing and implementing dietary guidelines in India.

    PubMed

    Krishnaswamy, Kamala

    2008-01-01

    Single nutrients are no solution to the problem of malnutrition. It is essential that food based dietary guidelines (FBDG) are developed and implemented to overcome the diet related diseases and promote health in the population. A multidisciplinary group was constituted to develop FBDGs in India. A manual with scientific details and an abridged version were prepared with 6 goals and 14 dietary guidelines covering all age groups to overcome the public health nutritional problems. The guidelines are based on dietary patterns and specific outcomes of health and disease. Dietary diversification has been suggested as the practical approach. Diets from locally available and culturally accepted foods in household measures have been suggested to ensure optimal health. For successful implementation of FBDGs, political/bureaucratic commitment are essential. It must become a tool in the developmental plans for food, nutrition, agriculture, rural, educational and biotechnology policies. Workshops and meetings were organized to sensitise the administrative set-up. The intersectoral nature of FBDG for implementation was highlighted. The department of women and child development, which is responsible for implementing the National Nutritional Policy, was recognized as nodal agency. Meetings were organised for secondary target audiences. The press was invited to participate in popularization of the FBDGs. Social marketing strategies were used to match the local dietary and cultural aspects. Interpersonal communication and professional societies were used for better dissemination. Industry and legislative bodies were requested to take active action in this regard. The FBDGs have to be implemented to achieve food and nutrition security and the Millennium Development Goals. PMID:18296304

  20. Epilepsy Imaging Study Guideline Criteria

    PubMed Central

    Gaillard, William D; Cross, J Helen; Duncan, John S; Stefan, Hermann; Theodore, William H

    2011-01-01

    Recognition of limited economic resources, as well as potential adverse effects of ‘over testing,’ has increased interest in ‘evidence-based’ assessment of new medical technology. This creates a particular problem for evaluation and treatment of epilepsy, increasingly dependent on advanced imaging and electrophysiology, since there is a marked paucity of epilepsy diagnostic and prognostic studies that meet rigorous standards for evidence classification. The lack of high quality data reflects fundamental weaknesses in many imaging studies but also limitations in the assumptions underlying evidence classification schemes as they relate to epilepsy, and to the practicalities of conducting adequately powered studies of rapidly evolving technologies. We review the limitations of current guidelines and propose elements for imaging studies that can contribute meaningfully to the epilepsy literature. PMID:21740417

  1. Guideline Implementation: Moderate Sedation/Analgesia.

    PubMed

    Fencl, Jennifer L

    2016-05-01

    Moderate sedation/analgesia is practiced in a variety of settings and delivered by a variety of health care providers, with a goal of reducing the patient's anxiety and discomfort during diagnostic and therapeutic procedures. The updated AORN "Guideline for care of the patient receiving moderate sedation/analgesia" provides guidance on RN administration of moderate sedation/analgesia within the scope of nursing practice as defined by the state boards of nursing. The guideline addresses patient selection and assessment, staffing for the procedure, patient monitoring, medication administration, and criteria for postoperative discharge. This article focuses on key points of the guideline to promote safe care throughout the perioperative continuum for a patient receiving moderate sedation/analgesia. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:27129752

  2. Use of medical informatics to implement and develop clinical practice guidelines.

    PubMed Central

    Owens, D K

    1998-01-01

    Clinical practice guidelines have enormous potential to improve the quality of and accountability in health care. Making the most of this potential should become easier as guideline developers integrate guidelines within information systems and electronic medical records. A major barrier to such integration is the lack of computing infrastructure in many clinical settings. To successfully implement guidelines in information systems, developers must create more specific recommendations than those that have been required for traditional guidelines. Using reusable software components to create guidelines can make the development of protocols faster and less expensive. In addition, using decision models to produce guidelines enables developers to structure guideline problems systematically, to prioritize information acquisition, to develop site-specific guidelines, and to evaluate the cost-effectiveness of the explicit incorporation of patient preferences into guideline recommendations. Ongoing research provides a foundation for the use of guideline development tools that can help developers tailor guidelines appropriately to their practice settings. This article explores how medical informatics can help clinicians find, use, and create practice guidelines. Images Figure 2. PMID:9549415

  3. Barriers and Strategies in Guideline Implementation-A Scoping Review.

    PubMed

    Fischer, Florian; Lange, Kerstin; Klose, Kristina; Greiner, Wolfgang; Kraemer, Alexander

    2016-01-01

    Research indicates that clinical guidelines are often not applied. The success of their implementation depends on the consideration of a variety of barriers and the use of adequate strategies to overcome them. Therefore, this scoping review aims to describe and categorize the most important barriers to guideline implementation. Furthermore, it provides an overview of different kinds of suitable strategies that are tailored to overcome these barriers. The search algorithm led to the identification of 1659 articles in PubMed. Overall, 69 articles were included in the data synthesis. The content of these articles was analysed by using a qualitative synthesis approach, to extract the most important information on barriers and strategies. The barriers to guideline implementation can be differentiated into personal factors, guideline-related factors, and external factors. The scoping review revealed the following aspects as central elements of successful strategies for guideline implementation: dissemination, education and training, social interaction, decision support systems and standing orders. Available evidence indicates that a structured implementation can improve adherence to guidelines. Therefore, the barriers to guideline implementation and adherence need to be analysed in advance so that strategies that are tailored to the specific setting and target groups can be developed. PMID:27417624

  4. Guidelines for Implementing State Skill Standards Certificate Program in Construction.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Workforce Development, Madison.

    This packet contains guidelines, a student competency checklist, and student evaluation sheet for use in a Wisconsin school-to-work state skill standards certificate program in construction. The guidelines provide a planning resource for implementing the program, which was created in partnership with unions, employers, the state Department of…

  5. Words matter: increasing the implementation of clinical guidelines

    PubMed Central

    Michie, S; Lester, K

    2005-01-01

    Objectives: To determine whether writing clinical guideline recommendations in behaviourally specified "plain English" language increases the likelihood of their implementation by service users (patients). Design: Randomised controlled trial in which participants received either the original text of the National Institute for Clinical Excellence (NICE) public guidelines for the management of schizophrenia or a behaviourally specified text with the same content. Setting: Mental health service user networks and voluntary sector organisations within two inner London boroughs. Participants: Eighty four mental health service users recruited by post or face to face contact at service user meetings. Intervention: The section of the NICE public guidelines for schizophrenia concerning psychological and pharmacological treatments was rewritten to improve style and behavioural specificity by applying evidence-based and psychologically informed principles of good written communication. Outcome measures: Cognitive predictors of behaviour, as specified by the evidence based theory of planned behaviour, constituted the primary outcome as it was not possible to measure the actual behaviour of guideline implementation. The predictors were behavioural intentions to implement the guidelines, attitudes towards implementation, and perceived behavioural control over implementation. Satisfaction with the guidelines and perceived comprehension were also measured. Results: Behaviourally specified "plain English" guidelines led to stronger intentions to implement the guidelines, more positive attitudes towards them, and greater perceived behavioural control over using them. There was no difference in satisfaction or perceived comprehension. Conclusions: Writing guidelines with high behavioural specificity in conjunction with the use of "plain English" may be a simple and effective method of increasing their implementation. Evaluation with a behavioural outcome is now needed. PMID:16195572

  6. A manual for implementing residual radioactive material guidelines

    SciTech Connect

    Gilbert, T.L.; Yu, C.; Yuan, Y.C.; Zielen, A.J.; Jusko, M.J.; Wallo, A. III

    1989-06-01

    This manual presents information for implementing US Department of Energy (DOE) guidelines for residual radioactive material at sites identified by the Formerly Utilized Sites Remedial Action Program (FUSRAP) and the Surplus Facilities Management Program (SFMP). It describes the analysis and models used to derive site-specific guidelines for allowable residual concentrations of radionuclides in soil and the design and use of the RESRAD computer code for calculating guideline values. It also describes procedures for implementing DOE policy for reducing residual radioactivity to levels that are as low as reasonably achievable. 36 refs., 16 figs, 22 tabs.

  7. Digital Imaging and Conservation: Model Guidelines.

    ERIC Educational Resources Information Center

    Dean, John F.

    2003-01-01

    Examines the intersection of conservation and digital imaging based on guidelines at the Cornell University (Ithaca, NY) library. Discusses the digitization of artifacts; assessing the condition prior to scanning; scanning considerations, including temperature and humidity, lighting, and security; stable storage of artifacts after scanning; and…

  8. State Laws and Guidelines for Implementing RTI

    ERIC Educational Resources Information Center

    Zirkel, Perry A.; Thomas, Lisa B.

    2010-01-01

    The legal source of schools' use of response to intervention (RTI) is a matter of federal and state special education laws, although its implementation is largely a matter of general education practice. The only mention of RTI is in the Individuals With Disabilities Education Act (IDEA), and it is limited to identification of students with…

  9. Do guidelines offer implementation advice to target users? A systematic review of guideline applicability

    PubMed Central

    Gagliardi, Anna R; Brouwers, Melissa C

    2015-01-01

    Objective Providers and patients are most likely to use and benefit from guidelines accompanied by implementation support. Guidelines published in 2007 and earlier assessed with the Appraisal of Guidelines, Research and Evaluation (AGREE) instrument scored poorly for applicability, which reflects the inclusion of implementation instructions or tools. The purpose of this study was to examine the applicability of guidelines published in 2008 or later and identify factors associated with applicability. Design Systematic review of studies that used AGREE to assess guidelines published in 2008 or later. Data sources MEDLINE and EMBASE were searched from 2008 to July 2014, and the reference lists of eligible items. Two individuals independently screened results for English language studies that reviewed guidelines using AGREE and reported all domain scores, and extracted data. Descriptive statistics were calculated across all domains. Multilevel regression analysis with a mixed effects model identified factors associated with applicability. Results Of 245 search results, 53 were retrieved as potentially relevant and 20 studies were eligible for review. The mean and median domain scores for applicability across 137 guidelines published in 2008 or later were 43.6% and 42.0% (IQR 21.8–63.0%), respectively. Applicability scored lower than all other domains, and did not markedly improve compared with guidelines published in 2007 or earlier. Country (UK) and type of developer (disease-specific foundation, non-profit healthcare system) appeared to be associated with applicability when assessed with AGREE II (not original AGREE). Conclusions Despite increasing recognition of the need for implementation tools, guidelines continue to lack such resources. To improve healthcare delivery and associated outcomes, further research is needed to establish the type of implementation tools needed and desired by healthcare providers and consumers, and methods for developing high

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

    PubMed

    Waldfahrer, F

    2016-04-01

    Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. PMID:27128403

  11. Guideline adaptation and implementation planning: a prospective observational study

    PubMed Central

    2013-01-01

    Background Adaptation of high-quality practice guidelines for local use has been advanced as an efficient means to improve acceptability and applicability of evidence-informed care. In a pan-Canadian study, we examined how cancer care groups adapted pre-existing guidelines to their unique context and began implementation planning. Methods Using a mixed-methods, case-study design, five cases were purposefully sampled from self-identified groups and followed as they used a structured method and resources for guideline adaptation. Cases received the ADAPTE Collaboration toolkit, facilitation, methodological and logistical support, resources and assistance as required. Documentary and primary data collection methods captured individual case experience, including monthly summaries of meeting and field notes, email/telephone correspondence, and project records. Site visits, process audits, interviews, and a final evaluation forum with all cases contributed to a comprehensive account of participant experience. Results Study cases took 12 to >24 months to complete guideline adaptation. Although participants appreciated the structure, most found the ADAPTE method complex and lacking practical aspects. They needed assistance establishing individual guideline mandate and infrastructure, articulating health questions, executing search strategies, appraising evidence, and achieving consensus. Facilitation was described as a multi-faceted process, a team effort, and an essential ingredient for guideline adaptation. While front-line care providers implicitly identified implementation issues during adaptation, they identified a need to add an explicit implementation planning component. Conclusions Guideline adaptation is a positive initial step toward evidence-informed care, but adaptation (vs. ‘de novo’ development) did not meet expectations for reducing time or resource commitments. Undertaking adaptation is as much about the process (engagement and capacity building) as it

  12. Guidelines for Implementing Change: A Case Study

    NASA Astrophysics Data System (ADS)

    Masekela, Belinda; Nienaber, Rita

    To attain and sustain a competitive advantage organizations are continually faced with the need to change their structures, processes and technologies. Converting to new technology and implementing a new information management system in an organization results in inevitable changes in organizational procedures impacting on the people involved. A major problem encountered during this process is resistance to change, which may contribute to total failure of this system. Change management is the process that can be used to negate this impact and assist employees in transitioning to a new way of doing things.

  13. Dietary guidelines and implementation for celiac disease.

    PubMed

    Kupper, Cynthia

    2005-04-01

    Medical nutrition therapy is the only accepted treatment for celiac disease. This paper summarizes a review of scientific studies using the gluten-free diet, nutritional risk factors, controversial elements of the diet, and its implementation in treating celiac disease. Treatment for celiac disease requires elimination of the storage proteins found in wheat, rye, and barley. The inclusion of oats and wheat starch is controversial. Research supports that oats may be acceptable for patients with celiac disease and can improve the nutritional quality of the diet. However, use of oats is not widely recommended in the United States because of concerns of potential contamination of commercial oats. Studies assessing the contamination of commercial oats are limited. Research indicates no differences in patients choosing a strict wheat starch-containing, gluten-free diet vs. a naturally gluten-free diet. Factors other than trace gluten may be the cause of continued villous atrophy in some patients. The impact of nutrient malabsorption caused from untreated celiac disease is well documented. The diet and gluten-free products are often low in B vitamins, calcium, vitamin D, iron, zinc, magnesium, and fiber. Few gluten-free products are enriched or fortified, adding to the risk of nutrient deficiencies. Patients newly diagnosed or inadequately treated have low bone mineral density, imbalanced macronutrients, low fiber intake, and micronutrient deficiencies. Also troubling is the increased incidence of obesity seen in persons with celiac disease following a gluten-free diet. Because of the nutritional risks associated with celiac disease, a registered dietitian must be part of the health care team that monitors the patient's nutritional status and compliance on a regular basis. PMID:15825119

  14. Multisensor image fusion guidelines in remote sensing

    NASA Astrophysics Data System (ADS)

    Pohl, C.

    2016-04-01

    Remote sensing delivers multimodal and -temporal data from the Earth's surface. In order to cope with these multidimensional data sources and to make the most of them, image fusion is a valuable tool. It has developed over the past few decades into a usable image processing technique for extracting information of higher quality and reliability. As more sensors and advanced image fusion techniques have become available, researchers have conducted a vast amount of successful studies using image fusion. However, the definition of an appropriate workflow prior to processing the imagery requires knowledge in all related fields - i.e. remote sensing, image fusion and the desired image exploitation processing. From the findings of this research it can be seen that the choice of the appropriate technique, as well as the fine-tuning of the individual parameters of this technique, is crucial. There is still a lack of strategic guidelines due to the complexity and variability of data selection, processing techniques and applications. This paper gives an overview on the state-of-the-art in remote sensing image fusion including sensors and applications. Putting research results in image fusion from the past 15 years into a context provides a new view on the subject and helps other researchers to build their innovation on these findings. Recommendations of experts help to understand further needs to achieve feasible strategies in remote sensing image fusion.

  15. Osteoporosis guideline implementation in family medicine using electronic medical records

    PubMed Central

    Pritchard, Janet; Karampatos, Sarah; Ioannidis, George; Adachi, Jonathan; Thabane, Lehana; Nash, Lynn; Mehan, Upe; Kozak, Joseph; Feldman, Sid; Hirsch, Steve; Jovaisas, Algis V.; Cheung, Angela; Lohfeld, Lynne; Papaioannou, Alexandra

    2016-01-01

    Abstract Objective To identify family physicians’ learning needs related to osteoporosis care; determine family physicians’ preferred modes of learning; and identify barriers to using electronic medical records (EMRs) to implement osteoporosis guidelines in practice. Design Web-based survey. Setting Ontario. Participants Family physicians. Main outcome measures Quantitative and qualitative data about learning needs related to osteoporosis diagnosis and management; preferred mode of learning about guidelines; and barriers to using EMRs to implement guidelines. Results Of the 12 332 family physicians invited to participate in the survey, 8.5% and 7.0% provided partial or fully completed surveys, respectively. More than 80% of respondents agreed that the priority areas for education were as follows: selecting laboratory tests for secondary osteoporosis and interpreting the test results; interpreting bone mineral density results; determining appropriate circumstances for ordering anterior-posterior lumbar spine x-ray scans; and understanding duration, types, and adverse effects of pharmacotherapy. Qualitative analysis revealed that managing moderate-risk patients was a learning need. Continuing medical education was the preferred mode of learning. Approximately 80% of respondents agreed that the scarcity of EMR tools to aid in guideline implementation was a barrier to using guidelines, and 50% of respondents agreed that if EMR-embedded tools were available, time would limit their ability to use them. Conclusion This survey identified key diagnostic- and treatment-related topics in osteoporosis care that should be the focus of future continuing professional development for family physicians. Developers of EMR tools, physicians, and researchers aiming to implement guidelines to improve osteoporosis care should consider the potential barriers indicated in this study.

  16. Designing, Developing, and Implementing Diversity Training: Guidelines for Practitioners.

    ERIC Educational Resources Information Center

    Kincaid, Tanna M.; Horner, Erin R.

    1997-01-01

    Discusses diversity in the workplace and offers guidelines for practitioners in designing, developing, and implementing diversity training. Highlights include linking the diversity initiative to the organization's mission, cultural climate assessments, reviewing policies and procedures, needs assessment, learner analysis, establishing objectives,…

  17. How to Implement the NCAA Financial Audit Guidelines.

    ERIC Educational Resources Information Center

    Connolly, Lawrence C., Jr.; And Others

    1987-01-01

    Suggestions for implementing new National Collegiate Athletic Association guidelines for intercollegiate athletics program financial audits include forming an internal task force, preparing an organization chart, choosing the type of audit, conducting a survey of booster groups, preparing a schedule of revenues and expenditures, selecting an…

  18. Cardiac advanced life support-surgical guideline: overview and implementation.

    PubMed

    Herrmann, Cheryl

    2014-01-01

    Cardiac arrest in the immediate postoperative recovery period in a patient who underwent cardiac surgery is typically related to reversible causes-tamponade, bleeding, ventricular arrhythmias, or heart blocks associated with conduction problems. When treated promptly, 17% to 79% of patients who experience cardiac arrest after cardiac surgery survive to discharge. The Cardiac Advanced Life Support-Surgical (CALS-S) guideline provides a standardized algorithm approach to resuscitation of patients who experience cardiac arrest after cardiac surgery. The purpose of this article is to discuss the CALS-S guideline and how to implement it. PMID:24752025

  19. Imaging Guidelines for Enhancing Justifications for Radiologic Studies

    PubMed Central

    2016-01-01

    Justification in the field of radiology refers to the appropriate use of radiologic imaging modalities, and may be achieved by establishing clinical imaging guidelines (CIGs). Recently, CIGs have been shown to be useful in selecting the proper medical imaging modality, resulting in the reduction of inappropriate radiologic examinations, thereby enhancing justifications. However, the development of CIGs is both time-consuming and difficult as the methodology of evidence-based medicine should be adhered to. Thus, although the radiologic societies in developed countries such as the United Kingdom and USA are already developing and implementing CIGs in their clinical practices, CIGs are not yet readily available in many other countries owing to differences in medical circumstances and resources. In this review, we assess the role and limitations of CIGs by examining the current status of CIGs in developed countries, and also describe the specific efforts made to establish CIGs in Korea. PMID:26908986

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

    PubMed

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

    2015-01-01

    The need to use clinical practice guidelines (CPG) arises from the health conditions and problems that public health institutions in the country face. CPG are informative documents that help improve the quality of care processes and patient safety; having among its objectives, to reduce the variability of medical practice. The Instituto Mexicano del Seguro Social designed a strategic plan for the dissemination, implementation, monitoring and control of CPG to establish an applicable model in the medical units in the three levels of care at the Instituto. This paper summarizes some of the strategies of the plan that were made with the knowledge and experience of clinicians and managers, with which they intend to promote the adoption of the key recommendations of the guidelines, to promote a sense of belonging for health personnel, and to encourage changes in organizational culture. PMID:26506498

  1. Implementation of Clinical Guidelines via a Computer Charting System

    PubMed Central

    Schriger, David L.; Baraff, Larry J.; Buller, Kelly; Shendrikar, Manali Ayatchit; Nagda, Sameer; Lin, Edward J.; Mikulich, Vladislav J.; Cretin, Shan

    2000-01-01

    Objective: The authors have shown that clinical guidelines embedded in an electronic medical record improved the quality, while lowering the cost, of care for health care workers who incurred occupational exposures to body fluid. They seek to determine whether this system has similar effects on the emergency department care of young children with febrile illness. Design: Off-on-off, interrupted time series with intent-to-treat analysis. Setting: University hospital emergency department. Subjects: 830 febrile children less than 3 years of age and the physicians who treated them. Interventions: Implementation of an electronic medical record that provides real-time advice regarding the content of the history and physical examination and recommendations regarding laboratory testing, treatment, diagnosis, and disposition. Measurements: Documentation of essential items in the medical record and after-care instructions; compliance with guidelines regarding testing, treatment, and diagnosis; charges. Results: The computer was used in 64 percent of eligible cases. Mean percentage documentation of 21 essential history and physical examination items increased from 80 percent during the baseline period to 92 percent in the intervention phase (13 percent increase; 95 percent CI, 10-15 percent). Mean percentage documentation of ten items in the after-care instructions increased from 48 percent at baseline to 81 percent during the intervention phase (33 percent increase; 95 percent confidence interval, 28-38 percent). All documentation decreased to baseline when the computer system was removed. There were no demonstrable improvements in appropriateness of care, nor was there evidence that appropriateness worsened. Mean charges were not changed by the intervention. Conclusion: The intervention markedly improved documentation, had little effect on the appropriateness of the process of care, and had no effect on charges. Results for the febrile child module differ from those for the

  2. Identifying Students with Learning Disabilities: The Effect of Implementing Statewide Guidelines.

    ERIC Educational Resources Information Center

    McLeskey, James; Waldron, Nancy L.

    1991-01-01

    Characteristics of 718 students labeled as learning disabled before implementation of Indiana's statewide guidelines were compared with characteristics of 790 students identified after guideline implementation. After implementation, students identified had more severe academic problems and severe ability/achievement discrepancy, though one-third…

  3. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  4. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  5. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  6. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

  7. 48 CFR 47.403 - Guidelines for implementation of the Fly America Act.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... implementation of the Fly America Act. 47.403 Section 47.403 Federal Acquisition Regulations System FEDERAL... Guidelines for implementation of the Fly America Act. This section 47.403 is based on the Guidelines for Implementation of the Fly America Act (case number B-138942), issued by the Comptroller General of the...

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

    ERIC Educational Resources Information Center

    Everson, Michelle; Zieffler, Andrew; Garfield, Joan

    2008-01-01

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

  9. Guideline classification to assist modeling, authoring, implementation and retrieval.

    PubMed Central

    Bernstam, E.; Ash, N.; Peleg, M.; Tu, S.; Boxwala, A. A.; Mork, P.; Shortliffe, E. H.; Greenes, R. A.

    2000-01-01

    The National Guideline Clearinghouse (NGC) and its guideline classification system are significant contributions to the study of clinical practice guidelines (CPGs) and their incorporation into routine clinical care. The NGC classification system is primarily designed to support guideline retrieval. We believe that a guideline classification system should also support identification of features that relate to incorporation of executable CPGs into computer-based applications for sharing and delivering guideline-based advice. We have developed a proposed expansion of the NGC guideline classification for this purpose. The axes of the proposed scheme have implications for designing formal models and structures for representing and authoring CPGs. This scheme also has implications for future research. PMID:11079846

  10. How can we improve guideline use? A conceptual framework of implementability

    PubMed Central

    2011-01-01

    Background Guidelines continue to be underutilized, and a variety of strategies to improve their use have been suboptimal. Modifying guideline features represents an alternative, but untested way to promote their use. The purpose of this study was to identify and define features that facilitate guideline use, and examine whether and how they are included in current guidelines. Methods A guideline implementability framework was developed by reviewing the implementation science literature. We then examined whether guidelines included these, or additional implementability elements. Data were extracted from publicly available high quality guidelines reflecting primary and institutional care, reviewed independently by two individuals, who through discussion resolved conflicts, then by the research team. Results The final implementability framework included 22 elements organized in the domains of adaptability, usability, validity, applicability, communicability, accommodation, implementation, and evaluation. Data were extracted from 20 guidelines on the management of diabetes, hypertension, leg ulcer, and heart failure. Most contained a large volume of graded, narrative evidence, and tables featuring complementary clinical information. Few contained additional features that could improve guideline use. These included alternate versions for different users and purposes, summaries of evidence and recommendations, information to facilitate interaction with and involvement of patients, details of resource implications, and instructions on how to locally promote and monitor guideline use. There were no consistent trends by guideline topic. Conclusions Numerous opportunities were identified by which guidelines could be modified to support various types of decision making by different users. New governance structures may be required to accommodate development of guidelines with these features. Further research is needed to validate the proposed framework of guideline

  11. CANCER GUIDELINES IMPLEMENTATION: SETTING PRIORITIES FOR FUTURE ASSESSMENTS OF CHEMICALS/AGENTS (DRAFT)

    EPA Science Inventory

    The Agency is committed to implement its revised Guidelines for Carcinogen Risk Assessment (Guidelines) through future reassessment and new assessment activities (subsequently referred to as assessments) once the Guidelines are issued as final. Each of these activi...

  12. ASPRS Digital Imagery Guideline Image Gallery Discussion

    NASA Technical Reports Server (NTRS)

    Ryan, Robert

    2002-01-01

    The objectives of the image gallery are to 1) give users and providers a simple means of identifying appropriate imagery for a given application/feature extraction; and 2) define imagery sufficiently to be described in engineering and acquisition terms. This viewgraph presentation includes a discussion of edge response and aliasing for image processing, and a series of images illustrating the effects of signal to noise ratio (SNR) on images. Another series of images illustrates how images are affected by varying the ground sample distances (GSD).

  13. Translation of hypertension treatment guidelines into practice: a review of implementation.

    PubMed

    Handler, Joel; Lackland, Daniel T

    2011-01-01

    Compared with the history of national guideline development, the science attached to implementation of guidelines is relatively new. Effectiveness of a highly evidence-based guideline, such as the 8th Joint National Committee recommendations on the treatment of high blood pressure, depends on successful translation into clinical practice. Implementation relies on several steps: clear and executable guideline language, audit and feedback attached to education of practitioners charged with carrying out the guidelines, team-based care delivery, credibility of blood pressure measurement, and measures to address therapeutic inertia and medication adherence. An evolving role of the electronic health record and patient empowerment are developments that will further promote implementation of the hypertension guideline. Further research will be needed to assess the efficacy and cost effectiveness of various implementation tools and strategies. PMID:21640688

  14. Developing and implementing health and sustainability guidelines for institutional food service.

    PubMed

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

    2012-05-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

  15. Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

    PubMed Central

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian

    2012-01-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

  16. Continuing Education, Guideline Implementation, and the Emerging Transdisciplinary Field of Knowledge Translation

    ERIC Educational Resources Information Center

    Davis, Dave

    2006-01-01

    This article discusses continuing education and the implementation of clinical practice guidelines or best evidence, quality improvement, and patient safety. Continuing education focuses on the perspective of the adult learner and is guided by well-established educational principles. In contrast, guideline implementation and related concepts…

  17. The philosophy of clinical practice guidelines: purposes, problems, practicality and implementation.

    PubMed

    Hutchinson, A

    1998-03-01

    There are a number of technical and professional challenges to the use of clinical practice guidelines in the United Kingdom. Until recently, many guidelines have been consensus-based rather than being explicitly linked to evidence of effectiveness and have also been of variable quality. Moreover, clarity of purpose has been lacking with some guidelines being developed as a means of limiting access to secondary care rather than as a means of assisting clinical decision-making. Implementation of new research into practice and of clinical practice guideline recommendations shares many of the same barriers to changing clinician behaviour. Without local support systems to assist with implementation, including clinical audit programmes and methods of feeding back information on current practice, it is unlikely that guidelines will change practice in the majority of clinicians. Progress on the implementation of guidelines in the British National Health Service is discussed. PMID:9563563

  18. Clinical imaging guidelines part 1: a proposal for uniform methodology.

    PubMed

    Remedios, Denis; Brink, James; Holmberg, Ola; Kawooya, Michael; Mendelson, Richard; Naidoo, Anusha; Reed, Martin; Bettmann, Michael

    2015-01-01

    Inappropriate imaging can lead to unnecessary medical radiologic exposures and cost and may not answer the clinical question. Imaging referral guidelines inform the justification of radiologic procedures and facilitate the choice of the best test first, but their acceptance by referrers, use, and value may be limited by shortcomings in the methodology of development. Focusing on common, essential elements of methodology will help guideline developers. In 2012 and 2013, the International Atomic Energy Agency hosted Technical Meetings on Radiation Protection of Patients Through the Development of Appropriateness Criteria in Diagnostic Imaging. Participants identified and agreed on issues concerning development of imaging referral guidelines. Items based on the Appraisal of Guidelines for Research and Evaluation II instrument were amended with additional items including development and consensus group composition. Consensus was sought on 28 items, 18 of which were agreed should be uniform, and 10 should allow for regional differences. Further work is required to encourage, provide, and identify higher quality evidence and to agree on a grading system for recommendations. Many key areas are common to guideline developers globally, opening the way for international collaboration to help demystify, simplify, and justify. PMID:25441484

  19. Guidelines for the Scholarly Use of Images.

    PubMed

    Lewis, Petra J

    2016-06-01

    As academic radiologists, we use a variety of images in our educational "products" regularly-whether they are lectures, websites, papers, digital media, or other resources. As the ability to download images from the Internet has proliferated, the need for us to have a basic understanding of copyright laws and how they might be applied to our products has increased. This article aims to provide answers to the most common questions. Please note that this article is for informational purposes and should not be considered legal advice. PMID:27017135

  20. Educating APNs for Implementing the Guidelines for Adolescents in "Bright Futures: Guidelines of Health Supervision of Infants, Children, and Adolescents."

    ERIC Educational Resources Information Center

    Porter, Cornelia P.; Pender, Nola J.; Hayman, Laura L.; Armstrong, Myrna L.; Riesch, Susan K.; Lewis, Mary Ann

    1997-01-01

    Discusses recommendations for preparing advanced practice nurses (APNs) to implement guidelines of a health curriculum: (1) ensuring age-appropriate teaching; (2) emphasizing the complex relationships of race/ethnicity, socioeconomic status, and gender; (3) reinforcing the self-care and resilience of adolescents; and (4) examining transitions…

  1. Operational Earthquake Forecasting: Proposed Guidelines for Implementation (Invited)

    NASA Astrophysics Data System (ADS)

    Jordan, T. H.

    2010-12-01

    The goal of operational earthquake forecasting (OEF) is to provide the public with authoritative information about how seismic hazards are changing with time. During periods of high seismic activity, short-term earthquake forecasts based on empirical statistical models can attain nominal probability gains in excess of 100 relative to the long-term forecasts used in probabilistic seismic hazard analysis (PSHA). Prospective experiments are underway by the Collaboratory for the Study of Earthquake Predictability (CSEP) to evaluate the reliability and skill of these seismicity-based forecasts in a variety of tectonic environments. How such information should be used for civil protection is by no means clear, because even with hundredfold increases, the probabilities of large earthquakes typically remain small, rarely exceeding a few percent over forecasting intervals of days or weeks. Civil protection agencies have been understandably cautious in implementing formal procedures for OEF in this sort of “low-probability environment.” Nevertheless, the need to move more quickly towards OEF has been underscored by recent experiences, such as the 2009 L’Aquila earthquake sequence and other seismic crises in which an anxious public has been confused by informal, inconsistent earthquake forecasts. Whether scientists like it or not, rising public expectations for real-time information, accelerated by the use of social media, will require civil protection agencies to develop sources of authoritative information about the short-term earthquake probabilities. In this presentation, I will discuss guidelines for the implementation of OEF informed by my experience on the California Earthquake Prediction Evaluation Council, convened by CalEMA, and the International Commission on Earthquake Forecasting, convened by the Italian government following the L’Aquila disaster. (a) Public sources of information on short-term probabilities should be authoritative, scientific, open, and

  2. Implementing Thrombosis Guidelines in Cancer Patients: A Review

    PubMed Central

    Farge-Bancel, Dominique; Bounameaux, Henri; Brenner, Benjamin; Büller, Harry R.; Kakkar, Ajay; Pabinger, Ingrid; Streiff, Michael; Debourdeau, Philippe

    2014-01-01

    Venous thromboembolism is a frequent and serious complication in patients with cancer. It is an independent prognostic factor of death in cancer patients and the second leading cause of death, but physicians often underestimate its importance, as well as the need for adequate prevention and treatment. Management of venous thromboembolism in patients with cancer requires the coordinated efforts of a wide range of clinicians, highlighting the importance of a multidisciplinary approach. However, a lack of consensus among various national and international clinical practice guidelines has contributed to knowledge and practice gaps among practitioners, and inconsistent approaches to venous thromboembolism. The 2013 international guidelines for thrombosis in cancer have sought to address these gaps by critically re-evaluating the evidence coming from clinical trials and synthesizing a number of guidelines documents. An individualized approach to prophylaxis is recommended for all patients. PMID:25386357

  3. Clinical imaging guidelines part 2: Risks, benefits, barriers, and solutions.

    PubMed

    Malone, James; del Rosario-Perez, Maria; Van Bladel, Lodewijk; Jung, Seung Eun; Holmberg, Ola; Bettmann, Michael A

    2015-02-01

    A recent international meeting was convened by two United Nations bodies to focus on international collaboration on clinical appropriateness/referral guidelines for use in medical imaging. This paper, the second of 4 from this technical meeting, addresses barriers to the successful development/deployment of clinical imaging guidelines and means of overcoming them. It reflects the discussions of the attendees, and the issues identified are treated under 7 headings: ■ Practical Strategy for Development and Deployment of Guidelines; ■ Governance Arrangements and Concerns with Deployment of Guidelines; ■ Finance, Sustainability, Reimbursement, and Related Issues; ■ Identifying Benefits and Radiation Risks from Radiological Examinations; ■ Information Given to Patients and the Public, and Consent Issues; ■ Special Concerns Related to Pregnancy; and ■ The Research Agenda. Examples of topics identified include the observation that guideline development is a global task and there is no case for continuing it as the project of the few professional organizations that have been brave enough to make the long-term commitment required. Advocacy for guidelines should include the expectations that they will facilitate: (1) better health care delivery; (2) lower cost of that delivery; with (3) reduced radiation dose and associated health risks. Radiation protection issues should not be isolated; rather, they should be integrated with the overall health care picture. The type of dose/radiation risk information to be provided with guidelines should include the uncertainty involved and advice on application of the precautionary principle with patients. This principle may be taken as an extension of the well-established medical principle of "first do no harm." PMID:25652302

  4. Guidelines for Implementing a Real Estate Cooperative Education Program.

    ERIC Educational Resources Information Center

    Pearson, Thomas R.

    Background information and guidelines are provided for the development of cooperative education programs for real estate industry personnel. The first section outlines the operation of cooperative education programs and presents two organizational plans: the alternating plan, where students attend class full-time and work full-time during…

  5. Consumer Education in the Secondary Curriculum: Guidelines for Implementation.

    ERIC Educational Resources Information Center

    Pennsylvania State Dept. of Education, Harrisburg. Bureau of General and Academic Education.

    Guidelines are suggested here for integrating consumer subject matter into existing secondary curricula, developing a team approach, or developing a systems approach that involves the entire school and community rather than offering a separate consumer education course. Any or all of the above suggestions might be utilized within a school…

  6. Association for Counselor Education and Supervision Guidelines for Research Mentorship: Development and Implementation

    ERIC Educational Resources Information Center

    Borders, L. DiAnne; Wester, Kelly L.; Granello, Darcy Haag; Chang, Catherine Y.; Hays, Danica G.; Pepperell, Jennifer; Spurgeon, Shawn L.

    2012-01-01

    The authors describe guidelines endorsed by the Association for Counselor Education and Supervision for research mentorship, including characteristics of mentors and mentees. Suggestions for implementing the guidelines at the individual, program, institution, and professional levels are focused on enhancing mentoring relationships as well as…

  7. Implementing clinical guidelines for chronic obstructive pulmonary disease: barriers and solutions

    PubMed Central

    Overington, Jeff D.; Huang, Yao C.; Abramson, Michael J.; Brown, Juliet L.; Goddard, John R.; Bowman, Rayleen V.; Fong, Kwun M.

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a complex chronic lung disease characterised by progressive fixed airflow limitation and acute exacerbations that frequently require hospitalisation. Evidence-based clinical guidelines for the diagnosis and management of COPD are now widely available. However, the uptake of these COPD guidelines in clinical practice is highly variable, as is the case for many other chronic disease guidelines. Studies have identified many barriers to implementation of COPD and other guidelines, including factors such as lack of familiarity with guidelines amongst clinicians and inadequate implementation programs. Several methods for enhancing adherence to clinical practice guidelines have been evaluated, including distribution methods, professional education sessions, electronic health records (EHR), point of care reminders and computer decision support systems (CDSS). Results of these studies are mixed to date, and the most effective ways to implement clinical practice guidelines remain unclear. Given the significant resources dedicated to evidence-based medicine, effective dissemination and implementation of best practice at the patient level is an important final step in the process of guideline development. Future efforts should focus on identifying optimal methods for translating the evidence into everyday clinical practice to ensure that patients receive the best care. PMID:25478199

  8. 49 CFR Appendix C to Part 224 - Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports C Appendix C to Part 224 Transportation Other Regulations... REFLECTORIZATION OF RAIL FREIGHT ROLLING STOCK Pt. 224, App. C Appendix C to Part 224—Guidelines for...

  9. 49 CFR Appendix C to Part 224 - Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports C Appendix C to Part 224 Transportation Other Regulations... REFLECTORIZATION OF RAIL FREIGHT ROLLING STOCK Pt. 224, App. C Appendix C to Part 224—Guidelines for...

  10. 49 CFR Appendix C to Part 224 - Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Guidelines for Electronic Submission of Reflectorization Implementation Compliance Reports C Appendix C to Part 224 Transportation Other Regulations... REFLECTORIZATION OF RAIL FREIGHT ROLLING STOCK Pt. 224, App. C Appendix C to Part 224—Guidelines for...

  11. [Implementation of clinical practice guidelines: how can we close the evidence-practice gap?].

    PubMed

    Muche-Borowski, Cathleen; Nothacker, M; Kopp, I

    2015-01-01

    Guidelines are intended as instruments of knowledge transfer to support decision-making by physicians, other health professionals and patients in clinical practice and thereby contribute to quality improvements in healthcare. To date they are an indispensable tool for healthcare. Their benefit for patients can only be seen in application, i.e. the implementation of guideline recommendations. For successful implementation, implementability and practicability play a crucial role and these characteristics can be influenced and should be promoted by the guideline development group. In addition, a force field analysis to identify barriers against and facilitators for the implementation of specific guideline recommendations from the perspective of physicians and patients is recommended to guide the development of an individual implementation strategy and the selection of appropriate interventions. However, implementation cannot be achieved by the guideline development group alone and a universal implementation strategy does not exist. Therefore, a process using theory, analysis, experience and shared responsibility of stakeholders in healthcare is recommended, with the aim to achieve sustainable behavioral change and improve the quality of care by guideline-oriented behavior. PMID:25412582

  12. Classroom Aggression: Determinants, Controlling Mechanisms, and Guidelines for the Implementation of a Behavior Modification Program

    ERIC Educational Resources Information Center

    Adams, Gerald R.

    1973-01-01

    This paper concentrates on one principal disruptive behavior-aggression. Several of the basic determinants of aggression have been summarized and some methods of effective control are reviewed. Guidelines for the implementation of a behavior modification program are presented. (Author)

  13. BARRIERS TO IMPLEMENT THE NATIONAL GUIDELINES ON NEWBORN CARE IN A RURAL MOUNTAINOUS PROVINCE OF VIETNAM

    PubMed Central

    Thi, Le Minh; Ha, BuiThiThu; Hoa, Dinh Thi Phuong

    2016-01-01

    Reducing the disparity in neonatal health among regions to ensure every mother and her newborn receive the health care they need is a priority in Vietnam. This study was conducted to assess the barriers in implementing the National guidelines on newborn care in a rural mountainous province of Vietnam. Qualitative methods were applied with 28 in-depth interviews and 4 focus group discussions in DakNong province. The results showed that there exist many barriers in implementing the national guideline in newborn care services. There is a big gap between health policy development and policy implementation. The Vietnam government had approved a good strategy and guidelines. Efforts now need to focus on implementing the national guideline and improving quality of care.

  14. A systematic approach to implementing and evaluating clinical guidelines: The results of fifteen years of Preventive Child Health Care guidelines in the Netherlands.

    PubMed

    Fleuren, Margot A H; van Dommelen, Paula; Dunnink, Trudy

    2015-07-01

    Preventive Child Health Care (PCHC) services are delivered to all children in the Netherlands by approximately 5500 doctors, nurses and doctor's assistants. In 1996, The Dutch Ministry of Health, Welfare and Sports asked for the development of evidence-based PCHC guidelines. Since 1998, twenty-five guidelines have been published. Levels of implementation affect outcomes and so implementation and evaluation of the actual use of guidelines are essential. At the outset, there was a national implementation plan with six main activities: a) determinant analysis before the implementation of a guideline, b) innovation strategies tailored to the determinants, c) dissemination to all professionals, d) ongoing evaluation of the awareness and use of the guidelines, e) trained implementation coordinator(s) in each PCHC organization and f) a national help desk. The awareness and use of the guidelines in random samples of doctors, nurses and doctor's assistants were surveyed using questionnaires. The respondents stated (on a 7-point scale) the proportion of all children they had exposed to given core elements in a guideline. The aim is for at least 90% of the professionals to be aware of the guideline and for 80% to perform the core elements for all (or nearly all) children. The six main activities, with the exception of ongoing evaluation, were gradually put into place, albeit only gradually, between 1998 and 2015 for all guidelines. In 2012, the use of individual core elements in all guidelines, dating from before 2012, varied from 28% to 100%. One guideline met both criteria of 90% awareness and 80% use, and three guidelines nearly met these criteria. Looking back on fifteen years of PCHC guidelines, we may conclude that the guidelines produced recently are implemented in accordance with the national implementation plan. Unfortunately, the evaluation of guideline use continues to be a difficulty. PMID:25982867

  15. The relationship between organizational culture and implementation of clinical practice guidelines: a narrative review.

    PubMed

    Dodek, Peter; Cahill, Naomi E; Heyland, Daren K

    2010-01-01

    The context in which critical care providers work has been shown to be associated with adherence to recommendations of clinical practice guidelines (CPGs). Consideration of contextual factors such as organizational culture may therefore be important when implementing guidelines. Organizational culture has been defined simply as "how things are around here" and encompasses leadership, communication, teamwork, conflict resolution, and other domains. This narrative review highlights the results of recent quantitative and qualitative studies, including studies on adherence to nutrition guidelines in the critical care setting, which demonstrate that elements of organizational culture, such as leadership support, interprofessional collaboration, and shared beliefs about the utility of guidelines, influence adherence to guideline recommendations. Outside nutrition therapy, there is emerging evidence that strategies focusing on organizational change (eg, revision of professional roles, interdisciplinary teams, integrated care delivery, computer systems, and continuous quality improvement) can favorably influence professional performance and patient outcomes. Consequently, future interventions aimed at implementing nutrition guidelines should aim to measure and take into account organizational culture, in addition to considering the characteristics of the patient, provider, and guideline. Further high quality, multimethod studies are required to improve our understanding of how culture influences guideline implementation, and which organizational change strategies might be most effective in optimizing nutrition therapy. PMID:21097767

  16. Incorporation of pharmacogenomics into routine clinical practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline development process.

    PubMed

    Caudle, Kelly E; Klein, Teri E; Hoffman, James M; Muller, Daniel J; Whirl-Carrillo, Michelle; Gong, Li; McDonagh, Ellen M; Sangkuhl, Katrin; Thorn, Caroline F; Schwab, Matthias; Agundez, Jose A G; Freimuth, Robert R; Huser, Vojtech; Lee, Ming Ta Michael; Iwuchukwu, Otito F; Crews, Kristine R; Scott, Stuart A; Wadelius, Mia; Swen, Jesse J; Tyndale, Rachel F; Stein, C Michael; Roden, Dan; Relling, Mary V; Williams, Marc S; Johnson, Samuel G

    2014-02-01

    The Clinical Pharmacogenetics Implementation Consortium (CPIC) publishes genotype-based drug guidelines to help clinicians understand how available genetic test results could be used to optimize drug therapy. CPIC has focused initially on well-known examples of pharmacogenomic associations that have been implemented in selected clinical settings, publishing nine to date. Each CPIC guideline adheres to a standardized format and includes a standard system for grading levels of evidence linking genotypes to phenotypes and assigning a level of strength to each prescribing recommendation. CPIC guidelines contain the necessary information to help clinicians translate patient-specific diplotypes for each gene into clinical phenotypes or drug dosing groups. This paper reviews the development process of the CPIC guidelines and compares this process to the Institute of Medicine's Standards for Developing Trustworthy Clinical Practice Guidelines. PMID:24479687

  17. Incorporation of Pharmacogenomics into Routine Clinical Practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline Development Process

    PubMed Central

    Caudle, Kelly E.; Klein, Teri E.; Hoffman, James M.; Müller, Daniel J.; Whirl-Carrillo, Michelle; Gong, Li; McDonagh, Ellen M.; Sangkuhl, Katrin; Thorn, Caroline F.; Schwab, Matthias; Agúndez, José A.G.; Freimuth, Robert R.; Huser, Vojtech; Lee, Ming Ta Michael; Iwuchukwu, Otito F.; Crews, Kristine R.; Scott, Stuart A.; Wadelius, Mia; Swen, Jesse J.; Tyndale, Rachel F.; Stein, C. Michael; Roden, Dan; Relling, Mary V.; Williams, Marc S.; Johnson, Samuel G.

    2014-01-01

    The Clinical Pharmacogenetics Implementation Consortium (CPIC) publishes genotype-based drug guidelines to help clinicians understand how available genetic test results could be used to optimize drug therapy. CPIC has focused initially on well-known examples of pharmacogenomic associations that have been implemented in selected clinical settings, publishing nine to date. Each CPIC guideline adheres to a standardized format and includes a standard system for grading levels of evidence linking genotypes to phenotypes and assigning a level of strength to each prescribing recommendation. CPIC guidelines contain the necessary information to help clinicians translate patient-specific diplotypes for each gene into clinical phenotypes or drug dosing groups. This paper reviews the development process of the CPIC guidelines and compares this process to the Institute of Medicine’s Standards for Developing Trustworthy Clinical Practice Guidelines. PMID:24479687

  18. Implementation of Spanish adaptation of the European guidelines on cardiovascular disease prevention in primary care

    PubMed Central

    2013-01-01

    Background The successful implementation of cardiovascular disease (CVD) prevention guidelines relies heavily on primary care physicians (PCPs) providing risk factor evaluation, intervention and patient education. The aim of this study was to ascertain the degree of awareness and implementation of the Spanish adaptation of the European guidelines on CVD prevention in clinical practice (CEIPC guidelines) among PCPs. Methods A cross-sectional survey of PCPs was conducted in Spain between January and June 2011. A random sample of 1,390 PCPs was obtained and stratified by region. Data were collected by means of a self-administered questionnaire. Results More than half (58%) the physicians were aware of and knew the recommendations, and 62% of those claimed to use them in clinical practice, with general physicians (without any specialist accreditation) being less likely to so than family doctors. Most PCPs (60%) did not assess cardiovascular risk, with the limited time available in the surgery being cited as the greatest barrier by 81%. The main reason to be sceptical about recommendations, reported by 71% of physicians, was that there are too many guidelines. Almost half the doctors cited the lack of training and skills as the greatest barrier to the implementation of lifestyle and behavioural change recommendations. Conclusions Most PCPs were aware of the Spanish adaptation of the European guidelines on CVD prevention (CEIPC guidelines) and knew their content. However, only one third of PCPs used the guidelines in clinical practice and less than half CVD risk assessment tools. PMID:23506390

  19. Implementation of National Guidelines for Healthy School Meals: The Relationship between Process and Outcome

    ERIC Educational Resources Information Center

    Holthe, Asle; Larsen, Torill; Samdal, Oddrun

    2011-01-01

    The implementation of policy interventions at the school level is often considered an organizational change process. The main goal of the present study was to examine the degree of implementation of Norwegian national guidelines for healthy school meals and how organizational capacity at the school level contributed to the degree of…

  20. SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

    SciTech Connect

    James, J; Place, V; Panda, A; Edmonson, H; Felmlee, J; Pooley, R

    2014-06-01

    Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over

  1. Compressive sensing image sensors-hardware implementation.

    PubMed

    Dadkhah, Mohammadreza; Deen, M Jamal; Shirani, Shahram

    2013-01-01

    The compressive sensing (CS) paradigm uses simultaneous sensing and compression to provide an efficient image acquisition technique. The main advantages of the CS method include high resolution imaging using low resolution sensor arrays and faster image acquisition. Since the imaging philosophy in CS imagers is different from conventional imaging systems, new physical structures have been developed for cameras that use the CS technique. In this paper, a review of different hardware implementations of CS encoding in optical and electrical domains is presented. Considering the recent advances in CMOS (complementary metal-oxide-semiconductor) technologies and the feasibility of performing on-chip signal processing, important practical issues in the implementation of CS in CMOS sensors are emphasized. In addition, the CS coding for video capture is discussed. PMID:23584123

  2. Codifying Implementation Guidelines for a Collaborative Improvement Initiative

    ERIC Educational Resources Information Center

    Coughlan, Paul; Coghlan, David

    2008-01-01

    The application of action learning in inter-organizational settings is largely undeveloped. This article presents a description of and reflection on an action learning approach to enabling collaborative improvement in the extended manufacturing enterprise. The article focuses in particular on implementing the action learning approach. However, the…

  3. Hospital implementation of resuscitation guidelines and review of CPR training programmes: a nationwide study.

    PubMed

    Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

    2016-06-01

    This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life support (ALS) algorithm was 81%. Hospital BLS course duration was [median (interquartile range)] 2.3 (1.5-2.5) h, whereas ALS course duration was 4.0 (2.5-8.0) h. Implementation of ERC 2010 guidelines on BLS is limited in Danish hospitals 2 years after guideline publication, whereas the majority of hospitals adhere to the ALS algorithm. CPR training differs among hospitals. PMID:26181002

  4. Asthma Management in Educational Settings: Implementing Guideline-Based Care in Washington State Schools.

    PubMed

    Evans-Agnew, Robin A; Klein, Nicole; Lecce, Sally

    2015-11-01

    Managing asthma in the schools is complex and requires careful planning. This article highlights key steps in implementing guideline-based care for children with asthma in Washington State schools: assessing students, establishing acuity, communicating with parents, and training staff. Advance planning can improve outcomes for students, parents, and school staff in managing this complex and prevalent disease. NASN recently developed asthma management guidelines. Developing state-specific guidelines provides an opportunity to speak specifically to state laws and nurse practice acts while also reinforcing the importance of specialized practice to school nurses, school administrators and teachers, parents, and students. PMID:26515566

  5. Clinical Pharmacogenetics Implementation Consortium Guidelines for HLA-B Genotype and Abacavir Dosing: 2014 update.

    PubMed

    Martin, M A; Hoffman, J M; Freimuth, R R; Klein, T E; Dong, B J; Pirmohamed, M; Hicks, J K; Wilkinson, M R; Haas, D W; Kroetz, D L

    2014-05-01

    The Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for HLA-B Genotype and Abacavir Dosing were originally published in April 2012. We reviewed recent literature and concluded that none of the evidence would change the therapeutic recommendations in the original guideline; therefore, the original publication remains clinically current. However, we have updated the Supplementary Material online and included additional resources for applying CPIC guidelines to the electronic health record. Up-to-date information can be found at PharmGKB (http://www.pharmgkb.org). PMID:24561393

  6. DOE-EPRI On-Line Monitoring Implementation Guidelines

    SciTech Connect

    E. Davis, R. Bickford

    2003-01-02

    Industry and EPRI experience at several plants has shown on-line monitoring to be very effective in identifying out-of-calibration instrument channels or indications of equipment-degradation problems. The EPRI implementation project for on-line monitoring has demonstrated the feasability of on-line monitoring at several participating nuclear plants. The results have been very enouraging, and substantial progress is anticipated in the coming years.

  7. Do guidelines influence the implementation of health programs? — Uganda’s experience

    PubMed Central

    2012-01-01

    Background A guideline contains processes and procedures intended to guide health service delivery. However, the presence of guidelines may not guarantee their implementation, which may be a result of weaknesses in the development process. This study was undertaken to describe the processes of developing health planning, services management, and clinical guidelines within the health sector in Uganda, with the goal of understanding how these processes facilitate or abate the utility of guidelines. Methods Qualitative and quantitative research methods were used to collect and analyze data. Data collection was undertaken at the levels of the central Ministry of Health, the district, and service delivery. Qualitative methods included review of documents, observations, and key informant interviews, as well as quantitative aspects included counting guidelines. Quantitative data were analyzed with Microsoft Excel, and qualitative data were analyzed using deductive content thematic analysis. Results There were 137 guidelines in the health sector, with programs related to Millennium Development Goals having the highest number (n = 83). The impetus for guideline development was stated in 78% of cases. Several guidelines duplicated content, and some conflicted with each other. The level of consultation varied, and some guidelines did not consider government-wide policies and circumstances at the service delivery level. Booklets were the main format of presentation, which was not tailored to the service delivery level. There was no framework for systematic dissemination, and target users were defined broadly in most cases. Over 60% of guidelines available at the central level were not available at the service delivery level, but there were good examples in isolated cases. There was no framework for systematic monitoring of use, evaluation, and review of guidelines. Suboptimal performance of the supervision framework that would encourage the use of guidelines, assess their

  8. Clinical practice guidelines in end-stage renal disease: a strategy for implementation.

    PubMed

    Kliger, A S; Haley, W E

    1999-04-01

    Clinical practice guidelines (CPGs) for end-stage renal failure (ESRD) were recently published, and represent a comprehensive review of available literature and the considered judgment of experts in ESRD. To prioritize and implement these guidelines, the evidence underlying each guideline should be ranked and the attributes of each should be defined. Strategies to improve practice patterns should be tested. Focused information for each high priority guideline should be disseminated, including a synopsis and assessment of the underlying evidence, the evidence model used to develop that guideline, and suggested strategies for CPG implementation. Clinical performance measures should be developed and used to measure current practice, and the success of changing practice patterns on clinical outcomes. Individual practitioners and dialysis facilities should be encouraged to utilize continuous quality improvement techniques to put the guidelines into effect. Local implementation should proceed at the same time as a national project to convert high priority CPGs into clinical performance measures proceeds. Patients and patient care organizations should participate in this process, and professional organizations must make a strong commitment to educate clinicians in the methodology of CPG and performance measure development and the techniques of continuous quality improvement. Health care regulators should understand that CPGs are not standards, but are statements that assist practitioners and patients in making decisions. PMID:10203373

  9. Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals

    PubMed Central

    Koh, Serena SL; Manias, Elizabeth; Hutchinson, Alison M; Donath, Susan; Johnston, Linda

    2008-01-01

    Background Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses' opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore. Methods Nurses were surveyed to identify their perceptions regarding barriers to implementation of clinical practice guidelines in their practice setting. The validated questionnaire, 'Barriers and facilitators assessment instrument', was administered to nurses (n = 1830) working in the medical, surgical, geriatric units, at five acute care hospitals in Singapore. Results An 80.2% response rate was achieved. The greatest barriers to implementation of clinical practice guidelines reported included: knowledge and motivation, availability of support staff, access to facilities, health status of patients, and, education of staff and patients. Conclusion Numerous barriers to the use of the Fall Prevention Clinical Practice Guideline have been identified. This study has laid the foundation for further research into implementation of clinical practice guidelines in Singapore by identifying barriers to change in acute care settings. PMID:18485235

  10. Guidelines for the implementation of an open source information system

    SciTech Connect

    Doak, J.; Howell, J.A.

    1995-08-01

    This work was initially performed for the International Atomic Energy Agency (IAEA) to help with the Open Source Task of the 93 + 2 Initiative; however, the information should be of interest to anyone working with open sources. The authors cover all aspects of an open source information system (OSIS) including, for example, identifying relevant sources, understanding copyright issues, and making information available to analysts. They foresee this document as a reference point that implementors of a system could augment for their particular needs. The primary organization of this document focuses on specific aspects, or components, of an OSIS; they describe each component and often make specific recommendations for its implementation. This document also contains a section discussing the process of collecting open source data and a section containing miscellaneous information. The appendix contains a listing of various providers, producers, and databases that the authors have come across in their research.

  11. Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia

    PubMed Central

    Bataar, Otgon; Lundeg, Ganbold; Tsenddorj, Ganbat; Jochberger, Stefan; Grander, Wilhelm; Baelani, Inipavudu; Wilson, Iain; Baker, Tim

    2010-01-01

    Abstract Objective To assess if secondary and tertiary hospitals in Mongolia have the resources needed to implement the 2008 Surviving Sepsis Campaign (SSC) guidelines. Methods To obtain key informant responses, we conducted a nationwide survey by sending a 74-item questionnaire to head physicians of the intensive care unit or department for emergency and critically ill patients of 44 secondary and tertiary hospitals in Mongolia. The questionnaire inquired about the availability of the hospital facilities, equipment, drugs and disposable materials required to implement the SSC guidelines. Descriptive methods were used for statistical analysis. Comparisons between central and peripheral hospitals were performed using non-parametric tests. Findings The response rate was 86.4% (38/44). No Mongolian hospital had the resources required to consistently implement the SSC guidelines. The median percentage of implementable recommendations and suggestions combined was 52.8% (interquartile range, IQR: 45.8–67.4%); of implementable recommendations only, 68% (IQR: 58.0–80.5%) and of implementable suggestions only, 43.5% (IQR: 34.8–57.6%). These percentages did not differ between hospitals located in the capital city and those located in rural areas. Conclusion The results of this study strongly suggest that the most recent SSC guidelines cannot be implemented in Mongolia due to a dramatic shortage of the required hospital facilities, equipment, drugs and disposable materials. Further studies are needed on current awareness of the problem, development of national reporting systems and guidelines for sepsis care in Mongolia, as well as on the quality of diagnosis and treatment and of the training of health-care professionals. PMID:21076565

  12. Requirements for guidelines systems: implementation challenges and lessons from existing software-engineering efforts

    PubMed Central

    2012-01-01

    Background A large body of work in the clinical guidelines field has identified requirements for guideline systems, but there are formidable challenges in translating such requirements into production-quality systems that can be used in routine patient care. Detailed analysis of requirements from an implementation perspective can be useful in helping define sub-requirements to the point where they are implementable. Further, additional requirements emerge as a result of such analysis. During such an analysis, study of examples of existing, software-engineering efforts in non-biomedical fields can provide useful signposts to the implementer of a clinical guideline system. Methods In addition to requirements described by guideline-system authors, comparative reviews of such systems, and publications discussing information needs for guideline systems and clinical decision support systems in general, we have incorporated additional requirements related to production-system robustness and functionality from publications in the business workflow domain, in addition to drawing on our own experience in the development of the Proteus guideline system (http://proteme.org). Results The sub-requirements are discussed by conveniently grouping them into the categories used by the review of Isern and Moreno 2008. We cite previous work under each category and then provide sub-requirements under each category, and provide example of similar work in software-engineering efforts that have addressed a similar problem in a non-biomedical context. Conclusions When analyzing requirements from the implementation viewpoint, knowledge of successes and failures in related software-engineering efforts can guide implementers in the choice of effective design and development strategies. PMID:22405400

  13. The U.S. prevention of cardiovascular disease guidelines and implications for implementation in LMIC.

    PubMed

    Wong, Nathan D; Moran, Andrew E

    2014-12-01

    The 2013 guidelines for the Prevention of Cardiovascular Disease released by the American College of Cardiology and the American Heart Association included guidelines of assessment of cardiovascular disease (CVD) risk, lifestyle management, management of overweight and obesity, and treatment of blood cholesterol. In addition, there were also 2014 guidelines on hypertension management released by members appointed to the Eighth Joint National Committee. Taken together, these guidelines, though extensively discussed and disseminated in the United States, have not been widely recognized beyond the United States, nor have their implications been considered for lower- and middle-income developing countries. With an estimated 80% of the global burden in CVD occurring in developing countries, it is important to develop strategies to adequately detect those at increased CVD risk and to manage their risk through lifestyle and where appropriate, pharmacologic means. Though certain aspects of each guideline may be suitable for implementation globally, including in developing countries, other recommendations would be unrealistic for many countries based on local epidemiology and resources. CVD prevention priorities can be set using guidance from recently published CVD prevention guidelines if appropriately modified to the context of lower- and middle-income developing countries. Establishment of global CVD prevention standards and rapid adaptation and dissemination of clinical guidelines are of paramount importance if we are to make significant progress into achieving World Health Organization 2025 goals to reduce the burden from CVD and other noncommunicable diseases. PMID:25592799

  14. [Recommendations of the ESC guidelines regarding cardiovascular imaging].

    PubMed

    Sechtem, U; Greulich, S; Ong, P

    2016-08-01

    Cardiac imaging plays a key role in the diagnosis and risk stratification in the ESC guidelines for the management of patients with stable coronary artery disease. Demonstration of myocardial ischaemia guides the decision which further diagnostic and therapeutic strategy should be followed in these patients. One should, however, not forget that there are no randomised studies supporting this type of management. In patients with a low pretest probability coronary CT angiography is the optimal tool to exclude coronary artery stenoses rapidly and effectively. In the near future, however, better data is needed showing how much cardiac imaging is really necessary and how cost-effective it is in patients with stable coronary artery disease. PMID:27388914

  15. Implementing guidelines on reporting research using animals (ARRIVE etc.): new requirements for publication in BJP.

    PubMed

    McGrath, John C; Lilley, Elliot

    2015-07-01

    The ARRIVE guidelines have been implemented in BJP for 4 years with the aim of increasing transparency in reporting experiments involving animals. BJP has assessed our success in implementing them and concluded that we could do better. This editorial discusses the issues and explains how we are changing our requirements for authors to report their findings in experiments involving animals. This is one of a series of editorials discussing updates to the BJP Instructions to Authors. PMID:25964986

  16. Web-Based Social Work Courses: Guidelines for Developing and Implementing an Online Environment

    ERIC Educational Resources Information Center

    Dawson, Beverly Araujo; Fenster, Judy

    2015-01-01

    Although web-based courses in schools of social work have proliferated over the past decade, the literature contains few guidelines on steps that schools can take to develop such courses. Using Knowles's framework, which delineates tasks and themes involved in implementing e-learning in social work education, this article describes the cultivation…

  17. Identification of attributes that promote the adoption and implementation of 2005 Dietary Guidelines for Americans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    As part of a larger study, this research was to identify attributes of the Dietary Guidelines for Americans (DGAs) that would promote their adoption and implementation by participants in a nutrition intervention. Project procedures were guided by the Diffusion of Innovations (DOI) theory. To identif...

  18. Determinants of implementation of maternal health guidelines in Kosovo: mixed methods study

    PubMed Central

    2013-01-01

    Background One of the challenges to implementing clinical practice guidelines is the need to adapt guidelines to the local context and identify barriers to their uptake. Several models of framework are available to consider for use in guideline adaptation. Methods We completed a multiphase study to explore the implementation of maternal health guidelines in Kosovo, focusing on determinants of uptake and methods to contextualize for local use. The study involved a survey, individual interviews, focus groups, and a consensus meeting with relevant stakeholders, including clinicians (obstetricians, midwives), managers, researchers, and policy makers from the national Ministry of Health and the World Health Organization office in Pristina, Kosovo. Results Participants identified several important barriers to implementation. First, lack of communication between clinicians and ministry representatives was seen as leading to duplication of effort in creating or adapting guidelines, as well as substantial mistrust between clinicians and policy makers. Second, there was a lack of communication across clinical groups that provide obstetric care and a lack of integration across the entire healthcare system, including rural and urban centers. This fragmentation was thought to have directly resulted from the war in 1998 – 1999. Third, the conflict substantially and adversely affected the healthcare infrastructure in Kosovo, which has resulted in an inability to monitor quality of care across the country. Furthermore, the impact on infrastructure has affected the ability to access required medications consistently and to smoothly transfer patients from rural to urban centers. Another issue raised during this project was the appropriateness of including guideline recommendations perceived to be ‘aspirational’. Conclusions Implementing clinical practice guidelines in low- and middle-income countries (LMICs) requires consideration of several specific barriers. Particularly

  19. Implementation of WHO guidelines on management of severe malnutrition in hospitals in Africa.

    PubMed Central

    Deen, Jacqueline L.; Funk, Matthias; Guevara, Victor C.; Saloojee, Haroon; Doe, James Y.; Palmer, Ayo; Weber, Martin W.

    2003-01-01

    OBJECTIVE: To investigate the problems, benefits, feasibility, and sustainability of implementation of WHO guidelines on management of severe malnutrition. METHODS: A postal survey invited staff from 12 African hospitals to participate in the study. Five hospitals were evaluated and two were selected to take part in the study: a district hospital in South Africa and a mission hospital in Ghana. At an initial visit, an experienced paediatrician reviewed the situation in the hospitals and introduced the principles of the guidelines through a participatory approach. During a second visit about six months later, the paediatrician reviewed the feasibility and sustainability of the introduced changes and helped find solutions to problems. At a final visit after one year, the paediatrician reassessed the overall situation. FINDINGS: Malnutrition management practices improved at both hospitals. Measures against hypoglycaemia, hypothermia, and infection were strengthened. Early, frequent feeding was established as a routine practice. Some micronutrients for inclusion in the diet were not locally available and needed to be imported. Problems were encountered with monitoring of weight gain and introducing a rehydration solution for malnutrition. CONCLUSION: Implementation of the main principles of the WHO guidelines on severe malnutrition was feasible, affordable, and sustainable at two African hospitals. The guidelines could be improved by including suggestions on how to adapt specific recommendations to local situations. The guidelines are well supported by experience and published reports, but more information is needed about some components and their impact on mortality. PMID:12764489

  20. Interprofessional Implementation of a Pain/Sedation Guideline on a Trauma Intensive Care Unit.

    PubMed

    Sacco, Tara L; LaRiccia, Brenton

    2016-01-01

    Trauma patients experience pain and agitation during their hospitalization. Many complications have been noted both in the absence of symptom management and the in presence of oversedation/narcotization. To combat noted untoward effects of pain and sedation management, an interprofessional team convened to develop a pain and sedation guideline for use in a trauma intensive care unit. Guideline development began with a comprehensive review of the literature. With the input of unit stakeholders, a nurse-driven analgosedation guideline was implemented for a 6-month trial. During this time, unit champions were integral to successful trial execution. Outcome measurement included patient and unit outcomes, nursing satisfaction, and a pre- and postimplementation patient comparison. Following implementation, unit length of stay decreased by 4.16% and there was a 17.81% decrease in average time on the ventilator following the initiation of weaning. Patient reports of nurse sensitivity and responsiveness to pain increased from 93.7 to 94.9. Nurses reported satisfaction with the practice change and improvements in care. In comparing pre- and postimplementation patient data, there was a significant decrease in mean analgesic treatment duration and an increase in the use of antipsychotics for delirium management. Following the trial period, this guideline was permanently adopted across the adult critical care service. The development of a nurse-driven analgosedation guideline was noted to be both feasible and successful. PMID:27163223

  1. Implementation of the SSHAC Guidelines for Level 3 and 4 PSHAs - Experience Gained from Actual Applications

    USGS Publications Warehouse

    Hanks, Thomas C.; Abrahamson, Norm A.; Boore, David M.; Coppersmith, Kevin J.; Knepprath, Nichole E.

    2009-01-01

    In April 1997, after four years of deliberations, the Senior Seismic Hazard Analysis Committee released its report 'Recommendations for Probabilistic Seismic Hazard Analysis: Guidance on Uncertainty and Use of Experts' through the U.S. Nuclear Regulatory Commission as NUREG/CR-6372, hereafter SSHAC (1997). Known informally ever since as the 'SSHAC Guidelines', SSHAC (1997) addresses why and how multiple expert opinions - and the intrinsic uncertainties that attend them - should be used in Probabilistic Seismic Hazard Analyses (PSHA) for critical facilities such as commercial nuclear power plants. Ten years later, in September 2007, the U.S. Geological Survey (USGS) entered into a 13-month agreement with the U.S. Nuclear Regulatory Commission (NRC) titled 'Practical Procedures for Implementation of the SSHAC Guidelines and for Updating PSHAs'. The NRC was interested in understanding and documenting lessons learned from recent PSHAs conducted at the higher SSHAC Levels (3 and 4) and in gaining input from the seismic community for updating PSHAs as new information became available. This study increased in importance in anticipation of new applications for nuclear power facilities at both existing and new sites. The intent of this project was not to replace the SSHAC Guidelines but to supplement them with the experience gained from putting the SSHAC Guidelines to work in practical applications. During the course of this project, we also learned that updating PSHAs for existing nuclear power facilities involves very different issues from the implementation of the SSHAC Guidelines for new facilities. As such, we report our findings and recommendations from this study in two separate documents, this being the first. The SSHAC Guidelines were written without regard to whether the PSHAs to which they would be applied were site-specific or regional in scope. Most of the experience gained to date from high-level SSHAC studies has been for site-specific cases, although three

  2. Use of the ABC care bundle to standardize guideline implementation in a cardiac surgical population: a pilot study.

    PubMed

    Poe, Stephanie S; Dawson, Patricia B; Cafeo, Christina; Sedlander, Debra; Curtis, Carol; Meyer, Pamela; Blumenthal, Roger; Baumgartner, William; Allen, Jerilyn

    2007-01-01

    A cardiac surgical progressive care unit implemented the ABC's of Cardiovascular Risk Reduction Care Bundle to determine whether the use of a packaged approach to medication prescription and lifestyle counseling would improve adherence to secondary risk-reduction guidelines in postcoronary artery bypass graft patients. A pilot study was carried out to assess changes in adherence to guideline recommendations post-Care Bundle implementation. Findings support using a systematic strategy to improve guideline adherence in this population. PMID:17563594

  3. Policies and Procedures That Facilitate Implementation of Evidence-Based Clinical Guidelines in U.S. Dental Schools.

    PubMed

    Polk, Deborah E; Nolan, Beth A D; Shah, Nilesh H; Weyant, Robert J

    2016-01-01

    The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed. PMID:26729681

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

    PubMed Central

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

    2010-01-01

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

  5. User satisfaction and frustration with a handheld, pen-based guideline implementation system for asthma.

    PubMed Central

    Shiffman, R. N.; Liaw, Y.; Navedo, D. D.; Freudigman, K. A.

    1999-01-01

    OBJECTIVE: To evaluate clinicians' satisfaction and frustrations with the use of a handheld computer system that implements a guideline for management of childhood asthma exacerbations. SETTING: Nine primary-care pediatric practices. DESIGN: Survey component of a randomized, prospective before-after trial. INTERVENTION: Newton MessagePad outfitted with custom software (called "AsthMonitor") that assists in documentation of clinical findings and provides guideline-based recommendations. RESULTS: Overall, 3 users gave strongly positive global ratings while 6 users were neutral. The majority used the documentation functions concurrently with care. Except for recommendations to administer oxygen (which were unsupported by evidence), users found the recommendations appropriate and appreciated the reminders. Seven of 9 participants believed it took more time to document with AsthMonitor. CONCLUSIONS: Handheld computers are acceptable to some office-based practitioners to provide guideline-based advice within the context of the clinical encounter. PMID:10566499

  6. Implementing NCEP guidelines in a Web-based disease-management system.

    PubMed Central

    Tsui, F. C.; Wagner, M.; Thompson, M. E.

    1997-01-01

    DMS is a Web-based disease-management system, which facilitates easy access for users and close connection to hospital information systems, based on clinical practice guidelines. Currently we are prototyping DMS in the area of hyperlipidemia management. However our approach is general. For each office visit, DMS generates an encounter form with recommendations based on the National Cholesterol Education Program (NCEP) guidelines. In between visits, DMS provides email notifications to clinicians about delinquent laboratory studies and recommendations for patient management based on recently available information. By reviewing previous efforts for implementing NCEP guidelines and some of the pitfalls that were encountered, we first constructed DMS for hyperlipidemia management. A detailed description of DMS is provided in this paper. PMID:9357728

  7. Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting.

    PubMed

    Smith, Katherine; Firth, Kimberly; Smeeding, Sandra; Wolever, Ruth; Kaufman, Joanna; Delgado, Roxana; Bellanti, Dawn; Xenakis, Lea

    2016-01-01

    Research suggests that the development of mind-body skills can improve individual and family resilience, particularly related to the stresses of illness, trauma, and caregiving. To operationalize the research evidence that mind-body skills help with health and recovery, Samueli Institute, in partnership with experts in mind-body programming, created a set of guidelines for developing and evaluating mind-body programs for service members, veterans, and their families. The Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting outline key strategies and issues to consider when developing, implementing, and evaluating a mind-body focused family empowerment approach in a military healthcare setting. Although these guidelines were developed specifically for a military setting, most of the same principles can be applied to the development of programs in the civilian setting as well. The guidelines particularly address issues unique to mind-body programs, such as choosing evidence-based modalities, licensure and credentialing, safety and contraindications, and choosing evaluation measures that capture the holistic nature of these types of programs. The guidelines are practical, practice-based guidelines, developed by experts in the fields of program development and evaluation, mind-body therapies, patient- and family-centered care, as well as, experts in military and veteran's health systems. They provide a flexible framework to create mind-body family empowerment programs and describe important issues that program developers and evaluators are encouraged to address to ensure the development of the most impactful, successful, evidence-supported programs possible. PMID:26686476

  8. Optimal Pain Assessment in Pediatric Rehabilitation: Implementation of a Nursing Guideline.

    PubMed

    Kingsnorth, Shauna; Joachimides, Nick; Krog, Kim; Davies, Barbara; Higuchi, Kathryn Smith

    2015-12-01

    In Ontario, Canada, the Registered Nurses' Association promotes a Best Practice Spotlight Organization initiative to enhance evidence-based practice. Qualifying organizations are required to implement strategies, evaluate outcomes, and sustain practices aligned with nursing clinical practice guidelines. This study reports on the development and evaluation of a multifaceted implementation strategy to support adoption of a nursing clinical practice guideline on the assessment and management of acute pain in a pediatric rehabilitation and complex continuing care hospital. Multiple approaches were employed to influence behavior, attitudes, and awareness around optimal pain practice (e.g., instructional resources, electronic reminders, audits, and feedback). Four measures were introduced to assess pain in communicating and noncommunicating children as part of a campaign to treat pain as the fifth vital sign. A prospective repeated measures design examined survey and audit data to assess practice aligned with the guideline. The Knowledge and Attitudes Survey (KNAS) was adapted to ensure relevance to the local practice setting and was assessed before and after nurses' participation in three education modules. Audit data included client demographics and pain scores assessed annually over a 3-year window. A final sample of 69 nurses (78% response rate) provided pre-/post-survey data. A total of 108 pediatric surgical clients (younger than 19 years) contributed audit data across the three collection cycles. Significant improvements in nurses' knowledge, attitudes, and behaviors related to optimal pain care for children with disabilities were noted following adoption of the pain clinical practice guideline. Targeted guideline implementation strategies are central to supporting optimal pain practice. PMID:26395294

  9. Barriers to guideline implementation and educational needs of general practitioners regarding heart failure: a qualitative study

    PubMed Central

    Peters-Klimm, Frank; Natanzon, Iris; Müller-Tasch, Thomas; Ludt, Sabine; Nikendei, Christoph; Lossnitzer, Nicole; Szecsenyi, Joachim; Herzog, Wolfgang; Jünger, Jana

    2012-01-01

    Objectives: A clinical practice guideline (CPG) contains specifically developed recommendations that can serve physicians as a decision aid in evidence-based practice. The implementation of heart failure (HF) CPGs represents a challenge in general practice. As part of the development of a tailored curriculum, aim of this study was to identify barriers of guideline adherence and needs for medical education (CME) in HF care. Methods: We conducted a modified focus group with elements of a workshop of three hours duration. Thirteen GPs collected and discussed together and parallel in smaller groups barriers of guideline implementation. Afterwards they performed a needs assessment for a tailored CME curriculum for chronic HF. The content of the discussions was analysed qualitatively according to Mayring and categorised thematically. Results: Barriers of guideline adherence were found in the following areas: doctor: procedural knowledge (knowledge gaps), communicative and organisational skills (e.g. time management) and attitude (dissatisfaction with time-money-relation). Patients: individual case-related problems (multimorbidity, psychiatric comorbidity, expectations and beliefs). Doctor and patient: Adherence and barriers of communication. Main measures for improvement of care concerned the areas of the identified barriers of guideline adherence with the focus on application-oriented training of the abovementioned procedural knowledge and skills, but also the supply of tools (like patient information leaflets) and patient education. Conclusion: For a CME-curriculum for HF tailored to the needs of GPs, a comprehensive educational approach seems necessary. It should be broad-based and include elements of knowledge and skills to be addressed and trained case-related. Additional elements should include support in the implementation of organisational processes in the practice and patient education. PMID:22737201

  10. A New Security Paradigm for Anti-Counterfeiting: Guidelines and an Implementation Roadmap

    NASA Astrophysics Data System (ADS)

    Lehtonen, Mikko

    Product counterfeitingand piracy continue to plague brand and trademark owners across industry sectors. This chapter analyses the reasons for ineffectiveness of past technical anti-counterfeitingstrategies and formulates managerial guidelines for effective use of RFID in anti-counterfeiting. An implementation roadmap toward secure authentication of products tagged with EPC Gen-2 tags is proposed and possible supply chain locations for product checks are discussed.

  11. Do knowledge brokers facilitate implementation of the stroke guideline in clinical practice?

    PubMed Central

    2013-01-01

    Background The implementation of clinical practice guidelines in rehabilitation practice is often troublesome and incomplete. An intervention to enhance the implementation of guidelines is the knowledge transfer program built around the activities of a knowledge broker (KB). This study investigates the use of KBs to implement guideline recommendations for intensive therapy and physical activity for patients post-stroke in 22 stroke units in hospitals and rehabilitation centers in The Netherlands. Methods/Design This study includes a quantitative evaluation with a non controlled pre-post intervention design and a mixed methods process evaluation. From each stroke unit, enterprising nurses and therapists will be recruited and trained as KB. The KB will work for one year on the implementation of the guideline recommendations in their team. To evaluate the effectiveness of the KB, a questionnaire will be administered to patients, health professionals and KBs at baseline (T0) and after one year (T1). Furthermore, semi structured interviews with 5 KBs will be performed at T1. The primary outcome of this implementation project will be the support health professionals give patients to exercise and be physically active, as reported by patients and health professionals themselves. The support immediately after the intervention is compared with the support at the start of the intervention. Additionally we will explore the influence of socio-demographic characteristics of health professionals and determinants identified in the Theory of Planned Behavior (intention, attitude, subjective norm and perceived behavioral control) on the change of supportive behavior of health professionals. Finally, KBs will complete a questionnaire on their own psychological and social demographic characteristics and on organizational conditions needed for health-care improvement such as time, workforce, sponsoring and support from management. Discussion With this study we will gain insight in when

  12. Staff experiences in implementing guidelines for Kangaroo Mother Care--a qualitative study.

    PubMed

    Wallin, Lars; Rudberg, Agneta; Gunningberg, Lena

    2005-01-01

    The aim of this study was to investigate staff experiences in implementing guidelines for Kangaroo Mother Care in neonatal care. The study was part of a randomized controlled trial, the overall goal of which was to assess the impact of external facilitation. A total of eight focus group interviews were held at two intervention and two control units. The establishment of a change team to implement the guideline resulted in activities that impacted staff behaviour, which in turn was perceived to influence patients' well-being. The guideline and contextual factors, such as leadership and staff colleagues' attitudes, were of significant importance in that process. The study intervention--facilitation--promoted implementation activities and was highly appreciated by the change teams. However, reviewing the development of events at one of the control units, the provided facilitation appeared to be no more effective than an improvement-focused organizational culture in which the nurse manager was actively involved in the change process. Overall, learning and behaviour change seemed to be a social phenomenon, something that greatly benefited from people's interaction with one another. PMID:15582640

  13. Guidelines for Implementing Advanced Distribution Management Systems-Requirements for DMS Integration with DERMS and Microgrids

    SciTech Connect

    Wang, Jianhui; Chen, Chen; Lu, Xiaonan

    2015-08-01

    This guideline focuses on the integration of DMS with DERMS and microgrids connected to the distribution grid by defining generic and fundamental design and implementation principles and strategies. It starts by addressing the current status, objectives, and core functionalities of each system, and then discusses the new challenges and the common principles of DMS design and implementation for integration with DERMS and microgrids to realize enhanced grid operation reliability and quality power delivery to consumers while also achieving the maximum energy economics from the DER and microgrid connections.

  14. Refining a taxonomy for guideline implementation: results of an exercise in abstract classification

    PubMed Central

    2013-01-01

    Background To better understand the efficacy of various implementation strategies, improved methods for describing and classifying the nature of these strategies are urgently required. The aim of this study was to develop and pilot the feasibility of a taxonomy to classify the nature and content of implementation strategies. Methods A draft implementation taxonomy was developed based on the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist. The draft taxonomy had four domains (professional, financial, organisational and regulatory) covering 49 distinct strategies. We piloted the draft taxonomy by using it to classify the implementation strategies described in the conference abstracts of the implementation stream of the 2010 Guideline International Network Conference. Five authors classified the strategies in each abstract individually. Final categorisation was then carried out in a face-to-face consensus meeting involving three authors. Results The implementation strategies described in 71 conference abstracts were classified. Approximately 15.5% of abstracts utilised strategies that could not be categorised using the draft taxonomy. Of those strategies that could be categorised, the majority were professionally focused (57%). A total of 41% of projects used only one implementation strategy, with 29% using two and 31% three or more. The three most commonly used strategies were changes in quality assurance, quality improvement and/or performance measurement systems, changes in information and communication technology, and distribution of guideline materials (via hard-copy, audio-visual and/or electronic means). Conclusions Further refinement of the draft taxonomy is required to provide hierarchical dimensions and granularity, particularly in the areas of patient-focused interventions, those concerned with audit and feedback and quality improvement, and electronic forms of implementation, including electronic decision support. PMID

  15. Implementation of asthma guidelines to West Australian community pharmacies: an exploratory, quasi-experimental study

    PubMed Central

    Trevenen, Michelle; Murray, Kevin; Kendall, Peter A; Schneider, Carl R; Clifford, Rhonda

    2016-01-01

    Objectives Pharmacy assistants are often the first point of contact for patients presenting in community pharmacies. The current role of pharmacy assistants in the supply of asthma-reliever medications (short-acting β-agonists) was identified as a barrier to appropriate guideline-based care. The aim of this research was to devise and evaluate a team-based intervention to formalise the role of pharmacy assistants and to improve asthma guideline-based care in community pharmacy. Design A controlled pre-post intervention study was conducted in 336 metropolitan pharmacies located in Perth, Western Australia. Pharmacies were stratified into 2 groups (187 intervention and 149 control) based on known confounders for asthma control. The intervention was designed using a common-sense approach and resources developed included a checklist, videos and web page. Delivery was via workshops (25 pharmacies) or academic detailing (162 pharmacies). Pharmacy practice was assessed preintervention and postintervention via covert simulated patient methodology. Primary outcome measures included patient medical referral, device use demonstration and counselling, internal referral and/or direct involvement of a pharmacist in consultations. Results There was a significant increase in patient medical referral in intervention pharmacies from 32% to 47% (p=0.0007) from preintervention to postintervention, while control pharmacies showed a non-significant decrease from 50% to 44% (p=0.22). Device counselling was not routinely carried out at any stage or in any cohort of this research and no significant changes in internal referral were observed. Conclusions Increases in medical referral indicate that asthma guideline compliance can be improved in community pharmacy if implementation employs a team-based approach and involves pharmacy assistants. However, results were variable and the intervention did not improve practice related to device counselling or internal referral/pharmacist involvement

  16. Embedded Implementation of VHR Satellite Image Segmentation.

    PubMed

    Li, Chao; Balla-Arabé, Souleymane; Ginhac, Dominique; Yang, Fan

    2016-01-01

    Processing and analysis of Very High Resolution (VHR) satellite images provide a mass of crucial information, which can be used for urban planning, security issues or environmental monitoring. However, they are computationally expensive and, thus, time consuming, while some of the applications, such as natural disaster monitoring and prevention, require high efficiency performance. Fortunately, parallel computing techniques and embedded systems have made great progress in recent years, and a series of massively parallel image processing devices, such as digital signal processors or Field Programmable Gate Arrays (FPGAs), have been made available to engineers at a very convenient price and demonstrate significant advantages in terms of running-cost, embeddability, power consumption flexibility, etc. In this work, we designed a texture region segmentation method for very high resolution satellite images by using the level set algorithm and the multi-kernel theory in a high-abstraction C environment and realize its register-transfer level implementation with the help of a new proposed high-level synthesis-based design flow. The evaluation experiments demonstrate that the proposed design can produce high quality image segmentation with a significant running-cost advantage. PMID:27240370

  17. Embedded Implementation of VHR Satellite Image Segmentation

    PubMed Central

    Li, Chao; Balla-Arabé, Souleymane; Ginhac, Dominique; Yang, Fan

    2016-01-01

    Processing and analysis of Very High Resolution (VHR) satellite images provide a mass of crucial information, which can be used for urban planning, security issues or environmental monitoring. However, they are computationally expensive and, thus, time consuming, while some of the applications, such as natural disaster monitoring and prevention, require high efficiency performance. Fortunately, parallel computing techniques and embedded systems have made great progress in recent years, and a series of massively parallel image processing devices, such as digital signal processors or Field Programmable Gate Arrays (FPGAs), have been made available to engineers at a very convenient price and demonstrate significant advantages in terms of running-cost, embeddability, power consumption flexibility, etc. In this work, we designed a texture region segmentation method for very high resolution satellite images by using the level set algorithm and the multi-kernel theory in a high-abstraction C environment and realize its register-transfer level implementation with the help of a new proposed high-level synthesis-based design flow. The evaluation experiments demonstrate that the proposed design can produce high quality image segmentation with a significant running-cost advantage. PMID:27240370

  18. Implementation of surveillance of invasive mosquitoes in Belgium according to the ECDC guidelines

    PubMed Central

    2014-01-01

    Background In 2012, the new guidelines for the surveillance of IMS in Europe, produced by the European Centre for Disease Prevention and Control (ECDC), were tested in Belgium. This study aimed at (1) testing the usefulness and applicability in the field of the ECDC guidelines for the surveillance of IMS in Europe and (2) surveying IMS throughout Belgium. Methods First, the scenarios, which Belgium is facing, were identified according to the ECDC guidelines. Second, the surveillance strategy and the methods were identified based on the guidelines and adjusted to the Belgium context. Two areas colonised by IMS and 20 potential points of entry (PoE) were selected. Mosquito Magnet Liberty Plus (CO2-baited) traps (23) and oviposition traps (147) were set-up, and larval sampling was performed monthly or bi-monthly from July till October 2012. Finally, the costs and workload of the surveillance activities were compared to the estimates provided by the ECDC guidelines. Results Surveillance at 20 potential PoE (complying with scenario 1) revealed that no new IMS were established in Belgium. Surveillance at two sites colonised by IMS (scenario 2) indicated that although control measures have drastically reduced the Ae. j. japonicus population this species is still present. Furthermore, Ae. koreicus is permanently established. For both scenarios, the problems encountered are discussed and recommendations are given. In addition, the actual workload was lower than the estimated workload, while the actual costs were higher than the estimated ones. Conclusions The ECDC guidelines are helpful, applicable and efficient to implement surveillance of IMS in Belgium. Recommendations were customised to the local context (political demands, salary and investment costs, and existing expertise). The workload and costs related to the preparatory phase (i.e., planning, contacts with the PoE, writing a protocol) were found to be missing in the cost evaluation suggested in the guidelines

  19. The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

    PubMed Central

    2014-01-01

    Background The potential of clinical practice guidelines has not been realized due to inconsistent adoption in clinical practice. Optimising intrinsic characteristics of guidelines (e.g., its wording and format) that are associated with uptake (as perceived by their end users) may have potential. Using findings from a realist review on guideline uptake and consultation with experts in guideline development, we designed a conceptual version of a future tool called Guideline Implementability Tool (GUIDE-IT). The tool will aim to involve family physicians in the guideline development process by providing a process to assess draft guideline recommendations. This feedback will then be given back to developers to consider when finalizing the recommendations. As guideline characteristics are best assessed by end-users, the objectives of the current study were to explore how family physicians perceive guideline implementability, and to determine what components should comprise the final GUIDE-IT prototype. Methods We conducted a qualitative study with family physicians inToronto, Ontario. Two experienced investigators conducted one-hour interviews with family physicians using a semi-structured interview guide to 1) elicit feedback on perceptions on guideline implementability; 2) to generate a discussion in response to three draft recommendations; and 3) to provide feedback on the conceptual GUIDE-IT. Sessions were audio taped and transcribed verbatim. Data collection and analysis were guided by content analyses. Results 20 family physicians participated. They perceived guideline uptake according to facilitators and barriers across 6 categories of guideline implementability (format, content, language, usability, development, and the practice environment). Participants’ feedback on 3 draft guideline recommendations were grouped according to guideline perception, cognition, and agreement. When asked to comment on GUIDE-IT, most respondents believed that the tool would be

  20. Implementing clinical practice guidelines about health promotion and disease prevention through shared decision making.

    PubMed

    Politi, Mary C; Wolin, Kathleen Y; Légaré, France

    2013-06-01

    Clinical practice guidelines aim to improve the health of patients by guiding individual care in clinical settings. Many guidelines specifically about health promotion or primary disease prevention are beginning to support informed patient choice, and suggest that clinicians and patients engage in shared discussions to determine how best to tailor guidelines to individuals. However, guidelines generally do not address how to translate evidence from the population to the individual in clinical practice, or how to engage patients in these discussions. In addition, they often fail to reconcile patients' preferences and social norms with best evidence. Shared decision making (SDM) is one solution to bridge guidelines about health promotion and disease prevention with clinical practice. SDM describes a collaborative process between patients and their clinicians to reach agreement about a health decision involving multiple medically appropriate treatment options. This paper discusses: 1) a brief overview of SDM; 2) the potential role of SDM in facilitating the implementation of prevention-focused practice guidelines for both preference-sensitive and effective care decisions; and 3) avenues for future empirical research to test how best to engage individual patients and clinicians in these complex discussions about prevention guidelines. We suggest that SDM can provide a structure for clinicians to discuss clinical practice guidelines with patients in a way that is evidence-based, patient-centered, and incorporates patients' preferences. In addition to providing a model for communicating about uncertainty at the individual level, SDM can provide a platform for engaging patients in a conversation. This process can help manage patients' and clinicians' expectations about health behaviors. SDM can be used even in situations with strong evidence for benefits at the level of the population, by helping patients and clinicians prioritize behaviors during time-pressured medical

  1. Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation.

    PubMed

    Yip, Cheng-Har; Smith, Robert A; Anderson, Benjamin O; Miller, Anthony B; Thomas, David B; Ang, Eng-Suan; Caffarella, Rosemary S; Corbex, Marilys; Kreps, Gary L; McTiernan, Anne

    2008-10-15

    A key determinant of breast cancer outcome in any population is the degree to which cancers are detected at early stages of disease. Populations in which cancers are detected at earlier stages have lower breast cancer mortality rates. The Breast Health Global Initiative (BHGI) held its third Global Summit in Budapest, Hungary in October 2007, bringing together internationally recognized experts to address the implementation of breast healthcare guidelines for early detection, diagnosis, and treatment in low- and middle-income countries (LMCs). A multidisciplinary panel of experts specifically addressed the implementation of BHGI guidelines for the early detection of disease as they related to resource allocation for public education and awareness, cancer detection methods, and evaluation goals. Public education and awareness are the key first steps, because early detection programs cannot be successful if the public is unaware of the value of early detection. The effectiveness and efficiency of screening modalities, including screening mammography, clinical breast examination (CBE), and breast self-examination, were reviewed in the context of resource availability and population-based need by the panel. Social and cultural barriers should be considered when early detection programs are being established, and the evaluation of early detection programs should include the use of well developed, methodologically sound process metrics to determine the effectiveness of program implementation. The approach and scope of any screening program will determine the success of any early detection program as measured by cancer stage at diagnosis and will drive the breadth of resource allocation needed for program implementation. PMID:18837017

  2. The Use of Systematic Reviews and Reporting Guidelines to Advance the Implementation of the 3Rs

    PubMed Central

    Avey, Marc T; Fenwick, Nicole; Griffin, Gilly

    2015-01-01

    In 1959, Russell and Burch published The Principles of Humane Experimental Technique, which included concrete advice on factors that they considered would govern progress in the implementation of these principles (enunciated as the 3Rs [Replacement, Reduction, and Refinement in animal-based studies]). One challenge to the implementation of the 3Rs was identified as information retrieval. Here, we further explore this challenge—the need for ‘research on research’—and the role that systematic reviews and reporting guidelines can play in implementation of the 3Rs. First, we examine the 2-fold nature of the challenge of information retrieval: 1) the identification of relevant publications spread throughout a large population of nonrelevant publications and 2) the incomplete reporting of relevant details within those publications. Second, we evaluate how systematic reviews and reporting guidelines can be used generally to address this challenge. Third, we assess the explicit reporting of the 3Rs in a cohort of preclinical animal systematic reviews. Our results show that Reduction methods are the most commonly reported by authors of systematic reviews but that, in general, reporting on how findings relate to the 3Rs is limited at best. Although systematic reviews are excellent tools for resolving the challenge of information retrieval, their utility for making progress in implementation of the 3Rs may be limited unless authors improve their reporting of these principles. PMID:25836961

  3. The use of systematic reviews and reporting guidelines to advance the implementation of the 3Rs.

    PubMed

    Avey, Marc T; Fenwick, Nicole; Griffin, Gilly

    2015-03-01

    In 1959, Russell and Burch published The Principles of Humane Experimental Technique, which included concrete advice on factors that they considered would govern progress in the implementation of these principles (enunciated as the 3Rs [Replacement, Reduction, and Refinement in animal-based studies]). One challenge to the implementation of the 3Rs was identified as information retrieval. Here, we further explore this challenge-the need for 'research on research'-and the role that systematic reviews and reporting guidelines can play in implementation of the 3Rs. First, we examine the 2-fold nature of the challenge of information retrieval: 1) the identification of relevant publications spread throughout a large population of nonrelevant publications and 2) the incomplete reporting of relevant details within those publications. Second, we evaluate how systematic reviews and reporting guidelines can be used generally to address this challenge. Third, we assess the explicit reporting of the 3Rs in a cohort of preclinical animal systematic reviews. Our results show that Reduction methods are the most commonly reported by authors of systematic reviews but that, in general, reporting on how findings relate to the 3Rs is limited at best. Although systematic reviews are excellent tools for resolving the challenge of information retrieval, their utility for making progress in implementation of the 3Rs may be limited unless authors improve their reporting of these principles. PMID:25836961

  4. Monitoring of clinical imaging guidelines part 3: norms, standards, and regulations.

    PubMed

    Babcock, Neil; Ebdon-Jackson, Steve; Remedios, Denis; Holmberg, Ola; del Rosario Perez, Maria; Bettmann, Michael A

    2015-03-01

    It is known that the use of imaging in clinical situations is not always optimal, leading to suboptimal health care and potential radiation risk. There may be overuse of imaging, underuse, or use of the wrong modality. The use of clinical imaging guidelines is likely to improve the use of imaging, but roadblocks exist. Some of these relate to regulatory oversight and mandates. There is wide variation by country and region in the regulatory setting, ranging from actual absence of regulatory authorities to mandated availability of clinical imaging guidelines in the European Community. Collaborative efforts to ensure that clinical imaging guidelines are at least available is a good starting point. Regulatory oversight and support are necessary to ensure the use of clinical imaging guidelines. Regulations should address 3 areas: availability, clinical utilization, and adherence to and revision of guidelines. The use of both internal and external audits, with the aim of both use of and adherence to guidelines and quality improvement, is the best tool for enhancing use. The major challenges that need to be addressed, collaboratively, to ensure the dissemination and use of clinical imaging guidelines are the development of regulations, of regulatory structures that can be effectively deployed, and of benchmarks for adherence and for utility. PMID:25743923

  5. Manual for implementing residual radioactive material guidelines using RESRAD, Version 5.0

    SciTech Connect

    Yu, C.; Zielen, A.J.; Cheng, J.J.

    1993-09-01

    This manual presents information for implementing US Department of Energy (DOE) guidelines for residual radioactive material. It describes the analysis and models used to derive site-specific guidelines for allowable residual concentrations of radionuclides in soil and the design and use of the RESRAD computer code for calculating doses, risks, and guideline values. It also describes procedures for implementing DOE policy for reducing residual radioactivity to levels that are as low as reasonably achievable. Two new pathways, radon inhalation and soil ingestion, have been added to RESRAD. Twenty-seven new radionuclides have also been added, and the cutoff half-life for associated radionuclides has been reduced to six months. Other major improvements to the RESRAD code include the ability to run sensitivity analyses, the addition of graphical output, user-specified dose factors, updated databases, an improved groundwater transport model, optional input of a groundwater concentration and a solubility constant, special models for tritium and carbon-14, calculation of cancer incidence risk, and the use of a mouse with menus.

  6. Barriers and enablers to implementing multiple stroke guideline recommendations: a qualitative study

    PubMed Central

    2013-01-01

    Background Translating evidence into practice is an important final step in the process of evidence-based practice. Medical record audits can be used to examine how well practice compares with published evidence, and identify evidence-practice gaps. After providing audit feedback to professionals, local barriers to practice change can be identified and targetted with focussed behaviour change interventions. This study aimed to identify barriers and enablers to implementing multiple stroke guideline recommendations at one Australian stroke unit. Methods A qualitative methodology was used. A sample of 28 allied health, nursing and medical professionals participated in a group or individual interview. These interviews occurred after staff had received audit feedback and identified areas for practice change. Questions focused on barriers and enablers to implementing guideline recommendations about management of: upper limb sensory impairments, mobility including sitting balance; vision; anxiety and depression; neglect; swallowing; communication; education for stroke survivors and carers; advice about return to work and driving. Qualitative data were analysed for themes using theoretical domains described by Michie and colleagues (2005). Results Six group and two individual interviews were conducted, involving six disciplines. Barriers were different across disciplines. The six key barriers identified were: (1) Beliefs about capabilities of individual professionals and their discipline, and about patient capabilities (2) Beliefs about the consequences, positive and negative, of implementing the recommendations (3) Memory of, and attention to, best practices (4) Knowledge and skills required to implement best practice; (5) Intention and motivation to implement best practice, and (6) Resources. Some barriers were also enablers to change. For example, occupational therapists required new knowledge and skills (a barrier), to better manage sensation and neglect impairments

  7. Coordinated, Collaborative and Coherent: Developing and Implementing E-Learning Guidelines within a National Tertiary Education System

    ERIC Educational Resources Information Center

    Suddaby, Gordon; Milne, John

    2008-01-01

    Purpose: The paper aims to discusses two complementary initiatives focussed on developing and implementing e-learning guidelines to support good pedagogy in e-learning practice. Design/methodology/approach: The first initiative is the development of a coherent set of open access e-learning guidelines for the New Zealand tertiary sector. The second…

  8. Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation

    PubMed Central

    Camm, A. John; Pinto, Fausto J.; Hankey, Graeme J.; Andreotti, Felicita; Hobbs, F.D. Richard

    2015-01-01

    Stroke is a leading cause of morbidity and mortality worldwide. Atrial fibrillation (AF) is an independent risk factor for stroke, increasing the risk five-fold. Strokes in patients with AF are more likely than other embolic strokes to be fatal or cause severe disability and are associated with higher healthcare costs, but they are also preventable. Current guidelines recommend that all patients with AF who are at risk of stroke should receive anticoagulation. However, despite this guidance, registry data indicate that anticoagulation is still widely underused. With a focus on the 2012 update of the European Society of Cardiology (ESC) guidelines for the management of AF, the Action for Stroke Prevention alliance writing group have identified key reasons for the suboptimal implementation of the guidelines at a global, regional, and local level, with an emphasis on access restrictions to guideline-recommended therapies. Following identification of these barriers, the group has developed an expert consensus on strategies to augment the implementation of current guidelines, including practical, educational, and access-related measures. The potential impact of healthcare quality measures for stroke prevention on guideline implementation is also explored. By providing practical guidance on how to improve implementation of the ESC guidelines, or region-specific modifications of these guidelines, the aim is to reduce the potentially devastating impact that stroke can have on patients, their families and their carers. PMID:26116685

  9. Guidelines for Technology Infrastructure in Connecticut Schools: An Implementation Guide for the Connecticut Statewide Educational Technology Plan.

    ERIC Educational Resources Information Center

    Center for Educational Leadership and Technology, Inc., Marlborough, MA.

    This document presents guidelines and recommendations for development of a technology infrastructure in Connecticut public schools that conforms to national industry standards for voice, video, and data communications. The guidelines present information on the state statutes regarding facilities implementation and describe industry standards.…

  10. [Measuring quality in the German Guideline Programme in Oncology (GGPO)—methodology and implementation].

    PubMed

    Nothacker, Monika; Muche-Borowski, Cathleen; Kopp, Ina B

    2014-01-01

    The German Guideline Programme in Oncology (GGPO) is a joint initiative between the German Cancer Society, the Association of the Scientific Medical Societies in Germany and German Cancer Aid. In accordance with the aims of the German National Cancer Plan, the GGPO supports the systematic development of high-quality guidelines. To enhance implementation and evaluation, the suggestion of performance measures (PMs) derived from guideline recommendations following a standardised methodology is obligatory within the GGPO. For this purpose, PM teams are convened representing the multidisciplinary guideline development groups including clinical experts, methodologists and patient representatives as well as those organisations that take an active part in and share responsibility for documentation and quality improvement, i.e., clinical cancer registries, certified cancer centres and, if appropriate, the institution responsible for external quality assurance according to the German Social Code (SGB). The primary selection criteria for PMs include strength of the underlying recommendation (strong, grade A), existing potential for improvement of care and measurability. The premises of data economy and standardised documentation are taken into account. Between May 2008 and July 2014, 12 guidelines with suggestions for 100 PMs have been published. The majority of the suggested performance measures is captured by the specific documentation requirements of the clinical cancer registries and certified cancer centres. This creates a solid basis for an active quality management and re-evaluation of the suggested PMs. In addition, the suspension of measures should be considered if improvement has been achieved on a broad scale and for a longer period in order to concentrate on a quality-oriented, economic documentation. PMID:25523845

  11. Specific issues related to developing, disseminating, and implementing pediatric practice guidelines for physicians, patients, families, and other stakeholders.

    PubMed Central

    Bauchner, H; Simpson, L

    1998-01-01

    OBJECTIVE: To describe ways in which medical information should be developed and disseminated, focusing on pediatric practice guidelines as an example of one type of information. PRINCIPAL FINDINGS: The methodology of guideline development is well known and has been previously reviewed. Guideline development poses problems for many medical specialties, but particularly for pediatrics, because (1) few diseases are prevalent, (2) only limited randomized controlled trials have been conducted with respect to specific diagnostic and therapeutic options, and (3) clinicians often are dealing with patient surrogates--parents--rather than with the actual patient. Patient and family involvement in guideline development and dissemination has been limited and may affect the likelihood that guidelines will be adopted and subsequently improve child health outcomes. The science of dissemination, including guidelines and other information, is poorly developed. Little is known about the most effective ways to ensure that guidelines reach clinicians and are adopted. Finally, the effect of guidelines on child health outcomes is itself uncertain. RECOMMENDATIONS: (1) Research efforts should focus on guideline dissemination and adoption. (2) The effect of guideline implementation on health outcomes needs to be better understood. (3) Parents should be more involved in guideline dissemination and adoption. PMID:9776953

  12. Chronic kidney disease guideline implementation in primary care: a qualitative report from the TRANSLATE CKD study

    PubMed Central

    Vest, Bonnie M.; York, Trevor R.M.; Sand, Jessica; Fox, Chester H.; Kahn, Linda S.

    2016-01-01

    Background Primary care physicians (PCPs) are optimally situated to identify and manage early-stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national mixed-methods cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice. Methods As part of mixed-methods process evaluation, semi-structured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the four domains of Normalization Process Theory (NPT). Results Identified themes illuminated the complex work undertaken in primary care practices to manage CKD. Barriers to guideline implementation were identified in each of the four NPT domains, including: 1) lack of knowledge and understanding around CKD (coherence), 2) difficulties engaging providers and patients in CKD management (cognitive participation), 3) limited time and competing demands (collective action), and 4) challenges obtaining and utilizing data to monitor progress (reflexive monitoring). Conclusions Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care. PMID:26355134

  13. APASL and AASLD Consensus Guidelines on Imaging Diagnosis of Hepatocellular Carcinoma: A Review

    PubMed Central

    Tan, Cher Heng; Low, Su-Chong Albert; Thng, Choon Hua

    2011-01-01

    Consensus guidelines for radiological diagnosis of hepatocellular carcinoma (HCC) have been drafted by several large international working groups. This article reviews the similarities and differences between the most recent guidelines proposed by the American Association for Study of Liver Diseases and the Asian Pacific Association for the Study of the Liver. Current evidence for the various imaging modalities for diagnosis of HCC and their relevance to the consensus guidelines are reviewed. PMID:22007313

  14. Implementation of nationwide image sharing system

    NASA Astrophysics Data System (ADS)

    Choi, SeungWook; Sim, Jungsuk; Ko, Wonsun; Park, ChanHyung; Lee, Jaeha; Lim, DongHyun; Lee, Juhyuk; Han, Jungu; Lee, Jongsu; Hong, HeonPyo; Choi, Bongsuk

    2003-05-01

    Korea is one of the leading countries in PACS implementation, and over 15% of all hospitals has been introducing and running in PACS. With the support of the Ministry of Health and Welfare, the National Computerization of Agency and National Cancer Center had a plan to try integration of PACS with a purpose of sharing medical image information. The target hospitals have been selected with over 500 beds, and the distance between hospitals from 40km and to 250km. As the vendors of PACS and HIS that had implemented in target hospitals were different, the 'sharing host' has been developed for the purpose of their integration, which enables communication through DICOM and HL7. In order to monitor the communication among the sharing hosts, the 'sharing center' also has been developed. This project was completed by November 2002. We expected that approximate of 100 doctors including 50 radiologists would use this project, high patient"s satisfaction and the decrease in national insurance fee for test and evaluation period. This project is the first attempt that the government has tried to integrate the independent PACS and HIS. On the model of this project, the government will try to expand it through all nation-wide.

  15. Measuring legal implementation of the international guidelines on HIV/AIDS and human rights.

    PubMed

    Watchirs, H

    2001-01-01

    With over 36 million people now living with the virus and over 21 million people dying of AIDS in the last two decades, HIV/AIDS is a global health and security problem. These shocking figures eclipse the human toll of many wars, and reveal in themselves that human rights are not being respected, protected, or fulfilled, either through negligent omissions or violations. A human rights approach to the epidemic was advocated early by advocates such as Jonathan Mann, who recognized that infections thrived in conditions of inequality. This approach was crystallized in the International Guidelines on HIV/AIDS and Human Rights that were developed at the Second International Consultation in 1996 convened by UNAIDS and the Office of the High Commissioner for Human Rights. The Guidelines cover three main areas: improving governmental responses in terms of multisectoral responsibility and accountability; widespread law reform and legal support services; and supporting increased private sector and community participation in effective responses to the epidemic. This article focuses on the half of the twelve Guidelines that concern rights that are justiciable and amenable to law reform. It highlights the responsibilities of States Parties to human rights treaties, as they bear the principal burden of the obligations to implement. PMID:11837019

  16. A framework for effective management of change in clinical practice: dissemination and implementation of clinical practice guidelines.

    PubMed

    Moulding, N T; Silagy, C A; Weller, D P

    1999-09-01

    Theories from social and behavioural science can make an important contribution to the process of developing a conceptual framework for improving use of clinical practice guidelines and clinician performance. A conceptual framework for guideline dissemination and implementation is presented which draws on relevant concepts from diffusion of innovation theory, the transtheoretical model of behaviour change, health education theory, social influence theory, and social ecology, as well as evidence from systematic literature reviews on the effectiveness of various behaviour change strategies. The framework emphasises the need for preimplementation assessment of (a) readiness of clinicians to adopt guidelines into practice, (b) barriers to change as experienced by clinicians, and (c) the level at which interventions should be targeted. It also incorporates the need for multifaceted interventions, identifies the type of barriers which will be addressed by each strategy, and develops the concept of progression through stages of guideline adoption by clinicians, with the use of appropriately targeted support strategies. The potential value of the model is that it may enable those involved in the process of guideline dissemination and implementation to direct strategies to target groups more effectively. Clearly, the effectiveness and utility of the model in facilitating guideline dissemination and implementation requires validation by further empirical research. Until such research is available, it provides a theoretical framework that may assist in the selection of appropriate guideline dissemination and implementation strategies. PMID:10847875

  17. Return of the pulmonary nodule: the radiologist's key role in implementing the 2015 BTS guidelines on the investigation and management of pulmonary nodules.

    PubMed

    Graham, Richard N J; Baldwin, David R; Callister, Matthew E J; Gleeson, Fergus V

    2016-01-01

    The British Thoracic Society has published new comprehensive guidelines for the management of pulmonary nodules. These guidelines are significantly different from those previously published, as they use two malignancy prediction calculators to better characterize the risk of malignancy. There are recommendations for a higher nodule size threshold for follow-up (≥5 mm or ≥80 mm(3)) and a reduction of the follow-up period to 1 year for solid pulmonary nodules; both of these will reduce the number of follow-up CT scans. PET-CT plays a crucial role in characterization also, with an ordinal scale being recommended for reporting. Radiologists will be the key in implementing these guidelines, and routine use of volumetric image-analysis software will be required to manage patients with pulmonary nodules correctly. PMID:26781558

  18. Implementing the Fatigue Guidelines at One NCCN Member Institution: Process and Outcomes

    PubMed Central

    Borneman, Tami; Piper, Barbara F.; Sun, Virginia Chih-Yi; Koczywas, Marianna; Uman, Gwen; Ferrell, Betty

    2008-01-01

    Fatigue, despite being the most common and distressing symptom in cancer, is often unrelieved because of numerous patient provider, and system barriers. The overall purpose of this 5-year prospective clinical trial is to translate the NCCN Cancer-Related Fatigue Clinical Practice Guidelines in Oncology and NCCN Adult Cancer Pain Clinical Practice Guidelines in Oncology into practice and develop a translational interventional model that can be replicated across settings. This article focuses on one NCCN member institution’s experience related to the first phase of the NCCN Cancer-Related Fatigue Guidelines implementation, describing usual care compared with evidence-based guidelines. Phase 1 of this 3-phased clinical trial compared the usual care of fatigue with that administered according to the NCCN guidelines. Eligibility criteria included age 18 years or older; English-speaking; diagnosed with breast, lung, colon, or prostate cancer; and fatigue and/or pain ratings of 4 or more on a 0 to 10 screening scale. Research nurses screened all available subjects in a cancer center medical oncology clinic to identify those meeting these criteria. Instruments included the Piper Fatigue Scale, a Fatigue Barriers Scale, a Fatigue Knowledge Scale, and a Fatigue Chart Audit Tool. Descriptive and inferential statistics were used in data analysis. At baseline, 45 patients had fatigue only (≥4) and 24 had both fatigue and pain (≥4). This combined sample (N = 69) was predominantly Caucasian (65%), female (63%), an average of 60 years old, diagnosed with stage 3 or 4 breast cancer, and undergoing treatment (82%). The most common barriers noted were patients’ belief that physicians would introduce the subject of fatigue if it was important (patient barrier); lack of fatigue documentation (professional barrier); and lack of supportive care referrals (system barrier). Findings showed several patient, professional, and system barriers that distinguish usual care from that

  19. Creative Implementation of 3Rs Principles within Industry Programs: Beyond Regulations and Guidelines

    PubMed Central

    Bratcher, Natalie A; Reinhard, Gregory R

    2015-01-01

    The industry involved with using animals as an essential part of research has supported the theory and philosophy of the 3Rs for years. However, both the culture and approach surrounding the 3Rs is evolving rapidly, and many institutions are attempting to surpass the regulations and guidelines to implement the 3Rs for improved science and animal welfare. Regulatory documents and guidelines such as the Animal Welfare Act, the Guide for the Care and Use of Laboratory Animals, the Public Health Service Policy on Humane Care and Use of Laboratory Animals, and the US Government Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training clearly outline how the IACUC should address the 3Rs, but there are many additional paradigms and resources that an institution can use to promote the 3Rs creatively. We review the legal mandates and guidelines that institutions must or should follow, and we present some creative approaches toward their compliance, including the creation of full-time dedicated 3Rs roles as well as temporary 3Rs-focused positions such as visiting scientist and postdoctoral fellowships and internships. We also discuss how to creatively achieve 3Rs progress through internal committees and working groups, involvement in 3Rs consortia, recognizing 3Rs advances through awards programs, and creating 3Rs volunteer opportunities. Adherence to regulations and guidelines creates a solid foundation for good animal care and science, and creative 3Rs approaches enable the growth of a robust animal welfare culture that enhances the potential for 3Rs benefits to animals and science. PMID:25836958

  20. Creative implementation of 3Rs principles within industry programs: beyond regulations and guidelines.

    PubMed

    Bratcher, Natalie A; Reinhard, Gregory R

    2015-03-01

    The industry involved with using animals as an essential part of research has supported the theory and philosophy of the 3Rs for years. However, both the culture and approach surrounding the 3Rs is evolving rapidly, and many institutions are attempting to surpass the regulations and guidelines to implement the 3Rs for improved science and animal welfare. Regulatory documents and guidelines such as the Animal Welfare Act, the Guide for the Care and Use of Laboratory Animals, the Public Health Service Policy on Humane Care and Use of Laboratory Animals, and the US Government Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training clearly outline how the IACUC should address the 3Rs, but there are many additional paradigms and resources that an institution can use to promote the 3Rs creatively. We review the legal mandates and guidelines that institutions must or should follow, and we present some creative approaches toward their compliance, including the creation of full-time dedicated 3Rs roles as well as temporary 3Rs-focused positions such as visiting scientist and postdoctoral fellowships and internships. We also discuss how to creatively achieve 3Rs progress through internal committees and working groups, involvement in 3Rs consortia, recognizing 3Rs advances through awards programs, and creating 3Rs volunteer opportunities. Adherence to regulations and guidelines creates a solid foundation for good animal care and science, and creative 3Rs approaches enable the growth of a robust animal welfare culture that enhances the potential for 3Rs benefits to animals and science. PMID:25836958

  1. The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline.

    PubMed

    Yamashita, Yasuyuki; Murayama, Sadayuki; Okada, Masahiro; Watanabe, Yoshiyuki; Kataoka, Masako; Kaji, Yasushi; Imamura, Keiko; Takehara, Yasuo; Hayashi, Hiromitsu; Ohno, Kazuko; Awai, Kazuo; Hirai, Toshinori; Kojima, Kazuyuki; Sakai, Shuji; Matsunaga, Naofumi; Murakami, Takamichi; Yoshimitsu, Kengo; Gabata, Toshifumi; Matsuzaki, Kenji; Tohno, Eriko; Kawahara, Yasuhiro; Nakayama, Takeo; Monzawa, Shuichi; Takahashi, Satoru

    2016-01-01

    Diagnostic imaging is undoubtedly important in modern medicine, and final clinical decisions are often made based on it. Fortunately, Japan has the highest numbers of diagnostic imaging instruments, such as CT and MRI devices, and boasts easy access to them as well as a high level of diagnostic accuracy. In consequence, a very large number of imaging examinations are performed, but diagnostic instruments are installed in so many medical facilities that expert management of these examinations tends to be insufficient. Particularly, in order to avoid risks, clinicians have recently become indifferent to indications of imaging modalities and tend to rely on CT or MRI resulting in increasing the number of imaging examinations in Japan. This is a serious problem from the viewpoints of avoidance of unnecessary exposure and medical economy. Under these circumstances, the Japan Radiological Society and Japanese College of Radiology jointly initiated the preparation of new guidelines for diagnostic imaging. However, the field of diagnostic imaging is extremely wide, and it is impossible to cover all diseases. Therefore, in drafting the guidelines, we selected important diseases and focused on "showing evidence and suggestions in the form of clinical questions (CQs)" concerning clinically encountered questions and "describing routine imaging techniques presently considered to be standards to guarantee the quality of imaging examinations". In so doing, we adhered to the basic principles of assuming the readers to be "radiologists specializing in diagnostic imaging", "simultaneously respecting the global standards and attending to the situation in Japan", and "making the guidelines consistent with those of other scientific societies related to imaging". As a result, the guidelines became the largest ever, consisting of 152 CQs, nine areas of imaging techniques, and seven reviews, but no other guidelines in the world summarize problems concerning diagnostic imaging in the form

  2. 36 CFR Exhibit B to Part 906 - Guidelines for Establishing Strategy To Implement Affirmative Action Personnel Plan

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Strategy To Implement Affirmative Action Personnel Plan B Exhibit B to Part 906 Parks, Forests, and Public.... B Exhibit B to Part 906—Guidelines for Establishing Strategy To Implement Affirmative Action... office of the State Employment Service (or union hiring hall when union labor is required). (6)...

  3. 36 CFR Exhibit B to Part 906 - Guidelines for Establishing Strategy To Implement Affirmative Action Personnel Plan

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Strategy To Implement Affirmative Action Personnel Plan B Exhibit B to Part 906 Parks, Forests, and Public.... B Exhibit B to Part 906—Guidelines for Establishing Strategy To Implement Affirmative Action... office of the State Employment Service (or union hiring hall when union labor is required). (6)...

  4. 36 CFR Exhibit B to Part 906 - Guidelines for Establishing Strategy To Implement Affirmative Action Personnel Plan

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Strategy To Implement Affirmative Action Personnel Plan B Exhibit B to Part 906 Parks, Forests, and Public.... B Exhibit B to Part 906—Guidelines for Establishing Strategy To Implement Affirmative Action... office of the State Employment Service (or union hiring hall when union labor is required). (6)...

  5. 36 CFR Exhibit B to Part 906 - Guidelines for Establishing Strategy To Implement Affirmative Action Personnel Plan

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Strategy To Implement Affirmative Action Personnel Plan B Exhibit B to Part 906 Parks, Forests, and Public.... B Exhibit B to Part 906—Guidelines for Establishing Strategy To Implement Affirmative Action... office of the State Employment Service (or union hiring hall when union labor is required). (6)...

  6. 36 CFR Exhibit B to Part 906 - Guidelines for Establishing Strategy To Implement Affirmative Action Personnel Plan

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Strategy To Implement Affirmative Action Personnel Plan B Exhibit B to Part 906 Parks, Forests, and Public.... B Exhibit B to Part 906—Guidelines for Establishing Strategy To Implement Affirmative Action... office of the State Employment Service (or union hiring hall when union labor is required). (6)...

  7. Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

    PubMed Central

    2012-01-01

    Background Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibility in practice is unknown. This study used the Normalization Process Theory (NPT) to understand the barriers and facilitators to implementing the guidelines and inform future implementation. Methods We conducted a process evaluation in five care homes in the north of England using qualitative methods (observation and interviews) to explore the views of managers, care staff, catering staff, and domestic staff. Data were analyzed thematically and discussed in data workshops; emerging themes were then mapped to the constructs of NPT. Results Many staff perceived the guidelines as unnecessarily restrictive and irrelevant to older people. In terms of NPT, the guidelines simply did not make sense (coherence), and as a result, relatively few staff invested in the guidelines (cognitive participation). Even where staff supported the guidelines, implementation was hampered by a lack of nutritional knowledge and institutional support (collective action). Finally, the absence of observable benefits to clients confirmed the negative preconceptions of many staff, with limited evidence of reappraisal following implementation (reflexive monitoring). Conclusions The successful implementation of the nutrition guidelines requires that the fundamental issues relating to their perceived value and fit with other priorities and goals be addressed. Specialist support is needed to equip staff with the technical knowledge and skills required for menu analysis and development and to devise ways of evaluating

  8. Enhanced implementation of low back pain guidelines in general practice: study protocol of a cluster randomised controlled trial

    PubMed Central

    2013-01-01

    Background Evidence-based clinical practice guidelines may improve treatment quality, but the uptake of guideline recommendations is often incomplete and slow. Recently new low back pain guidelines are being launched in Denmark. The guidelines are considered to reduce personal and public costs. The aim of this study is to evaluate whether a complex, multifaceted implementation strategy of the low back pain guidelines will reduce secondary care referral and improve patient outcomes compared to the usual simple implementation strategy. Methods/design In a two-armed cluster randomised trial, 100 general practices (clusters) and 2,700 patients aged 18 to 65 years from the North Denmark region will be included. Practices are randomly allocated 1:1 to a simple or a complex implementation strategy. Intervention practices will receive a complex implementation strategy, including guideline facilitator visits, stratification tools, and quality reports on low back pain treatment. Primary outcome is referral to secondary care. Secondary outcomes are pain, physical function, health-related quality of life, patient satisfaction with care and treatment outcome, employment status, and sick leave. Primary and secondary outcomes pertain to the patient level. Assessments of outcomes are blinded and follow the intention-to-treat principle. Additionally, a process assessment will evaluate the degree to which the intervention elements will be delivered as planned, as well as measure changes in beliefs and behaviours among general practitioners and patients. Discussion This study provides knowledge concerning the process and effect of an intervention to implement low back pain guidelines in general practice, and will provide insight on essential elements to include in future implementation strategies in general practice. Trial registration Registered as NCT01699256 on ClinicalTrials.gov. PMID:24139140

  9. Guidelines for a graph-theoretic implementation of structural equation modeling

    USGS Publications Warehouse

    Grace, James B.; Schoolmaster, Donald R., Jr.; Guntenspergen, Glenn R.; Little, Amanda M.; Mitchell, Brian R.; Miller, Kathryn M.; Schweiger, E. William

    2012-01-01

    Structural equation modeling (SEM) is increasingly being chosen by researchers as a framework for gaining scientific insights from the quantitative analyses of data. New ideas and methods emerging from the study of causality, influences from the field of graphical modeling, and advances in statistics are expanding the rigor, capability, and even purpose of SEM. Guidelines for implementing the expanded capabilities of SEM are currently lacking. In this paper we describe new developments in SEM that we believe constitute a third-generation of the methodology. Most characteristic of this new approach is the generalization of the structural equation model as a causal graph. In this generalization, analyses are based on graph theoretic principles rather than analyses of matrices. Also, new devices such as metamodels and causal diagrams, as well as an increased emphasis on queries and probabilistic reasoning, are now included. Estimation under a graph theory framework permits the use of Bayesian or likelihood methods. The guidelines presented start from a declaration of the goals of the analysis. We then discuss how theory frames the modeling process, requirements for causal interpretation, model specification choices, selection of estimation method, model evaluation options, and use of queries, both to summarize retrospective results and for prospective analyses. The illustrative example presented involves monitoring data from wetlands on Mount Desert Island, home of Acadia National Park. Our presentation walks through the decision process involved in developing and evaluating models, as well as drawing inferences from the resulting prediction equations. In addition to evaluating hypotheses about the connections between human activities and biotic responses, we illustrate how the structural equation (SE) model can be queried to understand how interventions might take advantage of an environmental threshold to limit Typha invasions. The guidelines presented provide for

  10. Avoiding Twisted Pixels: Ethical Guidelines for the Appropriate Use and Manipulation of Scientific Digital Images

    PubMed Central

    2014-01-01

    Digital imaging has provided scientists with new opportunities to acquire and manipulate data using techniques that were difficult or impossible to employ in the past. Because digital images are easier to manipulate than film images, new problems have emerged. One growing concern in the scientific community is that digital images are not being handled with sufficient care. The problem is twofold: (1) the very small, yet troubling, number of intentional falsifications that have been identified, and (2) the more common unintentional, inappropriate manipulation of images for publication. Journals and professional societies have begun to address the issue with specific digital imaging guidelines. Unfortunately, the guidelines provided often do not come with instructions to explain their importance. Thus they deal with what should or should not be done, but not the associated ‘why’ that is required for understanding the rules. This article proposes 12 guidelines for scientific digital image manipulation and discusses the technical reasons behind these guidelines. These guidelines can be incorporated into lab meetings and graduate student training in order to provoke discussion and begin to bring an end to the culture of “data beautification”. PMID:20567932

  11. Applying the RE-AIM Framework to Evaluate the Dissemination and Implementation of Clinical Practice Guidelines for Sexually Transmitted Infections.

    PubMed

    Jeong, Heon-Jae; Jo, Heui-Sug; Oh, Moo-Kyung; Oh, Hyung-Won

    2015-07-01

    Clinical practice guidelines (CPG) are one of the most effective ways to translate evidence of medical improvement into everyday practice. This study evaluated the dissemination and implementation of the Sexually Transmitted Infections-Korean Guidelines (STIKG) by applying the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. A survey questionnaire was administered to clinicians via the internet. Among the 332 respondents, 190 (57.2%) stated that they were aware of STIKG and 107 (33.2%) implemented STIKG in their practice. The odds that a physician was exposed to STIKG (dissemination) were 2.61 times greater among physicians with previous training or education for any CPG than those who did not. Clinicians who indicated that STIKG were easy to understand were 4.88 times more likely to implement STIKG in their practice than those who found them not so easy. When a clinician's workplace had a supporting system for CPG use, the odds of implementation was 3.76 times higher. Perceived level of effectiveness of STIKG did not significantly influence their implementation. The findings of this study suggest that, ultimately, knowing how to engage clinicians in CPG implementation is as important as how to disseminate such guidelines; moreover, easy-to-use guidelines and institutional support are key factors. PMID:26130944

  12. 78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... Association Guidelines for the Euthanasia of Animals: 2013 Edition SUMMARY: The National Institutes of Health... the American Veterinary Medical Association (AVMA) Guidelines for the Euthanasia of Animals: 2013... updated Guidelines. DATES: Public concerns regarding the updated AVMA Guidelines for the Euthanasia...

  13. Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for human leukocyte antigen B (HLA-B) genotype and allopurinol dosing: 2015 update.

    PubMed

    Saito, Y; Stamp, L K; Caudle, K E; Hershfield, M S; McDonagh, E M; Callaghan, J T; Tassaneeyakul, W; Mushiroda, T; Kamatani, N; Goldspiel, B R; Phillips, E J; Klein, T E; Lee, M T M

    2016-01-01

    The Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for HLA-B*58:01 Genotype and Allopurinol Dosing was originally published in February 2013. We reviewed the recent literature and concluded that none of the evidence would change the therapeutic recommendations in the original guideline; therefore, the original publication remains clinically current. However, we have updated the Supplemental Material and included additional resources for applying CPIC guidelines into the electronic health record. Up-to-date information can be found at PharmGKB (http://www.pharmgkb.org). PMID:26094938

  14. Measure Guideline: Implementing a Plenum Truss for a Compact Air Distribution System

    SciTech Connect

    Burdick, A.

    2013-10-01

    This Measure Guideline presents the steps to implement a compact duct system inside an attic bulkhead (plenum truss) of a one-story, slab-on-grade home. In a compact duct design, ductwork runs are reduced in length to yield a smaller and more compact duct system. Less energy will be lost through ductwork if the ducts are contained within the thermal enclosure of the house. These measures are intended for the production builder working to meet the 2012 International Energy Conservation Code (IECC) requirements and keep the ductwork within the thermal enclosure of the house. This measure of bringing the heating, ventilation and air conditioning (HVAC) equipment and ductwork within the thermal enclosure of the house is appropriate for the builder wishing to avoid cathedralizing the insulation in the attic space (i.e., locating it at the underside of the roof deck rather than along the attic floor) or adding dropped soffits.

  15. Measure Guideline: Implementing a Plenum Truss for a Compact Air Distribution System

    SciTech Connect

    Burdick, A.

    2013-10-01

    This Measure Guideline presents the steps to implement a compact duct system inside an attic bulkhead (plenum truss) of a one-story, slab-on-grade (SOG) home. In a compact duct design, ductwork runs are reduced in length to yield a smaller and more compact duct system. Less energy will be lost through ductwork if the ducts are contained within the thermal enclosure of the house. These measures are intended for the production builder working to meet the 2012 International Energy Conservation Code (IECC) requirements and keep the ductwork within the thermal enclosure of the house. This measure of bringing the heating, ventilation and air conditioning (HVAC) equipment and ductwork within the thermal enclosure of the house is appropriate for the builder wishing to avoid cathedralizing the insulation in the attic space (i.e., locating it at the underside of the roof deck rather than along the attic floor) or adding dropped soffits.

  16. Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines1

    PubMed Central

    Andrade, Vera Lúcia Fonseca; Fernandes, Filipa Alexandra Veludo

    2016-01-01

    Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice. PMID:27027676

  17. [German Society of Nuclear Medicine procedure guideline on beta-amyloid brain PET imaging].

    PubMed

    Barthel, Henryk; Meyer, Philipp T; Drzezga, Alexander; Bartenstein, Peter; Boecker, Henning; Brust, Peter; Buchert, Ralph; Coenen, Heinz H; la Fougère, Christian; Gründer, Gerhard; Grünwald, Frank; Krause, Bernd J; Kuwert, Torsten; Schreckenberger, Matthias; Tatsch, Klaus; Langen, Karl-Josef; Sabri, Osama

    2016-08-01

    Recently, a number of positron emission tomography (PET) radiotracers have been approved for clinical use. These tracers target cerebral beta-amyloid (Aβ) plaques, a hallmark of Alzheimer's disease. Increasing use of this method implies the need for respective standards. This German Society of Nuclear Medicine guideline describes adequate procedures for Aβ plaque PET imaging. It not only discusses the tracers used for that purpose, but also lists measures for correct patient preparation, image data generation, processing, analysis and interpretation. With that, this "S1" category (according to the German Association of the Scientific Medical Societies standard) guideline aims at contributing to quality assurance of nuclear imaging in Germany. PMID:27080914

  18. Implementation of the IDEA algorithm for image encryption

    NASA Astrophysics Data System (ADS)

    Dang, Philip P.; Chau, Paul M.

    2000-11-01

    In this paper, we present an implementation of the IDEA algorithm for image encryption. The image encryption is incorporated into the compression algorithm for transmission over a data network. In the proposed method, Embedded Wavelet Zero-tree Coding is used for image compression. Experimental results show that our proposed scheme enhances data security and reduces the network bandwidth required for video transmissions. A software implementation and system architecture for hardware implementation of the IDEA image encryption algorithm based on Field Programmable Gate Array (FPGA) technology are presented in this paper.

  19. A guideline-derived model to facilitate the implementation of test-ordering rules within a hospital information system.

    PubMed

    Yasini, Mobin; Duclos, Catherine; Venot, Alain; Lepage, Eric; Lamy, Jean-Baptiste

    2013-01-01

    The culture of evidence-based practice includes also the field of laboratory medicine. Clinical laboratory expenditure is growing rapidly for various reasons including increased utilization. Delivering decision support to requesters at the point of care is one of the main incentives for implementing laboratory guidelines. Laboratory guidelines were analyzed to extract test-ordering rules. Each rule was explicated in at least one clinical situation with triggers that launch the execution of the implemented rule. The Unified Modeling Language was used to represent the categories of information elements found in the guidelines and underline the information elements that need to be structured and coded in the EHR. These information elements are related to conditions including clinical conditions, habits, family history, demographic information, medical treatments, laboratory tests, and non-laboratory test procedures. Timestamping of each event is also important for implementing laboratory prescription rules. A linkage between the conditions of this model and HL7 RIM was feasible. Use of this model facilitates the implementation of evidence-based test-ordering rules and clarifies the EHR requirements for successful implementation of guidelines. PMID:23920651

  20. [Considerations on the development of nutrition-related guidelines by the World Health Organization and their implementation].

    PubMed

    Zamora, Gerardo; Meneses, Daniela; De-Regil, Luz Maria; Neufeld, Lynnette; Peña-Rosas, Juan Pablo; Sinisterra, Odalis Teresa

    2015-03-01

    The World Health Organization (WHO) follows a complex and rigorous process to develop global guidelines. With regard to nutrition-related guidelines, the joint participation of national authorities from Member States and their partners, including those of the social economy, is key to strengthening the process of evidence-informed guideline development and the subsequent implementation as part of national public health strategies. WHO puts forward a series of tools that can assist national authorities on health and social development in the elaboration of evidence-informed policies, considering their pertinence, relevance and implementability. This adoption and adaptation process must consider equity in order to avoid widening existing inequities. WHO global nutrition guidelines contribute to the effective implementation of nutrition interventions in Member States. Two experiences of implementation, one in Panama and one in Peru, exemplify this process. The paper ends by suggesting a deeper understanding and utilization of implementation research during programmes to identify what factors ensure effective interventions, appropriate scale up strategies and greater health equity. PMID:26320300

  1. Connecting Marketing and Implementation Research and Library Program Development: A Case Study of the Implementation of [U.S.] National Guidelines and Standards.

    ERIC Educational Resources Information Center

    Haycock, Ken; Cavill, Pat

    This case study examined: (1) what market research is required for planning for the implementation of "Information Power: Building Partnerships for Learning," the 1998 national guidelines for effective school library media programs; (2) what issues need to be addressed and what target audiences are required to effect change, as well as how these…

  2. Implementation of the NCSS Guidelines for Teaching Science-Related Social Issues: Exemplar Lessons.

    ERIC Educational Resources Information Center

    Otto, Robert A., Ed.

    This document contains the Guidelines for Teaching Science-Related Social Issues adopted in 1982 by the National Council for the Social Studies and 10 examplar lessons each keyed to particular guidelines and drawing upon contemporary issues. The premise upon which the guidelines are based is that science is a social issue and that the examination…

  3. Visual Image Sensor Organ Replacement: Implementation

    NASA Technical Reports Server (NTRS)

    Maluf, A. David (Inventor)

    2011-01-01

    Method and system for enhancing or extending visual representation of a selected region of a visual image, where visual representation is interfered with or distorted, by supplementing a visual signal with at least one audio signal having one or more audio signal parameters that represent one or more visual image parameters, such as vertical and/or horizontal location of the region; region brightness; dominant wavelength range of the region; change in a parameter value that characterizes the visual image, with respect to a reference parameter value; and time rate of change in a parameter value that characterizes the visual image. Region dimensions can be changed to emphasize change with time of a visual image parameter.

  4. Taking the next step to privacy compliance for hospitals: implementing the OHA guidelines.

    PubMed

    Beardwood, John

    2003-01-01

    The recently released "Guidelines for Managing Privacy, Data Protection and Security for Ontario Hospitals," prepared by the Ontario Hospital eHealth Council Privacy and Security Working Group (the "Guidelines") are useful in that they provide a comprehensive overview of the types of issues raised for hospitals by existing and pending privacy legislation, and a very high-level framework for addressing same. However, the Guidelines are, as stated high-level guidelines only,--leaving hospital management to grapple with the next big step towards privacy compliance: how to operationalize the Guidelines within their particular hospital. PMID:14674181

  5. Outcomes of Implementing an Evidence-Based Hypertension Clinical Guideline in an Academic Nurse Managed Health Center.

    PubMed

    Dyal, Brenda; Whyte, Maria; Blankenship, S Michele; Ford, Lynn Gallagher

    2016-02-01

    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787. PMID:26765990

  6. 77 FR 61735 - Changes and Examination Guidelines To Implement the First-Inventor-to-File Provisions of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-11

    ... Provisions of the Leahy-Smith America Invents Act, 77 FR 43742 (July 26, 2012), and Examination Guidelines for Implementing the First-Inventor-to-File Provisions of the Leahy-Smith America Invents Act, 77 FR... written comments in response to the notice of proposed rulemaking published July 26, 2012 (77 FR...

  7. Testing of hardware implementation of infrared image enhancing algorithm

    NASA Astrophysics Data System (ADS)

    Dulski, R.; Sosnowski, T.; PiÄ tkowski, T.; Trzaskawka, P.; Kastek, M.; Kucharz, J.

    2012-10-01

    The interpretation of IR images depends on radiative properties of observed objects and surrounding scenery. Skills and experience of an observer itself are also of great importance. The solution to improve the effectiveness of observation is utilization of algorithm of image enhancing capable to improve the image quality and the same effectiveness of object detection. The paper presents results of testing the hardware implementation of IR image enhancing algorithm based on histogram processing. Main issue in hardware implementation of complex procedures for image enhancing algorithms is high computational cost. As a result implementation of complex algorithms using general purpose processors and software usually does not bring satisfactory results. Because of high efficiency requirements and the need of parallel operation, the ALTERA's EP2C35F672 FPGA device was used. It provides sufficient processing speed combined with relatively low power consumption. A digital image processing and control module was designed and constructed around two main integrated circuits: a FPGA device and a microcontroller. Programmable FPGA device performs image data processing operations which requires considerable computing power. It also generates the control signals for array readout, performs NUC correction and bad pixel mapping, generates the control signals for display module and finally executes complex image processing algorithms. Implemented adaptive algorithm is based on plateau histogram equalization. Tests were performed on real IR images of different types of objects registered in different spectral bands. The simulations and laboratory experiments proved the correct operation of the designed system in executing the sophisticated image enhancement.

  8. Incidental findings in emergency imaging: frequency, recommendations, and compliance with consensus guidelines.

    PubMed

    Hanna, Tarek N; Shekhani, Haris; Zygmont, Matthew E; Kerchberger, James Matthew; Johnson, Jamlik-Omari

    2016-04-01

    The purpose of this study was to evaluate the frequency of incidental findings (IFs) in emergency department (ED) imaging reports and evaluate the adherence of imaging recommendations to consensus societal guidelines for IFs. A retrospective review of consecutive ED computed tomography (CT) and ultrasonography (US) reports from two university-affiliated EDs over a 2-month period was performed. Each imaging report was reviewed in its entirety, and incidental findings were documented along with recommendations for additional imaging. Imaging recommendations were compared to published societal guidelines from the American College of Radiology (ACR) and Fleischner Society. Three thousand one hundred thirty-one total cases consisting of 1967 CTs and 1164 US contained 514 incidental findings (16.4 %), with 329 CT IFs (64 %) and 185 US IFs (36 %). The ovary was the most common organ for an IF (n = 214, 42 %). Of all IFs, 347 (67.5 %) recommendations were concordant with societal guidelines and 167 (32.5 %) were discordant. 39.8 % of CT recommendations were discordant, while 19.5 % of US recommendations were discordant (p < 0.0001). Incidental findings are commonly encountered in the emergent setting. Variable adherence to societal guidelines is noted. Targeted radiologist education and technological solutions may decrease rates of discordance. PMID:26842832

  9. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision.

    PubMed

    Verberne, Hein J; Acampa, Wanda; Anagnostopoulos, Constantinos; Ballinger, Jim; Bengel, Frank; De Bondt, Pieter; Buechel, Ronny R; Cuocolo, Alberto; van Eck-Smit, Berthe L F; Flotats, Albert; Hacker, Marcus; Hindorf, Cecilia; Kaufmann, Philip A; Lindner, Oliver; Ljungberg, Michael; Lonsdale, Markus; Manrique, Alain; Minarik, David; Scholte, Arthur J H A; Slart, Riemer H J A; Trägårdh, Elin; de Wit, Tim C; Hesse, Birger

    2015-11-01

    Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf . PMID:26290421

  10. The degenerative spine: pattern recognition and guidelines to image interpretation.

    PubMed

    Parizel, P M; Van Hoyweghen, A J L; Bali, A; Van Goethem, J; Van Den Hauwe, L

    2016-01-01

    Degenerative disease of the spine, in the form of intervertebral disc degeneration and bony growth, causing osteophytes and impinging upon the spinal canal and neural foramina, is the most frequent disorder affecting the spine. In this chapter we first discuss briefly the indications for computed tomography or magnetic resonance imaging in suspected degenerative spine disease. We then describe changes of disc height, signal intensity, and disc contour with aging and repeated microtrauma, as well as the imaging techniques most appropriate to image them. A grading system for lumbar disc changes is provided. Stenosis of the canal and neural foramina is reviewed next, concluding with a description of degenerative changes affecting the vertebral endplates and bone marrow. PMID:27430442

  11. Guideline implementation for breast healthcare in low- and middle-income countries: treatment resource allocation.

    PubMed

    Eniu, Alexandru; Carlson, Robert W; El Saghir, Nagi S; Bines, Jose; Bese, Nuran Senel; Vorobiof, Daniel; Masetti, Riccardo; Anderson, Benjamin O

    2008-10-15

    A key determinant of breast cancer outcome is the degree to which newly diagnosed cancers are treated correctly in a timely fashion. Available resources must be applied in a rational manner to optimize population-based outcomes. A multidisciplinary international panel of experts addressed the implementation of treatment guidelines and developed process checklists for breast surgery, radiation treatment, and systemic therapy. The needed resources for stage I, stage II, locally advanced, and metastatic breast cancer were outlined, and process metrics were developed. The ability to perform modified radical mastectomy is the mainstay of locoregional treatment at the basic level of breast healthcare. Radiation therapy allows for consideration of breast-conserving therapy, postmastectomy chest wall irradiation, and palliation of painful or symptomatic metastases. Systemic therapy with cytotoxic chemotherapy is effective in the treatment of all biologic subtypes of breast cancer, but its provision is resource intensive. Although endocrine therapy requires few specialized resources, it requires knowledge of hormone receptor status. Targeted therapy against human epidermal growth factor receptor 2 (anti-HER-2) is very effective in tumors that overexpress HER-2/neu receptors, but cost largely prevents its use in resource-limited environments. Incremental allocation of resources can help address economic disparities and ensure equity in access to care. Checklists and allocation tables can support the objective of offering optimal care for all patients. The use of process metrics can facilitate the development of multidisciplinary, integrated, fiscally responsible, continuously improving, and flexible approaches to the global enhancement of breast cancer treatment. PMID:18837019

  12. Guideline report. Medical ultrasound imaging: progress and opportunities.

    PubMed

    Burns, M

    1989-01-01

    Utilization of medical ultrasound has expanded rapidly during the past several years. In 1988, sales of ultrasound equipment will approach $600 million, which is higher than any other individual imaging modality, including the most capital intensive, such as magnetic resonance imaging (MRI), computed tomography (CT), and cath lab angiography. This growth would have been difficult to predict previously, since ultrasound appeared to be a relatively mature imaging modality not too long ago. There are several reasons for this growth. Technological developments have been quite rapid; ultrasound has become easier to use, image quality has improved dramatically, and diagnostic accuracy has been enhanced. There has been a proliferation of new equipment at all ends of the price spectrum, allowing the user a wide choice in instrument performance, multi-function capabilities, and automated features to increase patient throughput. The DRG environment and the prospect for more pre-admission tests have also been a stimulus. Hospital buying activity has expanded, and many more ultrasound exams are now being conducted on an outpatient basis. Sales to freestanding imaging centers and individual physicians have similarly increased. The hospital user is willing to pay a large premium for advanced technical performance and is prepared to retire or replace older technology in less than three years. This replacement cycle is much shorter than the four to five year period which existed prior to 1985. By comparison, some of the more traditional imaging areas, such as radiology, have replacement rates of eight to ten years. The reason for early replacement is obvious. Ultrasound exams in hospitals generate revenues at a rate that justifies the purchase of the most advanced equipment. It also improves the referral rate and positions the hospital as a high quality provider. Even with low utilization rates, an ultrasound instrument can normally pay for itself in less than one year of regular

  13. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007.

    PubMed

    Anderson, Benjamin O; Yip, Cheng-Har; Smith, Robert A; Shyyan, Roman; Sener, Stephen F; Eniu, Alexandru; Carlson, Robert W; Azavedo, Edward; Harford, Joe

    2008-10-15

    Breast cancer outcomes in low- and middle-income countries (LMCs) correlate with the degree to which 1) cancers are detected at early stages, 2) newly detected cancers can be diagnosed correctly, and 3) appropriately selected multimodality treatment can be provided properly in a timely fashion. The Breast Health Global Initiative (BHGI) invited international experts to review and revise previously developed BHGI resource-stratified guideline tables for early detection, diagnosis, treatment, and healthcare systems. Focus groups addressed specific issues in breast pathology, radiation therapy, and management of locally advanced disease. Process metrics were developed based on the priorities established in the guideline stratification. The groups indicated that cancer prevention through health behavior modification could influence breast cancer incidence in LMCs. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies. Government intervention is needed to address drug-delivery problems relating to high cost and poor access. Guideline dissemination and implementation research plays a crucial role in improving care. Adaptation of technology is needed in LMCs, especially for breast imaging, pathology, radiation therapy, and systemic treatment. Curricula for education and training in LMCs should be developed, applied, and studied in LMC-based learning laboratories to aid information transfer of evidence-based BHGI guidelines. PMID:18816619

  14. Building better guidelines with BRIDGE-Wiz: development and evaluation of a software assistant to promote clarity, transparency, and implementability

    PubMed Central

    Michel, George; Rosenfeld, Richard M; Davidson, Caryn

    2011-01-01

    Objective To demonstrate the feasibility of capturing the knowledge required to create guideline recommendations in a systematic, structured, manner using a software assistant. Practice guidelines constitute an important modality that can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. However, many guideline recommendations are vague and underspecified, lack any linkage to supporting evidence or documentation of how they were developed, and prove to be difficult to transform into systems that influence the behavior of care providers. Methods The BRIDGE-Wiz application (Building Recommendations In a Developer's Guideline Editor) uses a wizard approach to address the questions: (1) under what circumstances? (2) who? (3) ought (with what level of obligation?) (4) to do what? (5) to whom? (6) how and why? Controlled natural language was applied to create and populate a template for recommendation statements. Results The application was used by five national panels to develop guidelines. In general, panelists agreed that the software helped to formalize a process for authoring guideline recommendations and deemed the application usable and useful. Discussion Use of BRIDGE-Wiz promotes clarity of recommendations by limiting verb choices, building active voice recommendations, incorporating decidability and executability checks, and limiting Boolean connectors. It enhances transparency by incorporating systematic appraisal of evidence quality, benefits, and harms. BRIDGE-Wiz promotes implementability by providing a pseudocode rule, suggesting deontic modals, and limiting the use of ‘consider’. Conclusion Users found that BRIDGE-Wiz facilitates the development of clear, transparent, and implementable guideline recommendations. PMID:21846779

  15. Guidelines to Update Images of Women in Television.

    ERIC Educational Resources Information Center

    Fjeldsted, Margaret, Ed.

    Input from 25 media groups, including the Screen Actors Guild and American Federation of Television and Radio Artists (AFTRA), considered the image of women on television and radio as part of public hearings held by the California Commission on the Status of Women. Presentations included here touch on the citizen's role in assuring fair treatment…

  16. Discursive gaps in the implementation of public health policy guidelines in India: the case of HIV testing.

    PubMed

    Sheikh, Kabir; Porter, John

    2010-12-01

    The implementation of standardized policy guidelines for care of diseases of public health importance has emerged as a subject of concern in low and middle-income countries (LMIC) globally. We conducted an empirical research study using the interpretive policy analysis approach to diagnose reasons for gaps in the implementation of national guidelines for HIV testing in Indian hospitals. Forty-six in-depth interviews were conducted with actors involved in policy implementation processes in five states of India, including practitioners, health administrators, policy-planners and donors. We found that actors' divergences from their putative roles in implementation were underpinned by their inhabitation of discrete 'systems of meaning' - frameworks for perceiving policy problems, acting and making decisions. Key gaps in policy implementation included conflicts between different actors' ideals of performance of core tasks and conformance with policy, and problems in communicating policy ideas across systems of meaning. These 'discursive' gaps were compounded by the lack of avenues for intellectual intercourse and by unaccounted interrelationships of power between implementing actors. Our findings demonstrate the importance of thinking beyond short-sighted ideals of aligning frontline practices with global policymakers' intentions. Recognising the deliberative nature of implementation, and strengthening discourse and communications between involved actors may be critical to the success of public health policies in Indian and comparable LMIC settings. Effective policy implementation in the long term also necessitates enhancing practitioners' contributions to the policy process, and equipping country public health functionaries to actualize their policy leadership roles. PMID:20950906

  17. Guidelines and criteria for the implementation of community-based health promotion programs for individuals with disabilities.

    PubMed

    Drum, Charles E; Peterson, Jana J; Culley, Carla; Krahn, Gloria; Heller, Tamar; Kimpton, Tory; McCubbin, Jeff; Rimmer, James; Seekins, Tom; Suzuki, Rie; White, Glen W

    2009-01-01

    Health promotion programs for people with disabilities are in the early stages of development. This critical review utilizes a credentialed expert panel to develop a set of guidelines for community-based health promotion programs for individuals with disabilities. The procedures include a review of background material, systematic literature review with drafted guidelines consisting of operational, participation and accessibility recommendations. The role that those with disabilities can play is addressed and includes program planning, implementation and evaluation, physical and programmatic accessibility of programs, and importance of evidence-based practices. PMID:19928482

  18. VHDL implementation of an image processor

    NASA Astrophysics Data System (ADS)

    Kelly, Michael; Hsu, Kenneth W.

    1998-06-01

    This paper describes the design of a flexible, pipelined general image processor (GIP) using VHDL to model the top level design and functional blocks consisting of histogram [1,2,3,4,5,6], modification, convolution, halftone, error diffusion, and threshold. GIP was simulated to have a processing speed of 70 Mpixels/second. A four pixel wide image data path is used so a clock of 17.5 MHz can be used. Mentor Graphics tool suites were used to perform the simulation and synthesis of the design. The total number of gates in 1.2 (mu) CMOSN gate array was estimated to be 236 K gates, less than 1 million transistors.

  19. Implementation of swept synthetic aperture imaging

    NASA Astrophysics Data System (ADS)

    Bottenus, Nick; Jakovljevic, Marko; Boctor, Emad; Trahey, Gregg E.

    2015-03-01

    Ultrasound imaging of deep targets is limited by the resolution of current ultrasound systems based on the available aperture size. We propose a system to synthesize an extended effective aperture in order to improve resolution and target detectability at depth using a precisely-tracked transducer swept across the region of interest. A Field II simulation was performed to demonstrate the swept aperture approach in both the spatial and frequency domains. The adaptively beam-formed system was tested experimentally using a volumetric transducer and an ex vivo canine abdominal layer to evaluate the impact of clutter-generating tissue on the resulting point spread function. Resolution was improved by 73% using a 30.8 degree sweep despite the presence of varying aberration across the array with an amplitude on the order of 100 ns. Slight variations were observed in the magnitude and position of side lobes compared to the control case, but overall image quality was not significantly degraded as compared by a simulation based on the experimental point spread function. We conclude that the swept aperture imaging system may be a valuable tool for synthesizing large effective apertures using conventional ultrasound hardware.

  20. Quality Improvement Guidelines for Imaging Detection and Treatment of Endoleaks following Endovascular Aneurysm Repair (EVAR)

    SciTech Connect

    Rand, T.; Uberoi, R.; Cil, B.; Munneke, G.; Tsetis, D.

    2013-02-15

    Major concerns after aortic aneurysm repair are caused by the presence of endoleaks, which are defined as persistent perigraft flow within the aortic aneurysm sac. Diagnosis of endoleaks can be performed with various imaging modalities, and indications for treatment are based on further subclassifications. Early detection and correct classification of endoleaks are crucial for planning patient management. The vast majority of endoleaks can be treated successfully by interventional means. Guidelines for Imaging Detection and Treatment of endoleaks are described in this article.

  1. Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

    PubMed Central

    Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B.; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

    2016-01-01

    Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future

  2. Optical Implementation of Matching Pursuit for Image Representation

    NASA Technical Reports Server (NTRS)

    Chao, T.; Lau, B.; Miceli, W.

    1994-01-01

    We have developed a technique for image analysis, representation, and decomposition. This technique was motivated by Stephane Mallat's matching-pursuit algorithm. We've altered and simplified the mechanics of his algorithm to enable an extremely fast implementation via optical processing. Initial computer simulations show that our algorithm is capable of decomposing and representing a 2-D image as a linear combination of basis images with both high speed and high fidelity.

  3. Implementation of Multispectral Image Classification on a Remote Adaptive Computer

    NASA Technical Reports Server (NTRS)

    Figueiredo, Marco A.; Gloster, Clay S.; Stephens, Mark; Graves, Corey A.; Nakkar, Mouna

    1999-01-01

    As the demand for higher performance computers for the processing of remote sensing science algorithms increases, the need to investigate new computing paradigms its justified. Field Programmable Gate Arrays enable the implementation of algorithms at the hardware gate level, leading to orders of m a,gnitude performance increase over microprocessor based systems. The automatic classification of spaceborne multispectral images is an example of a computation intensive application, that, can benefit from implementation on an FPGA - based custom computing machine (adaptive or reconfigurable computer). A probabilistic neural network is used here to classify pixels of of a multispectral LANDSAT-2 image. The implementation described utilizes Java client/server application programs to access the adaptive computer from a remote site. Results verify that a remote hardware version of the algorithm (implemented on an adaptive computer) is significantly faster than a local software version of the same algorithm implemented on a typical general - purpose computer).

  4. Knowledge and Implementation of the S3 Guideline on Gestational Diabetes among Gynecologists and Diabetologists Four Years after Publication

    PubMed Central

    Groten, T.; Schmitz, S.; Schippert, C.; Schleußner, E.; Hillemanns, P.; Lehmann, T.; von Versen-Höynck, F.

    2016-01-01

    Background: An S3 guideline on the diagnosis and differentiated management of gestational diabetes (GDM) was published in Germany in 2011. This guideline replaced the previously applicable recommendations for the diagnosis and treatment of GDM and, for the first time, compiled evidence-based recommendations for the care of patients with GDM. The new guideline has focused particularly on the counselling offered to all patients with GDM about the associated long-term health risks. In this study we investigated the state of knowledge about the guideline among gynecologists and diabetologists in Thuringia and Lower Saxony. Method: A questionnaire with 23 questions was sent out to 773 gynecologists and 76 diabetologists providing outpatient care in Lower Saxony and Thuringia. The statistical analysis was descriptive and inferential for comparisons between groups. Results: The response rate was 54 %; an average of 47.6 % of the individual questions were answered correctly in the completed questionnaires. The questions were answered correctly significantly more frequently by persons in the group with a good knowledge of the guidelines (75 vs. 61 %, p < 0.001). There were no significant differences between groups when differences between federal states or medical specialties were compared. Conclusions: The results of our study show a good general state of knowledge of the guideline and point to a high level of willingness to implement the recommendations of the S3 guideline on GDM. With regard to the follow-up care provided to patients with GDM and depression, this study found a significant need for further training. PMID:27582574

  5. Disposal orbits for GEO spacecraft: A method for evaluating the orbit height distributions resulting from implementing IADC guidelines

    NASA Astrophysics Data System (ADS)

    Hobbs, Stephen

    2010-04-01

    Geostationary orbit (GEO) is the most commercially valuable Earth orbit. The Inter-Agency Space Debris Coordination Committee (IADC) has produced guidelines to help protect this region from space debris. The guidelines propose moving a satellite at the end of its operational life to a disposal orbit, which is designed so that satellites left there will not infringe the operational GEO region within a period of at least 100 yr. Standards are being developed through the International Organisation for Standardization to translate the IADC guidelines into engineering practice. This article presents an analytical method for calculating the distribution of final orbits assuming the IADC guidelines in GEO are implemented, as a function of distributions of satellite parameters (mass per unit area, solar radiation pressure reaction coefficient), the fuel measurement uncertainty, and the desired reliability of the disposal manoeuvre. Results show that typically the fuel measurement uncertainty dominates the distribution of perigee heights rather than the scatter in satellite properties or desired manoeuvre reliability. The method is simple to implement and allows the effects of changes in system parameters to be evaluated quickly.

  6. Holographic Radar Imaging Privacy Techniques Utilizing Dual-Frequency Implementation

    SciTech Connect

    McMakin, Douglas L.; Hall, Thomas E.; Sheen, David M.

    2008-04-18

    Over the last 15 years, the Pacific Northwest National Laboratory has performed significant research and development activities to enhance the state of the art of holographic radar imaging systems to be used at security checkpoints for screening people for concealed threats hidden under their garments. These enhancement activities included improvements to privacy techniques to remove human features and providing automatic detection of body-worn concealed threats. The enhanced privacy and detection methods used both physical and software imaging techniques. The physical imaging techniques included polarization-diversity illumination and reception, dual-frequency implementation, and high-frequency imaging at 60 GHz. Software imaging techniques to enhance the privacy of the person under surveillance included extracting concealed threat artifacts from the imagery to automatically detect the threat. This paper will focus on physical privacy techniques using dual-frequency implementation.

  7. CEOS Land Surface Imaging Constellation Mid-Resolution Optical Guidelines

    NASA Technical Reports Server (NTRS)

    Keyes, Jennifer P.; Killough, B.

    2011-01-01

    The LSI community of users is large and varied. To reach all these users as well as potential instrument contributors this document has been organized by measurement parameters of interest such as Leaf Area Index and Land Surface Temperature. These measurement parameters and the data presented in this document are drawn from multiple sources, listed at the end of the document, although the two primary ones are "The Space-Based Global Observing System in 2010 (GOS-2010)" that was compiled for the World Meteorological Organization (WMO) by Bizzarro Bizzarri, and the CEOS Missions, Instruments, and Measurements online database (CEOS MIM). For each measurement parameter the following topics will be discussed: (1) measurement description, (2) applications, (3) measurement spectral bands, and (4) example instruments and mission information. The description of each measurement parameter starts with a definition and includes a graphic displaying the relationships to four general land surface imaging user communities: vegetation, water, earth, and geo-hazards, since the LSI community of users is large and varied. The vegetation community uses LSI data to assess factors related to topics such as agriculture, forest management, crop type, chlorophyll, vegetation land cover, and leaf or canopy differences. The water community analyzes snow and lake cover, water properties such as clarity, and body of water delineation. The earth community focuses on minerals, soils, and sediments. The geo-hazards community is designed to address and aid in emergencies such as volcanic eruptions, forest fires, and large-scale damaging weather-related events.

  8. Quality improvement for neonatal nurses, part II: using a PDSA quality improvement cycle approach to implement an oral feeding progression guideline for premature infants.

    PubMed

    Marcellus, Lenora; Harrison, Adele; Mackinnon, Kathleen

    2012-01-01

    The development of clinical practice guidelines involving multiple health care providers presents a challenge in the neonatal intensive care unit (NICU). Implementation and evaluation of the guideline is as important as the development of the guideline itself. We explored the use of a quality improvement approach in the implementation of a feeding framework. A Plan-Do-Study-Act (PDSA) quality improvement cycle model was used to implement and evaluate a stepwise oral infant feeding guideline with emphasis on parent and care provider satisfaction. Three PDSA cycles were conducted, with each cycle resulting in modifications to use of the framework and development of knowledge translation and parent education techniques and tools. A PDSA cycle approach can be used effectively in guideline implementation and evaluation involving multidisciplinary health care professionals. This is Part II of a two-part series. Part I introduced the concept of quality improvement and tools for advancing practice changes. PMID:22763248

  9. Clinical Development and Implementation of an Institutional Guideline for Prospective EEG Monitoring and Reporting of Delayed Cerebral Ischemia.

    PubMed

    Muniz, Carlos F; Shenoy, Apeksha V; OʼConnor, Kathryn L; Bechek, Sophia C; Boyle, Emily J; Guanci, Mary M; Tehan, Tara M; Zafar, Sahar F; Cole, Andrew J; Patel, Aman B; Westover, Michael B; Rosenthal, Eric S

    2016-06-01

    Delayed cerebral ischemia (DCI) is the most common and disabling complication among patients admitted to the hospital for subarachnoid hemorrhage (SAH). Clinical and radiographic methods often fail to detect DCI early enough to avert irreversible injury. We assessed the clinical feasibility of implementing a continuous EEG (cEEG) ischemia monitoring service for early DCI detection as part of an institutional guideline. An institutional neuromonitoring guideline was designed by an interdisciplinary team of neurocritical care, clinical neurophysiology, and neurosurgery physicians and nursing staff and cEEG technologists. The interdisciplinary team focused on (1) selection criteria of high-risk patients, (2) minimization of safety concerns related to prolonged monitoring, (3) technical selection of quantitative and qualitative neurophysiologic parameters based on expert consensus and review of the literature, (4) a structured interpretation and reporting methodology, prompting direct patient evaluation and iterative neurocritical care, and (5) a two-layered quality assurance process including structured clinician interviews assessing events of neurologic worsening and an adjudicated consensus review of neuroimaging and medical records. The resulting guideline's clinical feasibility was then prospectively evaluated. The institutional SAH monitoring guideline used transcranial Doppler ultrasound and cEEG monitoring for vasospasm and ischemia monitoring in patients with either Fisher group 3 or Hunt-Hess grade IV or V SAH. Safety criteria focused on prevention of skin breakdown and agitation. Technical components included monitoring of transcranial Doppler ultrasound velocities and cEEG features, including quantitative alpha:delta ratio and percent alpha variability, qualitative evidence of new focal slowing, late-onset epileptiform activity, or overall worsening of background. Structured cEEG reports were introduced including verbal communication for findings concerning

  10. Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems

    PubMed Central

    Roudsari, Abdul

    2011-01-01

    Objective There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. Methods A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. Results One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. Discussion and conclusion We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings. PMID:21724740

  11. Effectiveness of an implementation strategy for a breastfeeding guideline in Primary Care: cluster randomised trial

    PubMed Central

    2011-01-01

    Background The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be based upon the training of health professionals. Following the recommendations of a breastfeeding guide can modify the practice of health professionals and improve results with respect to exclusively or predominatly breastfed children at 6 months of age. Method/Design This study involves a community based cluster randomized trial in primary healthcare centres in Leganés (Madrid, Spain). The project aims to determine whether the use of an implementation strategy (including training session, information distribution, opinion leader) of a breastfeeding guideline in primary care is more effective than usual diffusion. The number of patients required will be 240 (120 in each arm). It will be included all the mothers of infants born during the study period (6 months) who come to the health centre on the first visit of the child care programme and who give their consent to participate. The main outcome variable is the exclusive o predominant breastfeeding at 6 moths of age.. Main effectiveness will be analyzed by comparing the percentage of infants with exclusive or predominant breastfeeding at 6 months between the intervention group and the control group. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion Strategies need to be found which facilitate the giving of effective advice on breastfeeding by professionals and which provide support to women during the breastfeeding period. By applying the guide's recommendations, clinical

  12. The College of American Pathologists guidelines for whole slide imaging validation are feasible for pediatric pathology: a pediatric pathology practice experience.

    PubMed

    Arnold, Michael A; Chenever, Emily; Baker, Peter B; Boué, Daniel R; Fung, Bonita; Hammond, Sue; Hendrickson, Brett W; Kahwash, Samir B; Pierson, Christopher R; Prasad, Vinay; Nicol, Kathleen K; Barr, Thomas

    2015-01-01

    Whole slide imaging (WSI) is rapidly transforming educational and diagnostic pathology services. Recently, the College of American Pathologists Pathology and Laboratory Quality Center (CAP-PLQC) published recommended guidelines for validating diagnostic WSI. We prospectively evaluated the guidelines to determine their utility in validating pediatric surgical pathology and cytopathology specimens. Our validation included varied pediatric specimen types, including complex or less common diagnoses, in accordance with the guidelines. We completed WSI review of 60 surgical pathology cases and attempted WSI review of 21 cytopathology cases. For surgical pathology cases, WSI diagnoses were highly concordant with glass slide diagnoses; a discordant diagnosis was observed in 1 of 60 cases (98.3% concordance). We found that nucleated red blood cells and eosinophilic granular bodies represented specific challenges to WSI review of pediatric specimens. Cytology specimens were more frequently discordant or failed for technical reasons, with overall concordance of 66.7%. Review of pediatric cytopathology specimens will likely require image capture in multiple focal planes. This study is the first to specifically evaluate WSI review for pediatric specimens and demonstrates that specimens representing the spectrum of pediatric surgical pathology practice can be reviewed using WSI. Our application of the proposed CAP-PLQC guidelines to pediatric surgical pathology specimens is, to our knowledge, the first prospective implementation of the CAP-PLQC guidelines. PMID:25387255

  13. Sequential and parallel image restoration: neural network implementations.

    PubMed

    Figueiredo, M T; Leitao, J N

    1994-01-01

    Sequential and parallel image restoration algorithms and their implementations on neural networks are proposed. For images degraded by linear blur and contaminated by additive white Gaussian noise, maximum a posteriori (MAP) estimation and regularization theory lead to the same high dimension convex optimization problem. The commonly adopted strategy (in using neural networks for image restoration) is to map the objective function of the optimization problem into the energy of a predefined network, taking advantage of its energy minimization properties. Departing from this approach, we propose neural implementations of iterative minimization algorithms which are first proved to converge. The developed schemes are based on modified Hopfield (1985) networks of graded elements, with both sequential and parallel updating schedules. An algorithm supported on a fully standard Hopfield network (binary elements and zero autoconnections) is also considered. Robustness with respect to finite numerical precision is studied, and examples with real images are presented. PMID:18296247

  14. Implementation of modified SPIHT algorithm for Compression of images

    NASA Astrophysics Data System (ADS)

    Kurume, A. V.; Yana, D. M.

    2011-12-01

    We present a throughput-efficient FPGA implementation of the Set Partitioning in Hierarchical Trees (SPIHT) algorithm for compression of images. The SPIHT uses inherent redundancy among wavelet coefficients and suited for both grey and color images. The SPIHT algorithm uses dynamic data structure which hinders hardware realization. we have modified basic SPIHT in two ways, one by using static (fixed) mappings which represent significant information and the other by interchanging the sorting and refinement passes.

  15. [How to write, how to implement and how to evaluate a practice guideline in order to improve quality of care?].

    PubMed

    Moret, L; Lefort, C; Terrien, N

    2012-11-01

    Initiatives of clinical practices improvement have been gradually developing in France for 20 years. Nevertheless, effective implementation of change is still difficult for numerous reasons. The use of clinical practices guidelines is one of the different ways of improvement. It is however necessary to adapt these national guidelines to the specificities of the hospital and the team, to ensure implementation and appropriation by the professionals. These recommendations are thus translated into applicable and concrete standard operating procedures. These documents have to be built by and for the concerned professionals. They are also communication and training tools, precise, directive, uniform in terms of presentation and attractive visually. Once drafted, they have to be distributed widely to the professionals to facilitate implementation. The simple distribution of the recommendations is insufficient to modify the clinical practices and require association of several methods of promotion for an optimal appropriation. How then to make sure of their effective use? Practices evaluation is one of the steps of continuous professional development, including continuous training and analysis of clinical practices by using methods promoted by the "Haute Autorité de santé". One of them is the clinical audit; use of method assessing non-pertinent treatment is interesting too. Analysis of the non-conformities and gaps between theory and practice allows identifying various possible causes (professional, institutional, organizational or personal) in order to implement corrective action plans, in a logic of continuous improvement. PMID:23039956

  16. One Rural Hospital's Experience Implementing the Society for Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.

    PubMed

    Curlej, Maria H; Katrancha, Elizabeth

    2016-01-01

    In an effort to take advantage of the Highmark Quality Blue Initiative () requiring information from hospitals detailing their central line-associated blood stream infections (CLABSIs) surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Recognizing the baseline rate of 2.4 CLABSIs per 1,000 central line days and its effect on patient outcomes and medical costs, this hospital made a commitment to improve their CLABSI outcomes. As a result, the facility adopted the Society for Healthcare Epidemiology of America (SHEA) guidelines. The purpose of this article is to review the CLABSI rates and examine the prevention strategies following implementation of the SHEA guidelines. A quantitative, descriptive retrospective program evaluation examined the hospital's pre- and post-SHEA implementation methods of decreasing CLABSIs and the subsequent CLABSI rates over 3 time periods. Any patient with a CLABSI infection admitted to this hospital July 2007 to June 2010 (N = 78). CLABSI rates decreased from 1.9 to 1.3 over the study period. Compliance with specific SHEA guidelines was evaluated and measures were put into place to increase compliance where necessary. CLABSI rates at this facility remain below the baseline of 2.4 for calendar year 2013 (0.79), 2014 (0.07), and 2015 (0.33). PMID:27618377

  17. Toward public health nutrition strategies in the European Union to implement food based dietary guidelines and to enhance healthier lifestyles.

    PubMed

    Stockley, L

    2001-04-01

    This paper suggests strategies for implementing the EU food based dietary guidelines. Dietary guidelines have been developed and disseminated in many countries across the world. However, the EU guidelines are the first to include a specific section on implementation. The aims of the guidelines are twofold, 1) to provide food based dietary guidelines which can be used as a consistent communication tool and 2) as a springboard to planning, implementing, and evaluating public health nutrition strategies. The report is not intended to be prescriptive. It aims to build upon a solid evidence base to provide practical and cost effective suggestions for developing public health strategies, which member countries can use and tailor to the social, cultural and health needs of their populations. Diet and physical activity related diseases impose vast costs on the European economy. However, despite the enormous costs to healthcare systems and in terms of lost productivity, there have been a very few resources allocated in Europe to attempting to prevent these, rather than treating them. The burden of disease exists in the majority of the population, and not in high-risk groups. The optimal public health strategy is thus to focus on the population as a whole, rather than targeting those with increased risk factors or pre-existing disease. Reviews have been carried out on the health impact effectiveness of various types of intervention to promote healthy eating and physical activity in the population. These conclude that the most effective interventions a) adopt an integrated, multidisciplinary, and comprehensive approach b) involve a complementary range of actions, and c) work at an individual, community, environmental and policy level. Information provision in isolation is not effective, and may exacerbate inequalities in health. In some countries inequities in diet and physical activity are not only significant contributors to inequalities in health, but are increasing

  18. Unconventional methods of imaging: computational microscopy and compact implementations

    NASA Astrophysics Data System (ADS)

    McLeod, Euan; Ozcan, Aydogan

    2016-07-01

    In the past two decades or so, there has been a renaissance of optical microscopy research and development. Much work has been done in an effort to improve the resolution and sensitivity of microscopes, while at the same time to introduce new imaging modalities, and make existing imaging systems more efficient and more accessible. In this review, we look at two particular aspects of this renaissance: computational imaging techniques and compact imaging platforms. In many cases, these aspects go hand-in-hand because the use of computational techniques can simplify the demands placed on optical hardware in obtaining a desired imaging performance. In the first main section, we cover lens-based computational imaging, in particular, light-field microscopy, structured illumination, synthetic aperture, Fourier ptychography, and compressive imaging. In the second main section, we review lensfree holographic on-chip imaging, including how images are reconstructed, phase recovery techniques, and integration with smart substrates for more advanced imaging tasks. In the third main section we describe how these and other microscopy modalities have been implemented in compact and field-portable devices, often based around smartphones. Finally, we conclude with some comments about opportunities and demand for better results, and where we believe the field is heading.

  19. Unconventional methods of imaging: computational microscopy and compact implementations.

    PubMed

    McLeod, Euan; Ozcan, Aydogan

    2016-07-01

    In the past two decades or so, there has been a renaissance of optical microscopy research and development. Much work has been done in an effort to improve the resolution and sensitivity of microscopes, while at the same time to introduce new imaging modalities, and make existing imaging systems more efficient and more accessible. In this review, we look at two particular aspects of this renaissance: computational imaging techniques and compact imaging platforms. In many cases, these aspects go hand-in-hand because the use of computational techniques can simplify the demands placed on optical hardware in obtaining a desired imaging performance. In the first main section, we cover lens-based computational imaging, in particular, light-field microscopy, structured illumination, synthetic aperture, Fourier ptychography, and compressive imaging. In the second main section, we review lensfree holographic on-chip imaging, including how images are reconstructed, phase recovery techniques, and integration with smart substrates for more advanced imaging tasks. In the third main section we describe how these and other microscopy modalities have been implemented in compact and field-portable devices, often based around smartphones. Finally, we conclude with some comments about opportunities and demand for better results, and where we believe the field is heading. PMID:27214407

  20. Image segmentation in wavelet transform space implemented on DSP

    NASA Astrophysics Data System (ADS)

    Ponomaryov, Volodymyr I.; Castillejos, Heydy; Peralta-Fabi, Ricardo

    2012-06-01

    A novel approach in the segmentation for the images of different nature employing the feature extraction in WT space before the segmentation process is presented. The designed frameworks (W-FCM, W-CPSFCM and WK-Means) according to AUC analysis have demonstrated better performance novel frameworks against other algorithms existing in literature during numerous simulation experiments with synthetic and dermoscopic images. The novel W-CPSFCM algorithm estimates a number of clusters in automatic mode without the intervention of a specialist. The implementation of the proposed segmentation algorithms on the Texas Instruments DSP TMS320DM642 demonstrates possible real time processing mode for images of different nature.

  1. The Effect of Education and Implementation of Evidence-Based Nursing Guidelines on Infants’ Weight Gaining in NICU

    PubMed Central

    Salehi, Zahra; Nouri, Jamileh Mokhtari; Khademolhoseyni, Seyyed Mohammad; Ebadi, Abbas

    2015-01-01

    Background: Educating evidence-based guidelines influences increased quality of nursing cares effectively. Infant’s weight gaining is one of the most important indicators for measuring quality of nursing care in NICU. The research is conducted with the aim of surveying the effect of education and implementation of educating evidence-based guidelines on infants’ weight gaining in NICU. Methods: This two-group clinical trial study was conducted in 2013 on one hundred infants in Baqiyatallah (AJ) hospital of Tehran. It was performed by using non-probable and convenient sampling. Data collection tools included; infants’ demographic questionnaire and a researcher-made checklist to record infants’ weight by using a weighing scale. Infants’ weight was recorded before intervention and two months after implementation of the guidelines, then data were analyzed by using SPSS19 statistical software. Findings: Mean weight of the infants in the control group on admission and on discharge was respectively; 1771(41.71) and 1712(42.68), and mean weight of the infants in intervention group on admission and on discharge was respectively; 1697(37.63) and 1793(40.71). After two months, infants’ weight gaining in intervention group was more than control group and it was statistically significant (P = 0.001). Conclusion: Results of the present study showed that implementation of evidence-based instruction an effective and economical method regarding infants’ weight gaining. Therefore it is recommended to the authorities and managers of the hospitals and educational centers of the healthcare services to put education and implementation of educating evidence-based instruction the priority of their work plans. PMID:25716388

  2. Implementation of GPU-Accelerated Back Projection for EPR imaging

    PubMed Central

    Qiao, Zhiwei; Redler, Gage; Epel, Boris; Qian, Yuhua; Halpern, Howard

    2016-01-01

    Electron paramagnetic resonance (EPR) Imaging (EPRI) is a robust method for measuring in vivo oxygen concentration (pO2). For 3D pulse EPRI, a commonly used reconstruction algorithm is the filtered backprojection (FBP) algorithm, in which the backprojection process is computationally intensive and may be time consuming when implemented on a CPU. A multistage implementation of the backprojection can be used for acceleration, however it is not flexible (requires equal linear angle projection distribution) and may still be time consuming. In this work, single-stage backprojection is implemented on a GPU (Graphics Processing Units) having 1152 cores to accelerate the process. The GPU implementation results in acceleration by over a factor of 200 overall and by over a factor of 3500 if only the computing time is considered. Some important experiences regarding the implementation of GPU-accelerated backprojection for EPRI are summarized. The resulting accelerated image reconstruction is useful for real-time image reconstruction monitoring and other time sensitive applications. PMID:26410654

  3. Diagnostic Yield of Chromosomal Microarray Analysis in an Autism Primary Care Practice: Which Guidelines to Implement?

    ERIC Educational Resources Information Center

    McGrew, Susan G.; Peters, Brittany R.; Crittendon, Julie A.; Veenstra-VanderWeele, Jeremy

    2012-01-01

    Genetic testing is recommended for patients with ASD; however specific recommendations vary by specialty. American Academy of Pediatrics and American Academy of Neurology guidelines recommend G-banded karyotype and Fragile X DNA. The American College of Medical Genetics recommends Chromosomal Microarray Analysis (CMA). We determined the yield of…

  4. Guidelines for the Implementation of Programs for Pupils Who Are Orthopedically Handicapped.

    ERIC Educational Resources Information Center

    Black, Robert S.; Fusco, Carol B.

    Guidelines are provided for the development of programs in South Carolina for orthopedically handicapped (OH) pupils. Basic information is given concerning the definition of orthopedic handicap, the legal mandates on the education of OH pupils, funding sources, authorized programs (whether self-contained programs, resource rooms, or itinerant…

  5. Design Guidelines as Controls on Development: The Politics of Implementation in a Small Ohio Town.

    ERIC Educational Resources Information Center

    Brown-Manrique, Gerardo

    1991-01-01

    Describes efforts of citizens of Oxford, Ohio, to preserve an existing historic environment while ensuring its commercial viability. Miami University is located in Oxford, and its architecture department prepared design guidelines for use by the Historic and Architectural Preservation Commission in evaluating proposals for adding, altering, or…

  6. Distributed Training for the Reserve Component: Course Conversion and Implementation Guidelines for Computer Conferencing.

    ERIC Educational Resources Information Center

    Hahn, H. A.; And Others

    The purpose of this handbook is to provide background and guidelines for course designers and instructional developers who will be developing Reserve Component training for the United States military using asynchronous computer conferencing techniques. The recommendations in this report are based on an international review of the literature in…

  7. A Model Policy Statement and Guidelines for Implementation: Equal Treatment of Students.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    This booklet offers a model policy statement that schools shall provide equal educational opportunities to all students regardless of sex. It includes stipulations and guidelines to achieve equal access in all areas of education. The following areas are considered: (1) Course offerings: every course shall be open to all students and schools should…

  8. An Implementation Strategy to Improve the Guideline Adherence of Insurance Physicians: A Process Evaluation Alongside an Experiment in a Controlled Setting

    ERIC Educational Resources Information Center

    Zwerver, Feico; Bonefaas-Groenewoud, Karin; Schellart, Antonius J. M.; Anema, Johannes R.; van der Beek, Allard J.

    2013-01-01

    Background: We developed an implementation strategy for the insurance medicine guidelines for depression, which we implemented via a post-graduate course for insurance physicians (IPs). In this study we evaluate the physicians' experiences of the implementation strategy by measuring the following aspects: recruitment and reach, dose delivered and…

  9. Management of anaemia and blood transfusion in critical care - implementing national guidelines in ICU.

    PubMed

    Watson, Sethina; Kendrick, Kate

    2014-01-01

    Anaemia in intensive care is common, with approximately 50% of patients receiving a red cell transfusion. Recognised complications from transfusion include 'transfusion associated lung injury', infection, and organ failure progression. Most cohort studies show a positive relationship between red cell transfusion and adverse outcomes. In 2012, the British Committee for Standards in Haematology issued guidelines for red cell (RBC) transfusion in critical care. They recommend a haemoglobin transfusion trigger of below 70 g/dL unless the patient is bleeding, has acute sepsis, neurological injury, or an acute coronary syndrome. RBC transfusions in a single intensive care unit (ICU) were prospectively assessed for compliance with national guidance. Each transfusion was categorised with a traffic light system: red for inappropriate, green for appropriate, and amber for those that were not clearly appropriate or inappropriate. The quality improvement project began with a clinical effectiveness audit of doctors' knowledge of critical care transfusion thresholds. Two quality improvement interventions were used: 1) a local blood transfusion guideline was produced and posters were placed in the ICU 2) this guidance was attached to the transfusion prescriptions. Data was collected after each intervention. A total of 30 random adult RBC transfusions were analysed between August 2013 and February 2014. Despite good results from the effectiveness audit an assessment of RBC transfusions demonstrated room for improvement. Prior to introduction of the guideline intervention, a total of two transfusions were green, one red and seven amber. Following both interventions there were seven green transfusions and three amber. No transfusions were classed as inappropriate. According to additional trust based ICU transfusion records, there was approximately a 50% reduction (41 to 18 RBC transfusions) in overall blood transfusions following the first intervention in October 2013. Simple

  10. Healthcare Professionals’ and Policy Makers’ Views on Implementing a Clinical Practice Guideline of Hypertension Management: A Qualitative Study

    PubMed Central

    Lee, Ping Yein; Liew, Su May; Abdullah, Adina; Abdullah, Nurdiana; Ng, Chirk Jenn; Hanafi, Nik Sherina; Chia, Yook Chin; Lai, Pauline S. M.; Wong, Stalia S. L.; Khoo, Ee Ming

    2015-01-01

    Introduction Most studies have reported barriers to guideline usage mainly from doctors’ perspective; few have reported the perspective of other stakeholders. This study aimed to determine the views and barriers to adherence of a national clinical practice guideline (CPG) on management of hypertension from the perspectives of policymakers, doctors and allied healthcare professionals. Methods This study used a qualitative approach with purposive sampling. Seven in depth interviews and six focus group discussions were conducted with 35 healthcare professionals (policy makers, doctors, pharmacists and nurses) at a teaching hospital in Kuala Lumpur, Malaysia, between February and June 2013. All interviews were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyse the data. Results Two main themes and three sub-themes emerged from this study. The main themes were (1) variation in the use of CPG and (2) barriers to adherence to CPG. The three sub-themes for barriers were issues inherent to the CPG, systems and policy that is not supportive of CPG use, and attitudes and behaviour of stakeholders. The main users of the CPG were the primary care doctors. Pharmacists only partially use the guidelines, while nurses and policy makers were not using the CPG at all. Participants had suggested few strategies to improve usage and adherence to CPG. First, update the CPG regularly and keep its content simple with specific sections for allied health workers. Second, use technology to facilitate CPG accessibility and provide protected time for implementation of CPG recommendations. Third, incorporate local CPG in professional training, link CPG adherence to key performance indicators and provide incentives for its use. Conclusions Barriers to the use of CPG hypertension management span across all stakeholders. The development and implementation of CPG focused mainly on doctors with lack of involvement of other healthcare stakeholders. Guidelines

  11. 32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency Implementing..., as circumstances require. If a change in national policy necessitates a change in agency implementing... to the attention of the Director, ISOO, or after a change in national policy that impacts...

  12. 32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency Implementing..., as circumstances require. If a change in national policy necessitates a change in agency implementing... to the attention of the Director, ISOO, or after a change in national policy that impacts...

  13. A high performance hardware implementation image encryption with AES algorithm

    NASA Astrophysics Data System (ADS)

    Farmani, Ali; Jafari, Mohamad; Miremadi, Seyed Sohrab

    2011-06-01

    This paper describes implementation of a high-speed encryption algorithm with high throughput for encrypting the image. Therefore, we select a highly secured symmetric key encryption algorithm AES(Advanced Encryption Standard), in order to increase the speed and throughput using pipeline technique in four stages, control unit based on logic gates, optimal design of multiplier blocks in mixcolumn phase and simultaneous production keys and rounds. Such procedure makes AES suitable for fast image encryption. Implementation of a 128-bit AES on FPGA of Altra company has been done and the results are as follow: throughput, 6 Gbps in 471MHz. The time of encrypting in tested image with 32*32 size is 1.15ms.

  14. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging.

    PubMed

    Bernard, Chantal; Chandrakanth, S A; Cornell, Ian Scott; Dalton, James; Evans, Andrew; Garcia, Bertha M; Godin, Chris; Godlewski, Marek; Jansen, Gerard H; Kabani, Amin; Louahlia, Said; Manning, Lisa; Maung, Raymond; Moore, Lisa; Philley, Joanne; Slatnik, Jack; Srigley, John; Thibault, Alain; Picard, Donald Daniel; Cracower, Hanah; Tetu, Bernard

    2014-01-01

    The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section), primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered. PMID:24843826

  15. Drug Utilization, Dosing, and Costs After Implementation of Intravenous Acetaminophen Guidelines for Pediatric Patients

    PubMed Central

    Fusco, Nicholas M.; Parbuoni, Kristine; Morgan, Jill A.

    2014-01-01

    OBJECTIVES The objectives of this evaluation of medication use were to characterize the use of intravenous acetaminophen at our institution and to determine if acetaminophen was prescribed at age-appropriate dosages per institutional guidelines, as well as to evaluate compliance with restrictions for use. Total acquisition costs associated with intravenous acetaminophen usage is described as well. METHODS This retrospective study evaluated the use of acetaminophen in pediatric patients younger than 18 years of age, admitted to a tertiary care hospital, who received at least 1 dose of intravenous acet-aminophen between August 1, 2011, and January 31, 2012. RESULTS A total of 52 doses of intravenous acetaminophen were administered to 31 patients during the 6-month study period. Most patients were admitted to the otorhinolaryngology service (55%), and the majority of doses were administered either in the operating room (46%) or in the intensive care unit (46%). Nineteen doses (37%) of intravenous acetaminophen were administered to patients who did not meet institutional guidelines' eligibility criteria. Three patients received single doses of intravenous acetaminophen that were greater than the dose recommended for their age. One patient during the study period received more than the recommended 24-hour maximum cumulative dose for acetaminophen. Total acquisition cost of intravenous acetaminophen therapy over the 6-month study period was $530.40. CONCLUSIONS Intravenous acetaminophen was used most frequently among pediatric patients admitted to the otorhinolaryngology service during the perioperative period. Nineteen doses (37%) were administered to patients who did not meet the institutional guidelines' eligibility criteria. Our data support reinforcing the availability of institutional guidelines to promote cost-effective use of intravenous acetaminophen while minimizing the prescription of inappropriate doses. PMID:24782690

  16. Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update.

    PubMed

    Crews, K R; Gaedigk, A; Dunnenberger, H M; Leeder, J S; Klein, T E; Caudle, K E; Haidar, C E; Shen, D D; Callaghan, J T; Sadhasivam, S; Prows, C A; Kharasch, E D; Skaar, T C

    2014-04-01

    Codeine is bioactivated to morphine, a strong opioid agonist, by the hepatic cytochrome P450 2D6 (CYP2D6); hence, the efficacy and safety of codeine are governed by CYP2D6 activity. Polymorphisms are a major cause of CYP2D6 variability. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for codeine based on CYP2D6 genotype. This document is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP2D6 genotype and codeine therapy. PMID:24458010

  17. The clinical pharmacogenetics implementation consortium guideline for SLCO1B1 and simvastatin-induced myopathy: 2014 update.

    PubMed

    Ramsey, L B; Johnson, S G; Caudle, K E; Haidar, C E; Voora, D; Wilke, R A; Maxwell, W D; McLeod, H L; Krauss, R M; Roden, D M; Feng, Q; Cooper-DeHoff, R M; Gong, L; Klein, T E; Wadelius, M; Niemi, M

    2014-10-01

    Simvastatin is among the most commonly used prescription medications for cholesterol reduction. A single coding single-nucleotide polymorphism, rs4149056T>C, in SLCO1B1 increases systemic exposure to simvastatin and the risk of muscle toxicity. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for simvastatin based on SLCO1B1 genotype. This article is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium guideline for SLCO1B1 and simvastatin-induced myopathy. PMID:24918167

  18. Computed Tomography Image Compressibility and Limitations of Compression Ratio-Based Guidelines.

    PubMed

    Pambrun, Jean-François; Noumeir, Rita

    2015-12-01

    Finding optimal compression levels for diagnostic imaging is not an easy task. Significant compressibility variations exist between modalities, but little is known about compressibility variations within modalities. Moreover, compressibility is affected by acquisition parameters. In this study, we evaluate the compressibility of thousands of computed tomography (CT) slices acquired with different slice thicknesses, exposures, reconstruction filters, slice collimations, and pitches. We demonstrate that exposure, slice thickness, and reconstruction filters have a significant impact on image compressibility due to an increased high frequency content and a lower acquisition signal-to-noise ratio. We also show that compression ratio is not a good fidelity measure. Therefore, guidelines based on compression ratio should ideally be replaced with other compression measures better correlated with image fidelity. Value-of-interest (VOI) transformations also affect the perception of quality. We have studied the effect of value-of-interest transformation and found significant masking of artifacts when window is widened. PMID:25804842

  19. Following a natural experiment of guideline adaptation and early implementation: a mixed-methods study of facilitation

    PubMed Central

    2012-01-01

    Background Facilitation is emerging as an important strategy in the uptake of evidence. However, it is not entirely clear from a practical perspective how facilitation occurs to help move research evidence into nursing practice. The Canadian Partnership Against Cancer, also known as the 'Partnership,' is a Pan-Canadian initiative supporting knowledge translation activity for improved care through guideline use. In this case-series study, five self-identified groups volunteered to use a systematic methodology to adapt existing clinical practice guidelines for Canadian use. With 'Partnership' support, local and external facilitators provided assistance for groups to begin the process by adapting the guidelines and planning for implementation. Methods To gain a more comprehensive understanding of the nature of facilitation, we conducted a mixed-methods study. Specifically, we examined the role and skills of individuals actively engaged in facilitation as well as the actual facilitation activities occurring within the 'Partnership.' The study was driven by and builds upon a focused literature review published in 2010 that examined facilitation as a role and process in achieving evidence-based practice in nursing. An audit tool outlining 46 discrete facilitation activities based on results of this review was used to examine the facilitation noted in the documents (emails, meeting minutes, field notes) of three nursing-related cases participating in the 'Partnership' case-series study. To further examine the concept, six facilitators were interviewed about their practical experiences. The case-audit data were analyzed through a simple content analysis and triangulated with participant responses from the focus group interview to understand what occurred as these cases undertook guideline adaptation. Results The analysis of the three cases revealed that almost all of the 46 discrete, practical facilitation activities from the literature were evidenced. Additionally, case

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

    SciTech Connect

    Liaukus, Christine

    2015-07-09

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

  1. Guidelines for youth sports clubs to develop, implement, and assess health promotion within its activities.

    PubMed

    Kokko, Sami

    2014-05-01

    The settings approach to health promotion is a world-known concept concerning settings like city, hospital, school, and workplace. The concept has also been used in some regionally specific settings, such as island, prison, or university. However, there are still many, often noninstitutional, settings that have a lot of potential but have not yet been recognized. One of the newcomers is the youth sports club, which has the potential to reach a lot of children and adolescents and is effective, via its casual educational nature based on voluntary participation. According to research, health is an important aim for most youth sports clubs, but it has not been converted into practical actions. Indeed, the clubs often recognize the importance of healthy lifestyles, but there is a lack of understanding of what to do to reinforce it within one's activities. That is why, on the basis of the results of the Health Promoting Sports Club survey in Finland, guidelines for clubs to enhance health promotion as a part of their activities were created. The aim of this article is to present the guidelines, theirs rationale, and practical examples. PMID:24357861

  2. 75 FR 61504 - Global Implementation of the Veterinary Medicinal Products Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... HUMAN SERVICES Food and Drug Administration Global Implementation of the Veterinary Medicinal Products... OIE's services and activities that are needed to carry out OIE's Veterinary International Conference... level. FOR FURTHER INFORMATION CONTACT: Program Contact: Merton V. Smith, Center for Veterinary...

  3. An extended diffraction-enhanced imaging method for implementing multiple-image radiography

    NASA Astrophysics Data System (ADS)

    Chou, Cheng-Ying; Anastasio, Mark A.; Brankov, Jovan G.; Wernick, Miles N.; Brey, Eric M.; Connor, Dean M., Jr.; Zhong, Zhong

    2007-04-01

    Diffraction-enhanced imaging (DEI) is an analyser-based x-ray imaging method that produces separate images depicting the projected x-ray absorption and refractive properties of an object. Because the imaging model of DEI does not account for ultra-small-angle x-ray scattering (USAXS), the images produced in DEI can contain artefacts and inaccuracies in medical imaging applications. In this work, we investigate an extended DEI method for concurrent reconstruction of three images that depict an object's projected x-ray absorption, refraction and USAXS properties. The extended DEI method can be viewed as an implementation of the recently proposed multiple-image radiography paradigm. Validation studies are conducted by use of computer-simulated and synchrotron measurement data.

  4. Implementation of realistic image rendition algorithm based on DSP

    NASA Astrophysics Data System (ADS)

    Lv, Lily; Gao, Kun; Ni, Guoqiang; Zhou, Liwei; Shao, Xiaoguang

    2010-11-01

    Realistic image rendition is to reproduce the human perception of natural scenes. Retinex is a classical algorithm that simultaneously provides high dynamic range compression contrast and color constancy of an image. In this paper, we discuss a design of a digital signal processor (DSP) implementation of the single scale monochromatic Retinex algorithm. The target processor is Texas Instruments TMS320DM642, a 32-bit fix point DSP which is clocked at 600 MHz. This DSP hardware platform designed is of powerful consumption and video image processing capability. We give an overview of the DSP hardware and software, and discuss some feasible optimizations to achieve a real-time version of the Retinex algorithm. In the end, the performance of the algorithm executing on DSP platform is shown.

  5. Implementation of Image-Guidance Techniques in Radiation Therapy

    NASA Astrophysics Data System (ADS)

    Thomas, Michael; Clark, Brenda; MacPherson, Miller; Montgomery, Lynn; Gerig, Lee

    2008-06-01

    For more than 100 years, physicists have been a vital part of the medical team required to deliver radiation therapy. Their role encompasses the verification of dose accuracy to the development and implementation of new techniques, the most recent of which is the incorporation of daily image guidance to account for inter- and intra-fraction target changes. For example, computed tomography (CT) integrated into radiotherapy treatment units allows the image-guided treatment of the prostate where the target location depends on the degree of rectal filling--a parameter that changes on timescales from minutes to weeks. Different technology is required for the adequate treatment of small lung tumours since respiration occurs on timescales of seconds. This presentation will review current image-guided techniques.

  6. Adopting and implementing nutrition guidelines in recreational facilities: Public and private sector roles. A multiple case study

    PubMed Central

    2012-01-01

    Background Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children’s access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them. Methods We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools. Results The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers’ nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY. Conclusions ANGCY uptake may continue to falter under the current voluntary

  7. [BQS1 indicators as a monitoring tool for guideline implementation using selected quality indicators in the treatment of patients with breast cancer and femoral neck fractures].

    PubMed

    Schräder, Peter; Reiter, Anne; Boy, Oliver; Fischer, Burkhard; Döbler, Klaus

    2009-01-01

    Successfully implemented clinical guidelines can contribute to improvement in the quality of care. In the context of clinical guidelines, quality indicators play an important role. Quality indicators can contribute to the further development and updating of existing guidelines by analysing their results. In addition, these results support internal and external quality improvement activities and supply information on the implementation status of guideline recommendations giving an impression of the actual quality of care. In this paper the data of the mandatory German performance measurement (specimen radiograph of impalpable breast lesions, preoperative waiting time with femoral neck fracture) were analysed in respect to the extent that guideline recommendations have been implemented in clinical care. We analysed a database of 189,756 and 331,087 patients for the quality indicators 'specimen radiograph' and 'preoperative waiting time', respectively. Depending on the quality of the clinical guideline the results varied. After the publication of this recommendation as part of the German high-quality guideline for neoplasms of the breast in 2004 the proportion of radiographic controls of specimens after breast cancer surgery increased from initially 36% to 84% in 2006, and the variance as a measure of the variability of care decreased considerably. By contrast, the percentage of patients with femoral neck fracture undergoing surgery within 48h did not change noticeably (2003: 19%; 2006: 16%). A German high-quality guideline making a clear recommendation for early surgery does not yet exist. Quality indicators of the German mandatory performance measurement system are suitable for measuring the extent to which guideline recommendations have been implemented and for supporting their (further) development. PMID:19374283

  8. Hematopoietic cell transplantation for mucopolysaccharidosis patients is safe and effective: results after implementation of international guidelines.

    PubMed

    Aldenhoven, Mieke; Jones, Simon A; Bonney, Denise; Borrill, Roisin E; Coussons, Mary; Mercer, Jean; Bierings, Marc B; Versluys, Birgitta; van Hasselt, Peter M; Wijburg, Frits A; van der Ploeg, Ans T; Wynn, Robert F; Boelens, Jaap Jan

    2015-06-01

    Allogeneic hematopoietic cell transplantation (HCT) is the only treatment able to prevent progressive neurodegenerative disease in a selected group of mucopolysaccharidosis (MPS) disorders. However, its use was historically limited by the high risk of graft failure and transplantation-related morbidity and mortality. Therefore, since 2005 new international HCT guidelines for MPS disorders were proposed. The survival and graft outcomes of MPS patients receiving HCT according to these guidelines in 2 European centers of expertise were evaluated. Two consecutive conditioning regimens were used, busulfan/cyclophosphamide or fludarabine/busulfan-based, both with exposure-targeted i.v. busulfan. A noncarrier matched sibling donor (MSD), matched unrelated cord blood (UCB), or matched unrelated donor (MUD) were considered to be preferred donors. If not available, a mismatched UCB donor was used. Participants were 62 MPS patients (56 MPS type I-Hurler, 2 MPS type II, 2 MPS type III, and 2 MPS type VI) receiving HCT at median age 13.5 months (range, 3 to 44). Forty-one patients received a UCB donor, 17 MSD, and 4 MUD. High overall survival (95.2%) and event-free survival (90.3%) were achieved with only low toxicity: 13.3% acute graft-versus-host disease aGVHD) grades II to IV and 14.8% chronic GVHD (1.9% extensive). A mismatched donor predicted for lower event-free survival (P = .04). A higher age at HCT was a predictor for both aGVHD (P = .001) and chronic GVHD (P = .01). The use of a mismatched donor was a predictor for aGVHD (P = .01). Higher rates of full-donor chimerism were achieved in successfully transplanted UCB recipients compared with MSD/MUD (P = .002). If complying with the international HCT guidelines, HCT in MPS patients results in high safety and efficacy. This allows extension of HCT to more attenuated MPS types. Because a younger age at HCT is associated with reduction of HCT-related toxicity, newborn screening may further increase safety. PMID

  9. Implementation of an Evidence-Based Guideline for the Referral of Adults Who Are Visually Impaired in the Netherlands: Potential Barriers

    ERIC Educational Resources Information Center

    Cruysberg, Juliette K.; van Rens, Ger H. M. B.

    2007-01-01

    This article reports on a study on the implementation of an evidence-based guideline for the referral for rehabilitation of adults who are visually impaired in the Netherlands. The purpose of the study was to find out if there are potential barriers to the implementation of the Nederlands Oogheelkundig Gezelschap (NOG) (2004) evidence-based…

  10. Effectiveness of implementation strategies in improving physician adherence to guideline recommendations in heart failure: a systematic review protocol

    PubMed Central

    Van Spall, Harriette G C; Shanbhag, Deepti; Gabizon, Itzhak; Ibrahim, Quazi; Graham, Ian D; Harlos, Karen; Haynes, R Brian; Connolly, Stuart J

    2016-01-01

    Introduction The uptake of Clinical Practice Guideline (CPG) recommendations that improve outcomes in heart failure (HF) remains suboptimal. We will conduct a systematic review to identify implementation strategies that improve physician adherence to class I recommendations, those with clear evidence that benefits outweigh the risks. We will use American, Canadian and European HF guidelines as our reference. Methods and analysis We will conduct a literature search in the databases of MEDLINE, EMBASE, HEALTHSTAR, CINAHL, Cochrane Library, Campbell Collaboration, Joanna Briggs Institute Evidence Based Practice, Centre for Reviews and Dissemination and Evidence Based Practice Centres. We will include prospective studies evaluating implementation interventions aimed at improving uptake of class I CPG recommendations in HF. We will extract data in duplicate. We will classify interventions according to their level of application (ie, provider, organisation, systems level) and common underlying characteristics (eg, education, decision-support, financial incentives) using the Cochrane Effective Practice and Organisation of Care Taxonomy. We will assess the impact of the intervention on adherence to the CPGs. Outcomes will include proportion of eligible patients who were: prescribed a CPG-recommended pharmacological treatment; referred for device consideration; provided self-care education at discharge; and provided left ventricular function assessment. We will include clinical outcomes such as hospitalisations, readmissions and mortality, if data is available. We will identify the common elements of successful and failing interventions, and examine the context in which they were applied, using the Process Redesign contextual framework. We will synthesise the results narratively and, if appropriate, will pool results for meta-analysis. Discussion and dissemination In this review, we will assess the impact of implementation strategies and contextual factors on physician

  11. Perioperative Nursing Leaders Implement Clinical Practice Guidelines Using the Iowa Model of Evidence-Based Practice.

    PubMed

    White, Shawna; Spruce, Lisa

    2015-07-01

    Many health care organizations, nursing leaders, and individual clinicians are not providing care consistently based on evidence and many are not aware of the evidence that is available. Preventable complications have an adverse effect on hospital reimbursement and the burden is placed on hospital personnel and nursing leaders to use current evidence to improve care and prevent complications, such as surgical site infections. Using AORN resources, leadership involvement and ownership, and implementing a theoretical model will contribute to implementing daily evidence-based practice and help to decrease the chasm between research and practice. PMID:26119609

  12. Social Studies Scope and Sequence Guidelines: Implementing the State Framework, K-12. Publication No. GC-64.

    ERIC Educational Resources Information Center

    Los Angeles Unified School District, CA.

    The booklet outlines skills, objectives, and activities for K-12 classroom teachers to consider as they develop and implement social studies programs. The document is presented in two major parts. Part I identifies major social studies objectives, including to help students develop understandings based on social science data and concepts,…

  13. Guidelines to Assist the Implementation of Differentiated Learning Activities in South African Secondary Schools

    ERIC Educational Resources Information Center

    de Jager, Thelma

    2013-01-01

    Despite previous research and recommendations in South Africa, secondary-school teachers still encounter economic, social and cultural challenges in implementing differentiated learning activities in the classroom. The diversity of learners with learning barriers inevitably leads to an increase in workload for the teachers. This article draws on…

  14. Implementation and Optimization of Image Processing Algorithms on Embedded GPU

    NASA Astrophysics Data System (ADS)

    Singhal, Nitin; Yoo, Jin Woo; Choi, Ho Yeol; Park, In Kyu

    In this paper, we analyze the key factors underlying the implementation, evaluation, and optimization of image processing and computer vision algorithms on embedded GPU using OpenGL ES 2.0 shader model. First, we present the characteristics of the embedded GPU and its inherent advantage when compared to embedded CPU. Additionally, we propose techniques to achieve increased performance with optimized shader design. To show the effectiveness of the proposed techniques, we employ cartoon-style non-photorealistic rendering (NPR), speeded-up robust feature (SURF) detection, and stereo matching as our example algorithms. Performance is evaluated in terms of the execution time and speed-up achieved in comparison with the implementation on embedded CPU.

  15. DSP Implementation of the Multiscale Retinex Image Enhancement Algorithm

    NASA Technical Reports Server (NTRS)

    Hines, Glenn D.; Rahman, Zia-ur; Jobson, Daniel J.; Woodell, Glenn A.

    2004-01-01

    The Retinex is a general-purpose image enhancement algorithm that is used to produce good visual representations of scenes. It performs a non-linear spatial/ spectral transform that synthesizes strong local contrast enhancement and color constancy. A real-time, video frame rate implementation of the Retinex is required to meet the needs of various potential users. Retinex processing contains a relatively large number of complex computations, thus to achieve real-time performance using current technologies requires specialized hardware and software. In this paper we discuss the design and development of a digital signal processor (DSP) implementation of the Retinex. The target processor is a Texas Instruments TMS320C6711 floating point DSP. NTSC video is captured using a dedicated frame grabber card, Retinex processed, and displayed on a standard monitor. We discuss the optimizations used to achieve real-time performance of the Retinex and also describe our future plans on using alternative architectures.

  16. DSP Implementation of the Retinex Image Enhancement Algorithm

    NASA Technical Reports Server (NTRS)

    Hines, Glenn; Rahman, Zia-Ur; Jobson, Daniel; Woodell, Glenn

    2004-01-01

    The Retinex is a general-purpose image enhancement algorithm that is used to produce good visual representations of scenes. It performs a non-linear spatial/spectral transform that synthesizes strong local contrast enhancement and color constancy. A real-time, video frame rate implementation of the Retinex is required to meet the needs of various potential users. Retinex processing contains a relatively large number of complex computations, thus to achieve real-time performance using current technologies requires specialized hardware and software. In this paper we discuss the design and development of a digital signal processor (DSP) implementation of the Retinex. The target processor is a Texas Instruments TMS320C6711 floating point DSP. NTSC video is captured using a dedicated frame-grabber card, Retinex processed, and displayed on a standard monitor. We discuss the optimizations used to achieve real-time performance of the Retinex and also describe our future plans on using alternative architectures.

  17. Response to open access endoscopy findings by general practitioners guidelines need education for implementation.

    PubMed

    Todd, J A; Zubir, M A; Goudie, B M; Johnston, D A

    2000-04-01

    General practitioners may gain valuable information from the use of open access endoscopy. The benefit to the individual patient depends on the interpretation of the endoscopy findings and the subsequent action. The aim of the study was to determine GPs response to open access endoscopy findings of three conditions with possible malignant complications: Barrett's oesophagus, gastric ulcer and colonic adenomatous polyps. The study took place at Ninewells Hospital, Dundee. Using the endoscopy unit's records for the year, 1 January 1995 to 31 December 1995, all patients having had an open access upper gastro-intestinal endoscopy or sigmoidoscopy were identified. Case-notes were reviewed of patients who had Barrett's oesophagus, gastric ulcer or colonic polyps diagnosed. During the year, 1158 upper gastro-intestinal endoscopies and 293 sigmoidoscopies were performed by the open access service. The referral rates for the conditions were as follows: Barrett's oesophagus 56%; Gastric ulcers 56%; Adenomatous polyps 88%; Non adenomatous polyps 12.5%. The provision of guidelines does not ensure a high referral rate, education is a vital partner. PMID:10862438

  18. Asia Oceania Guidelines for the Implementation of Programs for Cervical Cancer Prevention and Control

    PubMed Central

    Ngan, Hextan Y. S.; Garland, Suzanne M.; Bhatla, Neerja; Pagliusi, Sonia R.; Chan, Karen K. L.; Cheung, Annie N. Y.; Chu, Tang-Yuan; Domingo, Efren J.; Qiao, You Lin; Park, Jong Sup; Tay, Eng Hseon; Supakarapongkul, Wisit

    2011-01-01

    This paper aims to provide evidence-based recommendations for health professionals, to develop a comprehensive cervical cancer program for a clinic, a community, or a country. Ensuring access to healthcare is the responsibility of all societies, and the Asia Oceania Research Organisation in Genital Infections and Neoplasia (AOGIN) is committed to working collaboratively with governments and health professionals to facilitate prevention programs, to protect girls and women from cervical cancer, a disease that globally affects 500,000 and kills nearly 300,000 women annually, just over half of whom are in the Asia Oceania region. We share the vision that a comprehensive program of vaccination, screening, and treatment should be made accessible to all girls and women in the world. The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed. PMID:21559068

  19. Normalization of stable isotope data for carbonate minerals: Implementation of IUPAC guidelines

    NASA Astrophysics Data System (ADS)

    Kim, Sang-Tae; Coplen, Tyler B.; Horita, Juske

    2015-06-01

    Carbonate minerals provide a rich source of geochemical information because their δ13C and δ18O values provide information about surface and subsurface Earth processes. However, a significant problem is that the same δ18O value is not reported for the identical carbonate sample when analyzed in different isotope laboratories in spite of the fact that the International Union of Pure and Applied Chemistry (IUPAC) has provided reporting guidelines for two decades. This issue arises because (1) the δ18O measurements are performed on CO2 evolved by reaction of carbonates with phosphoric acid, (2) the acid-liberated CO2 is isotopically fractionated (enriched in 18O) because it contains only two-thirds of the oxygen from the solid carbonate, (3) this oxygen isotopic fractionation factor is a function of mineralogy, temperature, concentration of the phosphoric acid, and δ18O value of water in the phosphoric acid, (4) researchers may use any one of an assortment of oxygen isotopic fractionation factors that have been published for various minerals at various reaction temperatures, and (5) it sometimes is not clear how one should calculate δ18OVPDB values on a scale normalized such that the δ18O value of SLAP reference water is -55.5 ‰ relative to VSMOW reference water.

  20. Implementing effective hypertensive management--review of the 2014 high blood pressure management guidelines.

    PubMed

    Li, Shenjing; Kelly, Shawn C; Petrasko, Marian

    2015-01-01

    The Joint National Committee (JNC 8) hypertension guidelines have modified the blood pressure goals across the spectrum of disease processes and patient characteristics. This article will elucidate these changes and help clinicians improve the clinical care of patients with hypertension. Patients are now conceptually categorized into two different patient populations: those who are at a low- or high-risk of developing atherosclerotic cardiovascular disease (ASCVD) or chronic kidney disease (CKD). A low-risk population comprises patients aged 60 or older who do not have disease processes that enhance ASCVD or CKD disease development. High-risk patients are those with CKD and/or diabetes, and patients less than 60 years of age who remain at risk of future development. The current recommendation for blood-pressure goals in the low- and high-risk population is 150/90 mmHg and 140/90 mmHg, respectively. In all patients considered for antihypertensive therapy, the first line antihypertensive pharmacotherapy should include either a thiazide-type diuretic, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or an angiotensin receptor blocker (ARB). Beta blockers no longer have a role as standalone therapy. Thiazide- type diuretics and CCB continue to demonstrate benefit in the African American population and should continue to be considered as first line agents. CKD patients with concomitant hypertension should be treated with an ACE inhibitor or ARB. PMID:25985606

  1. Disparities in prenatal HIV testing: evidence for improving implementation of CDC screening guidelines.

    PubMed Central

    Pearlman, Deborah N.; Averbach, Abigail R.; Zierler, Sally; Cranston, Kevin

    2005-01-01

    OBJECTIVES: We investigated the within-group and between-group variation in prenatal HIV testing in a sample of low-income pregnant and recently postpartum women. METHODS: Multivariable linear regression was used to estimate proportional differences in prenatal HIV testing for the total sample and stratified by race. RESULTS: In bivariate analyses, race and site of care jointly affected the probability of being tested. Hispanic women had the highest probability of being tested in public practice settings but relative to white women, black women had a higher probability of being tested in public and private practice settings. Predictors of prenatal HIV testing differed by race. Receiving prenatal care in a community health center or hospital outpatient clinic increased the probability of testing for Hispanics. Being a recent victim of intimate partner violence was associated with less frequent testing for blacks. Positive beliefs about HIV screening, while significant for blacks and Hispanics, was the only factor associated with testing for whites. CONCLUSION: Our data suggest that racial biases may be influencing providers' approach to testing, rather than CDC's 2001 guidelines for HIV screening of pregnant women. Study findings are being used to modify social marketing campaigns and improve provider trainings regarding prenatal HIV testing. PMID:16080457

  2. Effectiveness of a clinical practice guideline implementation strategy for patients with anxiety disorders in primary care: cluster randomized trial

    PubMed Central

    2011-01-01

    Background Anxiety is a common mental health problem seen in primary care. However, its management in clinical practice varies greatly. Clinical practice guidelines (CPGs) have the potential to reduce variations and improve the care received by patients by promoting interventions of proven benefit. However, uptake and adherence to their recommendations can be low. Method/design This study involves a community based on cluster randomized trial in primary healthcare centres in the Madrid Region (Spain). The project aims to determine whether the use of implementation strategy (including training session, information, opinion leader, reminders, audit, and feed-back) of CPG for patients with anxiety disorders in primary care is more effective than usual diffusion. The number of patients required is 296 (148 in each arm), all older than 18 years and diagnosed with generalized anxiety disorder, panic disorder, and panic attacks by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). They are chosen by consecutive sampling. The main outcome variable is the change in two or more points into Goldberg anxiety scale at six and twelve months. Secondary outcome variables include quality of life (EuroQol 5D), and degree of compliance with the CPG recommendations on treatment, information, and referrals to mental health services. Main effectiveness will be analyzed by comparing the patients percentage improvement on the Goldberg scale between the intervention group and the control group. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion There is a need to identify effective implementation strategies for CPG for the management of anxiety disorders present in primary care. Ensuring the appropriate uptake of guideline recommendations can reduce clinical variation and improve the care patients receive. Trial

  3. Data structures for multimodality imaging: concepts and implementation

    NASA Astrophysics Data System (ADS)

    Mealha, Oscar E. C.; Sousa Pereira, Antonio; Santos, Maria Beatriz S.

    1992-06-01

    The integration of data coming from different imaging modalities is something to take into account, due to the importance it can have in the development of a fast and reliable diagnosis by the health staff. In the medical imaging field, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT) are examples of devices that generate 3-D data. Digital subtraction angiography (DSA) or ultrasound (US) output 2-D data, from which its possible to reconstruct 3-D data. An important fact is that 3-D space is common to all these devices and they are all capable of producing large amounts of data. Prior to display or even data integration, matching the various 3-D spaces has to be achieved with some specific technique, according to the anatomical region under examination. The augmented octree, an extension of the linear octree, is used for data integration; its properties can help to overcome some of the constraints that occur in medical imaging. To be fully accepted by the specialist, the display and manipulation of multimodality data must be interactive and done in real-time, or at least in `nearly' real-time. Parallel architectures seem to be a solution for some computation intensive applications, and so an implementation of the linear octree encoding process was developed on a 16 Transputer machine.

  4. [Evaluating the total incapacity to work: implementing French National Authority for Health guidelines in clinical practice].

    PubMed

    Chariot, Patrick; Bécache, Nathalie; François-Purssell, Irène; Dantchev, Nicolas; Delpla, Pierre-André; Fournier, Lionel; Proust, Bernard

    2013-10-01

    Total incapacity to work (TIW) is a legal concept that allows magistrates to assess the severity of violence against persons. The TIW is the duration of the victims' inability to fulfil their usual activities and is determined by physicians. Professional guidelines from the French National Authority for Health indicate that TIW applies both to physical and psychological problems. The law of 9 July 2010 makes explicit reference to TIW in cases of psychological violence and intimate partner harassment. Prosecutors base criminal penalties on the duration of TIW in cases of assault and battery. Whatever the physician, they should describe the mental state of the victim and identify the signs that may indicate the mental impact of reported assaults. Identifying combinations of symptoms can be useful in deciding whether the duration of TIW should be increased because of the psychic state. In case of stalking, assessment of TIW can allow prosecutors to link the reported facts to a criminal offence. In complex situations, the physician may be unable to assess a duration of TIW and can suggest expert assessment. In all cases, the duration of TIW needs to be based on functional criteria. The extent of harm to the life of relationships results from suffered violence, from the victim's reaction, and from the perception of their family and friends. In this area, we suggest to limit the first assessment of TIW to a few days and to reassess it later, according to real information reported by the victims, to careful observation of their behaviour, and to results of a questioning that should be as little suggestive as possible. At either end of the age scale and in case of preexisting functional impairment, assessment of TIW should take into account the actual and global capacity of the person before the assault. PMID:23659917

  5. Implementation of Out-of-Office Blood Pressure Monitoring in the Netherlands: From Clinical Guidelines to Patients' Adoption of Innovation.

    PubMed

    Carrera, Pricivel M; Lambooij, Mattijs S

    2015-10-01

    Out-of-office blood pressure monitoring is promoted by various clinical guidelines toward properly diagnosing and effectively managing hypertension and engaging the patient in their care process. In the Netherlands, however, the Dutch cardiovascular risk management (CVRM) guidelines do not explicitly prescribe 24-hour ambulatory blood pressure measurement (ABPM) and home BP measurement (HBPM). The aim of this descriptive study was to develop an understanding of patients' and physicians' acceptance and use of out-of-office BP monitoring in the Netherlands given the CVRM recommendations.Three small focus group discussions (FGDs) with patients and 1 FGD with physicians were conducted to explore the mechanisms behind the acceptance and use of out-of-office BP monitoring and reveal real-world challenges that limit the implementation of out-of-office BP monitoring methods. To facilitate the FGDs, an analytical framework based on the technology acceptance model (TAM), the theory of planned behavior and the model of personal computing utilization was developed to guide the FGDs and analysis of the transcriptions of each FGD.ABPM was the out-of-office BP monitoring method prescribed by physicians and used by patients. HBPM was not offered to patients even with patients' feedback of poor tolerance of ABPM. Even as there was little awareness about HBPM among patients, there were a few patients who owned and used sphygmomanometers. Patients professed and seemed to exhibit self-efficacy, whereas physicians had reservations about (all of their) patients' self-efficacy in properly using ABPM. Since negative experience with ABPM impacted patients' acceptance of ABPM, the interaction of factors that determined acceptance and use was found to be dynamic among patients but not for physicians.In reference to the CVRM guidelines, physicians implemented out-of-office BP monitoring but showed a strong preference for ABPM even where there is poor tolerance of the method. We found that

  6. The Impact of Social Media on Dissemination and Implementation of Clinical Practice Guidelines: A Longitudinal Observational Study

    PubMed Central

    Gronseth, Gary; Dubinsky, Richard; Penfold-Murray, Rebecca; Cox, Julie; Bever Jr, Christopher; Martins, Yolanda; Rheaume, Carol; Shouse, Denise; Getchius, Thomas SD

    2015-01-01

    Background Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific clinical problem or question. Merely reading a guideline rarely leads to implementation of recommendations. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination. The last few years have seen a burgeoning of social media such as Facebook, Twitter, and LinkedIn, and newer methods of dissemination such as podcasts and webinars. The role of these media in guideline dissemination has not been studied. Systematic evaluation of dissemination methods and comparison of the effectiveness of newer methods with traditional methods is not available. It is also not known whether specific dissemination methods may be more effectively targeted to specific audiences. Objective Our aim was to (1) develop an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the AAN clinical practice guidelines “Complementary and alternative medicine in multiple sclerosis” (“CAM in MS”) and (2) evaluate whether the addition of social media outreach improves awareness of the CPG and knowledge of CPG recommendations, and affects implementation of those recommendations. Methods Outcomes were measured by four surveys in each of the two target populations: patients and physicians/clinicians (“physicians”). The primary outcome was the difference in participants’ intent to discuss use of complementary and alternative medicine (CAM) with their physicians or patients, respectively, after novel dissemination, as compared with that after traditional dissemination. Secondary outcomes were changes in awareness of the CPG, knowledge of CPG content, and behavior regarding CAM use in multiple sclerosis (MS). Results Response rates were 25.08% (622/2480) for physicians and 43.5% (348/800) for patients. Awareness of the CPG increased after traditional

  7. Implementation of contemporary radiation therapy planning concepts for pediatric Hodgkin lymphoma: Guidelines from the International Lymphoma Radiation Oncology Group.

    PubMed

    Hodgson, David C; Dieckmann, Karin; Terezakis, Stephanie; Constine, Louis

    2015-01-01

    The optimal management of children with Hodgkin lymphoma (HL) should limit the risk of treatment-related toxicity without compromising disease control. Consequently, increasing effort is being directed to retaining the demonstrated efficacy of radiation therapy (RT) in maximizing the cure of HL while reducing the radiation exposure of normal tissues. Historically, guidelines for RT volume definition used in pediatric HL trials have referenced 2-dimensional imaging and bony landmarks to define classical involved field RT. With recognition of the efficacy of chemotherapy, the data on the adverse late effects of radiation, and the evolution of advanced imaging techniques that reveal the location of both tumor and normal tissues, it is necessary that radiation techniques for children and adolescents be refined. The concepts described by the International Commission on Radiation Units provide a common approach for field definition using 3-dimensional computed tomographic--based RT planning and volumetric image guidance. Here we describe the application of these concepts in the planning of RT for pediatric HL. This will be increasingly important as current and upcoming pediatric HL trials will employ these concepts to deliver RT. PMID:25413415

  8. NASA System Safety Handbook. Volume 2: System Safety Concepts, Guidelines, and Implementation Examples

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Feather, Martin; Rutledge, Peter; Sen, Dev; Youngblood, Robert

    2015-01-01

    This is the second of two volumes that collectively comprise the NASA System Safety Handbook. Volume 1 (NASASP-210-580) was prepared for the purpose of presenting the overall framework for System Safety and for providing the general concepts needed to implement the framework. Volume 2 provides guidance for implementing these concepts as an integral part of systems engineering and risk management. This guidance addresses the following functional areas: 1.The development of objectives that collectively define adequate safety for a system, and the safety requirements derived from these objectives that are levied on the system. 2.The conduct of system safety activities, performed to meet the safety requirements, with specific emphasis on the conduct of integrated safety analysis (ISA) as a fundamental means by which systems engineering and risk management decisions are risk-informed. 3.The development of a risk-informed safety case (RISC) at major milestone reviews to argue that the systems safety objectives are satisfied (and therefore that the system is adequately safe). 4.The evaluation of the RISC (including supporting evidence) using a defined set of evaluation criteria, to assess the veracity of the claims made therein in order to support risk acceptance decisions.

  9. Design of the Balance@Work project: systematic development, evaluation and implementation of an occupational health guideline aimed at the prevention of weight gain among employees

    PubMed Central

    2009-01-01

    Background Occupational health professionals may play an important role in preventive health promotion activities for employees. However, due to a lack of knowledge and evidence- and practice based methods and strategies, interventions are hardly being implemented by occupational physicians to date. The aim of the Balance@Work project is to develop, evaluate, and implement an occupational health guideline aimed at the prevention of weight gain among employees. Methods Following the guideline development protocol of the Netherlands Society of Occupational Medicine and the Intervention Mapping protocol, the guideline was developed based on literature, interviews with relevant stakeholders, and consensus among an expert group. The guideline consists of an individual and an environmental component. The individual component includes recommendations for occupational physicians on how to promote physical activity and healthy dietary behavior based on principles of motivational interviewing. The environmental component contains an obesogenic environment assessment tool. The guideline is evaluated in a randomised controlled trial among 20 occupational physicians. Occupational physicians in the intervention group apply the guideline to eligible workers during 6 months. Occupational physicians in the control group provide care as usual. Measurements take place at baseline and 6, 12, and 18 months thereafter. Primary outcome measures include waist circumference, daily physical activity and dietary behavior. Secondary outcome measures include sedentary behavior, determinants of behavior change, body weight and body mass index, cardiovascular disease risk profile, and quality of life. Additionally, productivity, absenteeism, and cost-effectiveness are assessed. Discussion Improving workers' daily physical activity and dietary behavior may prevent weight gain and subsequently improve workers' health, increase productivity, and reduce absenteeism. After an effect- and process

  10. Perceived value of applying Information Communication Technology to implement guidelines in developing countries; an online questionnaire study among public health workers

    PubMed Central

    Machingura, Pasipanodya Ian; Adekola, Olawumi; Mueni, Eunice; Oaiya, Omo; Gustafsson, Lars L; Heller, Richard F

    2014-01-01

    Introduction Practice guidelines can be used to support healthcare decision making. We sought to identify the use, and barriers to the implementation, of electronic based guidelines to support decision-making in maternal and child healthcare (MCH) and the rational use of medicines, in developing countries. Methods Graduates who had gained the Master of Public Health degree through the Peoples-uni (postgraduate public health education in developing countries) were sent an online survey questionnaire which had been piloted. Two reminders were sent to non-respondents at intervals of 10 days. Results were explored using descriptive analyses. Results 44 of the potential 48 graduates from 16 countries responded – most were from Africa. 82% and 89% of respondents were aware of guidelines on MCH and the rational use of medicines respectively. Electronic guidelines were more available in university hospitals than in provincial hospitals or rural care. All respondents thought that guidelines could improve the delivery of quality care, and 42 (95%) and 41 (93%) respectively thought that computers and mobile or smartphones could increase the use of guidelines in service delivery. Lack of access to computers, need to buy phone credit, need for training in the use of either computerized or phone based guidelines and fear of increased workload were potential barriers to use. Conclusion There is support for the use of electronic guidelines despite limited availability and barriers to use in developing countries. These findings, and other literature, provide a guide as to how the further development of ICT based guidelines may be implemented to improve health care decision making. PMID:25422718

  11. ANSI/AIAA S-081A, Pressure Vessel Standards Implementation Guidelines

    NASA Technical Reports Server (NTRS)

    Greene, Nathanael J.

    2009-01-01

    The stress rupture specification for Composite Overwrapped Pressure Vessels (COPV) is discussed. The composite shell of the COPV shall be designed to meet the design life considering the time it is under sustained load. A Mechcanical Damage Control Plan (MDCP) shall be created and implemented that assures the COPV will not fail due to mechanical damage due to manufacturing, testing, shipping, installation, or flight. Proven processes and procedures for fabrication and repair shall be used to preclude damage or material degradation during material processing, manufacturing operations, and refurbushment.Selected NDI techniques for the liner and/or boss(es) shall be performed before overwrapping with composite. When visual inspection reveals mechanical damage or defects exceeding manufacturing specification levels (and standard repair procedures), the damaged COPV shall be submitted to a material review board (MRB) for disposition. Every COPV shall be subjected to visual and other non-destructive inspection (NDI), per the inspection plan.

  12. [Implementation of section 87b of the guidelines of SGB XI--the point-of-view of the nurses aides].

    PubMed

    Eberhardt, Doris; Sadowski, Katharina

    2012-02-01

    According to section 87b of the guidelines of SGB XI (German Social Security Statutes), German nursing homes are authorised to recruit specially trained nurses aides for additional care and stimulation of high maintenance residents suffering from dementia or mental disabilities. This regulation started in July 2008. The nursing aides areespeciallytrained laypeople. Despitetheguidelines, local practice may be different. The scientists carried out a qualitative study. The aim of this study was to evaluate the implementation of the guidelines from the nurses aides' perspective. The objective was to describe the implementation ofthe guidelines and to identify beneficial and restrictive elements of the nurses aides practice in order to improve the development of the guidelines. Four nurses aides in four different nursing homes were questioned with semi-structured interviews. Data analysis was performed using a qualitativecontentanalysis as developed byMayring.Thefindings show that the effective tasks and methods of the nurses aides fit largely into the guidelines, and the subjects look upon their assignment favourably. All of the subjects were continuously supervised and felt well integrated. Potential conflicts in cooperation with the professional caregivers were due to different understandings of the roles and assignment of tasks. The quality of nurses aides' training was rated differently. A close connection to the client's behaviour and the nurses aides practice proved to be helpful. The results may indicate that although there is concordance with the guidelines and with the implementation as well as job satisfaction for the nurses aides, for the maintenance of satisfaction and a long-term effective guideline implementation some aspects should be considered and improved. PMID:22397192

  13. When rheumatologists report that they agree with a guideline, does this mean that they practise the guideline in clinical practice? Results of the International Recommendation Implementation Study (IRIS)

    PubMed Central

    Gvozdenović, Emilia; Allaart, Cornelia F; van der Heijde, Désirée; Ferraccioli, Gianfranco; Smolen, Josef S; Huizinga, Tom W J; Landewé, Robert

    2016-01-01

    Introduction The European League Against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) and the treat-to-target (T2T) principles have been developed in order to improve the treatment outcome of patients with RA, and have received broad attention. It is not clear, though, whether these recommendations are indeed followed up in clinical practice. Objective To investigate if rheumatologists that report to agree with existing guidelines indeed follow them up in clinical practice. Methods The International Recommendation Implementation Study (IRIS) included 132 participating rheumatologists from 14 countries. Participating rheumatologists received a questionnaire measuring their awareness/commitment with the EULAR/T2T recommendations and followed a dedicated educational programme. Subsequently, they were asked to enrol 5–10 patients with new-onset RA in the online IRIS database and monitor disease activity and treatment for a period of 1–2 years. Four recommendations (3 from the EULAR recommendations and one from the T2T recommendations) were selected on the basis of testability, and analysed with regard to compliance by participating rheumatologists. Results In total, 72 of the 132 participating rheumatologists contributed 378 patients to the database. Of these participants, 70 (98%) agreed upfront with the recommendation that disease-modifying antirheumatic drug (DMARD) therapy should be started as soon as possible after diagnosis in every patient; 69 (96%) of the rheumatologists agreed with the recommendation that methotrexate (MTX) should be part of the first treatment strategy. When measuring the actual performance, it was found that the recommendation on early DMARD start was met in 253 (67%) of the recorded patients, and the recommendation on MTX in 225 (60%) of the recorded patients. Of the participants, 60 (83%) agreed that composite measures should be recorded regularly, but only in 134(54%) of the patients were

  14. Method for Implementing Subsurface Solid Derived Concentration Guideline Levels (DCGL) - 12331

    SciTech Connect

    Lively, J.W.

    2012-07-01

    The U.S. Nuclear Regulatory Commission (NRC) and other federal agencies currently approve the Multi-Agency Radiation Site Survey and Investigation Manual (MARSSIM) as guidance for licensees who are conducting final radiological status surveys in support of decommissioning. MARSSIM provides a method to demonstrate compliance with the applicable regulation by comparing residual radioactivity in surface soils with derived concentration guideline levels (DCGLs), but specifically discounts its applicability to subsurface soils. Many sites and facilities undergoing decommissioning contain subsurface soils that are potentially impacted by radiological constituents. In the absence of specific guidance designed to address the derivation of subsurface soil DCGLs and compliance demonstration, decommissioning facilities have attempted to apply DCGLs and final status survey techniques designed specifically for surface soils to subsurface soils. The decision to apply surface soil limits and surface soil compliance metrics to subsurface soils typically results in significant over-excavation with associated cost escalation. MACTEC, Inc. has developed the overarching concepts and principles found in recent NRC decommissioning guidance in NUREG 1757 to establish a functional method to derive dose-based subsurface soil DCGLs. The subsurface soil method developed by MACTEC also establishes a rigorous set of criterion-based data evaluation metrics (with analogs to the MARSSIM methodology) that can be used to demonstrate compliance with the developed subsurface soil DCGLs. The method establishes a continuum of volume factors that relate the size and depth of a volume of subsurface soil having elevated concentrations of residual radioactivity with its ability to produce dose. The method integrates the subsurface soil sampling regime with the derivation of the subsurface soil DCGL such that a self-regulating optimization is naturally sought by both the responsible party and regulator

  15. Evaluation of the Impact of Implementing the Emergency Medical Services Traumatic Brain Injury Guidelines in Arizona: The Excellence in Prehospital Injury Care (EPIC) Study Methodology

    PubMed Central

    Spaite, Daniel W.; Bobrow, Bentley J.; Stolz, Uwe; Sherrill, Duane; Chikani, Vatsal; Barnhart, Bruce; Sotelo, Michael; Gaither, Joshua B.; Viscusi, Chad; Adelson, P. David; Denninghoff, Kurt R.

    2014-01-01

    Traumatic brain injury (TBI) exacts a great toll on society. Fortunately, there is growing evidence that the management of TBI in the early minutes after injury may significantly reduce morbidity and mortality. In response, evidence-based prehospital and in-hospital TBI treatment guidelines have been established by authoritative bodies. However, no large studies have yet evaluated the effectiveness of implementing these guidelines in the prehospital setting. This article describes the background, design, implementation, emergency medical services (EMS) treatment protocols, and statistical analysis of a prospective, controlled (before/after), statewide study designed to evaluate the effect of implementing the EMS TBI guidelines—the Excellence in Prehospital Injury Care (EPIC) study (NIH/NINDS R01NS071049, “EPIC”; and 3R01NS071049-S1, “EPIC4Kids”). The specific aim of the study is to test the hypothesis that statewide implementation of the international adult and pediatric EMS TBI guidelines will significantly reduce mortality and improve nonmortality outcomes in patients with moderate or severe TBI. Furthermore, it will specifically evaluate the effect of guideline implementation on outcomes in the subgroup of patients who are intubated in the field. Over the course of the entire study (~9 years), it is estimated that approximately 25,000 patients will be enrolled. PMID:25112451

  16. Guidelines for Hanford Site implementation of the National Environmental Policy Act

    SciTech Connect

    King, S.E.

    1989-03-01

    The National Environmental Policy Act (NEPA) environmental review process is mandatory for federal agencies. Understanding and complying with NEPA is extremely important to successfully planning and implementing programs at the Hanford Site. This report is intended to help planners and decision makers understand NEPA by describing the NEPA process as it is outlined in NEPA, in regulations, and in guidance information. The requirements and guidance documents that set forth the NEPA process are discussed. Some of the major NEPA concepts and issues are also addressed. This report is intended to be used as a general road map through the maze of NEPA requirements and guidance to ensure that Hanford Site activities are conducted in compliance with NEPA. Enhanced knowledge of the NEPA process is expected to increase the ability of the Hanford Site to work with regulators, interested parties and the public to ensure that the potential environmental impacts of DOE activities are fully considered at the Hanford Site. In addition, an enhanced understanding of NEPA will help project and program managers to integrate NEPA compliance requirements with program planning. 43 refs., 6 figs., 3 tabs.

  17. Design and implementation of non-linear image processing functions for CMOS image sensor

    NASA Astrophysics Data System (ADS)

    Musa, Purnawarman; Sudiro, Sunny A.; Wibowo, Eri P.; Harmanto, Suryadi; Paindavoine, Michel

    2012-11-01

    Today, solid state image sensors are used in many applications like in mobile phones, video surveillance systems, embedded medical imaging and industrial vision systems. These image sensors require the integration in the focal plane (or near the focal plane) of complex image processing algorithms. Such devices must meet the constraints related to the quality of acquired images, speed and performance of embedded processing, as well as low power consumption. To achieve these objectives, low-level analog processing allows extracting the useful information in the scene directly. For example, edge detection step followed by a local maxima extraction will facilitate the high-level processing like objects pattern recognition in a visual scene. Our goal was to design an intelligent image sensor prototype achieving high-speed image acquisition and non-linear image processing (like local minima and maxima calculations). For this purpose, we present in this article the design and test of a 64×64 pixels image sensor built in a standard CMOS Technology 0.35 μm including non-linear image processing. The architecture of our sensor, named nLiRIC (non-Linear Rapid Image Capture), is based on the implementation of an analog Minima/Maxima Unit. This MMU calculates the minimum and maximum values (non-linear functions), in real time, in a 2×2 pixels neighbourhood. Each MMU needs 52 transistors and the pitch of one pixel is 40×40 mu m. The total area of the 64×64 pixels is 12.5mm2. Our tests have shown the validity of the main functions of our new image sensor like fast image acquisition (10K frames per second), minima/maxima calculations in less then one ms.

  18. Implementation of national guidelines for the prevention and treatment of overweight and obesity in children and adolescents: a phenomenographic analysis of public health nurses’ perceptions

    PubMed Central

    Nordstrand, Aina; Fridlund, Bengt; Sollesnes, Ragnhild

    2016-01-01

    Objective To explore and describe how public health nurses (PHNs) perceive the implementation of national guidelines for the prevention and treatment of overweight and obesity among children and adolescents in well-baby clinics and school health services. Design, sample, and measurements An explorative descriptive design was carried out through individual interviews with 18 PHNs and analysed according to the phenomenographic tradition. Results Four implementation strategies were described and assigned a metaphor: the structured PHN, pragmatic PHN, critical PHN, and the resigned PHN. Competence, patient receptiveness, internal consensus, interdisciplinary collaboration, resources, and organizational embedding were the determinants identified that most frequently affect implementation, and these determinants were distributed at different levels of the organization. The extent of facilitation seemed to determine which implementation strategy would be used. Conclusions How PHNs implemented the guidelines for overweight and obesity were affected by determinants at different organizational levels. Contextual facilitation of implementation seemed better in larger organizations, but factors such as leadership, drive, and experience compensated in smaller municipalities. The implementation of guidelines was hindered when the barriers exceeded the benefits. PMID:27543411

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

    PubMed

    Chimeddamba, Oyun; Ayton, Darshini; Bazarragchaa, Nansalmaa; Dorjsuren, Bayarsaikhan; Peeters, Anna; Joyce, Catherine

    2016-01-01

    (1) BACKGROUND: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2) METHODS: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3) RESULTS: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4) CONCLUSIONS: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines. PMID:27070630

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

    PubMed Central

    Chimeddamba, Oyun; Ayton, Darshini; Bazarragchaa, Nansalmaa; Dorjsuren, Bayarsaikhan; Peeters, Anna; Joyce, Catherine

    2016-01-01

    (1) Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2) Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3) Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4) Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines. PMID:27070630

  1. Canadian chiropractors’ attitudes towards chiropractic philosophy and scope of practice: implications for the implementation of clinical practice guidelines

    PubMed Central

    Biggs, Lesley; Hay, David; Mierau, Dale

    1997-01-01

    The development of effective implementation strategies for chiropractic clinical practice guidelines (CPGs) presumes knowledge about the attitudes of the Canadian chiropractic profession. The purpose of this study was to explore the attitudes of Canadian chiropractors to philosophy and scope of practice. We hypothesized that given most Canadian chiropractors are trained at one school, the Canadian Memorial Chiropractic College (CMCC) in Toronto, there would be a reasonable degree of consensus about the practice of chiropractic in Canada, and therefore, effective implementation strategies could be developed. Drawing on a stratified random sample of Canadian chiropractors (n = 401), we found that 18.6% of respondents held conservative views, 22% held liberal views and 59.4% held moderate views. Conservative chiropractic philosophy rejects traditional chiropractic philosophy as espoused by D.D. and B.J. Palmer, and emphasizes the scientific validation of chiropractic concepts and methods. A conservative philosophy is associated with a narrow scope of practice in which chiropractic practice is restricted to musculoskeletal problems. A liberal chiropractic philosophy adheres to traditional chiropractic philosophy (offered either by D.D. or B.J. Palmer) and is associated with a broad scope of practice which includes the treatment of non-musculoskeletal conditions. Liberal-minded respondents are more likely to identify chiropractic as an alternate form of health care. Using ANOVA and MCA, the best predictors of the philosophy index were college of training and province of practice. Chiropractors who trained at the CMCC held more conservative views than those who were trained elsewhere. Moreover, we found significant provincial differences among the provinces on the philosophy index. Saskatchewan chiropractors held the most conservative views on the philosophy index; Quebec chiropractors held the most liberal views. We concluded that given the divergence of opinions among

  2. Infrared Jitter Imaging Data Reduction: Algorithms and Implementation

    NASA Astrophysics Data System (ADS)

    Devillard, Nicolas

    Jitter imaging (also known as microscanning) is probably one of the most efficient ways to perform astronomical observations in the infrared. It requires very efficient filtering and recentering methods to produce the best possible output from raw data. This paper discusses issues attached to Poisson offset generation, efficient infrared sky filtering, offset recovery between planes through cross-correlation and/or point pattern recognition techniques, plane shifting with subpixel resolution through various kernel-based interpolation schemes, and 3D filtering for plane accumulation. Several algorithms are described for each step, having in mind an automatic data processing in pipeline mode (i.e., without user interaction) as intended for the Very Large Telescope. Implementation of these algorithms in optimized ANSI C (the eclipse library) is also described here.

  3. Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

    PubMed Central

    2014-01-01

    Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

  4. The Importance and Degree of Implementation of the European Standards and Guidelines for Internal Quality Assurance in Universities: The Views of Portuguese Academics

    ERIC Educational Resources Information Center

    Manatos, Maria J.; Rosa, Maria J.; Sarrico, Cláudia S.

    2015-01-01

    This research seeks to explore academics' perceptions of the importance and degree of implementation of the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) for internal quality assurance. It uses empirical evidence from Portugal, gathered via a questionnaire given to all university academics. Results show…

  5. 5 CFR Appendix to Part 720 - Guidelines for the Development of a Federal Recruitment Program To Implement 5 U.S.C. Section...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Guidelines for the Development of a Federal Recruitment Program To Implement 5 U.S.C. Section 7201, as Amended 1 Appendix to Part 720 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) AFFIRMATIVE EMPLOYMENT PROGRAMS Pt. 720,...

  6. Dissemination Strategies to Improve Implementation of the PHS Smoking Cessation Guideline in MCH Public Health Clinics: Experimental Evaluation Results and Contextual Factors

    ERIC Educational Resources Information Center

    Manfredi, Clara; Cho, Young Ik; Warnecke, Richard; Saunders, Stephen; Sullivan, Myrtis

    2011-01-01

    We report results from an experimental study that tested the effectiveness of dissemination interventions to improve implementation of smoking cessation guidelines in maternal and child public health clinics. We additionally examine individual clinic results for contextual explanations not apparent from the experimental findings alone. Twelve…

  7. Advanced Imaging and Receipt of Guideline Concordant Care in Women with Early Stage Breast Cancer.

    PubMed

    Loggers, Elizabeth Trice; Buist, Diana S M; Gold, Laura S; Zeliadt, Steven; Hunter Merrill, Rachel; Etzioni, Ruth; Ramsey, Scott D; Sullivan, Sean D; Kessler, Larry

    2016-01-01

    Objective. It is unknown whether advanced imaging (AI) is associated with higher quality breast cancer (BC) care. Materials and Methods. Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI) or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT) versus mammogram and/or ultrasound (M-US) alone and receipt of guideline concordant care (GCC) using multivariable logistic regression. Results. Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT) (OR 1.55, 95% CI 1.08-2.26, and p = 0.02) and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+) BC (OR 1.74, 95% CI 1.17-2.59, and p = 0.01). Conclusion. GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively. PMID:27525122

  8. Advanced Imaging and Receipt of Guideline Concordant Care in Women with Early Stage Breast Cancer

    PubMed Central

    Buist, Diana S. M.; Gold, Laura S.; Zeliadt, Steven; Hunter Merrill, Rachel; Etzioni, Ruth; Ramsey, Scott D.; Sullivan, Sean D.; Kessler, Larry

    2016-01-01

    Objective. It is unknown whether advanced imaging (AI) is associated with higher quality breast cancer (BC) care. Materials and Methods. Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI) or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT) versus mammogram and/or ultrasound (M-US) alone and receipt of guideline concordant care (GCC) using multivariable logistic regression. Results. Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT) (OR 1.55, 95% CI 1.08–2.26, and p = 0.02) and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+) BC (OR 1.74, 95% CI 1.17–2.59, and p = 0.01). Conclusion. GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively. PMID:27525122

  9. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: Pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: Technical considerations for pediatric nuclear medicine imaging procedures.

    PubMed

    Koizumi, Kiyoshi; Masaki, Hidekazu; Matsuda, Hiroshi; Uchiyama, Mayuki; Okuno, Mitsuo; Oguma, Eiji; Onuma, Hiroshi; Kanegawa, Kimio; Kanaya, Shinichi; Kamiyama, Hiroshi; Karasawa, Kensuke; Kitamura, Masayuki; Kida, Tetsuo; Kono, Tatsuo; Kondo, Chisato; Sasaki, Masayuki; Terada, Hitoshi; Nakanishi, Atsushi; Hashimoto, Teisuke; Hataya, Hiroshi; Hamano, Shin-ichiro; Hirono, Keishi; Fujita, Yukihiko; Hoshino, Ken; Yano, Masayuki; Watanabe, Seiichi

    2014-06-01

    The Japanese Society of Nuclear Medicine has recently published the consensus guidelines for pediatric nuclear medicine. This article is the English version of the guidelines. Part 1 proposes the dose optimization in pediatric nuclear medicine studies. Part 2 comprehensively discusses imaging techniques for the appropriate conduct of pediatric nuclear medicine procedures, considering the characteristics of imaging in children. PMID:24647992

  10. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation.

    PubMed

    Bousquet, J; Schunemann, H J; Fonseca, J; Samolinski, B; Bachert, C; Canonica, G W; Casale, T; Cruz, A A; Demoly, P; Hellings, P; Valiulis, A; Wickman, M; Zuberbier, T; Bosnic-Anticevitch, S; Bedbrook, A; Bergmann, K C; Caimmi, D; Dahl, R; Fokkens, W J; Grisle, I; Lodrup Carlsen, K; Mullol, J; Muraro, A; Palkonen, S; Papadopoulos, N; Passalacqua, G; Ryan, D; Valovirta, E; Yorgancioglu, A; Aberer, W; Agache, I; Adachi, M; Akdis, C A; Akdis, M; Annesi-Maesano, I; Ansotegui, I J; Anto, J M; Arnavielhe, S; Arshad, H; Baiardini, I; Baigenzhin, A K; Barbara, C; Bateman, E D; Beghé, B; Bel, E H; Ben Kheder, A; Bennoor, K S; Benson, M; Bewick, M; Bieber, T; Bindslev-Jensen, C; Bjermer, L; Blain, H; Boner, A L; Boulet, L P; Bonini, M; Bonini, S; Bosse, I; Bourret, R; Bousquet, P J; Braido, F; Briggs, A H; Brightling, C E; Brozek, J; Buhl, R; Burney, P G; Bush, A; Caballero-Fonseca, F; Calderon, M A; Camargos, P A M; Camuzat, T; Carlsen, K H; Carr, W; Cepeda Sarabia, A M; Chavannes, N H; Chatzi, L; Chen, Y Z; Chiron, R; Chkhartishvili, E; Chuchalin, A G; Ciprandi, G; Cirule, I; Correia de Sousa, J; Cox, L; Crooks, G; Costa, D J; Custovic, A; Dahlen, S E; Darsow, U; De Carlo, G; De Blay, F; Dedeu, T; Deleanu, D; Denburg, J A; Devillier, P; Didier, A; Dinh-Xuan, A T; Dokic, D; Douagui, H; Dray, G; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; Emuzyte, R; Fink Wagner, A; Fletcher, M; Fiocchi, A; Forastiere, F; Gamkrelidze, A; Gemicioğlu, B; Gereda, J E; González Diaz, S; Gotua, M; Grouse, L; Guzmán, M A; Haahtela, T; Hellquist-Dahl, B; Heinrich, J; Horak, F; Hourihane, J O 'b; Howarth, P; Humbert, M; Hyland, M E; Ivancevich, J C; Jares, E J; Johnston, S L; Joos, G; Jonquet, O; Jung, K S; Just, J; Kaidashev, I; Kalayci, O; Kalyoncu, A F; Keil, T; Keith, P K; Khaltaev, N; Klimek, L; Koffi N'Goran, B; Kolek, V; Koppelman, G H; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Lambrecht, B; Lau, S; Larenas-Linnemann, D; Laune, D; Le, L T T; Lieberman, P; Lipworth, B; Li, J; Louis, R; Magard, Y; Magnan, A; Mahboub, B; Majer, I; Makela, M J; Manning, P; De Manuel Keenoy, E; Marshall, G D; Masjedi, M R; Maurer, M; Mavale-Manuel, S; Melén, E; Melo-Gomes, E; Meltzer, E O; Merk, H; Miculinic, N; Mihaltan, F; Milenkovic, B; Mohammad, Y; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Mösges, R; Namazova-Baranova, L; Naclerio, R; Neou, A; Neffen, H; Nekam, K; Niggemann, B; Nyembue, T D; O'Hehir, R E; Ohta, K; Okamoto, Y; Okubo, K; Ouedraogo, S; Paggiaro, P; Pali-Schöll, I; Palmer, S; Panzner, P; Papi, A; Park, H S; Pavord, I; Pawankar, R; Pfaar, O; Picard, R; Pigearias, B; Pin, I; Plavec, D; Pohl, W; Popov, T A; Portejoie, F; Postma, D; Potter, P; Price, D; Rabe, K F; Raciborski, F; Radier Pontal, F; Repka-Ramirez, S; Robalo-Cordeiro, C; Rolland, C; Rosado-Pinto, J; Reitamo, S; Rodenas, F; Roman Rodriguez, M; Romano, A; Rosario, N; Rosenwasser, L; Rottem, M; Sanchez-Borges, M; Scadding, G K; Serrano, E; Schmid-Grendelmeier, P; Sheikh, A; Simons, F E R; Sisul, J C; Skrindo, I; Smit, H A; Solé, D; Sooronbaev, T; Spranger, O; Stelmach, R; Strandberg, T; Sunyer, J; Thijs, C; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; van Hage, M; Vandenplas, O; Vezzani, G; Vichyanond, P; Viegi, G; Wagenmann, M; Walker, S; Wang, D Y; Wahn, U; Williams, D M; Wright, J; Yawn, B P; Yiallouros, P K; Yusuf, O M; Zar, H J; Zernotti, M E; Zhang, L; Zhong, N; Zidarn, M; Mercier, J

    2015-11-01

    Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards. PMID:26148220

  11. Guideline implementation for breast healthcare in low- and middle-income countries: breast healthcare program resource allocation.

    PubMed

    Harford, Joe; Azavedo, Edward; Fischietto, Mary

    2008-10-15

    Breast cancer is serious public health problem in countries of all resource levels. Although major advances in the detection and treatment of the disease have occurred in higher income settings, similar progress has been slow or scarce in most low- and middle-income countries (LMCs). The poorer outcomes in LMCs may relate to the limited capability of their healthcare systems (HCS) to provide successful early detection, diagnosis, and treatment of breast cancer. Impediments to better outcomes include insufficient numbers of appropriately trained healthcare workers, limited access to screening/treatment facilities, inadequate supplies of necessary drugs, and timeliness of treatment after diagnosis. Clearly, these HCS deficiencies are broader than the scope of the Breast Health Global Initiative (BHGI) and are not unique to the issue of breast cancer. To address issues in HCS that hinder the delivery of breast health services, the BHGI Healthcare Systems and Public Policy Panel explored the HCS structures and function needed to operate a breast care program (BCP). Like with all BHGI guidelines, those proposed by this panel were expressed in terms of 4 strata of resource levels: basic, limited, enhanced, and maximal. The current report describes the issues and questions related to HCS that are important to consider when designing, implementing, and measuring the performance of a BCP. Health ministers, other policymakers, healthcare personnel, administrators, and anyone else involved in developing a BCP can use and adapt this framework to improve outcomes and ensure the more effective use of resources. PMID:18837020

  12. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL)

    PubMed Central

    Todd, Christopher A.; Sanchez, Ana M.; Garcia, Ambrosia; Denny, Thomas N.; Sarzotti-Kelsoe, Marcella

    2014-01-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. PMID:24120573

  13. Systematic tailoring for the implementation of guideline recommendations for anxiety and depressive disorders in general practice: perceived usefulness of tailored interventions

    PubMed Central

    2013-01-01

    Background The uptake of guideline recommendations in general practice can potentially be improved by designing implementation interventions that are tailored to prospectively identify barriers. However, there is insufficient evidence regarding the most effective and efficient approaches to tailoring. Our study provides an insight into the usefulness of tailored interventions to prospectively identified barriers affecting the uptake of guideline recommendations for anxiety and depressive disorders experienced by general practitioners (GPs) in their local context. Methods A qualitative study was conducted, in which 23 GPs gave informed consent and 14 finally participated. To explore the barriers affecting the uptake of guideline recommendations, a face-to-face interview was conducted with each GP to generate a personalised list. In response to this list, interventions were tailored to remove the barriers experienced by the GPs. To examine the perceived usefulness of the tailored interventions, telephone interviews were conducted after one year and coded through thematic coding. The analysis was descriptive in nature. Results The most frequently perceived barriers were: a lack of knowledge and skills, no agreement on guideline recommendations, negative outcome expectancy, low self-efficacy, no consensus with patients, and a lack of information about treatments provided by mental health professionals, together with waiting lists. The tailored interventions ‘peer group supervision’ and ‘individualised telephone consultations’ were perceived as useful by most GPs. Besides the tailored interventions, a perceived benefit of using a self-rating scale, measuring depressive and anxiety symptoms, and the idea of delivering better patient care, were supportive in the uptake of guideline recommendations. Conclusions Our findings suggest that tailoring interventions to prospectively identified barriers, affecting the uptake of guideline recommendations for anxiety and

  14. Imaging of Scaphoid Fractures According to the New S3 Guidelines.

    PubMed

    Schmitt, R; Rosenthal, H

    2016-05-01

     Schmitt R, Rosenthal H. Imaging of Scaphoid Fractures According to the New S3 Guidelines. Fortschr Röntgenstr 2016; 188: 459 - 469. PMID:27074424

  15. Impact of the Creation and Implementation of a Clinical Management Guideline for Personality Disorders in Reducing Use of Mechanical Restraints in a Psychiatric Inpatient Unit

    PubMed Central

    Fernandez-Rivas, Aranzazu; Bustamante, Sonia; Rico-Vilademoros, Fernando; Vivanco, Esther; Martinez, Karmele; Angel Vecino, Miguel; Martín, Melba; Herrera, Sonia; Rodriguez, Jorge; Saenz, Carlos

    2014-01-01

    Objective: To evaluate the impact of the implementation of a guideline for the management of personality disorders on reducing the frequency of use of mechanical restraints in a psychiatric inpatient unit. Method: This retrospective study was conducted in a psychiatric inpatient unit with 42 beds, which serves an urban area of 330,000 inhabitants. The sample consisted of all patients with a clinical diagnosis of personality disorder (DSM-IV-TR criteria) who were admitted to the unit from January 2010 to December 2010 and from January 2011 to December 2011 (ie, before and after, respectively, the implementation of the guideline). The guideline focused on cluster B disorders and follows a psychodynamic perspective. Results: Restraint use was reduced from 38 of 87 patients with personality disorders (43.7%) to 3 of 112 (2.7%), for a relative risk of 0.06 (95% CI, 0.02–0.19) and an absolute risk reduction of 41% (95% CI, 29.9%–51.6%). The risk of being discharged against medical advice increased after the intervention, with a relative risk of 1.84 (95% CI, 0.96–3.51). Restraint use in patients with other diagnoses was also reduced to a similar extent. Conclusions: The use of mechanical restraints was dramatically reduced after the implementation of a clinical practice guideline on personality disorders, suggesting that these coercive measures might be decreased in psychiatric inpatient units. PMID:25834763

  16. Implementation of real-time 3D image communication system using stereoscopic imaging and display scheme

    NASA Astrophysics Data System (ADS)

    Kim, Seung-Chul; Kim, Dong-Kyu; Ko, Jung-Hwan; Kim, Eun-Soo

    2004-11-01

    In this paper, a new stereoscopic 3D imaging communication system for real-time teleconferencing application is implemented by using IEEE 1394 digital cameras, Intel Xeon server computer system and Microsoft"s DirectShow programming library and its performance is analyzed in terms of image-grabbing frame rate. In the proposed system, two-view images are captured by using two digital cameras and processed in the Intel Xeon server computer system. And then, disparity data is extracted from them and transmitted to the client system with the left image through an information network and in the recipient two-view images are reconstructed and displayed on the stereoscopic 3D display system. The program for controlling the overall system is developed using the Microsoft DirectShow SDK. From some experimental results, it is found that the proposed system can display stereoscopic images in real-time with a full-color of 16 bits and a frame rate of 15fps.

  17. [Guideline for the Development of Evidence-based Patient Information: insights into the methods and implementation of evidence-based health information].

    PubMed

    Lühnen, Julia; Albrecht, Martina; Hanßen, Käthe; Hildebrandt, Julia; Steckelberg, Anke

    2015-01-01

    The "Guideline for the Development of Evidence-based Patient Information" project is a novelty. The aim of this project is to enhance the quality of health information. The development and implementation process is guided by national and international standards. Involvement of health information developers plays an essential role. This article provides an insight into the guideline's underlying methodology, using graphics as an example. In addition, the results of a qualitative study exploring the competencies of health information developers are presented. These results will guide the implementation of the guideline. We conducted systematic literature searches (until June 2014), critical appraisal and descriptive analyses applying GRADE for two selected guideline questions. Out of 3,287 hits 11 RCTs were included in the analysis. The evidence has been rated to be of low to moderate quality. Additional graphics may have a positive effect on cognitive outcomes. However, the relevance of the results is questionable. For graphics, we found some indication that especially pictograms but also bar graphs have a positive effect on cognitive outcomes and meet patients' preferences. In order to prepare for the implementation of the guideline, we conducted a qualitative study to explore the competencies of health information developers using expert interviews. Four telephone interviews were conducted, audio recorded, transcribed and analysed according to Grounded Theory. Six categories were identified: literature search, development of health information, participation of target groups, continuing education and further training of health information developers, cooperation with different institutions, essential competencies. Levels of competencies regarding the methods of evidence-based medicine and evidence-based health information vary considerably and indicate a need for training. These results have informed the development of a training programme that will support the

  18. Soft Tissue Tumors in Adults: ESSR-Approved Guidelines for Diagnostic Imaging.

    PubMed

    Noebauer-Huhmann, Iris M; Weber, Marc-André; Lalam, Radhesh K; Trattnig, Siegfried; Bohndorf, Klaus; Vanhoenacker, Filip; Tagliafico, Alberto; van Rijswijk, Carla; Vilanova, Joan C; Afonso, P Diana; Breitenseher, Martin; Beggs, Ian; Robinson, Philip; de Jonge, Milko C; Krestan, Christian; Bloem, Johan L

    2015-12-01

    Soft tissue sarcomas are rare, but early, accurate diagnosis with subsequent appropriate treatment is crucial for the clinical outcome. The ESSR guidelines are intended to help radiologists in their decision-making and support discussion among clinicians who deal with patients with suspected or proven soft tissue tumors. Potentially malignant lesions recognized by ultrasound should be referred for magnetic resonance imaging (MRI), which also serves as a preoperative local staging modality, with specific technical requirements and mandatory radiological report elements. Radiography may add information about matrix calcification and osseous involvement. Indeterminate lesions, or lesions in which therapy is dependent on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist sarcoma center, where an interdisciplinary tumor group, with a specialized pathologist, radiologist, and the surgeon are involved. In sarcoma, a CT scan of the chest is mandatory. Additional staging modalities are entity-specific. There are no evidence-based recommendations for routine follow-up in surgically treated sarcomas. However, we would recommend regular follow-up with intervals dependent on tumor grade, for 10 years after the initial diagnosis. PMID:26696086

  19. Implementation of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial.

    PubMed

    Ziaeian, Boback; Dinkler, John; Watson, Karol

    2015-01-01

    Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in developed countries. The management of blood cholesterol through use of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) in at-risk patients is a pillar of medical therapy for the primary and secondary prevention of cardiovascular disease. The recent 2013 American College of Cardiology/American Heart Association guideline on managing blood cholesterol provides an important framework for the effective implementation of risk-reduction strategies. The guideline identifies four cohorts of patients with proven benefits from statin therapy and streamlines the dosing and monitoring recommendations based on evidence from published, randomized controlled trials. Primary care physicians and cardiologists play key roles in identifying populations at elevated ASCVD risk. In providing a practical management overview of the current blood cholesterol guideline, we facilitate more informed discussions on treatment options between healthcare providers and their patients. PMID:26198559

  20. Tobacco cessation Clinical Practice Guideline use by rural and urban hospital nurses: a pre-implementation needs assessment

    PubMed Central

    2012-01-01

    Background This study was a pre-program evaluation of hospital-based nurses' tobacco intervention beliefs, confidence, training, practice, and perceived intervention barriers and facilitators. It was designed to identify relevant information prior to implementing tobacco cessation guidelines across a large northern rural region, home to 1 urban and 12 rural hospitals. Methods This cross-sectional survey was distributed by nurse managers to nurses in the 13 hospitals and returned by nurses (N = 269) via mail to the researchers. Results Nurses were somewhat confident providing cessation interventions, agreed they should educate patients about tobacco, and 94% perceived tobacco counselling as part of their role. Although only 11% had received cessation training, the majority reported intervening, even if seldom--91% asked about tobacco-use, 96% advised quitting, 89% assessed readiness to quit, 88% assisted with quitting, and 61% arranged post-discharge follow-up. Few performed any of these steps frequently, and among those who intervened, the majority spent < 10 minutes. The most frequently performed activities tended to take the least amount of time, while the more complex activities (e.g., teaching coping skills and pharmacotherapy education) were seldom performed. Patient-related factors (quitting benefits and motivation) encouraged nurses to intervene and work-related factors discouraged them (time and workloads). There were significant rural-urban differences--more rural nurses perceived intervening as part of their role, reported having more systems in place to support cessation, reported higher confidence for intervening, and more frequently assisted patients with quitting and arranged follow-up. Conclusions The findings showed nurses' willingness to engage in tobacco interventions. What the majority were doing maps onto the recommended minimum of 1-3 minutes but intervention frequency and follow-up were suboptimal. The rural-urban differences suggest a need

  1. Disparities in intimate partner violence prenatal counseling: setting a baseline for the implementation of the Guidelines for Women's Preventive Services.

    PubMed

    Ta Park, Van M; Hayes, Donald K; Humphreys, Janice

    2014-05-01

    Prenatal health care counseling is associated with positive health outcomes for mothers and infants. Moreover, pregnant women are considered a vulnerable population at risk of being victims of intimate partner violence. Pregnancy provides a unique opportunity to identify and refer women experiencing intimate partner violence to community resources; however, in prior research, most women reported that their prenatal care providers did not talk to them about intimate partner violence. Given the importance for providers to offer prenatal health care counseling on intimate partner violence, it is concerning that there is scant knowledge on Asian, Native Hawaiian, and other Pacific Islander mothers' experiences in this area. The study's objectives were (a) to determine the proportion of mothers who received prenatal health care counseling on intimate partner violence; and, (b) to examine racial differences of those who received prenatal health care counseling on intimate partner violence. Hawai'i's Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2004-08 were analyzed for 8,120 mothers with information on receipt of intimate partner violence prenatal health care counseling. Overall, 47.7% of mothers were counseled on intimate partner violence. Compared to Whites, Native Hawaiians, Japanese, Chinese, and Koreans were significantly less likely to report receiving prenatal health care counseling in intimate partner violence, but the opposite association was observed for Samoans. Intimate partner violence continues to be a significant problem for women, thus, this study's findings may be used as important baseline data to measure the progress made given the implementation of the new Guidelines for Women's Preventive Services in intimate partner violence screening and counseling. PMID:24843836

  2. Guidelines for Creating Positive Sexual and Racial Images in Educational Materials.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Education, Baltimore.

    These guidelines have been developed to help the Maryland Department of Education and Maryland schools divest themselves of racial and sexual biases in the educational materials they produce and use. The information on equitable treatment of the sexes contains general content and language usage guidelines and examples to help avoid sexual…

  3. Implementation of seismic design and evaluation guidelines for the Department of Energy high-level waste storage tanks and appurtenances

    SciTech Connect

    Conrads, T.J.

    1993-06-01

    In the fall of 1992, a draft of the Seismic Design and Evaluation Guidelines for the Department of Energy (DOE) High-level Waste Storage Tanks and Appurtenances was issued. The guidelines were prepared by the Tanks Seismic Experts Panel (TSEP) and this task was sponsored by DOE, Environmental Management. The TSEP is comprised of a number of consultants known for their knowledge of seismic ground motion and expertise in the analysis of structures, systems and components subjected to seismic loads. The development of these guidelines was managed by staff from Brookhaven National Laboratory, Engineering Research and Applications Division, Department of Nuclear Energy. This paper describes the process used to incorporate the Seismic Design and Evaluation Guidelines for the DOE High-Level Waste Storage Tanks and Appurtenances into the design criteria for the Multi-Function Waste Tank Project at the Hanford Site. This project will design and construct six new high-level waste tanks in the 200 Areas at the Hanford Site. This paper also discusses the vehicles used to ensure compliance to these guidelines throughout Title 1 and Title 2 design phases of the project as well as the strategy used to ensure consistent and cost-effective application of the guidelines by the structural analysts. The paper includes lessons learned and provides recommendations for other tank design projects which might employ the TSEP guidelines.

  4. Barriers to the implementation of the UK HIV testing guidelines in secondary care: how many are medical?

    PubMed

    Warwick, Z

    2010-03-01

    A survey of consultants in Plymouth Teaching Hospital was performed to identify barriers to HIV testing in secondary care. Testing practices were compared with those recommended by the UK HIV testing guidelines and barriers to testing described. PMID:20215628

  5. Implementing a breast MR imaging program: all things considered.

    PubMed

    Raza, Sughra

    2010-05-01

    The role of magnetic resonance (MR) imaging in breast imaging and evaluation has increased rapidly. MR imaging now encompasses diagnostic evaluation as well as screening for breast cancer in high-risk groups, monitoring the extent of disease and the response to chemotherapy. It is expected that the utility of breast MR imaging will continue to increase, requiring additional facilities and expertise. Establishing a breast MR imaging program requires familiarity with several unique issues pertaining to the nature of this imaging modality. This article attempts to address some of these issues, including selection of a magnet based on needs of the particular practice and magnet field strength, selection of a dedicated breast coil, magnet location and siting, advantages and challenges of higher strength magnets such as 3 Tesla, establishing a referral base, scheduling of breast MR examinations, patient safety concerns, and examination interpretation and reporting. PMID:20494305

  6. Issues to consider before implementing digital breast tomosynthesis into a breast imaging practice.

    PubMed

    Hardesty, Lara A

    2015-03-01

    OBJECTIVE. The purpose of this article is to discuss issues surrounding the implementation of digital breast tomosynthesis (DBT) into a clinical breast imaging practice and assist radiologists, technologists, and administrators who are considering the addition of this new technology to their practices. CONCLUSION. When appropriate attention is given to image acquisition, interpretation, storage, technologist and radiologist training, patient selection, billing, radiation dose, and marketing, implementation of DBT into a breast imaging practice can be successful. PMID:25714303

  7. Canadian Consensus Guidelines on Use of Amyloid Imaging in Canada: Update and Future Directions from the Specialized Task Force on Amyloid imaging in Canada.

    PubMed

    Laforce, Robert; Rosa-Neto, Pedro; Soucy, Jean-Paul; Rabinovici, Gil D; Dubois, Bruno; Gauthier, S

    2016-07-01

    Positron emission tomography (PET) imaging of brain amyloid beta is now clinically available in several countries including the United States and the United Kingdom, but not Canada. It has become an established technique in the field of neuroimaging of aging and dementia, with data incorporated in the new consensus guidelines for the diagnosis of Alzheimer disease and predementia Alzheimer's disease-related conditions. At this point, there are three US Food and Drug Administration- and European Union-approved tracers. Guided by appropriate use criteria developed in 2013 by the Alzheimer's Association and the Society of Nuclear Medicine and Molecular Imaging, the utility of amyloid imaging in medical practice is now supported by a growing body of research. In this paper, we aimed to provide an update on the 2012 Canadian consensus guidelines to dementia care practitioners on proper use of amyloid imaging. We also wished to generate momentum for the industry to submit a new drug proposal to Health Canada. A group of local, national, and international dementia experts and imaging specialists met to discuss scenarios in which amyloid PET could be used appropriately. Peer-reviewed and published literature between January 2004 and May 2015 was searched. Technical and regulatory considerations pertaining to Canada were considered. The results of a survey of current practices in Canadian dementia centers were considered. A set of specific clinical and research guidelines was agreed on that defines the types of patients and clinical circumstances in which amyloid PET could be used in Canada. Future research directions were also outlined, notably the importance of studies that would assess the pharmaco-economics of amyloid imaging. PMID:26916179

  8. Characterizing the patterned images that precipitate seizures and optimizing guidelines to prevent them.

    PubMed

    Wilkins, Arnold; Emmett, John; Harding, Graham

    2005-08-01

    The use of guidelines to prevent the broadcast of epileptogenic television program content has reduced the incidence of seizures in Britain and Japan. Epileptogenic content includes both flicker and patterns. The guidelines for flicker were developed on the basis of a model that related stimulus parameters to the proportion of patients affected. We here extend the model to pattern stimuli. A set of rules is advocated that keeps the level of risk to a consistent minimum and simplifies compliance. We propose that striped patterns that last > 0.5 s, occupy more than one fourth the area of the screen, and have bright stripes > 50 cd/m2 in luminance be restricted as regards the number of cycles admissible. The guidelines are estimated to protect at least two thirds of susceptible patients. PMID:16060930

  9. 77 FR 43759 - Examination Guidelines for Implementing the First-Inventor-to-File Provisions of the Leahy-Smith...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ...- File Provisions of the Leahy-Smith America Invents Act AGENCY: United States Patent and Trademark... (Office) is publishing ] proposed examination guidelines concerning the first-inventor-to-file (FITF... ``first inventor to file'' system, treats United States patents and United States patent...

  10. 78 FR 11059 - Examination Guidelines for Implementing the First Inventor To File Provisions of the Leahy-Smith...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... of the Leahy-Smith America Invents Act, 77 FR 43742 (July 26, 2012) (notice of proposed rulemaking... America Invents Act, 77 FR 43759 (July 26, 2012) (notice of proposed examination guidelines). The Office... First Inventor To File Provisions of the Leahy-Smith America Invents Act, 77 FR 49427 (Aug. 16,...

  11. "Let Me Get You a Nicotine Patch": Nurses' Perceptions of Implementing Smoking Cessation Guidelines for Hospitalized Veterans.

    PubMed

    Katz, David A; Stewart, Kenda; Paez, Monica; Holman, John; Adams, Susan L; Vander Weg, Mark W; Battaglia, Catherine T; Joseph, Anne M; Titler, Marita G; Ono, Sarah

    2016-04-01

    Many hospitalized smokers do not receive guideline-recommended tobacco treatment, but little is known about the perceptions of inpatient nurses with regard to tobacco treatment. We used a sequential explanatory mixed methods design to help explain the findings of an academic detailing intervention trial on the inpatient medicine units of four Veterans Affairs (VA) hospitals. We surveyed 164 nurses and conducted semistructured interviews in a purposeful sample of 33 nurses with different attitudes toward cessation counseling. Content analysis was used to inductively characterize the issues raised by participants. Emerging themes were categorized using the knowledge-attitudes-behavior framework of guideline adherence. Knowledge-related and attitudinal barriers included perceived lack of skills in cessation counseling and skepticism about the effectiveness of cessation guidelines in hospitalized veterans. Nurses also reported multiple behavioral and organizational barriers to guideline adherence: resistance from patients, insufficient time and resources, the presence of smoking areas on VA premises, and lack of coordination with primary care. VA hospitals should train inpatient staff how to negotiate behavior change, integrate cessation counseling into nurses' workflow, develop alternative referral mechanisms for post-discharge cessation counseling, and adopt hospital policies to promote inpatient abstinence. PMID:27046185

  12. Implementation of WHO/CDC Guidelines for Intentional Injury Death Surveillance: A Mixed-Methods Approach in Dar es Salaam, Tanzania

    PubMed Central

    Outwater, Anne H.; Campbell, Jacquelyn C.; Mgaya, Edward

    2013-01-01

    A foundational implementation of the WHO/CDC Injury Surveillance Guidelines was conducted in Dar es Salaam region of the United Republic of Tanzania in 2005. The Guidelines were adapted to gather qualitative as well as quantitative data about intentional injury mortality which were collected concurrently at the Muhimbili National Hospital Mortuary. An interview schedule of 12 quantitative variables and one open-ended question, participant observation and newspaper reports were used. Mixed methods allowed an understanding of intentional injury mortality to emerge, even for those with the least amount of data, the 22% of homicides whose bodies were never claimed. Mixed methods made it possible to quantify intentional injury mortality rates, describe subpopulations with scanty data, and learn how to embed ongoing injury mortality surveillance into daily practice. PMID:24130432

  13. Implementation of WHO/CDC Guidelines for Intentional Injury Death Surveillance: A Mixed-Methods Approach in Dar es Salaam, Tanzania.

    PubMed

    Outwater, Anne H; Campbell, Jacquelyn C; Mgaya, Edward

    2011-08-01

    A foundational implementation of the WHO/CDC Injury Surveillance Guidelines was conducted in Dar es Salaam region of the United Republic of Tanzania in 2005. The Guidelines were adapted to gather qualitative as well as quantitative data about intentional injury mortality which were collected concurrently at the Muhimbili National Hospital Mortuary. An interview schedule of 12 quantitative variables and one open-ended question, participant observation and newspaper reports were used. Mixed methods allowed an understanding of intentional injury mortality to emerge, even for those with the least amount of data, the 22% of homicides whose bodies were never claimed. Mixed methods made it possible to quantify intentional injury mortality rates, describe subpopulations with scanty data, and learn how to embed ongoing injury mortality surveillance into daily practice. PMID:24130432

  14. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    PubMed Central

    Yoon, Yeonyee E.; Hong, Yoo Jin; Kim, Hyung-Kwan; Kim, Jeong A; Na, Jin Oh; Yang, Dong Hyun

    2014-01-01

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. PMID:25469078

  15. 2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

    PubMed Central

    Yoon, Yeonyee E.; Hong, Yoo Jin; Kim, Hyung-Kwan; Kim, Jeong A; Na, Jin Oh; Yang, Dong Hyun

    2014-01-01

    Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. PMID:25469139

  16. Compact Video Microscope Imaging System Implemented in Colloid Studies

    NASA Technical Reports Server (NTRS)

    McDowell, Mark

    2002-01-01

    Long description Photographs showing fiber-optic light source, microscope and charge-coupled discharge (CCD) camera head connected to camera body, CCD camera body feeding data to image acquisition board in PC, and Cartesian robot controlled via PC board. The Compact Microscope Imaging System (CMIS) is a diagnostic tool with intelligent controls for use in space, industrial, medical, and security applications. CMIS can be used in situ with a minimum amount of user intervention. This system can scan, find areas of interest in, focus on, and acquire images automatically. Many multiple-cell experiments require microscopy for in situ observations; this is feasible only with compact microscope systems. CMIS is a miniature machine vision system that combines intelligent image processing with remote control. The software also has a user-friendly interface, which can be used independently of the hardware for further post-experiment analysis. CMIS has been successfully developed in the SML Laboratory at the NASA Glenn Research Center and adapted for use for colloid studies and is available for telescience experiments. The main innovations this year are an improved interface, optimized algorithms, and the ability to control conventional full-sized microscopes in addition to compact microscopes. The CMIS software-hardware interface is being integrated into our SML Analysis package, which will be a robust general-purpose image-processing package that can handle over 100 space and industrial applications.

  17. Development and implementation of software systems for imaging spectroscopy

    USGS Publications Warehouse

    Boardman, J.W.; Clark, R.N.; Mazer, A.S.; Biehl, L.L.; Kruse, F.A.; Torson, J.; Staenz, K.

    2006-01-01

    Specialized software systems have played a crucial role throughout the twenty-five year course of the development of the new technology of imaging spectroscopy, or hyperspectral remote sensing. By their very nature, hyperspectral data place unique and demanding requirements on the computer software used to visualize, analyze, process and interpret them. Often described as a marriage of the two technologies of reflectance spectroscopy and airborne/spaceborne remote sensing, imaging spectroscopy, in fact, produces data sets with unique qualities, unlike previous remote sensing or spectrometer data. Because of these unique spatial and spectral properties hyperspectral data are not readily processed or exploited with legacy software systems inherited from either of the two parent fields of study. This paper provides brief reviews of seven important software systems developed specifically for imaging spectroscopy.

  18. Fast Implementation of Matched Filter Based Automatic Alignment Image Processing

    SciTech Connect

    Awwal, A S; Rice, K; Taha, T

    2008-04-02

    Video images of laser beams imprinted with distinguishable features are used for alignment of 192 laser beams at the National Ignition Facility (NIF). Algorithms designed to determine the position of these beams enable the control system to perform the task of alignment. Centroiding is a common approach used for determining the position of beams. However, real world beam images suffer from intensity fluctuation or other distortions which make such an approach susceptible to higher position measurement variability. Matched filtering used for identifying the beam position results in greater stability of position measurement compared to that obtained using the centroiding technique. However, this gain is achieved at the expense of extra processing time required for each beam image. In this work we explore the possibility of using a field programmable logic array (FPGA) to speed up these computations. The results indicate a performance improvement of 20 using the FPGA relative to a 3 GHz Pentium 4 processor.

  19. The effect of implementing a new guideline and operative pro forma on the detection and management of third- and fourth-degree perineal tears

    PubMed Central

    Cornell, Kristin; De Souza, Alison; Tacey, Mark; Long, David M; Veerasingham, Mayooran

    2016-01-01

    Background Obstetric anal sphincter injury (OASI) is a serious complication of vaginal births, resulting in possible long-term consequences such as incontinence and pain. Adequate detection and management of these injuries is vital in minimizing the impact they have on women. Aim To assess the rates of detection, management, and outcomes of OASI before and after the implementation of a new clinical practice guideline and operative pro forma. Materials and methods A 12-month audit of the incidence, management, and outcomes of OASI was conducted in 2009. An operative pro forma and practice guideline were implemented in 2010 followed by a further audit undertaken between 2010 and 2012. Statistical analysis was performed to determine any significant change in practice. Results The distribution of risk factors for OASI including primiparity, birthweight, and type of vaginal delivery was similar between the two audited groups. After implementation of the pro forma, the reported incidence of OASI increased from 1.62% to 3.1% (P=0.004). Significant changes in management included an increase in the use of recommended suture material (48% vs 80%, P=0.002), postoperative antibiotics (78% vs 99%, P=0.001), postoperative catheterization (52% vs 90%, P<0.001), and inpatient physiotherapy consultations (44% vs 97%, P=<0.001). An increase was seen in women attending their 6-week follow-up appointment (33% vs 54% P=0.058); however, this was just below the level of statistical significance. Conclusion The introduction of the new pro forma and guideline resulted in an increase in the reported incidence of OASI, improved management, and follow-up of patients. PMID:27226734

  20. Teaching High School Science Using Image Processing: A Case Study of Implementation of Computer Technology.

    ERIC Educational Resources Information Center

    Greenberg, Richard; Raphael, Jacqueline; Keller, Jill L.; Tobias, Sheila

    1998-01-01

    Outlines an in-depth case study of teachers' use of image processing in biology, earth science, and physics classes in one high school science department. Explores issues surrounding technology implementation. Contains 21 references. (DDR)

  1. Implementing the National Institute of Clinical Excellence improving outcome guidelines for head and neck cancer: developing a business plan with reorganisation of head and neck cancer services.

    PubMed

    Jeannon, J-P; Abbs, I; Calman, F; Gleeson, M; Lyons, A; Hussain, K; McGurk, M; O'Connell, M; Probert, D; Ng, R; Simo, R

    2008-04-01

    The implementation of the National Institute of Clinical Excellence improving outcome guidelines (NICE-IOG) manual for head and neck cancer may have a huge potential cost implication. Head and neck cancer is a rare disease which utilises large quantities of resources which can only be provided in a tertiary centre. Head and neck cancer services should be centralised into a single site for each cancer network. A new higher tariff rate for complex head and neck cancer cases is needed which recognises the true cost of this work. Each network should set its own tariff to make head and neck cancer care financially viable. PMID:18429872

  2. Executive Summary: Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

    PubMed

    Barlam, Tamar F; Cosgrove, Sara E; Abbo, Lilian M; MacDougall, Conan; Schuetz, Audrey N; Septimus, Edward J; Srinivasan, Arjun; Dellit, Timothy H; Falck-Ytter, Yngve T; Fishman, Neil O; Hamilton, Cindy W; Jenkins, Timothy C; Lipsett, Pamela A; Malani, Preeti N; May, Larissa S; Moran, Gregory J; Neuhauser, Melinda M; Newland, Jason G; Ohl, Christopher A; Samore, Matthew H; Seo, Susan K; Trivedi, Kavita K

    2016-05-15

    Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics. PMID:27118828

  3. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

    PubMed

    Barlam, Tamar F; Cosgrove, Sara E; Abbo, Lilian M; MacDougall, Conan; Schuetz, Audrey N; Septimus, Edward J; Srinivasan, Arjun; Dellit, Timothy H; Falck-Ytter, Yngve T; Fishman, Neil O; Hamilton, Cindy W; Jenkins, Timothy C; Lipsett, Pamela A; Malani, Preeti N; May, Larissa S; Moran, Gregory J; Neuhauser, Melinda M; Newland, Jason G; Ohl, Christopher A; Samore, Matthew H; Seo, Susan K; Trivedi, Kavita K

    2016-05-15

    Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics. PMID:27080992

  4. Digital implementation of a neural network for imaging

    NASA Astrophysics Data System (ADS)

    Wood, Richard; McGlashan, Alex; Yatulis, Jay; Mascher, Peter; Bruce, Ian

    2012-10-01

    This paper outlines the design and testing of a digital imaging system that utilizes an artificial neural network with unsupervised and supervised learning to convert streaming input (real time) image space into parameter space. The primary objective of this work is to investigate the effectiveness of using a neural network to significantly reduce the information density of streaming images so that objects can be readily identified by a limited set of primary parameters and act as an enhanced human machine interface (HMI). Many applications are envisioned including use in biomedical imaging, anomaly detection and as an assistive device for the visually impaired. A digital circuit was designed and tested using a Field Programmable Gate Array (FPGA) and an off the shelf digital camera. Our results indicate that the networks can be readily trained when subject to limited sets of objects such as the alphabet. We can also separate limited object sets with rotational and positional invariance. The results also show that limited visual fields form with only local connectivity.

  5. Implementation of Imaging Technology for Recordkeeping at the World Bank.

    ERIC Educational Resources Information Center

    Smith, Clive D.

    1997-01-01

    Describes the evolution of an electronic document management system for the World Bank, including record-keeping components, and how the Pittsburgh requirements for evidence in record keeping were used to evaluate it. Discusses imaging technology for scanning paper records, metadata for retrieval and record keeping, and extending the system to…

  6. Parallel asynchronous hardware implementation of image processing algorithms

    NASA Technical Reports Server (NTRS)

    Coon, Darryl D.; Perera, A. G. U.

    1990-01-01

    Research is being carried out on hardware for a new approach to focal plane processing. The hardware involves silicon injection mode devices. These devices provide a natural basis for parallel asynchronous focal plane image preprocessing. The simplicity and novel properties of the devices would permit an independent analog processing channel to be dedicated to every pixel. A laminar architecture built from arrays of the devices would form a two-dimensional (2-D) array processor with a 2-D array of inputs located directly behind a focal plane detector array. A 2-D image data stream would propagate in neuron-like asynchronous pulse-coded form through the laminar processor. No multiplexing, digitization, or serial processing would occur in the preprocessing state. High performance is expected, based on pulse coding of input currents down to one picoampere with noise referred to input of about 10 femtoamperes. Linear pulse coding has been observed for input currents ranging up to seven orders of magnitude. Low power requirements suggest utility in space and in conjunction with very large arrays. Very low dark current and multispectral capability are possible because of hardware compatibility with the cryogenic environment of high performance detector arrays. The aforementioned hardware development effort is aimed at systems which would integrate image acquisition and image processing.

  7. High responsivity CMOS imager pixel implemented in SOI technology

    NASA Technical Reports Server (NTRS)

    Zheng, X.; Wrigley, C.; Yang, G.; Pain, B.

    2000-01-01

    Availability of mature sub-micron CMOS technology and the advent of the new low noise active pixel sensor (APS) concept have enabled the development of low power, miniature, single-chip, CMOS digital imagers in the decade of the 1990's.

  8. EVALUATION OF MAGNETIC RESONANCE IMAGING GUIDELINES FOR DIFFERENTIATION BETWEEN THORACOLUMBAR INTERVERTEBRAL DISK EXTRUSIONS AND INTERVERTEBRAL DISK PROTRUSIONS IN DOGS.

    PubMed

    De Decker, Steven; Gomes, Sergio A; Packer, Rowena Ma; Kenny, Patrick J; Beltran, Elsa; Parzefall, Birgit; Fenn, Joe; Nair, Devi; Nye, George; Volk, Holger A

    2016-09-01

    Four MRI variables have recently been suggested to be independently associated with a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion. Midline intervertebral disk herniation, and partial intervertebral disk degeneration were associated with intervertebral disk protrusion, while presence of a single intervertebral disk herniation and disk material dispersed beyond the boundaries of the intervertebral disk space were associated with intervertebral disk extrusion. The aim of this retrospective, cross-sectional study was to determine whether using these MRI variables improves differentiation between thoracolumbar intervertebral disk extrusions and protrusions. Eighty large breed dogs with surgically confirmed thoracolumbar intervertebral disk extrusions or protrusions were included. Randomized MRI studies were presented on two occasions to six blinded observers, which were divided into three experience categories. During the first assessment, observers made a presumptive diagnosis of thoracolumbar intervertebral disk extrusion or protrusion without guidelines. During the second assessment they were asked to make a presumptive diagnosis with the aid of guidelines. Agreement was evaluated by Kappa-statistics. Diagnostic accuracy significantly improved from 70.8 to 79.6% and interobserver agreement for making a diagnosis of intervertebral disk extrusion or intervertebral disk protrusion improved from fair (κ = 0.27) to moderate (κ = 0.41) after using the proposed guidelines. Diagnostic accuracy was significantly influenced by degree of observer experience. Intraobserver agreement for the assessed variables ranged from fair to excellent and interobserver agreement ranged from fair to moderate. The results of this study suggest that the proposed imaging guidelines can aid in differentiating thoracolumbar intervertebral disk extrusions from protrusions. PMID:27374979

  9. The FAO/NACA Asia Regional Technical Guidelines on Health Management for the Responsible Movement of Live Aquatic Animals: lessons learned from their development and implementation.

    PubMed

    Subasinghe, R P; Bondad-Reantaso, M G

    2008-04-01

    Aquaculture is the fastest growing food producing sector in the world and it is expected to produce significant quantities of fish in the coming years to meet the growing global demand for aquatic animal products. The expansion and diversification of the sector, along with globalisation and trade liberalisation have resulted in aquatic animals and animal products moving around the world rapidly, causing serious disease outbreaks stemming from incursions of pathogens through unregulated transboundary movements. It has become necessary to develop appropriate guidelines for establishing national regulatory frameworks to improve responsibility in transboundary movement of live aquatic animals. In 2000, the Food and Agriculture Organization of the United Nations (FAO), in collaboration with the Network of Aquaculture Centres in Asia-Pacific (NACA) and in partnership with 21 Asian countries, developed the Asia Regional Technical Guidelines on Health Management for the Responsible Movement of Live Aquatic Animals. The present article outlines the development process of the guidelines, the lessons learned from their implementation at national level and the way forward. PMID:18666478

  10. Implementation of quality assurance in national foot and mouth disease laboratories, based on the guidelines of the Office International des Epizooties.

    PubMed

    De Clercq, K

    1998-12-01

    The final act of the Uruguay Round of the General Agreement on Tariffs and Trade, 1994, contains the Agreement on the Application of Sanitary and Phytosanitary Measures, which aims to reduce the negative effects of health barriers on international trade to a minimum. Therefore, the Office International des Epizooties (OIE) Regional Commission for Europe proposed that an accreditation system based on the EN 45000 standard should be applied to achieve international recognition of certificates and testing laboratories. To this end, the OIE Standards Commission published a series of guidelines for the evaluation of laboratory quality and proficiency testing. In 1995, the Food and Agriculture Organization European Commission for the Control of Foot and Mouth Disease recommended that the OIE proposal should be applied in all foot and mouth disease (FMD) diagnostic laboratories in Europe. This review summarises the EN 45001 standard and the OIE guidelines, and proposes that these guidelines should be taken as a basis for the implementation of a quality assurance programme in FMD laboratories. PMID:9850551

  11. Implementation of a Microwave Imaging Reflectometer on DIII-D

    NASA Astrophysics Data System (ADS)

    Kriete, D. M.; Tobias, B. J.

    2013-10-01

    The microwave imaging reflectometer (MIR) is a new plasma diagnostic system on DIII-D that will make localized measurements of density fluctuations on a poloidal cross section of the tokamak. The data from these measurements will provide a quantitative picture of plasma turbulence and MHD instabilities. This project's focus is to install the MIR system on DIII-D, perform calibration tests on it, and develop data analysis tools to process MIR data, with a focus on estimating measurement error. Tests include taking dark shots to subtract out passive noise from the measurements and taking plasma shots to better quantify active noise. Synthetic diagnostics based on numerical codes will also be used to evaluate the MIR system. The MIR uses the same optics as the existing electron cyclotron emission imaging (ECEI) system so, after completion, physicists will have access to a 2D image of both density and temperature fluctuations within the plasma. The MIR thus has broad utility across experiments seeking to understand turbulent transport. Supported by the National Undergraduate Fellowship Program in Plasma Physics and Fusion Energy Sciences and the US DOE under DE-FC02-04ER54698 and DE-AC02-09CH11466.

  12. A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations

    PubMed Central

    2010-01-01

    Background There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain. Methods We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline dissemination and implementation studies published between 1966 and 1998. Use of theory was classified according to type of use (explicitly theory based, some conceptual basis, and theoretical construct used) and stage of use (choice/design of intervention, process/mediators/moderators, and post hoc/explanation). Results Fifty-three of 235 studies (22.5%) were judged to have employed theories, including 14 studies that explicitly used theory. The majority of studies (n = 42) used only one theory; the maximum number of theories employed by any study was three. Twenty-five different theories were used. A small number of theories accounted for the majority of theory use including PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation), diffusion of innovations, information overload and social marketing (academic detailing). Conclusions There was poor justification of choice of intervention and use of theory in implementation research in the identified studies until at least 1998. Future research should explicitly identify the justification for the interventions. Greater use of explicit theory to understand barriers, design interventions, and explore mediating pathways and moderators is needed to advance the science of implementation research. PMID:20181130

  13. Method for implementation of back-illuminated CMOS or CCD imagers

    NASA Technical Reports Server (NTRS)

    Pain, Bedabrata (Inventor)

    2008-01-01

    A method for implementation of back-illuminated CMOS or CCD imagers. An oxide layer buried between silicon wafer and device silicon is provided. The oxide layer forms a passivation layer in the imaging structure. A device layer and interlayer dielectric are formed, and the silicon wafer is removed to expose the oxide layer.

  14. SIMPLE: implementation of recommendations from international evidence-based guidelines on caesarean sections in the Netherlands. Protocol for a controlled before and after study

    PubMed Central

    2013-01-01

    Background Caesarean section (CS) rates are rising worldwide. In the Netherlands, the most significant rise is observed in healthy women with a singleton in vertex position between 37 and 42 weeks gestation, whereas it is doubtful whether an improved outcome for the mother or her child was obtained. It can be hypothesized that evidence-based guidelines on CS are not implemented sufficiently. Therefore, the present study has the following objectives: to develop quality indicators on the decision to perform a CS based on key recommendations from national and international guidelines; to use the quality indicators in order to gain insight into actual adherence of Dutch gynaecologists to guideline recommendations on the performance of a CS; to explore barriers and facilitators that have a direct effect on guideline application regarding CS; and to develop, execute, and evaluate a strategy in order to reduce the CS incidence for a similar neonatal outcome (based on the information gathered in the second and third objectives). Methods An independent expert panel of Dutch gynaecologists and midwives will develop a set of quality indicators on the decision to perform a CS. These indicators will be used to measure current care in 20 hospitals with a population of 1,000 women who delivered by CS, and a random selection of 1,000 women who delivered vaginally in the same period. Furthermore, by interviewing healthcare professionals and patients, the barriers and facilitators that may influence the decision to perform a CS will be measured. Based on the results, a tailor-made implementation strategy will be developed and tested in a controlled before-and-after study in 12 hospitals (six intervention, six control hospitals) with regard to effectiveness, experiences, and costs. Discussion This study will offer insight into the current CS care and into the hindering and facilitating factors influencing obstetrical policy on CS. Furthermore, it will allow definition of patient

  15. Design and implementation of GRID-based PACS in a hospital with multiple imaging departments

    NASA Astrophysics Data System (ADS)

    Yang, Yuanyuan; Jin, Jin; Sun, Jianyong; Zhang, Jianguo

    2008-03-01

    Usually, there were multiple clinical departments providing imaging-enabled healthcare services in enterprise healthcare environment, such as radiology, oncology, pathology, and cardiology, the picture archiving and communication system (PACS) is now required to support not only radiology-based image display, workflow and data flow management, but also to have more specific expertise imaging processing and management tools for other departments providing imaging-guided diagnosis and therapy, and there were urgent demand to integrate the multiple PACSs together to provide patient-oriented imaging services for enterprise collaborative healthcare. In this paper, we give the design method and implementation strategy of developing grid-based PACS (Grid-PACS) for a hospital with multiple imaging departments or centers. The Grid-PACS functions as a middleware between the traditional PACS archiving servers and workstations or image viewing clients and provide DICOM image communication and WADO services to the end users. The images can be stored in distributed multiple archiving servers, but can be managed with central mode. The grid-based PACS has auto image backup and disaster recovery services and can provide best image retrieval path to the image requesters based on the optimal algorithms. The designed grid-based PACS has been implemented in Shanghai Huadong Hospital and been running for two years smoothly.

  16. Implementation of multispectral image fusion system based on SoPC

    NASA Astrophysics Data System (ADS)

    Meng, Lingfei; Wang, Zhihui

    2013-10-01

    Combining the theory of wavelet transform based image fusion and SOPC design method, the authors uses SOPC as the core device to design and implement a image fusion system. The fusion system adopts the Verilog hardware description language, Dsp builder and Quartus II development platform together with macro module to complete the logic design and timing control of each module. In the fusion system, we can achieve simple pixel-level image fusion of two registered images. This design not only builds up an image fusion system based on SOPC in accident, but also provides a hardware design principle in SoPC for the future design and Implementation of more comprehensive function of image processing.

  17. Design and implementation of range-gated underwater laser imaging system

    NASA Astrophysics Data System (ADS)

    Ge, Wei-long; Zhang, Xiao-hui

    2014-02-01

    A range-gated underwater laser imaging system is designed and implemented in this article, which is made up of laser illumination subsystem, photoelectric imaging subsystem and control subsystem. The experiment of underwater target drone detection has been done, the target of distance 40m far from the range-gated underwater laser imaging system can be imaged in the pool which water attenuation coefficient is 0.159m-1. Experimental results show that the range-gated underwater laser imaging system can detect underwater objects effectively.

  18. Systematic review of the cost-effectiveness of implementing guidelines on low back pain management in primary care: is transferability to other countries possible?

    PubMed Central

    Jensen, Cathrine Elgaard; Jensen, Martin Bach; Petersen, Karin Dam

    2016-01-01

    Objective The primary aim is to identify, summarise and quality assess the available literature on the cost-effectiveness of implementing low back pain guidelines in primary care. The secondary aim is to assess the transferability of the results to determine whether the identified studies can be included in a comparison with a Danish implementation study to establish which strategy procures most value for money. Design Systematic review. Data sources The search was conducted in Embase, PubMed, Cochrane Library, NHS Economic Evaluation Database, Scopus, CINAHL and EconLit. No restrictions were made concerning language, year of publication or publication type. The bibliographies of the included studies were searched for any studies not captured in the literature search. Eligibility criteria for selecting studies To be included, a study must be: (1) based on a randomised controlled trial comparing implementation strategies, (2) the guideline must concern treatment of low back pain in primary care and (3) the economic evaluation should contain primary data on cost and cost-effectiveness. Results The title and abstract were assessed for 308 studies; of these, three studies were found eligible for inclusion. The Consensus Health Economic Criteria (CHEC) list showed that the 3 studies were of moderate methodological quality while application of Welte's model showed that cost results from two studies could, with adjustments, be transferred to a Danish setting. It was questionable whether the associated effects could be transferred. Conclusions Despite the resemblance of the implementation strategies, the 3 studies report conflicting results on cost-effectiveness. This review showed that transferring the results from the identified studies is not straightforward and underlines the importance of transparent reporting. Future research should focus on transferability of effects, for example, development of a supplement to Welte's model. PMID:27267108

  19. Using the Six Sigma Process to Implement the Centers for Disease Control and Prevention Guideline for Hand Hygiene in 4 Intensive Care Units

    PubMed Central

    Eldridge, Noel E; Woods, Susan S; Bonello, Robert S; Clutter, Kay; Ellingson, LeAnn; Harris, Mary Ann; Livingston, Barbara K; Bagian, James P; Danko, Linda H; Dunn, Edward J; Parlier, Renee L; Pederson, Cheryl; Reichling, Kim J; Roselle, Gary A; Wright, Steven M

    2006-01-01

    BACKGROUND The Centers for Disease Control and Prevention (CDC) Guideline for Hand Hygiene in Health Care Settings was issued in 2002. In 2003, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) established complying with the CDC Guideline as a National Patient Safety Goal for 2004. This goal has been maintained through 2006. The CDC's emphasis on the use of alcohol-based hand rubs (ABHRs) rather than soap and water was an opportunity to improve compliance, but the Guideline contained over 40 specific recommendations to implement. OBJECTIVE To use the Six Sigma process to examine hand hygiene practices and increase compliance with the CDC hand hygiene recommendations required by JCAHO. DESIGN Six Sigma Project with pre-post design. PARTICIPANTS Physicians, nurses, and other staff working in 4 intensive care units at 3 hospitals. MEASUREMENTS Observed compliance with 10 required hand hygiene practices, mass of ABHR used per month per 100 patient-days, and staff attitudes and perceptions regarding hand hygiene reported by questionnaire. RESULTS Observed compliance increased from 47% to 80%, based on over 4,000 total observations. The mass of ABHR used per 100 patient-days in 3 intensive care units (ICUs) increased by 97%, 94%, and 70%; increases were sustained for 9 months. Self-reported compliance using the questionnaire did not change. Staff reported increased use of ABHR and increased satisfaction with hand hygiene practices and products. CONCLUSIONS The Six Sigma process was effective for organizing the knowledge, opinions, and actions of a group of professionals to implement the CDC's evidence-based hand hygiene practices in 4 ICUs. Several tools were developed for widespread use. PMID:16637959

  20. Implementation of real-time digital endoscopic image processing system

    NASA Astrophysics Data System (ADS)

    Song, Chul Gyu; Lee, Young Mook; Lee, Sang Min; Kim, Won Ky; Lee, Jae Ho; Lee, Myoung Ho

    1997-10-01

    Endoscopy has become a crucial diagnostic and therapeutic procedure in clinical areas. Over the past four years, we have developed a computerized system to record and store clinical data pertaining to endoscopic surgery of laparascopic cholecystectomy, pelviscopic endometriosis, and surgical arthroscopy. In this study, we developed a computer system, which is composed of a frame grabber, a sound board, a VCR control board, a LAN card and EDMS. Also, computer system controls peripheral instruments such as a color video printer, a video cassette recorder, and endoscopic input/output signals. Digital endoscopic data management system is based on open architecture and a set of widely available industry standards; namely Microsoft Windows as an operating system, TCP/IP as a network protocol and a time sequential database that handles both images and speech. For the purpose of data storage, we used MOD and CD- R. Digital endoscopic system was designed to be able to store, recreate, change, and compress signals and medical images. Computerized endoscopy enables us to generate and manipulate the original visual document, making it accessible to a virtually unlimited number of physicians.

  1. Noise reduction and image enhancement using a hardware implementation of artificial neural networks

    NASA Astrophysics Data System (ADS)

    David, Robert; Williams, Erin; de Tremiolles, Ghislain; Tannhof, Pascal

    1999-03-01

    In this paper, we present a neural based solution developed for noise reduction and image enhancement using the ZISC, an IBM hardware processor which implements the Restricted Coulomb Energy algorithm and the K-Nearest Neighbor algorithm. Artificial neural networks present the advantages of processing time reduction in comparison with classical models, adaptability, and the weighted property of pattern learning. The goal of the developed application is image enhancement in order to restore old movies (noise reduction, focus correction, etc.), to improve digital television images, or to treat images which require adaptive processing (medical images, spatial images, special effects, etc.). Image results show a quantitative improvement over the noisy image as well as the efficiency of this system. Further enhancements are being examined to improve the output of the system.

  2. SU-E-I-68: Practical Considerations On Implementation of the Image Gently Pediatric CT Protocols

    SciTech Connect

    Zhang, J; Adams, C; Lumby, C; Dillon, J; Woods, E; Richer, E

    2014-06-01

    Purpose: One limitation associated with the Image Gently pediatric CT protocols is practical implementation of the recommended manual techniques. Inconsistency as a result of different practice is a possibility among technologist. An additional concern is the added risk of data error that would result in over or underexposure. The Automatic Exposure Control (AEC) features automatically reduce radiation for children. However, they do not work efficiently for the patients of very small size and relative large size. This study aims to implement the Image Gently pediatric CT protocols in the practical setting while maintaining the use of AEC features for pediatric patients of varying size. Methods: Anthropomorphological abdomen phantoms were scanned in a CT scanner using the Image Gently pediatric protocols, the AEC technique with a fixed adult baseline, and automatic protocols with various baselines. The baselines were adjusted corresponding to patient age, weight and posterioranterior thickness to match the Image Gently pediatric CT manual techniques. CTDIvol was recorded for each examination. Image noise was measured and recorded for image quality comparison. Clinical images were evaluated by pediatric radiologists. Results: By adjusting vendor default baselines used in the automatic techniques, radiation dose and image quality can match those of the Image Gently manual techniques. In practice, this can be achieved by dividing pediatric patients into three major groups for technologist reference: infant, small child, and large child. Further division can be done but will increase the number of CT protocols. For each group, AEC can efficiently adjust acquisition techniques for children. This implementation significantly overcomes the limitation of the Image Gently manual techniques. Conclusion: Considering the effectiveness in clinical practice, Image Gently Pediatric CT protocols can be implemented in accordance with AEC techniques, with adjusted baselines, to

  3. [Nephrologic diagnosis besides ultrasonography: which other imaging methods? Guideline on the use of radiologic methods].

    PubMed

    Golfieri, Rita; Barone, Domenico

    2002-12-01

    The present paper represents an overview of the imaging methods which could integrate the first ultrasonographic approach to nephrologic diagnosis. It summarizes the clinical indications and the appropriate imaging protocols including conventional radiology, CT, MR and Nuclear Medicine in five different clinical scenarios: reno-vascular hypertension, hematuria, acute pyelonephritis, acute and chronic renal failure, and acute urinary colic. PMID:12508736

  4. Design and implementation of sparse aperture imaging systems

    NASA Astrophysics Data System (ADS)

    Chung, Soon-Jo; Miller, David W.; de Weck, Olivier L.

    2002-12-01

    In order to better understand the technological difficulties involved in designing and building a sparse aperture array, the challenge of building a white light Golay-3 telescope was undertaken. The MIT Adaptive Reconnaissance Golay-3 Optical Satellite (ARGOS) project exploits wide-angle Fizeau interferometer technology with an emphasis on modularity in the optics and spacecraft subsystems. Unique design procedures encompassing the nature of coherent wavefront sensing, control and combining as well as various system engineering aspects to achieve cost effectiveness, are developed. To demonstrate a complete spacecraft in a 1-g environment, the ARGOS system is mounted on a frictionless air-bearing, and has the ability to track fast orbiting satellites like the ISS or the planets. Wavefront sensing techniques are explored to mitigate initial misalignment and to feed back real-time aberrations into the optical control loop. This paper presents the results and the lessons learned from the conceive, design and implementation phases of ARGOS. A preliminary assess-ment shows that the beam combining problem is the most challenging aspect of sparse optical arrays. The need for optical control is paramount due to tight beam combining tolerances. The wavefront sensing/control requirements appear to be a major technology and cost driver.

  5. Committee Opinion No. 656 Summary: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.

    PubMed

    2016-02-01

    Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient. With few exceptions, radiation exposure through radiography, computed tomography scan, or nuclear medicine imaging techniques is at a dose much lower than the exposure associated with fetal harm. If these techniques are necessary in addition to ultrasonography or magnetic resonance imaging or are more readily available for the diagnosis in question, they should not be withheld from a pregnant patient. Breastfeeding should not be interrupted after gadolinium administration. PMID:26942384

  6. Committee Opinion No. 656: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.

    PubMed

    2016-02-01

    Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient. With few exceptions, radiation exposure through radiography, computed tomography scan, or nuclear medicine imaging techniques is at a dose much lower than the exposure associated with fetal harm. If these techniques are necessary in addition to ultrasonography or magnetic resonance imaging or are more readily available for the diagnosis in question, they should not be withheld from a pregnant patient. Breastfeeding should not be interrupted after gadolinium administration. PMID:26942391

  7. Design and implementation of the parallel processing system of multi-channel polarization images

    NASA Astrophysics Data System (ADS)

    Li, Zhi-yong; Huang, Qin-chao

    2013-08-01

    Compared with traditional optical intensity image processing, polarization images processing has two main problems. One is that the amount of data is larger. The other is that processing tasks is more complex. To resolve these problems, the parallel processing system of multi-channel polarization images is designed by the multi-DSP technique. It contains a communication control unit (CCU) and a data processing array (DPA). CCU controls communications inside and outside the system. Its logics are designed by a FPGA chip. DPA is made up of four Digital Signal Processor (DSP) chips, which are interlinked by the loose coupling method. DPA implements processing tasks including images registration and images synthesis by parallel processing methods. The polarization images parallel processing model is designed on multi levels including the system task, the algorithm and the operation. Its program is designed by the assemble language. While the polarization image resolution is 782x582 pixels, the pixel data length is 12 bits in the experiment. After it received 3 channels of polarization image simultaneously, this system implements parallel task to acquire the target polarization characteristics. Experimental results show that this system has good real-time and reliability. The processing time of images registration is 293.343ms while the registration accuracy achieves 0.5 pixel. The processing time of images synthesis is 3.199ms.

  8. Design, implementation and operation of a multimodality research imaging informatics repository

    PubMed Central

    2015-01-01

    Background Biomedical imaging research increasingly involves acquiring, managing and processing large amounts of distributed imaging data. Integrated systems that combine data, meta-data and workflows are crucial for realising the opportunities presented by advances in imaging facilities. Methods This paper describes the design, implementation and operation of a multi-modality research imaging data management system that manages imaging data obtained from biomedical imaging scanners operated at Monash Biomedical Imaging (MBI), Monash University in Melbourne, Australia. In addition to Digital Imaging and Communications in Medicine (DICOM) images, raw data and non-DICOM biomedical data can be archived and distributed by the system. Imaging data are annotated with meta-data according to a study-centric data model and, therefore, scientific users can find, download and process data easily. Results The research imaging data management system ensures long-term usability, integrity inter-operability and integration of large imaging data. Research users can securely browse and download stored images and data, and upload processed data via subject-oriented informatics frameworks including the Distributed and Reflective Informatics System (DaRIS), and the Extensible Neuroimaging Archive Toolkit (XNAT). PMID:25870760

  9. Implementation of total focusing method for phased array ultrasonic imaging on FPGA

    NASA Astrophysics Data System (ADS)

    Guo, JianQiang; Li, Xi; Gao, Xiaorong; Wang, Zeyong; Zhao, Quanke

    2015-02-01

    This paper describes a multi-FPGA imaging system dedicated for the real-time imaging using the Total Focusing Method (TFM) and Full Matrix Capture (FMC). The system was entirely described using Verilog HDL language and implemented on Altera Stratix IV GX FPGA development board. The whole algorithm process is to: establish a coordinate system of image and divide it into grids; calculate the complete acoustic distance of array element between transmitting array element and receiving array element, and transform it into index value; then index the sound pressure values from ROM and superimpose sound pressure values to get pixel value of one focus point; and calculate the pixel values of all focus points to get the final imaging. The imaging result shows that this algorithm has high SNR of defect imaging. And FPGA with parallel processing capability can provide high speed performance, so this system can provide the imaging interface, with complete function and good performance.

  10. Implementation and Testing of Low Cost Uav Platform for Orthophoto Imaging

    NASA Astrophysics Data System (ADS)

    Brucas, D.; Suziedelyte-Visockiene, J.; Ragauskas, U.; Berteska, E.; Rudinskas, D.

    2013-08-01

    Implementation of Unmanned Aerial Vehicles for civilian applications is rapidly increasing. Technologies which were expensive and available only for military use have recently spread on civilian market. There is a vast number of low cost open source components and systems for implementation on UAVs available. Using of low cost hobby and open source components ensures considerable decrease of UAV price, though in some cases compromising its reliability. In Space Science and Technology Institute (SSTI) in collaboration with Vilnius Gediminas Technical University (VGTU) researches have been performed in field of constructing and implementation of small UAVs composed of low cost open source components (and own developments). Most obvious and simple implementation of such UAVs - orthophoto imaging with data download and processing after the flight. The construction, implementation of UAVs, flight experience, data processing and data implementation will be further covered in the paper and presentation.

  11. School-Based Programs for Children with Emotional Disturbance: Obstacles to Program Design and Implementation and Guidelines for School Practitioners

    ERIC Educational Resources Information Center

    Reddy, Linda A.; Newman, Erik

    2009-01-01

    Children classified as emotionally disturbed constitute a most challenging and expensive population in the public schools. This article presents a tri-part model of barriers to program design, implementation, and evaluation for children classified as emotionally disturbed in public school settings. An examination of the available school-based…

  12. Guidelines for Postsecondary Institutions for Implementation of the Family Educational Rights and Privacy Act of 1974 as Amended. Revised Edition.

    ERIC Educational Resources Information Center

    American Association of Collegiate Registrars and Admissions Officers, Washington, DC.

    This publication is designed to provide guidance, clarification of intent, and suggested implementation processes and procedures for officials of postsecondary educational institutions concerning the Family Educational Rights and Privacy Act of 1974 (FERPA), as Amended in 1988 and 1993. FERPA's purpose is to ensure certain student rights…

  13. Monitoring and evaluating recovery from natural disasters using remote sensing - towards creating guidelines on the use of satellite images in the context of disaster recovery

    NASA Astrophysics Data System (ADS)

    Saito, K.; Brown, D.; Spence, R.; Chenvidyakarn, T.; Adams, B.; Bevington, J.; Platt, S.; Chuenpagdee, R.; Juntarashote, K.; Khan, A.

    2009-04-01

    The use of high-resolution optical satellite images is being investigated for evaluating and monitoring recovery after natural disasters. Funded by EPSRC, UK, the aim of the RECOVERY project is to develop indicators of recovery that can exploit the wealth of data now available, including those from satellite imagery, internet-based statistics and advanced field survey techniques. The final output will be a set of guidelines that suggests how remote sensing can be used to help monitor and evaluate the recovery process after natural disasters. The final guideline that will be produced at the end of the two year project, which started in February 2008, will be freely available to aid agencies and anyone that is interested. Currently there is no agreed standard approach for evaluating the effectiveness of recovery aid, although international frameworks such as PDNA (Post-Disaster Needs Assessment, United Nations Development Program, European Commission and World Bank) is currently being developed, and TRIAMS (Tsunami Recovery and Impact Assessment and Monitoring System, by UNDP and WHO) is being implemented to monitor the recovery from the Indian Ocean Tsunami. The RECOVERY project consists of three phases. Phase 1 was completed by September 2008 and focused on user needs survey, developing the recovery indicators and satellite image data identification/acquisition. The user needs survey was conducted to identify whether there were any indicators that the aid community would like to see prioritised. The survey result suggested that most indicators are equally important. Based on this result and also referring to the TRIAMS framework, a comprehensive list of indicators were developed which belong to six large categories, i.e. housing, infrastructure, services, livelihood, environment, social/security, risk reduction. For the RECOVERY project, two case study sites have been identified, i.e. the village of Baan Nam Khem on the west coast of Thailand, which was heavily

  14. Further optimization of SeDDaRA blind image deconvolution algorithm and its DSP implementation

    NASA Astrophysics Data System (ADS)

    Wen, Bo; Zhang, Qiheng; Zhang, Jianlin

    2011-11-01

    Efficient algorithm for blind image deconvolution and its high-speed implementation is of great value in practice. Further optimization of SeDDaRA is developed, from algorithm structure to numerical calculation methods. The main optimization covers that, the structure's modularization for good implementation feasibility, reducing the data computation and dependency of 2D-FFT/IFFT, and acceleration of power operation by segmented look-up table. Then the Fast SeDDaRA is proposed and specialized for low complexity. As the final implementation, a hardware system of image restoration is conducted by using the multi-DSP parallel processing. Experimental results show that, the processing time and memory demand of Fast SeDDaRA decreases 50% at least; the data throughput of image restoration system is over 7.8Msps. The optimization is proved efficient and feasible, and the Fast SeDDaRA is able to support the real-time application.

  15. Pediatric Intensive Care Unit admission criteria for haemato-oncological patients: a basis for clinical guidelines implementation.

    PubMed

    Piastra, Marco; Fognani, Giuliana; Franceschi, Alessia

    2011-06-16

    Recent advances in supportive care and progress in the development and use of chemotherapy have considerably improved the prognosis of many children with malignancy, thus the need for intensive care admission and management is increasing, reaching about 40% of patients throughout the disease course. Cancer remains a major death cause in children, though outcomes have considerably improved over the past decades. Prediction of outcome for children with cancer in Pediatric Intensive Care Unit (PICU) obviously requires clinical guidelines, and these are not well defined, as well as admission criteria. Major determinants of negative outcomes remain severe sepsis/septic shock association and respiratory failure, deserving specific approach in children with cancer, particularly those receiving a bone marrow transplantation. A nationwide consensus should be achieved among pediatric intensivists and oncologists regarding the threshold clinical conditions requiring Intensive Care Unit (ICU) admission as well as specific critical care protocols. As demonstrated for the critically ill non-oncologic child, it appears unreasonable that pediatric patients with malignancy can be admitted to an adult Intensive Care Unit ICU. On a national basis a pool of refecence institutions should be identified and early referral to an oncologic PICU is warranted. PMID:21772950

  16. Pediatric Intensive Care Unit admission criteria for haemato-oncological patients: a basis for clinical guidelines implementation

    PubMed Central

    Piastra, Marco; Fognani, Giuliana; Franceschi, Alessia

    2011-01-01

    Recent advances in supportive care and progress in the development and use of chemotherapy have considerably improved the prognosis of many children with malignancy, thus the need for intensive care admission and management is increasing, reaching about 40% of patients throughout the disease course. Cancer remains a major death cause in children, though outcomes have considerably improved over the past decades. Prediction of outcome for children with cancer in Pediatric Intensive Care Unit (PICU) obviously requires clinical guidelines, and these are not well defined, as well as admission criteria. Major determinants of negative outcomes remain severe sepsis/septic shock association and respiratory failure, deserving specific approach in children with cancer, particularly those receiving a bone marrow transplantation. A nationwide consensus should be achieved among pediatric intensivists and oncologists regarding the threshold clinical conditions requiring Intensive Care Unit (ICU) admission as well as specific critical care protocols. As demonstrated for the critically ill non-oncologic child, it appears unreasonable that pediatric patients with malignancy can be admitted to an adult Intensive Care Unit ICU. On a national basis a pool of refecence institutions should be identified and early referral to an oncologic PICU is warranted. PMID:21772950

  17. [Breast imaging of mass, architectural distortion and asymmetry: Clinical practice guidelines].

    PubMed

    Chopier, J; Roedlich, M N; Mathelin, C

    2015-12-01

    The development of the mammary imaging (mammography, ultrasound, MRI) enables the discovery of more and more lesions. The BI-RADS lexicon is the reference book for their descriptive analysis. Four elementary images must be individualized: masses and architectural distortion described in 3 imaging techniques, asymmetries and microcalcifications described in mammography. The aim of this work was to review three of these images: mass, architectural distortion and asymmetry, allowing the various actors involved in senology to propose an up-to-date diagnostic and interventional strategy, based on their positive predictive values (PPV) or negative predictive values of cancer and allowing the classification BI-RADS of the lesion. The masses are the most often encountered lesions as well in screening as in diagnosis. Their PPV is superior in diagnosis than in screening and it increases with the age. Their irregular forms, their spiculated outlines and their evolutionary character are the most relevant elements of suspicion. The architectural distortion is the rarest image and always classified suspect BI-RADS 4, except in case of a known scar. The asymmetry is less common; its PPV is low and rises only in case of evolutionary asymmetry. PMID:26541564

  18. Real-time implementation of optimized maximum noise fraction transform for feature extraction of hyperspectral images

    NASA Astrophysics Data System (ADS)

    Wu, Yuanfeng; Gao, Lianru; Zhang, Bing; Zhao, Haina; Li, Jun

    2014-01-01

    We present a parallel implementation of the optimized maximum noise fraction (G-OMNF) transform algorithm for feature extraction of hyperspectral images on commodity graphics processing units (GPUs). The proposed approach explored the algorithm data-level concurrency and optimized the computing flow. We first defined a three-dimensional grid, in which each thread calculates a sub-block data to easily facilitate the spatial and spectral neighborhood data searches in noise estimation, which is one of the most important steps involved in OMNF. Then, we optimized the processing flow and computed the noise covariance matrix before computing the image covariance matrix to reduce the original hyperspectral image data transmission. These optimization strategies can greatly improve the computing efficiency and can be applied to other feature extraction algorithms. The proposed parallel feature extraction algorithm was implemented on an Nvidia Tesla GPU using the compute unified device architecture and basic linear algebra subroutines library. Through the experiments on several real hyperspectral images, our GPU parallel implementation provides a significant speedup of the algorithm compared with the CPU implementation, especially for highly data parallelizable and arithmetically intensive algorithm parts, such as noise estimation. In order to further evaluate the effectiveness of G-OMNF, we used two different applications: spectral unmixing and classification for evaluation. Considering the sensor scanning rate and the data acquisition time, the proposed parallel implementation met the on-board real-time feature extraction.

  19. Some practical guidelines for UV imaging in the protein crystallization laboratory

    PubMed Central

    Desbois, Sebastien; Seabrook, Shane A.; Newman, Janet

    2013-01-01

    High-throughput imaging of protein crystallization experiments with ultraviolet (UV) light has recently become commercially available and can enable crystallographers to differentiate between crystals of protein and those of salt, as the visualization of protein crystals is based on intrinsic tryptophan fluorescence. Unfortunately, UV imaging is not a panacea, as some protein crystals will not fluoresce under UV excitation and some salt crystals are UV-fluorescently active. As a new technology, there is little experience within the general community on how to use this technology effectively and what caveats to look out for. Here, an attempt is made to identify some of the common problems that may arise using UV-imaging technology by examining test proteins, common crystallization reagents and a range of proteins by assessing their UV–Vis absorbance spectra. Some pointers are offered as to which systems may not be appropriate for this methodology. PMID:23385768

  20. Some practical guidelines for UV imaging in the protein crystallization laboratory.

    PubMed

    Desbois, Sebastien; Seabrook, Shane A; Newman, Janet

    2013-02-01

    High-throughput imaging of protein crystallization experiments with ultraviolet (UV) light has recently become commercially available and can enable crystallographers to differentiate between crystals of protein and those of salt, as the visualization of protein crystals is based on intrinsic tryptophan fluorescence. Unfortunately, UV imaging is not a panacea, as some protein crystals will not fluoresce under UV excitation and some salt crystals are UV-fluorescently active. As a new technology, there is little experience within the general community on how to use this technology effectively and what caveats to look out for. Here, an attempt is made to identify some of the common problems that may arise using UV-imaging technology by examining test proteins, common crystallization reagents and a range of proteins by assessing their UV-Vis absorbance spectra. Some pointers are offered as to which systems may not be appropriate for this methodology. PMID:23385768

  1. International guidelines for contrast-enhanced ultrasonography: ultrasound imaging in the new millennium

    PubMed Central

    Lorentzen, Torben

    2016-01-01

    The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramatically extended, and now includes functional imaging and tissue characterization, which in many cases enable tumor diagnosis without a biopsy. It is virtually impossible to imagine the practice of modern medicine as we know it in high-income countries without the use of imaging, and yet, an estimated two thirds of the global population may receive no such care. Ultrasound imaging with CEUS has the potential to correct this inequity. PMID:26867761

  2. Hardware Implementation of a Lossless Image Compression Algorithm Using a Field Programmable Gate Array

    NASA Astrophysics Data System (ADS)

    Klimesh, M.; Stanton, V.; Watola, D.

    2000-10-01

    We describe a hardware implementation of a state-of-the-art lossless image compression algorithm. The algorithm is based on the LOCO-I (low complexity lossless compression for images) algorithm developed by Weinberger, Seroussi, and Sapiro, with modifications to lower the implementation complexity. In this setup, the compression itself is performed entirely in hardware using a field programmable gate array and a small amount of random access memory. The compression speed achieved is 1.33 Mpixels/second. Our algorithm yields about 15 percent better compression than the Rice algorithm.

  3. Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation.

    PubMed

    Tremblay, Emilie; Thérasse, Eric; Thomassin-Naggara, Isabelle; Trop, Isabelle

    2012-01-01

    The use of computed tomography (CT) and magnetic resonance (MR) imaging has increased tremendously in the past 2 decades. Hence, pregnant and breast-feeding women, although generally healthier than the population at large, are also more likely to require contrast material-enhanced imaging. When a contrast-enhanced CT or MR imaging study is being considered for a pregnant or lactating patient, the potential risks to the fetus related to exposure to radiation, high magnetic fields, or contrast agents must be considered and weighed carefully against the risks of potential misdiagnosis due to withholding contrast agents and imaging studies. Fetal radiation doses up to 1 mGy are considered acceptable; with larger doses, the risk of carcinogenesis approximately doubles, although it remains low in absolute terms. No damage to a developing human fetus caused by MR imaging exposure has been documented. However, caution is advised, and risks and benefits must always be considered before evaluating a pregnant patient with MR imaging. The use of iodinated contrast agents is generally safe during pregnancy; nevertheless, these agents should be used with caution due to the risk of fetal hypothyroidism and should be administered only when the clinical situation clearly requires doing so. The use of gadolinium-based contrast agents during pregnancy remains controversial due to lack of human clinical data and potential toxicity. Use of all contrast agents is considered safe during lactation. It is hoped that this knowledge will help radiologists develop a consensus with their clinical colleagues regarding case management of pregnant and lactating patients. PMID:22403117

  4. Encrypted imaging based on algebraic implementation of double random phase encoding.

    PubMed

    Nakano, Kazuya; Takeda, Masafumi; Suzuki, Hiroyuki; Yamaguchi, Masahiro

    2014-05-10

    The security of important information captured by sensors and cameras is currently a growing concern as information theft via techniques such as side-channel attacks become increasingly more prevalent. Double random phase encoding (DRPE) is an optical encryption method based on optical Fourier transform that is currently being used to implement secure coherent optical systems. In this paper, we propose a new DRPE implementation for incoherent optical systems based on integral photography that can be applied to "encrypted imaging (EI)" to optically encrypt an image before it is captured by an image sensor. Because the proposed incoherent DRPE is constituted from conventional DRPE by rewriting the optical encryption via discretization and Euler's formula, its security level is the same as that of conventional DRPE. The results of an experiment in which we encrypted a plaintext image optically and then decrypted it numerically demonstrate that our proposed incoherent optical security system is feasible. PMID:24922013

  5. Principles and guidelines for the development of a science-based decision making process facilitating the implementation of the 3Rs by governmental regulators.

    PubMed

    Gauthier, Clément

    2002-01-01

    National government establishments, including regulatory agencies, are part of national science systems, which are a subset of larger national innovation systems. The forces that have influenced the basic roles of national government establishments in five countries over the past 10 yr are reviewed on the basis of a study commissioned by Industry Canada in 1999 for the Council of Science and Technology Advisors to the Canadian government. The most significant response among countries has been found to be the financial and managerial restructuring of government science and technology establishments driven by the push toward self-financing. Trends in the roles of government science and technology in six areas are also ranked, with increasing the health and safety of the nation, providing support to industry and participating in international cooperation occupying the first three positions. Potential ramifications of these trends on the implementation of the concept of replacement, reduction, and refinement (the 3Rs) in ensuring the ethical use of animals in regulatory testing are discussed. Science advice and its role in governmental decision making is reviewed on the basis of the 1999 Report of the Council of Science and Technology Advisors, Science Advice for Government Effectiveness. Six principles developed for the effective use of science advice in making regulatory decision have been adapted and are proposed with accompanying guidelines as a framework for the development of a science-based decision making process to facilitate the implementation of the 3Rs by governmental regulators. The proposed series of principles and guidelines are designed to reflect the rapidly evolving and complex context for government decision making, and to remain consistent across government departments and across nations. PMID:12388860

  6. Experimental implementation of coded aperture coherent scatter spectral imaging of cancerous and healthy breast tissue samples

    NASA Astrophysics Data System (ADS)

    Lakshmanan, Manu N.; Greenberg, Joel A.; Samei, Ehsan; Kapadia, Anuj J.

    2015-03-01

    A fast and accurate scatter imaging technique to differentiate cancerous and healthy breast tissue is introduced in this work. Such a technique would have wide-ranging clinical applications from intra-operative margin assessment to breast cancer screening. Coherent Scatter Computed Tomography (CSCT) has been shown to differentiate cancerous from healthy tissue, but the need to raster scan a pencil beam at a series of angles and slices in order to reconstruct 3D images makes it prohibitively time consuming. In this work we apply the coded aperture coherent scatter spectral imaging technique to reconstruct 3D images of breast tissue samples from experimental data taken without the rotation usually required in CSCT. We present our experimental implementation of coded aperture scatter imaging, the reconstructed images of the breast tissue samples and segmentations of the 3D images in order to identify the cancerous and healthy tissue inside of the samples. We find that coded aperture scatter imaging is able to reconstruct images of the samples and identify the distribution of cancerous and healthy tissues (i.e., fibroglandular, adipose, or a mix of the two) inside of them. Coded aperture scatter imaging has the potential to provide scatter images that automatically differentiate cancerous and healthy tissue inside of ex vivo samples within a time on the order of a minute.

  7. Implementation of measure of relative tendency to phase image filtering spacial based

    NASA Astrophysics Data System (ADS)

    Syakrani, Nurjannah; Baskoro, Edy T.; Mengko, Tati L. R.; Suksmono, A. B.

    2014-03-01

    Complex image can split to magnitudo and phase images. The phase of complex function is uniquely defined only in the principal or wrapped value range (-π, π]. Complex image is producted by special equipment as MRI, InSAR and Optics. Image acquisition has noise mostly. The noise come from modality, transmission media or object of image. Generally, the noise has two classification that are additive as Gaussian or multiplicative as speckle. The noise make image processing effectiveless. One of measure of relative tendency in Statistics is quartile consist of low, middle (median) and upper quartiles. Until now, basic spatial filtering method is constructed mean based that linear category or median based that simple nonlinear category. There is different formulation to get measure of central or relatif tendency between magnitudo and phase data. This paper propose a new filtering method base on quartile to phase image specially. Using 3×3 window to implementation of quartile algorithm in Matlab is tested to simulation phase image named Peak2XY by two kind of noises that are Gaussian and Speckle. For example, PSNR of upper quartile filtering to Peak2XY by Gaussian noise with mean =0, variance=0.01, are LoQu = +20.2622; MidQu = +23.7045; UpQu = +21.3528. The quartile filtering method also tested to head phase image of Magnetics Resonance Imaging and Fuji of InSAR phase image.

  8. Public informations guidelines

    SciTech Connect

    1986-06-01

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

  9. Structure for implementation of back-illuminated CMOS or CCD imagers

    NASA Technical Reports Server (NTRS)

    Pain, Bedabrata (Inventor); Cunningham, Thomas J. (Inventor)

    2009-01-01

    A structure for implementation of back-illuminated CMOS or CCD imagers. An epitaxial silicon layer is connected with a passivation layer, acting as a junction anode. The epitaxial silicon layer converts light passing through the passivation layer and collected by the imaging structure to photoelectrons. A semiconductor well is also provided, located opposite the passivation layer with respect to the epitaxial silicon layer, acting as a junction cathode. Prior to detection, light does not pass through a dielectric separating interconnection metal layers.

  10. The Archival Appraisal of Moving Images: A RAMP Study with Guidelines.

    ERIC Educational Resources Information Center

    Kula, Sam

    Produced as part of the United Nations Educational, Scientific, and Cultural Organization (UNESCO) Records and Archives Management Programme (RAMP), this publication provides government and non-government archivists and records managers with a comparative study of past and present policies and practices for selecting moving images for…

  11. On the numerical implementation of discrete finite Hilbert transform for image reconstruction

    NASA Astrophysics Data System (ADS)

    Yang, Yi; Tang, Shaojie; Tang, Xiangyang

    2012-03-01

    The finite Hilbert transform plays an essential role in the recently developed derivative back projection (DBP) image reconstruction methods. The accuracy of the numerical methods in implementing the finite Hilbert transform has a significant impact on the reconstruction algorithms' performance. A number of numerical implementations using linear and sinc interpolation kernels have been developed to carry out the Hilbert transform. In this study, we propose a new numerical method using a non-linear interpolation kernel to implement the finite Hilber transform. We evaluate the performance of the proposed non-linear implementation of the finite Hilbert transform in DBP image reconstruction and compare it with that of the implementations using the linear and sinc interpolation kernels, in which the contrast-to-noise ratio, noise power spectrum and modulation transfer function are investigated. The preliminary results show that the finite Hilbert transform implemented with the nonlinear interpolation kernel exhibits slightly better noise performance than the ones implemented with the linear or sinc interpolation.

  12. Retrofit implementation of Zernike phase plate imaging for cryo-TEM

    PubMed Central

    Marko, Michael; Leith, ArDean; Hsieh, Chyongere; Danev, Radostin

    2011-01-01

    In-focus phase-plate imaging is particularly beneficial for cryo-TEM because it offers a substantial overall increase in image contrast, without an electron dose penalty, and it simplifies image interpretation. We show how phase-plate cryo-TEM can be implemented with an appropriate existing TEM, and provide a basic practical introduction to use of thin-film (carbon) phase plates. We point out potential pitfalls of phase-plate operation, and discuss solutions. We provide information on evaluating a particular TEM for its suitability. PMID:21272647

  13. Concept and implementation of a virtual image slicer at the VLT

    NASA Astrophysics Data System (ADS)

    Guisard, S.; Sterzik, M.; Muñoz, I.

    2014-07-01

    The concept of "Virtual Image Slicer" was developed and implemented at the Very Large Telescope (VLT). The Virtual Image Slicer consists in elongating the stars in a given direction by the use of the Active Optics of the telescope. Alignment of the major axis of the elongated star along the entrance slit of the spectrograph allows to increase the total signal collected in a single (polarimetric) spectrum by a factor of up to 100 or more relative to a perfectly shaped image for bright sources.

  14. CUDA implementation of histogram stretching function for improving X-ray image.

    PubMed

    Lee, Yong H; Kim, Kwan W; Kim, Soon S

    2013-01-01

    This paper presents a method to improve the contrast of digital X-ray image using CUDA program on a GPU. The histogram is commonly used to get the statistical distribution of the contrast in image processing. To increase the visibility of the image in real time, we use the histogram stretching function. It is difficult to implement the function on a GPU because the CUDA program is due to handle the complex process to transfer the source data and the processed results between the memory of GPU and the host system. As a result, we show to operate the histogram stretching function quickly on GPU by the CUDA program. PMID:23920761

  15. Design and Implementation of CNEOST Image Database Based on NoSQL System

    NASA Astrophysics Data System (ADS)

    Wang, X.

    2013-07-01

    The China Near Earth Object Survey Telescope (CNEOST) is the largest Schmidt telescope in China, and it has acquired more than 3 TB astronomical image data since it saw the first light in 2006. After the upgradation of the CCD camera in 2013, over 10 TB data will be obtained every year. The management of massive images is not only an indispensable part of data processing pipeline but also the basis of data sharing. Based on the analysis of requirement, an image management system is designed and implemented by employing the non-relational database.

  16. Design and Implementation of CNEOST Image Database Based on NoSQL System

    NASA Astrophysics Data System (ADS)

    Wang, Xin

    2014-04-01

    The China Near Earth Object Survey Telescope is the largest Schmidt telescope in China, and it has acquired more than 3 TB astronomical image data since it saw the first light in 2006. After the upgrade of the CCD camera in 2013, over 10 TB data will be obtained every year. The management of the massive images is not only an indispensable part of data processing pipeline but also the basis of data sharing. Based on the analysis of requirement, an image management system is designed and implemented by employing the non-relational database.

  17. GUIDELINES FOR IMPLEMENTATION OF AN ADVANCED OUTAGE CONTROL CENTER TO IMPROVE OUTAGE COORDINATION, PROBLEM RESOLUTION, AND OUTAGE RISK MANAGEMENT

    SciTech Connect

    Germain, Shawn St; Farris, Ronald; Whaley, April M; Medema, Heather; Gertman, David

    2014-09-01

    reporting progress. The use of these technologies will also improve the knowledge capture and management capabilities of the organization. The purpose of this research is to improve management of NPP outages through the development of an advanced outage control center (AOCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. This technical report for industry implementation outlines methods and considerations for the establishment of an AOCC. This report provides a process for implementation of a change management plan, evaluation of current outage processes, the selection of technology, and guidance for the implementation of the selected technology. Methods are presented for both adoption of technologies within an existing OCC and for a complete OCC replacement, including human factors considerations for OCC design and setup.

  18. Development and Implementation of Image-based Algorithms for Measurement of Deformations in Material Testing

    PubMed Central

    Barazzetti, Luigi; Scaioni, Marco

    2010-01-01

    This paper presents the development and implementation of three image-based methods used to detect and measure the displacements of a vast number of points in the case of laboratory testing on construction materials. Starting from the needs of structural engineers, three ad hoc tools for crack measurement in fibre-reinforced specimens and 2D or 3D deformation analysis through digital images were implemented and tested. These tools make use of advanced image processing algorithms and can integrate or even substitute some traditional sensors employed today in most laboratories. In addition, the automation provided by the implemented software, the limited cost of the instruments and the possibility to operate with an indefinite number of points offer new and more extensive analysis in the field of material testing. Several comparisons with other traditional sensors widely adopted inside most laboratories were carried out in order to demonstrate the accuracy of the implemented software. Implementation details, simulations and real applications are reported and discussed in this paper. PMID:22163612

  19. Recognition of simple visual images using a sparse distributed memory: Some implementations and experiments

    NASA Technical Reports Server (NTRS)

    Jaeckel, Louis A.

    1990-01-01

    Previously, a method was described of representing a class of simple visual images so that they could be used with a Sparse Distributed Memory (SDM). Herein, two possible implementations are described of a SDM, for which these images, suitably encoded, will serve both as addresses to the memory and as data to be stored in the memory. A key feature of both implementations is that a pattern that is represented as an unordered set with a variable number of members can be used as an address to the memory. In the 1st model, an image is encoded as a 9072 bit string to be used as a read or write address; the bit string may also be used as data to be stored in the memory. Another representation, in which an image is encoded as a 256 bit string, may be used with either model as data to be stored in the memory, but not as an address. In the 2nd model, an image is not represented as a vector of fixed length to be used as an address. Instead, a rule is given for determining which memory locations are to be activated in response to an encoded image. This activation rule treats the pieces of an image as an unordered set. With this model, the memory can be simulated, based on a method of computing the approximate result of a read operation.

  20. LIFE CYCLE ENGINEERING GUIDELINES

    EPA Science Inventory

    This document provides guidelines for the implementation of LCE concepts, information, and techniques in engineering products, systems, processes, and facilities. To make this document as practical and useable as possible, a unifying LCE framework is presented. Subsequent topics ...

  1. PACS image archive server implementation in the developing countries such as China

    NASA Astrophysics Data System (ADS)

    Zhang, Dong; Shu, Yunhong; Zhuang, Tian-ge

    2000-05-01

    While Picture Archiving and Communicating System project is underway through out the western countries, China is making a revolutionary advance in digital medical record. Hospitals in China have made their first steps toward implementation of PACS. Due to the ever-increasing amount of medical image data, a completed archive server is of great need as the base of filmless radiology, a cost effective, high performance digital archive system will remain as the most essential and challenging part of PACS. However there is an inevitable and inherent dilemma in those hospitals in the developing countries like China -- limited amount of development funds. So we are urged to design a low cost but efficient image archive system to cater to the expectation of the hospital. This paper describes a high capacity PACS image archive system model that is developed with rather low cost. To build a reliable and flexible image archive system involves a number of factors such as system capacity requirement, storage and retrieval performance and cost saving etc. We have undertaken the hierarchy image storage mechanism. Judicious image dispatch is employed to meet the goal of timely image retrieval. The whole design can be divided into two parts, one is Scheduled Image Flow Service (SIFS) whose purpose is to periodically backup, archive and pre-fetch image, the other one is Online Image Retrieval Service (OIRS) to provide quick access to the online and nearline images through the network interface. Automatic image transfer is realized between different storage tiers with high level of control. All the procedure is highly automatic except the manually depositing and undepositing off-line optical disks. System evaluations on random retrieval time are presented to show the effect of image location. The concept of image tiered storage will largely reduce the cost of storage. Real-time response to the retrieval demand can send wanted images to a radiologist in a reasonable time. We have done

  2. Implementation and evaluation of various demons deformable image registration algorithms on a GPU

    NASA Astrophysics Data System (ADS)

    Gu, Xuejun; Pan, Hubert; Liang, Yun; Castillo, Richard; Yang, Deshan; Choi, Dongju; Castillo, Edward; Majumdar, Amitava; Guerrero, Thomas; Jiang, Steve B.

    2010-01-01

    Online adaptive radiation therapy (ART) promises the ability to deliver an optimal treatment in response to daily patient anatomic variation. A major technical barrier for the clinical implementation of online ART is the requirement of rapid image segmentation. Deformable image registration (DIR) has been used as an automated segmentation method to transfer tumor/organ contours from the planning image to daily images. However, the current computational time of DIR is insufficient for online ART. In this work, this issue is addressed by using computer graphics processing units (GPUs). A gray-scale-based DIR algorithm called demons and five of its variants were implemented on GPUs using the compute unified device architecture (CUDA) programming environment. The spatial accuracy of these algorithms was evaluated over five sets of pulmonary 4D CT images with an average size of 256 × 256 × 100 and more than 1100 expert-determined landmark point pairs each. For all the testing scenarios presented in this paper, the GPU-based DIR computation required around 7 to 11 s to yield an average 3D error ranging from 1.5 to 1.8 mm. It is interesting to find out that the original passive force demons algorithms outperform subsequently proposed variants based on the combination of accuracy, efficiency and ease of implementation.

  3. Contrast Media Extravasation of Computed Tomography and Magnetic Resonance Imaging: Management Guidelines for the Radiologist.

    PubMed

    Nicola, Refky; Shaqdan, Khalid Wael; Aran, Shima; Prabhakar, Anand M; Singh, Ajay Kumar; Abujudeh, Hani H

    2016-01-01

    Intravenous contrast administration has been of great importance in diagnostic radiology, but it is not without risks either due to the local, systemic allergic reactions or due to subcutaneous extravasation of contrast media. Subcutaneous contrast medium extravasationis an infrequent, yet a well-recognized complication. However, most incidents are minor and can be managed conservatively, but there are a few cases that require immediate surgical intervention. This article discusses the risks factors, clinical manifestations, and conservative and surgical approaches of subcutaneous contrast media extravasation for both computed tomography and magnetic resonance imaging. PMID:26477550

  4. Selection and Pilot Implementation of a Mobile Image Viewer: A Case Study

    PubMed Central

    He, Miao; Wu, Teresa; Demaerschalk, Bart M; Mitchell, Joseph Ross; Hara, Amy K

    2015-01-01

    Background For health care providers, mobile image viewing increases image accessibility, which could lead to faster interpretation/consultations and improved patient outcomes. Objective We explored the technical requirements and challenges associated with implementing a commercial mobile image viewer and conducted a small study testing the hypothesis that the mobile image viewer would provide faster image access. Methods A total of 19 clinicians (9 radiologists, 3 surgeons, 4 neurologists, and 3 physician assistants) evaluated (1) a desktop commercial picture archiving and communication system (PACS) viewer, (2) a desktop viewer developed internally over 20 years and deployed throughout the enterprise (ENTERPRISE viewer) and (3) a commercial Food and Drug Administration class II-cleared mobile viewer compatible with Web browsers, tablets, and mobile phones. Data were collected during two separate 7-day periods, before and after mobile image viewer deployment. Data included image viewer chosen, time to view first image, technical issues, diagnostic confidence, and ease of use. Results For 565 image-viewing events, ease of use was identical for PACS and mobile viewers (mean 3.6 for all scores of a possible 4.0), and significantly worse for the enterprise viewer (mean 2.9, P=.001). Technical issues were highest with the enterprise viewer (26%, 56/215) compared with the mobile (7%,19/259, P=.001) and PACS (8%, 7/91, P=.003) viewers. Mean time to first image for the mobile viewer (2.4 minutes) was significantly faster than PACS (12.5 minutes, P=.001) and the enterprise viewer (4.5 minutes, P=.001). Diagnostic confidence was similar for PACS and mobile viewers and worst for enterprise viewer. Mobile image viewing increased by sixfold, from 14% (37/269, before the deployment) to 88.9% (263/296, after the deployment). Conclusions A mobile viewer provided faster time to first image, improved technical performance, ease of use, and diagnostic confidence, compared with

  5. Haemorrhagia post partum; an implementation study on the evidence-based guideline of the Dutch Society of Obstetrics and Gynaecology (NVOG) and the MOET (Managing Obstetric Emergencies and Trauma-course) instructions; the Fluxim study

    PubMed Central

    2010-01-01

    Background One of the most important causes of maternal mortality and severe morbidity worldwide is post partum haemorrhage (PPH). Factors as substandard care are frequently reported in the international literature and there are similar reports in the Netherlands. The incidence of PPH in the Dutch population is 5% containing 10.000 women a year. The introduction of an evidence-based guideline on PPH by the Dutch society of Obstetrics and Gynaecology (NVOG) and the initiation of the MOET course (Managing Obstetrics Emergencies and Trauma) did not lead to a reduction of PPH. This implies the possibility of an incomplete implementation of both the NVOG guideline and MOET-instructions. Therefore, the aim of this study is to develop and test a tailored strategy to implement both the NVOG guideline and MOET-instructions Methods/Design One step in the development procedure is to evaluate the implementation of the guideline and MOET-instructions in the current care. Therefore measurement of the actual care will be performed in a representative sample of 20 hospitals. This will be done by prospective observation of the third stage of labour of 320 women with a high risk of PPH using quality indicators extracted from the NVOG guideline and MOET instructions. In the next step barriers and facilitators for guideline adherence will be analyzed by performance of semi structured interviews with 30 professionals and 10 patients, followed by a questionnaire study among all Dutch gynaecologists and midwives to quantify the barriers mentioned. Based on the outcomes, a tailored strategy to implement the NVOG guideline and MOET-instructions will be developed and tested in a feasibility study in 4 hospitals, including effect-, process- and cost evaluation. Discussion This study will provide insight into current Dutch practice, in particular to what extent the PPH guidelines of the NVOG and the MOET-instructions have been implemented in the actual care, and into the barriers and

  6. Implementing a real-time chain of segmentation of images on a multi-FPGA architecture

    NASA Astrophysics Data System (ADS)

    Akil, Mohamed; Zahirazami, Shahram

    1998-03-01

    In this paper we present the study and the implementation of an optimized chain of segmentation operators. We implemented this chain in real time, consisting of a Deriche contour detection, double threshold, closing of contours and finally region labeling, on a multi-FPGA architecture. This architecture has four processing FPGAs and four memory modules. Deriche operator, closing of contours and labeling occupy each one an FPGA. Double threshold and detection of the extremities filled partially the forth FPGA. The slowest component of the chain is Deriche operator which can go up to 11.4 Mhz, assuring the process of an image every 40 ms. Deriche operator tries to extract the contours by assuming that a contour is a step super positioned by a white gaussian noise. Our implementation consists of a smoothing part of four second order filters and a Sobel as a derivation part. The second order filters are causal and non-causal horizontal and vertical operators. The gradient image passes through a double threshold filter to select the real contours and the crests and the background pixels. Closing of contours eliminates the false crests and finally the labeling gives a unique label to each closed region. The latency of the chain is in the order of three images. This implementation shows the efficiency of the chain and also it demonstrates the capabilities of our architecture as a prototyping system.

  7. Implementation of a radiology electronic imaging network: the community teaching hospital experience.

    PubMed

    Arreola, M; Neiman, H L; Sugarman, A; Laurenti, L; Forys, R

    1997-08-01

    Because of their typically small in-house computer and network staff, non-university hospitals often hesitate to consider picture archiving and communication system (PACS) as a solution to the very demanding financial, clinical, and technological needs of today's Radiology Department. This article presents the experiences of the 3-year process for the design and implementation of the Radiology Electronic Imaging Network (REIN) in the Department of Radiology at The Western Pennsylvania Hospital (WPH). WPH embarked on this project in late 1994 to find a solution to the very pressing demands to reduce operating costs and improve service to primary care clinicians, both on-site and at WPH-affiliated clinics. A five-member committee consisting of in-house medical, administrative, information services, and medical physics staff was formed to design a network that would satisfy specific needs of WPH by using a phased mini-PACS approach and to select the various vendors to implement it. Suppliers for individual mini-PACS were selected to provide modality-specific solutions. For the backbone network, vendors were evaluated based on their technological progress, competence and resources, the commitment of the company to the imaging network business, and their willingness to embark on a mid-sized PACS project such as this. Based on patient volume, workflow patterns, and image quality requirements, the committee produced proposals detailing number and location of workstations, short- and long-term memory requirements, and so on. Computed tomography/magnetic resonance imaging, computer radiography, ultrasound, nuclear medicine, digital fluoroscopy, and angiography mini-PACS have been implemented over the past 2 years, and most of these are already integrated into the main REIN. This article presents detailed information concerning the design, selection and implementation processes, including storage requirement calculations. This indicates that PACS implementation is achievable

  8. The parallel implementation of a backpropagation neural network and its applicability to SPECT image reconstruction

    SciTech Connect

    Kerr, J.P.

    1992-01-01

    The objective of this study was to determine the feasibility of using an Artificial Neural Network (ANN), in particular a backpropagation ANN, to improve the speed and quality of the reconstruction of three-dimensional SPECT (single photon emission computed tomography) images. In addition, since the processing elements (PE)s in each layer of an ANN are independent of each other, the speed and efficiency of the neural network architecture could be better optimized by implementing the ANN on a massively parallel computer. The specific goals of this research were: to implement a fully interconnected backpropagation neural network on a serial computer and a SIMD parallel computer, to identify any reduction in the time required to train these networks on the parallel machine versus the serial machine, to determine if these neural networks can learn to recognize SPECT data by training them on a section of an actual SPECT image, and to determine from the knowledge obtained in this research if full SPECT image reconstruction by an ANN implemented on a parallel computer is feasible both in time required to train the network, and in quality of the images reconstructed.

  9. The parallel implementation of a backpropagation neural network and its applicability to SPECT image reconstruction

    SciTech Connect

    Kerr, J.P.

    1992-12-31

    The objective of this study was to determine the feasibility of using an Artificial Neural Network (ANN), in particular a backpropagation ANN, to improve the speed and quality of the reconstruction of three-dimensional SPECT (single photon emission computed tomography) images. In addition, since the processing elements (PE)s in each layer of an ANN are independent of each other, the speed and efficiency of the neural network architecture could be better optimized by implementing the ANN on a massively parallel computer. The specific goals of this research were: to implement a fully interconnected backpropagation neural network on a serial computer and a SIMD parallel computer, to identify any reduction in the time required to train these networks on the parallel machine versus the serial machine, to determine if these neural networks can learn to recognize SPECT data by training them on a section of an actual SPECT image, and to determine from the knowledge obtained in this research if full SPECT image reconstruction by an ANN implemented on a parallel computer is feasible both in time required to train the network, and in quality of the images reconstructed.

  10. Facies dimensions within carbonate reservoirs - guidelines from satellite images of modern analogs

    SciTech Connect

    Harris, P.M.; Kowalik, W.S.

    1995-08-01

    Modern analogs illustrate the distribution of carbonate facies within an overall depositional setting and can be an integral part of a subsurface geologic model in indicating the dimensions, trend, and interrelationships of facies that might be related to reservoir and non-reservoir distribution. Satellite images from several modern carbonate areas depict the geologic characteristics that can be expected in ancient shallow-water settings. Isolated carbonate platforms- the Bahamas, Caicos Platform in the British West Indies, Chinchorro Bank offshore of Yucatan, and portions of the Belize area; Ramp-style shelf-to-basin transitions - Abu Dhabi and northern Yucatan; Rimmed shelf margins - South Florida, portions of Belize, and the Great Barrier Reef of Australia; Broad, deep shelf lagoons - the Great Barrier Reef and Belize; Reef variability - South Florida, the Bahamas, Caicos, Northern Yucatan, and Abu Dhabi; Shallow lagoon/tidal flat settings - South Florida, the Bahamas, Caicos, Northern Yucatan, Shark Bay in Western Australia, Abu Dhabi; Mixed carbonate and siliciclastic depostion - South Florida, Belize, the Great Barrier Reef, Shark Bay and Abu Dhabi. The geologic framework as illustrated by these areas is important at the development scale where lateral variation of porosity and permeability, i.e. reservoir quality, is commonly tied to facies changes and facies dimensions are required as input to reservoir models. The geologic framework is essential at the exploration scale for reservoir facies prediction and stratigraphic play concepts which are related directly to depositional facies patterns.

  11. Gaining insight into the Clinical Practice Guideline development processes: qualitative study in a workshop to implement the GRADE proposal in Spain

    PubMed Central

    Calderón, Carlos; Rotaeche, Rafael; Etxebarria, Arritxu; Marzo, Mercé; Rico, Rosa; Barandiaran, Marta

    2006-01-01

    Background The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the significance of the perceptions and attitudes expressed by the actual experts participating in the system try-out. Methods Qualitative research with an ethnographic approach, through non-participant observation and focus groups within the context of a consensus workshop in which 19 CPG experts participated to evaluate the GRADE proposal using 12 evidence tables taken from hypertension, asthma and arthritis CPGs. The interventions were recorded, under a guarantee of confidentiality. The transcriptions and field notes were analyzed, based on a sociological discourse analysis model, and the provisional findings were re-sent to participants in order to improve their validity. Results 1) Certain problems over procedure and terminology hindered the acceptance of this new method as a common reference system for the preparation of CPGs. 2). A greater closeness to clinical practice was accompanied by concerns over value judgments and subjectivity, with a demand for greater explicitness in the consensus process. 3). The type of "evidence" on which the guidelines are based, how and by whom the evidence is prepared, and what the role of the different actors should be, all constitute unresolved concerns in the CPG preparation and implementation processes. 4). The grading process is not neutral: professional background, prior experience and the degree of leadership all condition the participants' input and interactions. Conclusion The findings obtained allow the quantitative evaluation to be better interpreted and, in turn, go beyond the particularities of the GRADE method. Adaptation to the complexities of clinical practice, the need for carefully designed multi

  12. Implementation of a near backscattering imaging system on the National Ignition Facility

    NASA Astrophysics Data System (ADS)

    Mackinnon, A. J.; McCarville, T.; Piston, K.; Niemann, C.; Jones, G.; Reinbachs, I.; Costa, R.; Celeste, J.; Holtmeier, G.; Griffith, R.; Kirkwood, R.; MacGowan, B.; Glenzer, S. H.; Latta, M. R.

    2004-10-01

    A near backscattering imaging diagnostic system is being implemented on the first quad of beams on the National Ignition Facility. This diagnostic images diffusing scatter plates, placed around the final focus lenses on the National Ignition Facility target chamber, to quantitatively measure the fraction of light backscattered outside of the focusing cone angle of incident laser beam. A wide-angle imaging system relays an image of light scattered outside the lens onto a gated charge coupled device camera, providing 3 mm resolution over a 2 m field of view. To account for changes of the system throughput due to exposure to target debris the system will be routinely calibrated in situ at 532 and 355 nm using a dedicated pulsed laser source.

  13. Hardware Implementation of Lossless Adaptive Compression of Data From a Hyperspectral Imager

    NASA Technical Reports Server (NTRS)

    Keymeulen, Didlier; Aranki, Nazeeh I.; Klimesh, Matthew A.; Bakhshi, Alireza

    2012-01-01

    Efficient onboard data compression can reduce the data volume from hyperspectral imagers on NASA and DoD spacecraft in order to return as much imagery as possible through constrained downlink channels. Lossless compression is important for signature extraction, object recognition, and feature classification capabilities. To provide onboard data compression, a hardware implementation of a lossless hyperspectral compression algorithm was developed using a field programmable gate array (FPGA). The underlying algorithm is the Fast Lossless (FL) compression algorithm reported in Fast Lossless Compression of Multispectral- Image Data (NPO-42517), NASA Tech Briefs, Vol. 30, No. 8 (August 2006), p. 26 with the modification reported in Lossless, Multi-Spectral Data Comressor for Improved Compression for Pushbroom-Type Instruments (NPO-45473), NASA Tech Briefs, Vol. 32, No. 7 (July 2008) p. 63, which provides improved compression performance for data from pushbroom-type imagers. An FPGA implementation of the unmodified FL algorithm was previously developed and reported in Fast and Adaptive Lossless Onboard Hyperspectral Data Compression System (NPO-46867), NASA Tech Briefs, Vol. 36, No. 5 (May 2012) p. 42. The essence of the FL algorithm is adaptive linear predictive compression using the sign algorithm for filter adaption. The FL compressor achieves a combination of low complexity and compression effectiveness that exceeds that of stateof- the-art techniques currently in use. The modification changes the predictor structure to tolerate differences in sensitivity of different detector elements, as occurs in pushbroom-type imagers, which are suitable for spacecraft use. The FPGA implementation offers a low-cost, flexible solution compared to traditional ASIC (application specific integrated circuit) and can be integrated as an intellectual property (IP) for part of, e.g., a design that manages the instrument interface. The FPGA implementation was benchmarked on the Xilinx

  14. Implementing PET-guided biopsy: integrating functional imaging data with digital x-ray mammography cameras

    NASA Astrophysics Data System (ADS)

    Weinberg, Irving N.; Zawarzin, Valera; Pani, Roberto; Williams, Rodney C.; Freimanis, Rita L.; Lesko, Nadia M.; Levine, E. A.; Perrier, N.; Berg, Wendie A.; Adler, Lee P.

    2001-05-01

    Purpose: Phantom trials using the PET data for localization of hot spots have demonstrated positional accuracies in the millimeter range. We wanted to perform biopsy based on information from both anatomic and functional imaging modalities, however we had a communication challenge. Despite the digital nature of DSM stereotactic X-ray mammography devices, and the large number of such devices in Radiology Departments (approximately 1600 in the US alone), we are not aware of any methods of connecting stereo units to other computers in the Radiology department. Methods: We implemented a local network between an external IBM PC (running Linux) and the Lorad Stereotactic Digital Spot Mammography PC (running DOS). The application used IP protocol on the parallel port, and could be run in the background on the LORAD PC without disrupting important clinical activities such as image acquisition or archiving. With this software application, users of the external PC could pull x-ray images on demand form the Load DSM computer. Results: X-ray images took about a minute to ship to the external PC for analysis or forwarding to other computers on the University's network. Using image fusion techniques we were able to designate locations of functional imaging features as the additional targets on the anatomic x-rays. These pseudo-features could then potentially be used to guide biopsy using the stereotactic gun stage on the Lorad camera. New Work to be Presented: A method of transferring and processing stereotactic x-ray mammography images to a functional PET workstation for implementing image-guided biopsy.

  15. Image preprocessing for improving computational efficiency in implementation of restoration and superresolution algorithms.

    PubMed

    Sundareshan, Malur K; Bhattacharjee, Supratik; Inampudi, Radhika; Pang, Ho-Yuen

    2002-12-10

    Computational complexity is a major impediment to the real-time implementation of image restoration and superresolution algorithms in many applications. Although powerful restoration algorithms have been developed within the past few years utilizing sophisticated mathematical machinery (based on statistical optimization and convex set theory), these algorithms are typically iterative in nature and require a sufficient number of iterations to be executed to achieve the desired resolution improvement that may be needed to meaningfully perform postprocessing image exploitation tasks in practice. Additionally, recent technological breakthroughs have facilitated novel sensor designs (focal plane arrays, for instance) that make it possible to capture megapixel imagery data at video frame rates. A major challenge in the processing of these large-format images is to complete the execution of the image processing steps within the frame capture times and to keep up with the output rate of the sensor so that all data captured by the sensor can be efficiently utilized. Consequently, development of novel methods that facilitate real-time implementation of image restoration and superresolution algorithms is of significant practical interest and is the primary focus of this study. The key to designing computationally efficient processing schemes lies in strategically introducing appropriate preprocessing steps together with the superresolution iterations to tailor optimized overall processing sequences for imagery data of specific formats. For substantiating this assertion, three distinct methods for tailoring a preprocessing filter and integrating it with the superresolution processing steps are outlined. These methods consist of a region-of-interest extraction scheme, a background-detail separation procedure, and a scene-derived information extraction step for implementing a set-theoretic restoration of the image that is less demanding in computation compared with the

  16. Image preprocessing for improving computational efficiency in implementation of restoration and superresolution algorithms

    NASA Astrophysics Data System (ADS)

    Sundareshan, Malur K.; Bhattacharjee, Supratik; Inampudi, Radhika; Pang, Ho-Yuen

    2002-12-01

    Computational complexity is a major impediment to the real-time implementation of image restoration and superresolution algorithms in many applications. Although powerful restoration algorithms have been developed within the past few years utilizing sophisticated mathematical machinery (based on statistical optimization and convex set theory), these algorithms are typically iterative in nature and require a sufficient number of iterations to be executed to achieve the desired resolution improvement that may be needed to meaningfully perform postprocessing image exploitation tasks in practice. Additionally, recent technological breakthroughs have facilitated novel sensor designs (focal plane arrays, for instance) that make it possible to capture megapixel imagery data at video frame rates. A major challenge in the processing of these large-format images is to complete the execution of the image processing steps within the frame capture times and to keep up with the output rate of the sensor so that all data captured by the sensor can be efficiently utilized. Consequently, development of novel methods that facilitate real-time implementation of image restoration and superresolution algorithms is of significant practical interest and is the primary focus of this study. The key to designing computationally efficient processing schemes lies in strategically introducing appropriate preprocessing steps together with the superresolution iterations to tailor optimized overall processing sequences for imagery data of specific formats. For substantiating this assertion, three distinct methods for tailoring a preprocessing filter and integrating it with the superresolution processing steps are outlined. These methods consist of a region-of-interest extraction scheme, a background-detail separation procedure, and a scene-derived information extraction step for implementing a set-theoretic restoration of the image that is less demanding in computation compared with the

  17. X-ray phase-contrast imaging of the breast—advances towards clinical implementation

    PubMed Central

    Herzen, J; Willner, M; Grandl, S; Scherer, K; Bamberg, F; Reiser, M F; Pfeiffer, F; Hellerhoff, K

    2014-01-01

    Breast cancer constitutes about one-quarter of all cancers and is the leading cause of cancer death in women. To reduce breast cancer mortality, mammographic screening programmes have been implemented in many Western countries. However, these programmes remain controversial because of the associated radiation exposure and the need for improvement in terms of diagnostic accuracy. Phase-contrast imaging is a new X-ray-based technology that has been shown to provide enhanced soft-tissue contrast and improved visualization of cancerous structures. Furthermore, there is some indication that these improvements of image quality can be maintained at reduced radiation doses. Thus, X-ray phase-contrast mammography may significantly contribute to advancements in early breast cancer diagnosis. Feasibility studies of X-ray phase-contrast breast CT have provided images that allow resolution of the fine structure of tissue that can otherwise only be obtained by histology. This implies that X-ray phase-contrast imaging may also lead to the development of entirely new (micro-) radiological applications. This review provides a brief overview of the physical characteristics of this new technology and describes recent developments towards clinical implementation of X-ray phase-contrast imaging of the breast. PMID:24452106

  18. Implementation of a laser beam analyzer using the image acquisition card IMAQ (NI)

    NASA Astrophysics Data System (ADS)

    Rojas-Laguna, R.; Avila-Garcia, M. S.; Alvarado-Mendez, Edgar; Andrade-Lucio, Jose A.; Obarra-Manzano, O. G.; Torres-Cisneros, Miguel; Castro-Sanchez, R.; Estudillo-Ayala, J. M.; Ibarra-Escamilla, Baldeamr

    2001-08-01

    In this work we address our attention to the implementation of a beam analyzer. The software was designed under LabView, platform and using the Image Acquisition Card IMAQ of National Instruments. The objective is to develop a graphic interface which has to include image processing tools such as characteristic enhancement such as bright, contrast and morphologic operations and quantification of dimensions. An application of this graphic interface is like laser beam analyzer of medium cost, versatile, precise and easily reconfigurable under this programing environment.

  19. Development and implementation of a high-performance, cardiac-gated dual-energy imaging system

    NASA Astrophysics Data System (ADS)

    Shkumat, N. A.; Siewerdsen, J. H.; Dhanantwari, A. C.; Williams, D. B.; Richard, S.; Tward, D. J.; Paul, N. S.; Yorkston, J.; Van Metter, R.

    2007-03-01

    Mounting evidence suggests that the superposition of anatomical clutter in a projection radiograph poses a major impediment to the detectability of subtle lung nodules. Through decomposition of projections acquired at multiple kVp, dual-energy (DE) imaging offers to dramatically improve lung nodule detectability and, in part through quantitation of nodule calcification, increase specificity in nodule characterization. The development of a high-performance DE chest imaging system is reported, with design and implementation guided by fundamental imaging performance metrics. A diagnostic chest stand (Kodak RVG 5100 digital radiography system) provided the basic platform, modified to include: (i) a filter wheel, (ii) a flat-panel detector (Trixell Pixium 4600), (iii) a computer control and monitoring system for cardiac-gated acquisition, and (iv) DE image decomposition and display. Computational and experimental studies of imaging performance guided optimization of key acquisition technique parameters, including: x-ray filtration, allocation of dose between low- and high-energy projections, and kVp selection. A system for cardiac-gated acquisition was developed, directing x-ray exposures to within the quiescent period of the heart cycle, thereby minimizing anatomical misregistration. A research protocol including 200 patients imaged following lung nodule biopsy is underway, allowing preclinical evaluation of DE imaging performance relative to conventional radiography and low-dose CT.

  20. Optical image encryption based on cascaded iterative angular spectrum algorithm and its implementation with parallel hardware

    NASA Astrophysics Data System (ADS)

    Yu, Biin; Peng, Xiang; Tian, Jindong; Niu, Hanben

    2006-01-01

    A cascaded iterative angular spectrum approach (CIASA) based on the methodology of virtual optics is presented for optical security applications. The technique encodes the target image into two different phase only masks (POM) using a concept of free-space angular spectrum propagation. The two phase-masks are designed and located in any two arbitrary planes interrelated through the free space propagation domain in order to implement the optical encryption or authenticity verification. And both phase masks can serve as enciphered texts. Compared with previous methods, the proposed algorithm employs an improved searching strategy: modifying the phase-distributions of both masks synchronously as well as enlarging the searching space. And with such a scheme, we make use of a high performance floating-point Digital Signal Processor (DSP) to accomplish a design of multiple-locks and multiple-keys optical image encryption system. An evaluation of the system performance is made and it is shown that the algorithm results in much faster convergence and better image quality for the recovered image. And two masks and system parameters can be used to design keys for image encryption, therefore the decrypted image can be obtained only when all these keys are under authorization. This key-assignment strategy may reduce the risk of being intruded and show a high security level. These characters may introduce a high level security that makes the encrypted image more difficult to be decrypted by an unauthorized person.

  1. On the design and implementation of a parallel, object-oriented, image processing toolkit

    SciTech Connect

    Kamath, C; Baldwin, C; Fodor, I; Tang, N A

    2000-06-22

    Advanced in technology have enabled us to collect data from observations, experiments, and simulations at an ever increasing pace. As these data sets approach the terabyte and petabyte range, scientists are increasingly using semi-automated techniques from data mining and pattern recognition to find useful information in the data. In order for data mining to be successful, the raw data must first be processed into a form suitable for the detection of patterns. When the data is in the form of images, this can involve a substantial amount of processing on very large data sets. To help make this task more efficient, they are designing and implementing an object-oriented image processing toolkit that specifically targets massively-parallel, distributed-memory architectures. They first show that it is possible to use object-oriented technology to effectively address the diverse needs of image applications. Next, they describe how we abstract out the similarities in image processing algorithms to enable re-use in the software. They will also discuss the difficulties encountered in parallelizing image algorithms on massively parallel machines as well as the bottlenecks to high performance. They will demonstrate the work using images from an astronomical data set, and illustrate how techniques such as filters and denoising through the thresholding of wavelet coefficients can be applied when a large image is distributed across several processors.

  2. Design and implementation of a parallel object-oriented image processing toolkit

    NASA Astrophysics Data System (ADS)

    Kamath, Chandrika; Baldwin, Chuck H.; Fodor, Imola K.; Tang, Nu A.

    2000-10-01

    Advances in technology have enabled us to collect data from observations, experiments, and simulations at an ever increasing pace. As these data sets approach the terabyte and petabyte range, scientists are increasingly using semi-automated techniques from data mining and pattern recognition to find useful information in the data. In order for data mining to be successful, the raw data must first be processed into a form suitable for the detection of patterns. When the data is in the form of images, this can involve a substantial amount of processing on very large data sets. To help make this task more efficient, we are designing and implementing an object-oriented image processing toolkit that specifically targets massively-parallel, distributed-memory architectures. We first show that it is possible to use object-oriented technology to effectively address the diverse needs of image applications. Next, we describe how we abstract out the similarities in image processing algorithms to enable re-use in our software. We will also discuss the difficulties encountered in parallelizing image algorithms on the massively parallel machines as well as the bottlenecks to high performance. We will demonstrate our work using images from an astronomical data set, and illustrate how techniques such as filters and denoising through the thresholding of wavelet coefficients can be applied when a large image is distributed across several processors.

  3. Star-field identification algorithm. [for implementation on CCD-based imaging camera

    NASA Technical Reports Server (NTRS)

    Scholl, M. S.

    1993-01-01

    A description of a new star-field identification algorithm that is suitable for implementation on CCD-based imaging cameras is presented. The minimum identifiable star pattern element consists of an oriented star triplet defined by three stars, their celestial coordinates, and their visual magnitudes. The algorithm incorporates tolerance to faulty input data, errors in the reference catalog, and instrument-induced systematic errors.

  4. A DSP implementation of lifting based DWT for image processing applications

    NASA Astrophysics Data System (ADS)

    Gholipour, Morteza; Noubari, Hossein A.; Kamarei, Mahmoud

    2011-10-01

    Discrete Wavelet Transform (DWT) is widely used in signal processing applications. In this paper, we describe hardware implementation of a lifting-based DWT, which is used in image compression. The CDF(2,2) lifting-based wavelet transform is modeled and simulated using MATLAB. Based on DSP methodologies, the signal flow graph and dependence graph are derived. The dependence graph is optimized and used to implement the hardware description of the circuit in Verilog. We have synthesized and implemented the circuit using both Field Programmable Gate Array (FPGA) and Application Specific Integrated Circuit (ASIC) design approaches. To confirm the circuit operation, post-synthesis and post-layout simulations were done for FPGA and ASIC designs, respectively.

  5. Optimization and implementation of the integer wavelet transform for image coding.

    PubMed

    Grangetto, Marco; Magli, Enrico; Martina, Maurizio; Olmo, Gabriella

    2002-01-01

    This paper deals with the design and implementation of an image transform coding algorithm based on the integer wavelet transform (IWT). First of all, criteria are proposed for the selection of optimal factorizations of the wavelet filter polyphase matrix to be employed within the lifting scheme. The obtained results lead to the IWT implementations with very satisfactory lossless and lossy compression performance. Then, the effects of finite precision representation of the lifting coefficients on the compression performance are analyzed, showing that, in most cases, a very small number of bits can be employed for the mantissa keeping the performance degradation very limited. Stemming from these results, a VLSI architecture is proposed for the IWT implementation, capable of achieving very high frame rates with moderate gate complexity. PMID:18244658

  6. Medical image denoising via optimal implementation of non-local means on hybrid parallel architecture.

    PubMed

    Nguyen, Tuan-Anh; Nakib, Amir; Nguyen, Huy-Nam

    2016-06-01

    The Non-local means denoising filter has been established as gold standard for image denoising problem in general and particularly in medical imaging due to its efficiency. However, its computation time limited its applications in real world application, especially in medical imaging. In this paper, a distributed version on parallel hybrid architecture is proposed to solve the computation time problem and a new method to compute the filters' coefficients is also proposed, where we focused on the implementation and the enhancement of filters' parameters via taking the neighborhood of the current voxel more accurately into account. In terms of implementation, our key contribution consists in reducing the number of shared memory accesses. The different tests of the proposed method were performed on the brain-web database for different levels of noise. Performances and the sensitivity were quantified in terms of speedup, peak signal to noise ratio, execution time, the number of floating point operations. The obtained results demonstrate the efficiency of the proposed method. Moreover, the implementation is compared to that of other techniques, recently published in the literature. PMID:27084318

  7. Labview Implementation of Image Processing and Phasing Control for the SIBOA Segmented Mirror Testbed

    NASA Technical Reports Server (NTRS)

    Partridge, James D.

    2002-01-01

    'NASA is preparing to launch the Next Generation Space Telescope (NGST). This telescope will be larger than the Hubble Space Telescope, be launched on an Atlas missile rather than the Space Shuttle, have a segmented primary mirror, and be placed in a higher orbit. All these differences pose significant challenges.' This effort addresses the challenge of implementing an algorithm for aligning the segments of the primary mirror during the initial deployment that was designed by Philip Olivier and members of SOMTC (Space Optics Manufacturing Technology Center). The implementation was to be performed on the SIBOA (Systematic Image Based Optical Alignment) test bed. Unfortunately, hardware/software aspect concerning SIBOA and an extended time period for algorithm development prevented testing before the end of the study period. Properties of the digital camera were studied and understood, resulting in the current ability of selecting optimal settings regarding saturation. The study was successful in manually capturing several images of two stacked segments with various relative phases. These images can be used to calibrate the algorithm for future implementation. Currently the system is ready for testing.

  8. A guideline management system.

    PubMed

    Ciccarese, Paolo; Caffi, Ezio; Boiocchi, Lorenzo; Quaglini, Silvana; Stefanelli, Mario

    2004-01-01

    This paper describes the architecture of NewGuide, a guide-line management system for handling the whole life cycle of a computerized clinical practice guideline. NewGuide components are organized in a distributed architecture: an editor to formalize guidelines, a repository to store them, an inference engine to implement guidelines instances in a multi-user environment, and a reporting system storing the guidelines logs in order to be able to completely trace any individual physician guideline-based decision process. There is a system "central level" that maintains official versions of the guidelines, and local Healthcare Organizations may download and implement them according to their needs. The architecture has been implemented using the Java 2 Enterprise Edition (J2EE) platform. Simple Object Access Protocol (SOAP) and a set of con-tracts are the key factors for the integration of NewGuide with healthcare legacy systems. They allow maintaining unchanged legacy user interfaces and connecting the system with what-ever electronic patient record. The system functionality will be illustrated in three different contexts: homecare-based pressure ulcer prevention, acute ischemic stroke treatment and heart failure management by general practitioners. PMID:15360768

  9. Implementation of a Synchronized Oscillator Circuit for Fast Sensing and Labeling of Image Objects

    PubMed Central

    Kowalski, Jacek; Strzelecki, Michal; Kim, Hyongsuk

    2011-01-01

    We present an application-specific integrated circuit (ASIC) CMOS chip that implements a synchronized oscillator cellular neural network with a matrix size of 32 × 32 for object sensing and labeling in binary images. Networks of synchronized oscillators are a recently developed tool for image segmentation and analysis. Its parallel network operation is based on a “temporary correlation” theory that attempts to describe scene recognition as if performed by the human brain. The synchronized oscillations of neuron groups attract a person’s attention if he or she is focused on a coherent stimulus (image object). For more than one perceived stimulus, these synchronized patterns switch in time between different neuron groups, thus forming temporal maps that code several features of the analyzed scene. In this paper, a new oscillator circuit based on a mathematical model is proposed, and the network architecture and chip functional blocks are presented and discussed. The proposed chip is implemented in AMIS 0.35 μm C035M-D 5M/1P technology. An application of the proposed network chip for the segmentation of insulin-producing pancreatic islets in magnetic resonance liver images is presented. PMID:22163803

  10. Logic design and implementation of FPGA for a high frame rate ultrasound imaging system

    NASA Astrophysics Data System (ADS)

    Liu, Anjun; Wang, Jing; Lu, Jian-Yu

    2002-05-01

    Recently, a method has been developed for high frame rate medical imaging [Jian-yu Lu, ``2D and 3D high frame rate imaging with limited diffraction beams,'' IEEE Trans. Ultrason. Ferroelectr. Freq. Control 44(4), 839-856 (1997)]. To realize this method, a complicated system [multiple-channel simultaneous data acquisition, large memory in each channel for storing up to 16 seconds of data at 40 MHz and 12-bit resolution, time-variable-gain (TGC) control, Doppler imaging, harmonic imaging, as well as coded transmissions] is designed. Due to the complexity of the system, field programmable gate array (FPGA) (Xilinx Spartn II) is used. In this presentation, the design and implementation of the FPGA for the system will be reported. This includes the synchronous dynamic random access memory (SDRAM) controller and other system controllers, time sharing for auto-refresh of SDRAMs to reduce peak power, transmission and imaging modality selections, ECG data acquisition and synchronization, 160 MHz delay locked loop (DLL) for accurate timing, and data transfer via either a parallel port or a PCI bus for post image processing. [Work supported in part by Grant 5RO1 HL60301 from NIH.

  11. Implementation of a multi-spectral color imaging device without color filter array

    NASA Astrophysics Data System (ADS)

    Langfelder, G.; Longoni, A. F.; Zaraga, F.

    2011-01-01

    In this work the use of the Transverse Field Detector (TFD) as a device for multispectral image acquisition is proposed. The TFD is a color imaging pixel capable of color reconstruction without color filters. Its basic working principle is based on the generation of a suitable electric field configuration inside a Silicon depleted region by means of biasing voltages applied to surface contacts. With respect to previously proposed methods for performing multispectral capture, the TFD has a unique characteristic of electrically tunable spectral responses. This feature allows capturing an image with different sets of spectral responses (RGB, R'G'B', and so on) simply by tuning the device biasing voltages in multiple captures. In this way no hardware complexity (no external filter wheels or varying sources) is added with respect to a colorimetric device. The estimation of the spectral reflectance of the area imaged by a TFD pixel is based in this work on a linear combination of six eigenfunctions. It is shown that a spectral reconstruction can be obtained either (1) using two subsequent image captures that generate six TFD spectral responses or (2) using a new asymmetric biasing scheme, which allows the implementation of five spectral responses for each TFD pixel site in a single configuration, definitely allowing one-shot multispectral imaging.

  12. On the Implementation of a Land Cover Classification System for SAR Images Using Khoros

    NASA Technical Reports Server (NTRS)

    Medina Revera, Edwin J.; Espinosa, Ramon Vasquez

    1997-01-01

    The Synthetic Aperture Radar (SAR) sensor is widely used to record data about the ground under all atmospheric conditions. The SAR acquired images have very good resolution which necessitates the development of a classification system that process the SAR images to extract useful information for different applications. In this work, a complete system for the land cover classification was designed and programmed using the Khoros, a data flow visual language environment, taking full advantages of the polymorphic data services that it provides. Image analysis was applied to SAR images to improve and automate the processes of recognition and classification of the different regions like mountains and lakes. Both unsupervised and supervised classification utilities were used. The unsupervised classification routines included the use of several Classification/Clustering algorithms like the K-means, ISO2, Weighted Minimum Distance, and the Localized Receptive Field (LRF) training/classifier. Different texture analysis approaches such as Invariant Moments, Fractal Dimension and Second Order statistics were implemented for supervised classification of the images. The results and conclusions for SAR image classification using the various unsupervised and supervised procedures are presented based on their accuracy and performance.

  13. Using indium tin oxide material to implement the imaging of microwave plasma ignition process

    SciTech Connect

    Wang, Qiang; Hou, Lingyun; Zhang, Guixin Zhang, Boya; Liu, Cheng; Wang, Zhi; Huang, Jian

    2014-02-17

    In this paper, a method is introduced to get global observation of microwave plasma ignition process at high pressure. A microwave resonator was designed with an indium tin oxide coated glass at bottom. Microwave plasma ignition was implemented in methane and air mixture at 10 bars by a 2 ms-3 kW-2.45 GHz microwave pulse, and the high speed images of the ignition process were obtained. The images visually proved that microwave plasma ignition could lead to a multi-point ignition. The system may also be applied to obtain Schlieren images, which is commonly used to observe the development of flame kernel in an ignition process.

  14. Sequential Principal Component Analysis -An Optimal and Hardware-Implementable Transform for Image Compression

    NASA Technical Reports Server (NTRS)

    Duong, Tuan A.; Duong, Vu A.

    2009-01-01

    This paper presents the JPL-developed Sequential Principal Component Analysis (SPCA) algorithm for feature extraction / image compression, based on "dominant-term selection" unsupervised learning technique that requires an order-of-magnitude lesser computation and has simpler architecture compared to the state of the art gradient-descent techniques. This algorithm is inherently amenable to a compact, low power and high speed VLSI hardware embodiment. The paper compares the lossless image compression performance of the JPL's SPCA algorithm with the state of the art JPEG2000, widely used due to its simplified hardware implementability. JPEG2000 is not an optimal data compression technique because of its fixed transform characteristics, regardless of its data structure. On the other hand, conventional Principal Component Analysis based transform (PCA-transform) is a data-dependent-structure transform. However, it is not easy to implement the PCA in compact VLSI hardware, due to its highly computational and architectural complexity. In contrast, the JPL's "dominant-term selection" SPCA algorithm allows, for the first time, a compact, low-power hardware implementation of the powerful PCA algorithm. This paper presents a direct comparison of the JPL's SPCA versus JPEG2000, incorporating the Huffman and arithmetic coding for completeness of the data compression operation. The simulation results show that JPL's SPCA algorithm is superior as an optimal data-dependent-transform over the state of the art JPEG2000. When implemented in hardware, this technique is projected to be ideally suited to future NASA missions for autonomous on-board image data processing to improve the bandwidth of communication.

  15. Efficient lossy compression implementations of hyperspectral images: tools, hardware platforms, and comparisons

    NASA Astrophysics Data System (ADS)

    García, Aday; Santos, Lucana; López, Sebastián.; Callicó, Gustavo M.; Lopez, Jose F.; Sarmiento, Roberto

    2014-05-01

    Efficient onboard satellite hyperspectral image compression represents a necessity and a challenge for current and future space missions. Therefore, it is mandatory to provide hardware implementations for this type of algorithms in order to achieve the constraints required for onboard compression. In this work, we implement the Lossy Compression for Exomars (LCE) algorithm on an FPGA by means of high-level synthesis (HSL) in order to shorten the design cycle. Specifically, we use CatapultC HLS tool to obtain a VHDL description of the LCE algorithm from C-language specifications. Two different approaches are followed for HLS: on one hand, introducing the whole C-language description in CatapultC and on the other hand, splitting the C-language description in functional modules to be implemented independently with CatapultC, connecting and controlling them by an RTL description code without HLS. In both cases the goal is to obtain an FPGA implementation. We explain the several changes applied to the original Clanguage source code in order to optimize the results obtained by CatapultC for both approaches. Experimental results show low area occupancy of less than 15% for a SRAM-based Virtex-5 FPGA and a maximum frequency above 80 MHz. Additionally, the LCE compressor was implemented into an RTAX2000S antifuse-based FPGA, showing an area occupancy of 75% and a frequency around 53 MHz. All these serve to demonstrate that the LCE algorithm can be efficiently executed on an FPGA onboard a satellite. A comparison between both implementation approaches is also provided. The performance of the algorithm is finally compared with implementations on other technologies, specifically a graphics processing unit (GPU) and a single-threaded CPU.

  16. Multithreaded real-time 3D image processing software architecture and implementation

    NASA Astrophysics Data System (ADS)

    Ramachandra, Vikas; Atanassov, Kalin; Aleksic, Milivoje; Goma, Sergio R.

    2011-03-01

    Recently, 3D displays and videos have generated a lot of interest in the consumer electronics industry. To make 3D capture and playback popular and practical, a user friendly playback interface is desirable. Towards this end, we built a real time software 3D video player. The 3D video player displays user captured 3D videos, provides for various 3D specific image processing functions and ensures a pleasant viewing experience. Moreover, the player enables user interactivity by providing digital zoom and pan functionalities. This real time 3D player was implemented on the GPU using CUDA and OpenGL. The player provides user interactive 3D video playback. Stereo images are first read by the player from a fast drive and rectified. Further processing of the images determines the optimal convergence point in the 3D scene to reduce eye strain. The rationale for this convergence point selection takes into account scene depth and display geometry. The first step in this processing chain is identifying keypoints by detecting vertical edges within the left image. Regions surrounding reliable keypoints are then located on the right image through the use of block matching. The difference in the positions between the corresponding regions in the left and right images are then used to calculate disparity. The extrema of the disparity histogram gives the scene disparity range. The left and right images are shifted based upon the calculated range, in order to place the desired region of the 3D scene at convergence. All the above computations are performed on one CPU thread which calls CUDA functions. Image upsampling and shifting is performed in response to user zoom and pan. The player also consists of a CPU display thread, which uses OpenGL rendering (quad buffers). This also gathers user input for digital zoom and pan and sends them to the processing thread.

  17. Implementation of 3D prostrate ring-scanning mechanism for NIR diffuse optical imaging phantom validation

    NASA Astrophysics Data System (ADS)

    Yu, Jhao-Ming; Chen, Liang-Yu; Pan, Min-Cheng; Hsu, Ya-Fen; Pan, Min-Chun

    2015-03-01

    Diffuse optical imaging (DOI) providing functional information of tissues has drawn great attention for the last two decades. Near infrared (NIR) DOI systems composed of scanning bench, opt-electrical measurement module, system control, and data processing and image reconstruction schemes are developed for the screening and diagnosis of breast tumors. Mostly, the scanning bench belonging to fixed source-and-detector configuration limits computed image resolution to an extent. To cope with the issue, we propose, design and implement a 3D prostrate ring-scanning equipment for NIR DOI with flexible combinations of illumination and detection, and with the function of radial, circular and vertical movement without hard compression of breast tissue like the imaging system using or incorporating with X-ray mammographic bench. Especially, a rotation-sliding-and-moving mechanism was designed for the guidance of source- and detection-channel movement. Following the previous justification for synthesized image reconstruction, in the paper the validation using varied phantoms is further conducted and 3D image reconstruction for their absorption and scattering coefficients is illustrated through the computation of our in-house coded schemes. The source and detection NIR data are acquired to reconstruct the 3D images through the operation of scanning bench in the movement of vertical, radial and circular directions. Rather than the fixed configuration, the addressed screening/diagnosing equipment has the flexibility for optical-channel expansion with a compromise among construction cost, operation time, and spatial resolution of reconstructed μa and μs' images.

  18. Design and implementation of Dilation X-ray Imager for NIF "DIXI"

    NASA Astrophysics Data System (ADS)

    Ayers, M. J.; Nagel, S. R.; Felker, B.; Bell, P. M.; Bradley, D. K.; Piston, K.; Parker, J.; Lamb, Z.; Kilkenny, J. D.; Hilsabeck, T. J.; Chung, T.; Hares, J. D.; Dymoke-Bradshaw, A. K. L.

    2013-09-01

    Gated X-Ray imagers have been used on many ICF experiments around the world for time resolved imaging of the target implosions. DIXI (Dilation X-ray Imager) is a new fixed base diagnostic that has been developed for use in the National Ignition Facility. The DIXI diagnostic utilizes pulse-dilation technology [1,2,3,4] and uses a high magnification pinhole imaging system to project images onto the instrument. DIXI is located outside the NIF target chamber approximately 6.5m from target chamber center (TCC). The pinholes are located 10cm from TCC and are aligned to the DIXI optical axis using a diagnostic instrument manipulator (DIM) on an adjacent port. By use of an extensive lead and poly shielded drawer enclosure DIXI is capable of collecting data at DT neutron yields up to Yn~ 1016 on CCD readout and up to Yn~ 1017 on film. Compared to existing pinhole x-ray framing cameras DIXI also provides a significant improvement in temporal resolution, <10ps, and the ability to capture a higher density of images due to the fact the pinhole array does not require collimators. The successful deployment of DIXI on the NIF required careful attention to the following subsystems, pinhole imaging, debris shielding, filtering and image plate (FIP), EMI protection, large format CsI photocathode design, detector head, detector head electronics, control electronics, CCD, film recording and neutron shielding. Here we discuss the initial design, improvements implemented after rigorous testing, infrastructure and commissioning of DIXI on the NIF.

  19. Commercial Implementation of Ultrasonic Velocity Imaging Methods via Cooperative Agreement Between NASA Lewis Research Center and Sonix, Inc.

    NASA Technical Reports Server (NTRS)

    Roth, Don J.; Hendricks, J. Lynne; Whalen, Mike F.; Bodis, James R.; Martin, Katherine

    1996-01-01

    This article describes the commercial implementation of ultrasonic velocity imaging methods developed and refined at NASA Lewis Research Center on the Sonix c-scan inspection system. Two velocity imaging methods were implemented: thickness-based and non-thickness-based reflector plate methods. The article demonstrates capabilities of the commercial implementation and gives the detailed operating procedures required for Sonix customers to achieve optimum velocity imaging results. This commercial implementation of velocity imaging provides a 100x speed increase in scanning and processing over the lab-based methods developed at LeRC. The significance of this cooperative effort is that the aerospace and other materials development-intensive industries which use extensive ultrasonic inspection for process control and failure analysis will now have an alternative, highly accurate imaging method commercially available.

  20. Implementation of a direct-imaging and FX correlator for the BEST-2 array

    NASA Astrophysics Data System (ADS)

    Foster, G.; Hickish, J.; Magro, A.; Price, D.; Zarb Adami, K.

    2014-04-01

    A new digital backend has been developed for the Basic Element for SKA Training II (BEST-2) array at Radiotelescopi di Medicina, INAF-IRA, Italy, which allows concurrent operation of an FX correlator, and a direct-imaging correlator and beamformer. This backend serves as a platform for testing some of the spatial Fourier transform concepts which have been proposed for use in computing correlations on regularly gridded arrays. While spatial Fourier transform-based beamformers have been implemented previously, this is, to our knowledge, the first time a direct-imaging correlator has been deployed on a radio astronomy array. Concurrent observations with the FX and direct-imaging correlator allow for direct comparison between the two architectures. Additionally, we show the potential of the direct-imaging correlator for time-domain astronomy, by passing a subset of beams though a pulsar and transient detection pipeline. These results provide a timely verification for spatial Fourier transform-based instruments that are currently in commissioning. These instruments aim to detect highly redshifted hydrogen from the epoch of reionization and/or to perform wide-field surveys for time-domain studies of the radio sky. We experimentally show the direct-imaging correlator architecture to be a viable solution for correlation and beamforming.

  1. Pre-Hardware Optimization of Spacecraft Image Processing Software Algorithms and Hardware Implementation

    NASA Technical Reports Server (NTRS)

    Kizhner, Semion; Flatley, Thomas P.; Hestnes, Phyllis; Jentoft-Nilsen, Marit; Petrick, David J.; Day, John H. (Technical Monitor)

    2001-01-01

    Spacecraft telemetry rates have steadily increased over the last decade presenting a problem for real-time processing by ground facilities. This paper proposes a solution to a related problem for the Geostationary Operational Environmental Spacecraft (GOES-8) image processing application. Although large super-computer facilities are the obvious heritage solution, they are very costly, making it imperative to seek a feasible alternative engineering solution at a fraction of the cost. The solution is based on a Personal Computer (PC) platform and synergy of optimized software algorithms and re-configurable computing hardware technologies, such as Field Programmable Gate Arrays (FPGA) and Digital Signal Processing (DSP). It has been shown in [1] and [2] that this configuration can provide superior inexpensive performance for a chosen application on the ground station or on-board a spacecraft. However, since this technology is still maturing, intensive pre-hardware steps are necessary to achieve the benefits of hardware implementation. This paper describes these steps for the GOES-8 application, a software project developed using Interactive Data Language (IDL) (Trademark of Research Systems, Inc.) on a Workstation/UNIX platform. The solution involves converting the application to a PC/Windows/RC platform, selected mainly by the availability of low cost, adaptable high-speed RC hardware. In order for the hybrid system to run, the IDL software was modified to account for platform differences. It was interesting to examine the gains and losses in performance on the new platform, as well as unexpected observations before implementing hardware. After substantial pre-hardware optimization steps, the necessity of hardware implementation for bottleneck code in the PC environment became evident and solvable beginning with the methodology described in [1], [2], and implementing a novel methodology for this specific application [6]. The PC-RC interface bandwidth problem for the

  2. The implementation of thermal image visualization by HDL based on pseudo-color

    NASA Astrophysics Data System (ADS)

    Zhu, Yong; Zhang, JiangLing

    2004-11-01

    The pseudo-color method which maps the sampled data to intuitive perception colors is a kind of powerful visualization way. And the all-around system of pseudo-color visualization, which includes the primary principle, model and HDL (Hardware Description Language) implementation for the thermal images, is expatiated on in the paper. The thermal images whose signal is modulated as video reflect the temperature distribution of measured object, so they have the speciality of mass and real-time. The solution to the intractable problem is as follows: First, the reasonable system, i.e. the combining of global pseudo-color visualization and local special area accurate measure, muse be adopted. Then, the HDL pseudo-color algorithms in SoC (System on Chip) carry out the system to ensure the real-time. Finally, the key HDL algorithms for direct gray levels connection coding, proportional gray levels map coding and enhanced gray levels map coding are presented, and its simulation results are showed. The pseudo-color visualization of thermal images implemented by HDL in the paper has effective application in the aspect of electric power equipment test and medical health diagnosis.

  3. Implementation of NICE Clinical Guideline 95 for assessment of stable chest pain in a rapid access chest pain clinic reduces the mean number of investigations and cost per patient

    PubMed Central

    Lee, Alvin J X; Michail, Michael; Quaderi, Shumonta A; Richardson, James A; Aggarwal, Suneil K; Speechly-Dick, M Elsya

    2015-01-01

    Objective In 2010, the National Institute for Health and Care Excellence (NICE) in the UK published Clinical Guideline 95 (CG95) advocating risk stratification of patients using ‘CADScore’ to guide appropriate cardiac investigations for chest pain of recent onset. Implementation of the guideline in the University College London Hospitals NHS Foundation Trust was evaluated to see if it led to a reduction in the average cost of the diagnostic journey per patient and fewer investigations per patient in order to confirm a diagnosis. Methods This was a single centre study at a Tertiary Centre in Central London. The investigative journey for each patient presenting to the Rapid Access Chest Pain Clinic (RACPC) at University College London Hospitals NHS Foundation Trust was recorded. Retrospective analysis on this data was performed. Results Data for 4968 patients presenting to the RACPC from 2004 to 2012 was analysed and a size-matched cohort of 1503 patients preimplementation and postimplementation of the guidelines was compared. The mean cost of investigations postimplementation was £291.83 as compared to £319.54 preimplementation of the guidelines despite higher costs associated with some of the recommended initial investigations. The mean number of tests per patient postguidelines was 0.78 compared to 0.97 for preguidelines. An approximate twofold increase in patients not requiring tests was seen post-CG95 implementation (245 pre-CG95 vs 476 post-CG95). Conclusions The implementation of the NICE guidelines in our trust has reduced the average cost of the investigative journey and the number of investigations required per patient. PMID:25722859

  4. Implementation and characterisation of new neutron imaging system for dynamic processes investigation at the Es-Salam research reactor.

    PubMed

    Kharfi, F; Denden, O; Abdelkader, A

    2011-10-01

    Neutron imaging is a powerful method for non-destructive investigations where high penetration through metals and in particular high contrast for hydrogenous materials maybe exploited. Due to the complexity of digital neutron static or video image formation, image capture conditions and parameters must be accurately selected. In this work, implementation of a new neutron imaging system based on CCD camera and LiF-ZnS scintillator is presented. The image characteristics in terms of contrast, noise and dynamic range and investigation limits of this new imaging system were studied as a function of the neutron source properties. PMID:21640596

  5. An investigation and implementation of real-time image cropping on mobile computing devices based on saliency and face detection

    NASA Astrophysics Data System (ADS)

    Gao, Lisheng; Fu, Deqian; Jhang, Seong Tae

    2012-04-01

    Thumbnail images provide mobile computing users of an easier and smoother image exploring experience. Recognizing the objects in an image is important in many retrieval tasks, but thumbnails generated by shrinking the original image often contain less information. The ability of computer vision systems to identify key components of images is investigated in this research. We evaluate automatic cropping techniques 1) based on a general method that detects salient portions of images, and 2) based on automatic face detection. Both of the two methods have been implemented on the mobile computing platform and a desktop platform as a comparison. The experimental results demonstrate the validness of the proposed approaches.

  6. Implementation methods of medical image sharing for collaborative health care based on IHE XDS-I profile.

    PubMed

    Zhang, Jianguo; Zhang, Kai; Yang, Yuanyuan; Sun, Jianyong; Ling, Tonghui; Wang, Mingqing; Bak, Peter

    2015-10-01

    IHE XDS-I profile proposes an architecture model for cross-enterprise medical image sharing, but there are only a few clinical implementations reported. Here, we investigate three pilot studies based on the IHE XDS-I profile to see whether we can use this architecture as a foundation for image sharing solutions in a variety of health-care settings. The first pilot study was image sharing for cross-enterprise health care with federated integration, which was implemented in Huadong Hospital and Shanghai Sixth People's Hospital within the Shanghai Shen-Kang Hospital Management Center; the second pilot study was XDS-I-based patient-controlled image sharing solution, which was implemented by the Radiological Society of North America (RSNA) team in the USA; and the third pilot study was collaborative imaging diagnosis with electronic health-care record integration in regional health care, which was implemented in two districts in Shanghai. In order to support these pilot studies, we designed and developed new image access methods, components, and data models such as RAD-69/WADO hybrid image retrieval, RSNA clearinghouse, and extension of metadata definitions in both the submission set and the cross-enterprise document sharing (XDS) registry. We identified several key issues that impact the implementation of XDS-I in practical applications, and conclude that the IHE XDS-I profile is a theoretically good architecture and a useful foundation for medical image sharing solutions across multiple regional health-care providers. PMID:26835497

  7. ASCI 2010 appropriateness criteria for cardiac magnetic resonance imaging: a report of the Asian Society of Cardiovascular Imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group

    PubMed Central

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

    2010-01-01

    There has been a growing need for standard Asian population guidelines for cardiac CT and cardiac MR due to differences in culture, healthcare system, ethnicity and disease prevalence. The Asian Society of Cardiovascular Imaging, as the only society dedicated to cardiovascular imaging in Asia, formed a cardiac CT and cardiac MR guideline working group in order to help Asian practitioners to establish cardiac CT and cardiac MR services. In this ASCI cardiac MR appropriateness criteria report, 23 Technical Panel members representing various Asian countries were invited to rate 50 indications that can frequently be encountered in clinical practice in Asia. Indications were rated on a scale of 1–9 to be categorized into ‘appropriate’ (7–9), ‘uncertain’ (4–6), or ‘inappropriate’ (1–3). According to median scores of the 23 members, the final ratings for indications were 24 appropriate, 18 uncertain and 8 inappropriate with 22 ‘highly-agreed’ (19 appropriate and 3 inappropriate) indications. This report is expected to have a significant impact on the cardiac MR practices in many Asian countries by promoting the appropriate use of cardiac MR. Electronic supplementary material The online version of this article (doi:10.1007/s10554-010-9687-z) contains supplementary material, which is available to authorized users. PMID:20734234

  8. Implementation of ILLIAC 4 algorithms for multispectral image interpretation. [earth resources data

    NASA Technical Reports Server (NTRS)

    Ray, R. M.; Thomas, J. D.; Donovan, W. E.; Swain, P. H.

    1974-01-01

    Research has focused on the design and partial implementation of a comprehensive ILLIAC software system for computer-assisted interpretation of multispectral earth resources data such as that now collected by the Earth Resources Technology Satellite. Research suggests generally that the ILLIAC 4 should be as much as two orders of magnitude more cost effective than serial processing computers for digital interpretation of ERTS imagery via multivariate statistical classification techniques. The potential of the ARPA Network as a mechanism for interfacing geographically-dispersed users to an ILLIAC 4 image processing facility is discussed.

  9. Review and Implementation of the Emerging CCSDS Recommended Standard for Multispectral and Hyperspectral Lossless Image Coding

    NASA Technical Reports Server (NTRS)

    Sanchez, Jose Enrique; Auge, Estanislau; Santalo, Josep; Blanes, Ian; Serra-Sagrista, Joan; Kiely, Aaron

    2011-01-01

    A new standard for image coding is being developed by the MHDC working group of the CCSDS, targeting onboard compression of multi- and hyper-spectral imagery captured by aircraft and satellites. The proposed standard is based on the "Fast Lossless" adaptive linear predictive compressor, and is adapted to better overcome issues of onboard scenarios. In this paper, we present a review of the state of the art in this field, and provide an experimental comparison of the coding performance of the emerging standard in relation to other state-of-the-art coding techniques. Our own independent implementation of the MHDC Recommended Standard, as well as of some of the other techniques, has been used to provide extensive results over the vast corpus of test images from the CCSDS-MHDC.

  10. Dragonfly: an implementation of the expand–maximize–compress algorithm for single-particle imaging1

    PubMed Central

    Ayyer, Kartik; Lan, Ti-Yen; Elser, Veit; Loh, N. Duane

    2016-01-01

    Single-particle imaging (SPI) with X-ray free-electron lasers has the potential to change fundamentally how biomacromolecules are imaged. The structure would be derived from millions of diffraction patterns, each from a different copy of the macromolecule before it is torn apart by radiation damage. The challenges posed by the resultant data stream are staggering: millions of incomplete, noisy and un-oriented patterns have to be computationally assembled into a three-dimensional intensity map and then phase reconstructed. In this paper, the Dragonfly software package is described, based on a parallel implementation of the expand–maximize–compress reconstruction algorithm that is well suited for this task. Auxiliary modules to simulate SPI data streams are also included to assess the feasibility of proposed SPI experiments at the Linac Coherent Light Source, Stanford, California, USA. PMID:27504078

  11. Phantoms for diffuse optical imaging based on totally absorbing objects, part 2: experimental implementation

    NASA Astrophysics Data System (ADS)

    Martelli, Fabrizio; Ninni, Paola Di; Zaccanti, Giovanni; Contini, Davide; Spinelli, Lorenzo; Torricelli, Alessandro; Cubeddu, Rinaldo; Wabnitz, Heidrun; Mazurenka, Mikhail; Macdonald, Rainer; Sassaroli, Angelo; Pifferi, Antonio

    2014-07-01

    We present the experimental implementation and validation of a phantom for diffuse optical imaging based on totally absorbing objects for which, in the previous paper [J. Biomed. Opt. 18(6), 066014, (2013)], we have provided the basic theory. Totally absorbing objects have been manufactured as black polyvinyl chloride (PVC) cylinders and the phantom is a water dilution of intralipid-20% as the diffusive medium and India ink as the absorber, filled into a black scattering cell made of PVC. By means of time-domain measurements and of Monte Carlo simulations, we have shown the reliability, the accuracy, and the robustness of such a phantom in mimicking typical absorbing perturbations of diffuse optical imaging. In particular, we show that such a phantom can be used to generate any absorption perturbation by changing the volume and position of the totally absorbing inclusion.

  12. Implementation and performance evaluation of a network-attached CD image file server

    NASA Astrophysics Data System (ADS)

    Wu, Jinglian; Dong, Yonggui; Sun, Zhaoyan; Jia, Huibo

    2002-09-01

    A network-attached CD Image file server, working on the Linux operating system, is implemented. By taking advantage of virtual file system (VFS) infrastructure and loopback device, the data of CD are mirrored in harddisks and can be shared by clients synchronously through network. The primary benefits of such a server are cost effectiveness, high capacity and excellent compatibility with Chinese characters. The performance of the server is evaluated by testing its throughput during I/O request. The experimental results show that, compared with conventional methods such as sharing the CD-ROM hard devices via network as, the rate of reading data from the CD Image is much higher. This is especially true when the server is dealing with multi-client access.

  13. In vivo visualization of robotically implemented synthetic tracked aperture ultrasound (STRATUS) imaging system using curvilinear array

    NASA Astrophysics Data System (ADS)

    Zhang, Haichong K.; Aalamifar, Fereshteh; Boctor, Emad M.

    2016-04-01

    Synthetic aperture for ultrasound is a technique utilizing a wide aperture in both transmit and receive to enhance the ultrasound image quality. The limitation of synthetic aperture is the maximum available aperture size limit determined by the physical size of ultrasound probe. We propose Synthetic-Tracked Aperture Ultrasound (STRATUS) imaging system to overcome the limitation by extending the beamforming aperture size through ultrasound probe tracking. With a setup involving a robotic arm, the ultrasound probe is moved using the robotic arm, while the positions on a scanning trajectory are tracked in real-time. Data from each pose are synthesized to construct a high resolution image. In previous studies, we have demonstrated the feasibility through phantom experiments. However, various additional factors such as real-time data collection or motion artifacts should be taken into account when the in vivo target becomes the subject. In this work, we build a robot-based STRATUS imaging system with continuous data collection capability considering the practical implementation. A curvilinear array is used instead of a linear array to benefit from its wider capture angle. We scanned human forearms under two scenarios: one submerged the arm in the water tank under 10 cm depth, and the other directly scanned the arm from the surface. The image contrast improved 5.51 dB, and 9.96 dB for the underwater scan and the direct scan, respectively. The result indicates the practical feasibility of STRATUS imaging system, and the technique can be potentially applied to the wide range of human body.

  14. Linear array implementation of the EM algorithm for PET image reconstruction

    SciTech Connect

    Rajan, K.; Patnaik, L.M.; Ramakrishna, J.

    1995-08-01

    The PET image reconstruction based on the EM algorithm has several attractive advantages over the conventional convolution back projection algorithms. However, the PET image reconstruction based on the EM algorithm is computationally burdensome for today`s single processor systems. In addition, a large memory is required for the storage of the image, projection data, and the probability matrix. Since the computations are easily divided into tasks executable in parallel, multiprocessor configurations are the ideal choice for fast execution of the EM algorithms. In tis study, the authors attempt to overcome these two problems by parallelizing the EM algorithm on a multiprocessor systems. The parallel EM algorithm on a linear array topology using the commercially available fast floating point digital signal processor (DSP) chips as the processing elements (PE`s) has been implemented. The performance of the EM algorithm on a 386/387 machine, IBM 6000 RISC workstation, and on the linear array system is discussed and compared. The results show that the computational speed performance of a linear array using 8 DSP chips as PE`s executing the EM image reconstruction algorithm is about 15.5 times better than that of the IBM 6000 RISC workstation. The novelty of the scheme is its simplicity. The linear array topology is expandable with a larger number of PE`s. The architecture is not dependant on the DSP chip chosen, and the substitution of the latest DSP chip is straightforward and could yield better speed performance.

  15. Critical appraisal of clinical guidelines.

    PubMed

    Netsch, Debra S; Kluesner, Jean A

    2010-01-01

    Utilization of clinical guidelines is gaining in popularity due to their significant impact on clinical practice. While a plethora of guidelines exist, many are lacking in quality, based on current critical appraisal standards. It then becomes necessary for the end users of the guidelines to adopt or develop those that are deemed adequate for implementation. This often requires that users possess critical appraisal skills as they become proficient in discerning between guidelines of varying quality. This article provides direction and tools to support the critical appraisal process in the adoption of clinical guidelines. PMID:20838314

  16. TH-A-16A-01: Image Quality for the Radiation Oncology Physicist: Review of the Fundamentals and Implementation

    SciTech Connect

    Seibert, J; Imbergamo, P

    2014-06-15

    The expansion and integration of diagnostic imaging technologies such as On Board Imaging (OBI) and Cone Beam Computed Tomography (CBCT) into radiation oncology has required radiation oncology physicists to be responsible for and become familiar with assessing image quality. Unfortunately many radiation oncology physicists have had little or no training or experience in measuring and assessing image quality. Many physicists have turned to automated QA analysis software without having a fundamental understanding of image quality measures. This session will review the basic image quality measures of imaging technologies used in the radiation oncology clinic, such as low contrast resolution, high contrast resolution, uniformity, noise, and contrast scale, and how to measure and assess them in a meaningful way. Additionally a discussion of the implementation of an image quality assurance program in compliance with Task Group recommendations will be presented along with the advantages and disadvantages of automated analysis methods. Learning Objectives: Review and understanding of the fundamentals of image quality. Review and understanding of the basic image quality measures of imaging modalities used in the radiation oncology clinic. Understand how to implement an image quality assurance program and to assess basic image quality measures in a meaningful way.

  17. A case-based approach to implementing guidelines for stroke prevention in patients with atrial fibrillation: balancing the risks and benefits.

    PubMed

    Amin, Alpesh; Deitelzweig, Steven

    2015-01-01

    Atrial fibrillation (AF) puts patients at risk of complications, including stroke. Warfarin therapy has been the mainstay of antithrombotic treatment for reducing the risk of stroke in AF. However, warfarin has limitations that have motivated development of several novel oral anticoagulants (NOACs), including dabigatran, rivaroxaban, apixaban, and edoxaban. Clinical trials demonstrate that the NOACs offer efficacy and safety that are equivalent to, or better than, those of warfarin for reducing the risk of stroke in patients with nonvalvular AF. This review examines stroke risk reduction in patients with AF from the perspective of the clinician balancing the risks and benefits of treatment options, evaluates the most recent guidelines, and discusses 2 hypothetical patient cases to better illustrate how clinicians may apply available data in the clinical setting. We reviewed guidelines for the reduction of stroke risk in AF and data from clinical trials on the NOACs. Choosing antithrombotic treatment involves assessing the benefits of therapy versus its risks. Risk indexes, including CHADS2, CHA2DS2-VASc, and HAS-BLED can help determine how to treat patients with AF. Current guidelines suggest using these risk indexes to customize treatment to individual patients. Many current treatment guidelines also incorporate recommendations for the use of NOACs as an alternative to warfarin. As additional data emerge and guidelines are updated, these recommendations will likely evolve. In the interim, clinicians may consider published guidelines and clinical trial results on NOACs. Real-world experience will provide clinicians with additional insight into their treatment decisions. PMID:26300695

  18. Synthetic transmit aperture technique in medical ultrasound imaging implemented on a GPU

    NASA Astrophysics Data System (ADS)

    Li, Ying; Chen, Xiaodong; Zhang, Chuang; Wang, Yi; Jiao, Zhihai; Yu, Daoyin

    2014-11-01

    In the medical ultrasound imaging, the synthetic transmit aperture (STA) technique is very promising and has been a hot research topic. It is dynamically focused in both transmit and receive yielding an improvement in resolution. But this imaging technique sets high demands on processing capabilities and makes implementation of a full STA system very challenging and costly. Many attempts have been made to reduce the demands on the system making it a more realistic task to implement. In this paper we don't consider how to reduce the demands, but consider how to accelerate the processing speed of the system. The recent introduction of general-purpose graphic processing units (GPU) seems to be quite promising in this view, especially for the affordable programming complexity. In this paper we explain the main computational features of STA processing unit, trying to disclose the degree of parallelism in the operations. On the basis of the compute unified device architecture (CUDA) programming model and the extremely flexible structure of the Single Instruction Multiple Threads (SIMT) model, we show that the optimization of STA processing unit can be performed more efficiently. The input data is read from Matlab, the post-processing and display also use Matlab. Performance shows that, using a single NIVDIA GTX-650 GPU board, this amount to a speed up of more than a factor of 30 compared to a highly optimized beamformer running on our test workstation with a 3.20-GHz Intel Core-i5 processor.

  19. POLCA, a library running in a modern environment, implements a protocol for averaging randomly oriented images.

    PubMed

    Bellon, P L; Lanzavecchia, S

    1990-07-01

    The library POLCA implements the averaging of biological structures whose images are recorded in digital form from electron micrographs. The averaging protocol is based upon a method developed about ten years ago, which allows one to operate on a sequence of objects oriented and displaced at random within their frame; the relative rotations and the displacements of the structures are detected with the use of correlation algorithms and modified to make all objects appear the same, apart from their noisy components. The average image is then obtained by a simple addition and the signal-to-noise ratio is improved by a factor equal to the square root of the number of objects used to calculate the average. With respect to the original implementation of the method, two novel features characterize the library: the first one deals with the functions that are cross-correlated to determine the relative rotations of the structures; the functions used here are the inverse transforms of the amplitude spectra (IAS functions), which give rise to sharp maxima when they are cross-correlated. The second peculiarity is the systematic adoption, in the transformations of coordinates and in other circumstances, of an interpolation technique based upon the Fourier series kernel. POLCA is written in C and runs on a VME machine under the UNIX V/68 operating system. A programming style has been adopted to exploit fully the machine resources. PMID:2207751

  20. PCIPS 2.0: Powerful multiprofile image processing implemented on PCs

    NASA Technical Reports Server (NTRS)

    Smirnov, O. M.; Piskunov, N. E.

    1992-01-01

    Over the years, the processing power of personal computers has steadily increased. Now, 386- and 486-based PC's are fast enough for many image processing applications, and inexpensive enough even for amateur astronomers. PCIPS is an image processing system based on these platforms that was designed to satisfy a broad range of data analysis needs, while requiring minimum hardware and providing maximum expandability. It will run (albeit at a slow pace) even on a 80286 with 640K memory, but will take full advantage of bigger memory and faster CPU's. Because the actual image processing is performed by external modules, the system can be easily upgraded by the user for all sorts of scientific data analysis. PCIPS supports large format lD and 2D images in any numeric type from 8-bit integer to 64-bit floating point. The images can be displayed, overlaid, printed and any part of the data examined via an intuitive graphical user interface that employs buttons, pop-up menus, and a mouse. PCIPS automatically converts images between different types and sizes to satisfy the requirements of various applications. PCIPS features an API that lets users develop custom applications in C or FORTRAN. While doing so, a programmer can concentrate on the actual data processing, because PCIPS assumes responsibility for accessing images and interacting with the user. This also ensures that all applications, even custom ones, have a consistent and user-friendly interface. The API is compatible with factory programming, a metaphor for constructing image processing procedures that will be implemented in future versions of the system. Several application packages were created under PCIPS. The basic package includes elementary arithmetics and statistics, geometric transformations and import/export in various formats (FITS, binary, ASCII, and GIF). The CCD processing package and the spectral analysis package were successfully used to reduce spectra from the Nordic Telescope at La Palma. A

  1. Implementation of Fiducial-Based Image Registration in the Cyberknife Robotic System

    SciTech Connect

    Saw, Cheng B. Chen Hungcheng; Wagner, Henry

    2008-07-01

    Fiducial-based image registration methodology as implemented in the Cyberknife system is explored. The Cyberknife is a radiosurgery system that uses image guidance technology and computer-controlled robotics to determine target positions and adjust beam directions accordingly during the dose delivery. The image guidance system consists of 2 x-ray sources mounted on the ceiling and a detection system mounted on both sides of the treatment couch. Two orthogonal live radiographs are taken prior to and during patient treatment. Fiducial markers are identified on these radiographs and compared to a library of digital reconstructed radiographs (DRRs) using the fiducial extraction software. The fiducial extraction software initially sets an intensity threshold on the live radiographs to generate white areas on black images referred to as 'blobs.' Different threshold values are being used and blobs at the same location are assumed to originate from the same object. The number of blobs is then reduced by examining each blob against a predefined set of properties such as shape and exposure levels. The remaining blobs are further reduced by examining the location of the blobs in the inferior-superior patient axis. Those blobs that have the corresponding positions are assumed to originate from the same object. The remaining blobs are used to create fiducial configurations and are compared to the reference configuration from the computed tomography (CT) image dataset for treatment planning. The best-fit configuration is considered to have the appropriate fiducial markers. The patient position is determined based on these fiducial markers. During the treatment, the radiation beam is turned off when the Cyberknife changes nodes. This allows a time window to acquire live radiographs for the determination of the patient target position and to update the robotic manipulator to change beam orientations accordingly.

  2. Implementation of fiducial-based image registration in the Cyberknife robotic system.

    PubMed

    Saw, Cheng B; Chen, Hungcheng; Wagner, Henry

    2008-01-01

    Fiducial-based image registration methodology as implemented in the Cyberknife system is explored. The Cyberknife is a radiosurgery system that uses image guidance technology and computer-controlled robotics to determine target positions and adjust beam directions accordingly during the dose delivery. The image guidance system consists of 2 x-ray sources mounted on the ceiling and a detection system mounted on both sides of the treatment couch. Two orthogonal live radiographs are taken prior to and during patient treatment. Fiducial markers are identified on these radiographs and compared to a library of digital reconstructed radiographs (DRRs) using the fiducial extraction software. The fiducial extraction software initially sets an intensity threshold on the live radiographs to generate white areas on black images referred to as "blobs." Different threshold values are being used and blobs at the same location are assumed to originate from the same object. The number of blobs is then reduced by examining each blob against a predefined set of properties such as shape and exposure levels. The remaining blobs are further reduced by examining the location of the blobs in the inferior-superior patient axis. Those blobs that have the corresponding positions are assumed to originate from the same object. The remaining blobs are used to create fiducial configurations and are compared to the reference configuration from the computed tomography (CT) image dataset for treatment planning. The best-fit configuration is considered to have the appropriate fiducial markers. The patient position is determined based on these fiducial markers. During the treatment, the radiation beam is turned off when the Cyberknife changes nodes. This allows a time window to acquire live radiographs for the determination of the patient target position and to update the robotic manipulator to change beam orientations accordingly. PMID:18456167

  3. A new morphological anomaly detection algorithm for hyperspectral images and its GPU implementation

    NASA Astrophysics Data System (ADS)

    Paz, Abel; Plaza, Antonio

    2011-10-01

    Anomaly detection is considered a very important task for hyperspectral data exploitation. It is now routinely applied in many application domains, including defence and intelligence, public safety, precision agriculture, geology, or forestry. Many of these applications require timely responses for swift decisions which depend upon high computing performance of algorithm analysis. However, with the recent explosion in the amount and dimensionality of hyperspectral imagery, this problem calls for the incorporation of parallel computing techniques. In the past, clusters of computers have offered an attractive solution for fast anomaly detection in hyperspectral data sets already transmitted to Earth. However, these systems are expensive and difficult to adapt to on-board data processing scenarios, in which low-weight and low-power integrated components are essential to reduce mission payload and obtain analysis results in (near) real-time, i.e., at the same time as the data is collected by the sensor. An exciting new development in the field of commodity computing is the emergence of commodity graphics processing units (GPUs), which can now bridge the gap towards on-board processing of remotely sensed hyperspectral data. In this paper, we develop a new morphological algorithm for anomaly detection in hyperspectral images along with an efficient GPU implementation of the algorithm. The algorithm is implemented on latest-generation GPU architectures, and evaluated with regards to other anomaly detection algorithms using hyperspectral data collected by NASA's Airborne Visible Infra-Red Imaging Spectrometer (AVIRIS) over the World Trade Center (WTC) in New York, five days after the terrorist attacks that collapsed the two main towers in the WTC complex. The proposed GPU implementation achieves real-time performance in the considered case study.

  4. Implementation of multi-vendor DICOM standard image transfer in hospital wide ATM network.

    PubMed

    Kimura, M; Tani, S; Baatar, S; Naito, Y; Kanno, T; Sakusabe, T; Aizawa, M

    1998-01-01

    At Hamamatsu University Hospital, an ATM + FDDI network was installed in January 1995, when the hospital information system was upgraded. With its unique 'wheel' shape configuration, FDDI automatically backs up in case of an ATM switch failure. The authors implemented a DICOM image database server and DICOM viewer in the Hamamatsu University Hospital ATM + FDDI network. The DICOM standard worked well between different vendor products. In sending 512 x 512, 2 byte CT images, 40% of the transfer time was spent for the network data transfer, which is 70% of the theoretical value of 10 Mb peripheral transfer rate. Meanwhile, ATM load factor increased less than 0.5%. As we have a very fast data transfer network, we must check display speed, hard disc access time, PC bus speed, and display software, in order to enjoy the high speed network transfer fully. The sequence of image transmission within a study is not stated in the DICOM document and is depending on the server. Therefore, there should be an agreement between server and clients, still more than DICOM, in order to make better PACS. PMID:9804003

  5. Ruby-Helix: an implementation of helical image processing based on object-oriented scripting language.

    PubMed

    Metlagel, Zoltan; Kikkawa, Yayoi S; Kikkawa, Masahide

    2007-01-01

    Helical image analysis in combination with electron microscopy has been used to study three-dimensional structures of various biological filaments or tubes, such as microtubules, actin filaments, and bacterial flagella. A number of packages have been developed to carry out helical image analysis. Some biological specimens, however, have a symmetry break (seam) in their three-dimensional structure, even though their subunits are mostly arranged in a helical manner. We refer to these objects as "asymmetric helices". All the existing packages are designed for helically symmetric specimens, and do not allow analysis of asymmetric helical objects, such as microtubules with seams. Here, we describe Ruby-Helix, a new set of programs for the analysis of "helical" objects with or without a seam. Ruby-Helix is built on top of the Ruby programming language and is the first implementation of asymmetric helical reconstruction for practical image analysis. It also allows easier and semi-automated analysis, performing iterative unbending and accurate determination of the repeat length. As a result, Ruby-Helix enables us to analyze motor-microtubule complexes with higher throughput to higher resolution. PMID:16996276

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

    PubMed

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

    2012-04-01

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. Institute of Medicine and the United Kingdom's National Institute for Health and Clinical Excellence have developed recommendations to define trustworthy guidelines within their locales. Many groups charged with guideline development find the lengthy list of standards developed by such organizations to be aspirational but infeasible to follow in entirety. Founded in 2002, the Guidelines International Network (G-I-N) is a network of guideline developers that includes 93 organizations and 89 individual members representing 46 countries. The G-I-N board of trustees recognized the importance of guideline development processes that are both rigorous and feasible even for modestly funded groups to implement and initiated an effort toward consensus about minimum standards for high-quality guidelines. In contrast to other existing standards for guideline development at national or local levels, the key components proposed by G-I-N will represent the consensus of an international, multidisciplinary group of active guideline developers. This article presents G-I-N's proposed set of key components for guideline development. These key components address panel composition, decision-making process, conflicts of interest, guideline objective, development methods, evidence review, basis of recommendations, ratings of evidence and recommendations, guideline review, updating processes, and funding. It is hoped that this article promotes discussion and eventual agreement on a set of international standards for guideline development. PMID:22473437

  7. SPAN security policies and guidelines

    NASA Technical Reports Server (NTRS)

    Sisson, Patricia L.; Green, James L.

    1989-01-01

    A guide is provided to system security with emphasis on requirements and guidelines that are necessary to maintain an acceptable level of security on the network. To have security for the network, each node on the network must be secure. Therefore, each system manager, must strictly adhere to the requirements and must consider implementing the guidelines discussed. There are areas of vulnerability within the operating system that may not be addressed. However, when a requirement or guideline is discussed, implementation techniques are included. Information related to computer and data security is discussed to provide information on implementation options. The information is presented as it relates to a VAX computer environment.

  8. Implementation of three-dimensional wavelet encoding spectroscopic imaging: in vivo application and method comparison.

    PubMed

    Young, Richard; Serrai, Hacene

    2009-01-01

    We have recently proposed a two-dimensional Wavelet Encoding-Spectroscopic Imaging (WE-SI) technique as an alternative to Chemical Shift Imaging (CSI), to reduce acquisition time and crossvoxel contamination in magnetic resonance spectroscopic imaging (MRSI). In this article we describe the extension of the WE-SI technique to three dimensions and its implementation on a clinical 1.5 T General Electric (GE) scanner. Phantom and in vivo studies are carried out to demonstrate the usefulness of this technique for further acquisition time reduction with low voxel contamination. In wavelet encoding, a set of dilated and translated prototype functions called wavelets are used to span a localized space by dividing it into a set of subspaces with predetermined sizes and locations. In spectroscopic imaging, this process is achieved using radiofrequency (RF) pulses with profiles resembling the wavelet shapes. Slice selective excitation and refocusing RF pulses, with single-band and dual-band profiles similar to Haar wavelets, are used in a modified PRESS sequence to acquire 3D WE-SI data. Wavelet dilation and translation are achieved by changing the strength of the localization gradients and frequency shift of the RF pulses, respectively. The desired spatial resolution in each direction sets the corresponding number of dilations (increases in the localization gradients), and consequently, the number of translations (frequency shift) of the Haar wavelets (RF pulses), which are used to collect magnetic resonance (MR) signals from the corresponding subspaces. Data acquisition time is reduced by using the minimum recovery time (TR(min)), also called effective time, when successive MR signals from adjacent subspaces are collected. Inverse wavelet transform is performed on the acquired data to produce metabolite maps. The proposed WE-SI method is compared in terms of acquisition time, pixel bleed, and signal-to-noise ratio to the CSI technique. The study outcome shows that 3D WE

  9. Virginia School Health Guidelines.

    ERIC Educational Resources Information Center

    Virginia State Dept. of Education, Richmond.

    Virginia's Department of Education and Department of Health are concerned with the health of children and youth, and with the implementation of comprehensive school health programs. These guidelines provide a basis for developing a model school health program or for enriching an existing program, focusing on health services and school environment.…

  10. Images of Doctors and their Implements: A Visual Dialogue between the Patient and the Doctor.

    PubMed

    Baker, Patricia A

    2016-01-01

    Images of physicians, patients, and medical instruments were placed on Graeco-Roman funerary monuments, altars and fresco paintings. These representations are examined here to determine whether there existed a standard convention by which physicians were depicted in order that the lay and possibly illiterate viewers could identify what the scene represented. Greek physicians were frequently shown with cupping vessels, midwives were seen with birthing stools, while Roman physicians were often shown with various surgical implements. It is argued that the correlation between the types of objects depicted with the medical practitioner was deliberately made by the artist to signify the nature of medicine the individual practiced, so that the viewer could identify the role the practitioner had in their society. PMID:26946686

  11. Implementation of wireless 3D stereo image capture system and synthesizing the depth of region of interest

    NASA Astrophysics Data System (ADS)

    Ham, Woonchul; Song, Chulgyu; Kwon, Hyeokjae; Badarch, Luubaatar

    2014-05-01

    In this paper, we introduce the mobile embedded system implemented for capturing stereo image based on two CMOS camera module. We use WinCE as an operating system and capture the stereo image by using device driver for CMOS camera interface and Direct Draw API functions. We send the raw captured image data to the host computer by using WiFi wireless communication and then use GPU hardware and CUDA programming for implementation of real time three-dimensional stereo image by synthesizing the depth of ROI(region of interest). We also try to find and declare the mechanism of deblurring of CMOS camera module based on the Kirchhoff diffraction formula and propose a deblurring model. Synthesized stereo image is real time monitored on the shutter glass type three-dimensional LCD monitor and disparity values of each segment are analyzed to prove the validness of emphasizing effect of ROI.

  12. Alliance for a Healthier Generation's Competitive Beverage and Food Guidelines: Do Elementary School Administrators Know about Them and Do They Report Implementing Them?

    ERIC Educational Resources Information Center

    Ohri-Vachaspati, Punam; Turner, Lindsey; Chaloupka, Frank J.

    2012-01-01

    Background: The availability of competitive foods in schools is a modifiable factor in efforts to prevent childhood obesity. The Alliance for a Healthier Generation launched the Healthy Schools Program in 2006 to encourage schools to create healthier food environments, including the adoption of nutritional guidelines for competitive beverages and…

  13. The Implementation of non-uniformity correction in multi-TDICCD imaging system

    NASA Astrophysics Data System (ADS)

    Zhai, Guofang; Cheng, Yun; Han, Zhixue; Wang, Dong

    2015-10-01

    Abstract—a non-uniformity correction algorithm is proposed and implemented on a Field-Programmable Gate Array (FPGA) hardware platform to solve a problem of pixel response non-uniformity(PRNU) for multiple Time Delay and Integration Charge Couple Device(TDICCD) camera. The non-uniformity is introduced and a synthetical correction algorithm is presented, in which the two-point correction method is applied to a single channel, gain averaging correction method among multi-channel and scene-adaptive correction method among multiple-TDICCD. Then, the correction algorithm is generated. Finally, the FPGA ability for fix-point processing is analyzed; the correction algorithm is optimized, and implemented on FPGA. Testing results indicate that the non-uniformity can be decreased from 8.27% to 0.51% for three TDICCDs camera's images with this proposed correction algorithm, proving that this correction algorithm is with high real-time performance, great engineering realization and satisfaction for the system requirements.

  14. Neutron imaging with coded sources: new challenges and the implementation of a simultaneous iterative reconstruction technique

    SciTech Connect

    Santos-Villalobos, Hector J; Bingham, Philip R; Gregor, Jens

    2013-01-01

    The limitations in neutron flux and resolution (L/D) of current neutron imaging systems can be addressed with a Coded Source Imaging system with magnification (xCSI). More precisely, the multiple sources in an xCSI system can exceed the flux of a single pinhole system for several orders of magnitude, while maintaining a higher L/D with the small sources. Moreover, designing for an xCSI system reduces noise from neutron scattering, because the object is placed away from the detector to achieve magnification. However, xCSI systems are adversely affected by correlated noise such as non-uniform illumination of the neutron source, incorrect sampling of the coded radiograph, misalignment of the coded masks, mask transparency, and the imperfection of the system Point Spread Function (PSF). We argue that a model-based reconstruction algorithm can overcome these problems and describe the implementation of a Simultaneous Iterative Reconstruction Technique algorithm for coded sources. Design pitfalls that preclude a satisfactory reconstruction are documented.

  15. Improvement of dem Generation from Aster Images Using Satellite Jitter Estimation and Open Source Implementation

    NASA Astrophysics Data System (ADS)

    Girod, L.; Nuth, C.; Kääb, A.

    2015-12-01

    The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) system embarked on the Terra (EOS AM-1) satellite has been a source of stereoscopic images covering the whole globe at a 15m resolution at a consistent quality for over 15 years. The potential of this data in terms of geomorphological analysis and change detection in three dimensions is unrivaled and needs to be exploited. However, the quality of the DEMs and ortho-images currently delivered by NASA (ASTER DMO products) is often of insufficient quality for a number of applications such as mountain glacier mass balance. For this study, the use of Ground Control Points (GCPs) or of other ground truth was rejected due to the global "big data" type of processing that we hope to perform on the ASTER archive. We have therefore developed a tool to compute Rational Polynomial Coefficient (RPC) models from the ASTER metadata and a method improving the quality of the matching by identifying and correcting jitter induced cross-track parallax errors. Our method outputs more accurate DEMs with less unmatched areas and reduced overall noise. The algorithms were implemented in the open source photogrammetric library and software suite MicMac.

  16. Thermal imaging as a smartphone application: exploring and implementing a new concept

    NASA Astrophysics Data System (ADS)

    Yanai, Omer

    2014-06-01

    Today's world is going mobile. Smartphone devices have become an important part of everyday life for billions of people around the globe. Thermal imaging cameras have been around for half a century and are now making their way into our daily lives. Originally built for military applications, thermal cameras are starting to be considered for personal use, enabling enhanced vision and temperature mapping for different groups of professional individuals. Through a revolutionary concept that turns smartphones into fully functional thermal cameras, we have explored how these two worlds can converge by utilizing the best of each technology. We will present the thought process, design considerations and outcome of our development process, resulting in a low-power, high resolution, lightweight USB thermal imaging device that turns Android smartphones into thermal cameras. We will discuss the technological challenges that we faced during the development of the product, and what are the system design decisions taken during the implementation. We will provide some insights we came across during this development process. Finally, we will discuss the opportunities that this innovative technology brings to the market.

  17. Implementation of an imaging spectrometer for localization and identification of radioactive sources

    NASA Astrophysics Data System (ADS)

    Lemaire, H.; Khalil, R. Abou; Amgarou, K.; Angélique, J.-C.; Bonnet, F.; De Toro, D.; Carrel, F.; Giarmana, O.; Gmar, M.; Menaa, N.; Menesguen, Y.; Normand, S.; Patoz, A.; Schoepff, V.; Talent, P.; Timi, T.

    2014-11-01

    Spatial localization of radioactive sources is currently a main issue interesting nuclear industry as well as homeland security applications and can be achieved using gamma cameras. For several years, CEA LIST has been designing a new system, called GAMPIX, with improved sensitivity, portability and ease of use. The main remaining limitation of this system is the lack of spectrometric information, preventing the identification of radioactive materials. This article describes the development of an imaging spectrometer based on the GAMPIX technology. Experimental tests have been carried out according to both spectrometric methods enabled by the pixelated Timepix chip used in the GAMPIX gamma camera. The first method is based on the size of the impacts produced by a gamma-ray energy deposition in the detection matrix. The second one uses the Time over Threshold (ToT) mode of the Timepix chip and deals with time spent by pulses generated by charge preamplifiers over a user-specified threshold. Both energy resolution and sensitivity studies demonstrated the superiority of the ToT approach which will consequently be further explored. Energy calibration, tests of different pixel sizes for the Timepix chip and use of the Medipix3 chip are future milestones to improve performances of the newly implemented imaging spectrometer.

  18. [Design and implementation of real-time processing platform for movement error correction of hyperspectrual imaging].

    PubMed

    Yu, Tao; Hu, Bing-liang; Gao, Xiao-hui; Wei, Ru-yi; Jing, Juan-juan

    2012-08-01

    The approach that deals with compressed and packed image data transmitted from satellite to the ground is too slow for real-time application occasion, it also has huge image, multi-processing step and complexity recovery arithmetic synchronously, so it is urgent to build accurate and fast data processing platform for real-time processing. For the moment, the platform for data recovery and error correction is much less, the so-called successful platform may directly affect the effect of target detection and identification because of processing speed, precision, flexibility, configuration and upgrade. The platform we build is to set spatial modulation spectrometer as the research goal, We design and implement a hardware platform based on Xilinx Virtex-5 FPGA, It is combined with ISE IP soft-core resources which is configurable, high-precision and flexible by focusing on analyzing key aspects of the hardware platform. And the relevant test data were drawn, then a good way for spectrum recovery and error correction was explored. PMID:23156797

  19. A travel report of the implementation of virtual whole slide images in routine surgical pathology.

    PubMed

    Nap, Marius; Teunissen, Rob; Pieters, Math

    2012-04-01

    Virtual microscopy is the terminology used to indicate the use of digitized images of whole slides for inspection of cells and tissue sections on computer screens as an add-on or replacement for conventional microscopy using bright field or other types of illumination in combination with a wide variety of microscope brands. Although technically there is no longer a limit in the size and colour composition of the images, the logistics of embedding virtual microscopy in daily routine of a diagnostic process are still a relatively open area where new pitfalls and opportunities can be found. In this article, we described various aspects in the process. None of them had been planned in advance, but mostly originated from observations done during the different steps towards implementation of virtual microscopy in daily routine, for example, the choice between the different scanner types and their (dis)advantages, issues on storing and retrieval and at last, the effect of digitalization on the diagnostic process. This approach resulted in a manuscript that in a way has more the appearance of a story than of a scientific study with strict protocols, with a clear cut question in advance, a research plan and expected outcome. Depending on the purpose of the virtual slides in a given situation, different solutions must be found locally. PMID:22429211

  20. A Guideline for Pedagogical Approaches to "Zai([image omitted])" and "You([image omitted])" in Mandarin Chinese for Thai University Students

    ERIC Educational Resources Information Center

    Petcherdchoo, Sasarux

    2009-01-01

    The purpose of the study is to provide a guideline for the pedagogical approaches to teach Thai students the grammar of the Chinese adverbs "zai" and "you". Questionnaire results revealed that the reasons for the misuse of "zai" and "you" by Thai university students can be classified into three causes: (1) "zai" and "you" suggest repeatedness and…

  1. Algorithms for builder guidelines

    SciTech Connect

    Balcomb, J.D.; Lekov, A.B.

    1989-06-01

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

  2. Rationale, design, and implementation protocol of the Dutch clinical practice guideline Pain in patients with cancer: a cluster randomised controlled trial with short message service (SMS) and interactive voice response (IVR)

    PubMed Central

    2011-01-01

    Background One-half of patients with cancer have pain. In nearly one out of two cancer patients with pain, this was undertreated. Inadequate pain control still remains an important problem in this group of patients. Therefore, in 2008 a national, evidence-based multidisciplinary clinical practice guideline 'pain in patients with cancer' has been developed. Yet, publishing a guideline is not enough. Implementation is needed to improve pain management. An innovative implementation strategy, Short Message Service with Interactive Voice Response (SVS-IVR), has been developed and pilot tested. This study aims to evaluate on effectiveness of this strategy to improve pain reporting, pain measurement and adequate pain therapy. In addition, whether the active role of the patient and involvement of caregivers in pain management may change. Methods/design A cluster randomised controlled trial with two arms will be performed in six oncology outpatient clinics of hospitals in the Southeastern region of the Netherlands, with three hospitals in the intervention and three in the control condition. Follow-up measurements will be conducted in all hospitals to study the long-term effect of the intervention. The intervention includes training of professionals (medical oncologists, nurses, and general practitioners) and SMS-IVR to report pain in patients with cancer to improve pain reporting by patients, pain management by medical oncologists, nurses, and general practitioners, and decrease pain intensity. Discussion This innovative implementation strategy with technical tools and the involvement of patients, may enhance the use of the guideline 'pain in patients with cancer' for pain management. Short Message Service alerts may serve as a tool to support self-management of patients. Therefore, the SMS-IVR intervention may increase the feeling of having control over one's life. Trail registration Netherlands Trial Register (NTR): NTR2739 PMID:22142327

  3. STS payloads mission control study continuation phase A-1. Volume 2-B: Task 2. Evaluation and refinement of implementation guidelines for the selected STS payload operator concept

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The functions of Payload Operations Control Centers (POCC) at JSC, GSFC, JPL, and non-NASA locations are analyzed to establish guidelines for standardization, and facilitate the development of a fully integrated NASA-wide system of ground facilities for all classes of payloads. Operational interfaces between the space transportation system operator and the payload operator elements are defined. The advantages and disadvantages of standardization are discussed.

  4. Implementation of real-time nonuniformity correction with multiple NUC tables using FPGA in an uncooled imaging system

    NASA Astrophysics Data System (ADS)

    Oh, Gyong Jin; Kim, Lyang-June; Sheen, Sue-Ho; Koo, Gyou-Phyo; Jin, Sang-Hun; Yeo, Bo-Yeon; Lee, Jong-Ho

    2009-05-01

    This paper presents a real time implementation of Non Uniformity Correction (NUC). Two point correction and one point correction with shutter were carried out in an uncooled imaging system which will be applied to a missile application. To design a small, light weight and high speed imaging system for a missile system, SoPC (System On a Programmable Chip) which comprises of FPGA and soft core (Micro-blaze) was used. Real time NUC and generation of control signals are implemented using FPGA. Also, three different NUC tables were made to make the operating time shorter and to reduce the power consumption in a large range of environment temperature. The imaging system consists of optics and four electronics boards which are detector interface board, Analog to Digital converter board, Detector signal generation board and Power supply board. To evaluate the imaging system, NETD was measured. The NETD was less than 160mK in three different environment temperatures.

  5. Implementation of wireless 3D stereo image capture system and 3D exaggeration algorithm for the region of interest

    NASA Astrophysics Data System (ADS)

    Ham, Woonchul; Song, Chulgyu; Lee, Kangsan; Badarch, Luubaatar

    2015-05-01

    In this paper, we introduce the mobile embedded system implemented for capturing stereo image based on two CMOS camera module. We use WinCE as an operating system and capture the stereo image by using device driver for CMOS camera interface and Direct Draw API functions. We aslo comments on the GPU hardware and CUDA programming for implementation of 3D exaggeraion algorithm for ROI by adjusting and synthesizing the disparity value of ROI (region of interest) in real time. We comment on the pattern of aperture for deblurring of CMOS camera module based on the Kirchhoff diffraction formula and clarify the reason why we can get more sharp and clear image by blocking some portion of aperture or geometric sampling. Synthesized stereo image is real time monitored on the shutter glass type three-dimensional LCD monitor and disparity values of each segment are analyzed to prove the validness of emphasizing effect of ROI.

  6. Research and implementation of the algorithm for unwrapped and distortion correction basing on CORDIC for panoramic image

    NASA Astrophysics Data System (ADS)

    Zhang, Zhenhai; Li, Kejie; Wu, Xiaobing; Zhang, Shujiang

    2008-03-01

    The unwrapped and correcting algorithm based on Coordinate Rotation Digital Computer (CORDIC) and bilinear interpolation algorithm was presented in this paper, with the purpose of processing dynamic panoramic annular image. An original annular panoramic image captured by panoramic annular lens (PAL) can be unwrapped and corrected to conventional rectangular image without distortion, which is much more coincident with people's vision. The algorithm for panoramic image processing is modeled by VHDL and implemented in FPGA. The experimental results show that the proposed panoramic image algorithm for unwrapped and distortion correction has the lower computation complexity and the architecture for dynamic panoramic image processing has lower hardware cost and power consumption. And the proposed algorithm is valid.

  7. [Infective endocarditis : New ESC guidelines 2015].

    PubMed

    Plicht, B; Lind, A; Erbel, R

    2016-07-01

    Infective endocarditis is an endovascular infection usually caused by bacteria. Mortality rate is still approximately 20 %. To improve patients' prognosis by implementation of current diagnostic and therapeutic evidence, the European Society of Cardiology published an updated version of the guidelines for management of infective endocarditis in 2015. It strengthens the role of imaging modalities like PET/CT for detection of infectious foci when echocardiography remains negative and highlights the use of modern tests for identification of possible pathogens. New diagnostic criteria were introduced to integrate these methods for improved diagnostic sensitivity. Complicated cases should be treated in reference centers with on-site cardiac surgery. The antibiotic and early surgical management should be discussed in a multidisciplinary endocarditis team. A few years ago, the indication for endocarditis prophylaxis was limited to high-risk patients. These recommendations were confirmed in current guidelines. PMID:27307162

  8. Design and implementation of Gm-APD array readout integrated circuit for infrared 3D imaging

    NASA Astrophysics Data System (ADS)

    Zheng, Li-xia; Yang, Jun-hao; Liu, Zhao; Dong, Huai-peng; Wu, Jin; Sun, Wei-feng

    2013-09-01

    A single-photon detecting array of readout integrated circuit (ROIC) capable of infrared 3D imaging by photon detection and time-of-flight measurement is presented in this paper. The InGaAs avalanche photon diodes (APD) dynamic biased under Geiger operation mode by gate controlled active quenching circuit (AQC) are used here. The time-of-flight is accurately measured by a high accurate time-to-digital converter (TDC) integrated in the ROIC. For 3D imaging, frame rate controlling technique is utilized to the pixel's detection, so that the APD related to each pixel should be controlled by individual AQC to sense and quench the avalanche current, providing a digital CMOS-compatible voltage pulse. After each first sense, the detector is reset to wait for next frame operation. We employ counters of a two-segmental coarse-fine architecture, where the coarse conversion is achieved by a 10-bit pseudo-random linear feedback shift register (LFSR) in each pixel and a 3-bit fine conversion is realized by a ring delay line shared by all pixels. The reference clock driving the LFSR counter can be generated within the ring delay line Oscillator or provided by an external clock source. The circuit is designed and implemented by CSMC 0.5μm standard CMOS technology and the total chip area is around 2mm×2mm for 8×8 format ROIC with 150μm pixel pitch. The simulation results indicate that the relative time resolution of the proposed ROIC can achieve less than 1ns, and the preliminary test results show that the circuit function is correct.

  9. Implementation and evaluation of simultaneous video-electroencephalography and functional magnetic resonance imaging.

    PubMed

    Chaudhary, Umair J; Kokkinos, Vasileios; Carmichael, David W; Rodionov, Roman; Gasston, David; Duncan, John S; Lemieux, Louis

    2010-10-01

    The objective of this study was to demonstrate that the addition of simultaneous and synchronised video to electroencephalography (EEG)-correlated functional magnetic resonance imaging (fMRI) could increase recorded information without data quality reduction. We investigated the effect of placing EEG, video equipment and their required power supplies inside the scanner room, on EEG, video and MRI data quality, and evaluated video-EEG-fMRI by modelling a hand motor task. Gradient-echo, echo-planner images (EPI) were acquired on a 3-T MRI scanner at variable camera positions in a test object [with and without radiofrequency (RF) excitation], and human subjects. EEG was recorded using a commercial MR-compatible 64-channel cap and amplifiers. Video recording was performed using a two-camera custom-made system with EEG synchronization. An in-house script was used to calculate signal to fluctuation noise ratio (SFNR) from EPI in test object with variable camera positions and in human subjects with and without concurrent video recording. Five subjects were investigated with video-EEG-fMRI while performing hand motor task. The fMRI time series data was analysed using statistical parametric mapping, by building block design general linear models which were paradigm prescribed and video based. Introduction of the cameras did not alter the SFNR significantly, nor did it show any signs of spike noise during RF off conditions. Video and EEG quality also did not show any significant artefact. The Statistical Parametric Mapping{T} maps from video based design revealed additional blood oxygen level-dependent responses in the expected locations for non-compliant subjects compared to the paradigm prescribed design. We conclude that video-EEG-fMRI set up can be implemented without affecting the data quality significantly and may provide valuable information on behaviour to enhance the analysis of fMRI data. PMID:20233646

  10. Minimally-Invasive, Image-Guided Cochlear Implantation Surgery: First report of clinical implementation

    PubMed Central

    Labadie, Robert F; Balachandran, Ramya; Noble, Jack H; Blachon, Grégoire S; Mitchell, Jason E; Reda, Fitsum A; Dawant, Benoit M; Fitzpatrick, J Michael

    2015-01-01

    OBJECTIVE Minimally-invasive image-guided approach to cochlear implantation (CI) involves drilling a narrow, linear tunnel to the cochlea. Reported herein is the first clinical implementation of this approach. STUDY DESIGN Prospective, cohort study. METHODS On preoperative CT, a safe linear trajectory through the facial recess targeting the scala tympani was planned. Intraoperatively, fiducial markers were bone-implanted, a second CT was acquired, and the trajectory was transferred from preoperative to intraoperative CT. A customized microstereotactic frame was rapidly designed and constructed to constrain a surgical drill along the desired trajectory. Following sterilization, the frame was employed to drill the tunnel to the middle ear. After lifting a tympanomeatal flap and performing a cochleostomy, the electrode array was threaded through the drilled tunnel and into the cochlea. RESULTS Eight of nine patients were successfully implanted using the proposed approach with six insertions completely within scala tympani. Traditional mastoidectomy was performed on one patient following difficulty threading the electrode array via the narrow tunnel. Other difficulties encountered included use of the back-up implant when an electrode was dislodged during threading via the tunnel, tip fold-over, and facial nerve paresis (House-Brackmann II/VII at 12 months) secondary to heat during drilling. Average time of intervention was 182±36 minutes. CONCLUSION Minimally-invasive, image-guided CI is clinically achievable. Further clinical study is necessary to address technological difficulties during drilling and insertion and to assess potential benefits including decreased time of intervention, standardization of surgical intervention, and decreased tissue dissection potentially leading to shorter recovery and earlier implant activation. PMID:24272427

  11. Automated routing of DICOM CT, MR, and CR images: solving the pitfalls of vendor-specific DICOM implementations.

    PubMed

    Junck, K L; McEachern, M; Grandhi, S; Lewey, G

    1998-08-01

    This paper details our experience in developing and implementing an automated DICOM Image Router. This workstation serves as a gateway between image acquisition devices and image display and storage devices. Images are checked for demographic input errors and data format inconsistencies between the source and destination devices. Based on the configured rules, and image may be held for manual correction and/or distributed to multiple locations. Distribution is based on easily configured environmental variables and rules files which may be changed as needed. For example, CT images are typically sent to the archive and to a radiologist's display workstation. If the patient came from the Emergency Department, a copy of the images are sent to a clinician display workstation located in the Emergency Department. If the patient has suffered trauma to the head, a copy of the images are sent to a display workstation in the Neurosurgery Department for possible consultation. The software was developed on a UNIX-based platform and utilizes a Fast Ethernet network. To date, images from a variety of devices have been acquired: General Electric HiSpeed CT/I scanner, General Electric Signa MRI scanner, Philips Thoravision Digital Chest unit, and Fuji AC-3CS Computed Radiography (CR) unit. Each device has presented new challenges in providing a uniform look to patient demographics in the PACS archive. The workstation also provides a buffer in the event of network outages, storing images for later transmission when the network and/or a workstation recover. PMID:9735450

  12. Guidelines for Project Management

    NASA Technical Reports Server (NTRS)

    Ben-Arieh, David

    2001-01-01

    Project management is an important part of the professional activities at Kennedy Space Center (KSC). Project management is the means by which many of the operations at KSC take shape. Moreover, projects at KSC are implemented in a variety of ways in different organizations. The official guidelines for project management are provided by NASA headquarters and are quite general. The project reported herein deals with developing practical and detailed project management guidelines in support of the project managers. This report summarizes the current project management effort in the Process Management Division and presents a new modeling approach of project management developed by the author. The report also presents the Project Management Guidelines developed during the summer.

  13. Implementing a prototyping network for injection moulded imaging lenses in Finland

    NASA Astrophysics Data System (ADS)

    Keränen, K.; Mäkinen, J.-T.; Pääkkönen, E. J.; Koponen, M.; Karttunen, M.; Hiltunen, J.; Karioja, P.

    2005-10-01

    A network for prototyping imaging lenses using injection moulding was established in Finland. The network consists of several academic and industrial partners capable of designing, processing and characterising imaging lenses produced by injection moulding technology. In order to validate the operation of the network a demonstrator lens was produced. The process steps included in the manufacturing were lens specification, designing and modelling, material selection, mould tooling, moulding process simulation, injection moulding and characterisation. A magnifying imaging singlet lens to be used as an add-on in a camera phone was selected as a demonstrator. The design of the add-on lens proved to be somewhat challenging, but a double aspheric singlet lens design fulfilling nearly the requirement specification was produced. In the material selection task the overall characteristics profile of polymethyl methacrylate (PMMA) material was seen to be the most fitting to the pilot case. It is a low cost material with good moulding properties and therefore it was selected as a material for the pilot lens. Lens mould design was performed using I-DEAS and tested by using MoldFlow 3D injection moulding simulation software. The simulations predicted the achievable lens quality in the processing, when using a two-cavity mould design. First cavity was tooled directly into the mould plate and the second cavity was made by tooling separate insert pieces for the mould. Mould material was steel and the inserts were made from Moldmax copper alloy. Parts were tooled with high speed milling machines. Insert pieces were hand polished after tooling. Prototype lenses were injection moulded using two PMMA grades, namely 6N and 7N. Different process parameters were also experimented in the injection moulding test runs. Prototypes were characterised by measuring mechanical dimensions, surface profile, roughness and MTF of the lenses. Characterisations showed that the lens surface RMS

  14. Implementation of the NHLBI Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Rationale and Study Design for Young Hearts, Strong Starts, a Cluster-Randomized Trial Targeting Body Mass Index, Blood Pressure, and Tobacco

    PubMed Central

    LaBresh, Kenneth A.; Lazorick, Suzanne; Ariza, Adolfo J.; Furberg, Robert D.; Whetstone, Lauren; Hobbs, Connie; de Jesus, Janet; Bender, Randall H.; Salinas, Ilse G.; Binns, Helen J.

    2014-01-01

    Background Cardiovascular disease (CVD) and the underlying atherosclerosis begin in childhood, and their presence and intensity are related to known cardiovascular disease risk factors. Attention to risk factor control in childhood has the potential to reduce subsequent risk of CVD. Objective The Young Hearts Strong Starts Study was designed to test strategies facilitating adoption of the National, Heart, Lung and Blood Institute supported Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. This study compares guideline-based quality measures for body mass index, blood pressure, and tobacco using two strategies: a multifaceted, practice-directed intervention versus standard dissemination. Study Design Two primary care research networks recruited practices and provided support for the intervention and outcome evaluations. Individual practices were randomly assigned to the intervention or control groups using a cluster randomized design based on network affiliation, number of clinicians per practice, urban versus nonurban location, and practice type. The units of observation are individual children because measure adherence is abstracted from individual patient’s medical records. The units of randomization are physician practices. This results in a multilevel design in which patients are nested within practices. The intervention practices received toolkits and supported guideline implementation including academic detailing, an ongoing e-learning group. This project is aligned with the American Board of Pediatrics Maintenance of Certification requirements including monthly physician self-abstraction, webinars, and other elements of the trial. Significance This trial will provide an opportunity to demonstrate tools and strategies to enhance CV prevention in children by guideline-based interventions. PMID:24295879

  15. On the behavior of instantaneous frequency estimators implemented on Doppler flow imagers.

    PubMed

    Nowicki, A; Reid, J; Pedersen, P C; Schmidt, A W; Oung, H

    1990-01-01

    Analytical and experimental results have been used to examine the behavior of the "autocorrelator" or instantaneous frequency detector (IFD) applied to color-coded Doppler flow mapping. Two effects were studied. The first was the influence of noise, as modified by a stationary echo canceler, on the Doppler frequency detector. Our theoretical considerations predict that uncorrelated input noise signals become partially correlated after cancellation, and bias the response to flow signals. This effect was confirmed by experiment. The canceler introduces a constant negative bias into the denominator of the algorithm implemented by the estimator, thus changing the indicated frequency. The second phenomenon, examined through processing computer simulated Doppler signals added to real noise, is related to the possible ambiguity, called aliasing, of measurements of the mean frequency for wide-band Doppler spectra. We show that aliasing cannot be observed with these spectra unless the signal is first processed by a canceler. Thus, regions of apparent reversed flow direction on two-dimensional flow images of turbulence must usually be due to real reversal of the flow direction. PMID:2238257

  16. Ultrasound Imaging System Implementation and Ignition Protocol for the Microgravity Smoldering Combustion (MSC) Experiments

    NASA Technical Reports Server (NTRS)

    Walther, David C.; Anthenien, Ralph A.; Roslon, Mark; Fernandez-Pello, A. Carlos; Urban, David L.

    1999-01-01

    The Microgravity Smoldering Combustion (MSC) experiment is a study of the smolder characteristics of porous combustible materials in a microgravity environment. The objective of the study is to provide a better understanding of the controlling mechanisms of smolder, both in microgravity and normal earth gravity. Experiments have been conducted aboard the NASA Space Shuttle in the Get Away Special Canister (GAS-CAN), an apparatus requiring completely remote operation. Future GAS-CAN experiments will utilize an ultrasound imaging system (UIS) which has been incorporated into the MSC experimental apparatus. Thermocouples are currently used to measure temperature and reaction front velocities. A less intrusive method is desirable, however, as smolder is a very weak reaction and it has been found that heat transfer along the thermocouple is sufficient to affect the smolder reaction. It is expected that the UIS system will eventually replace the existing array of thermocouples as a non-intrusive technique without compromising data acquisition. The UIS measures line of sight permeability, providing information about the reaction front position and extent. Additionally, the ignition sequence of the MSC experiments has been optimized from previous experiments to provide longer periods of self-supported smolder. An ignition protocol of a fixed power to the igniter for a fixed time is now implemented. This, rather than a controlled temperature profile ignition protocol at the igniter surface, along with the UIS system, will allow for better study of the effect of gravity on a smolder reaction.

  17. Evaluation of multifrequency range imaging technique implemented on the Chung-Li VHF atmospheric radar

    NASA Astrophysics Data System (ADS)

    Chen, Jenn-Shyong; Tsai, Shih-Chiao; Su, Ching-Lun; Chu, Yen-Hsyang

    2016-05-01

    The multifrequency range imaging technique (RIM) has been implemented on the Chung-Li VHF array radar since 2008 after its renovation. This study made a more complete examination and evaluation of the RIM technique to facilitate the performance of the radar for atmospheric studies. RIM experiments with various radar parameters such as pulse length, pulse shape, receiver bandwidth, transmitter frequency set, and so on were conducted. The radar data employed for the study were collected from 2008 to 2013. It has been shown that two factors, the range/time delay of the signal traveling in the media and the standard deviation of Gaussian-shaped range-weighting function, play crucial roles in ameliorating the RIM-produced brightness (or power distribution); the two factors are associated with some radar parameters and system characteristics. The range/time delay of the signal was found to increase with time; moreover, it was slightly different for the echoes from the atmosphere with and without the presence of significant precipitation. A procedure of point-by-point correction of range/time delay was thus executed for the presence of precipitation to minimize the bogus brightness discontinuity at range gate boundaries. With the RIM technique, the Chung-Li VHF radar demonstrates its first successful observation of double-layer structures as well as their temporal and spatial variations with time.

  18. Implementing a Pediatric Obesity Care Guideline in a Freestanding Children’s Hospital to Improve Child Safety and Hospital Preparedness1

    PubMed Central

    Porter, Renee M.; Thrasher, Jodi; Krebs, Nancy F.

    2013-01-01

    Medical and surgical care of children with severe obesity is complicated and requires recognition of the problem, appropriate equipment, and safe management. There is little literature describing patient, provider, and institutional needs for the severely obese pediatric patient. Nonetheless, the limited data suggest 3 broad categories of needs unique to this population: (a) airway management, (b) drug dosing and pharmacology, and (c) equipment and infrastructure. We describe an opportunity at the Children’s Hospital Colorado to better prepare and optimize care for this patient population by creation of a Pediatric Obesity Care Guideline that focused on key areas of quality and safety. PMID:22178030

  19. Compressed sensing reconstruction for whole-heart imaging with 3D radial trajectories: a graphics processing unit implementation.

    PubMed

    Nam, Seunghoon; Akçakaya, Mehmet; Basha, Tamer; Stehning, Christian; Manning, Warren J; Tarokh, Vahid; Nezafat, Reza

    2013-01-01

    A disadvantage of three-dimensional (3D) isotropic acquisition in whole-heart coronary MRI is the prolonged data acquisition time. Isotropic 3D radial trajectories allow undersampling of k-space data in all three spatial dimensions, enabling accelerated acquisition of the volumetric data. Compressed sensing (CS) reconstruction can provide further acceleration in the acquisition by removing the incoherent artifacts due to undersampling and improving the image quality. However, the heavy computational overhead of the CS reconstruction has been a limiting factor for its application. In this article, a parallelized implementation of an iterative CS reconstruction method for 3D radial acquisitions using a commercial graphics processing unit is presented. The execution time of the graphics processing unit-implemented CS reconstruction was compared with that of the C++ implementation, and the efficacy of the undersampled 3D radial acquisition with CS reconstruction was investigated in both phantom and whole-heart coronary data sets. Subsequently, the efficacy of CS in suppressing streaking artifacts in 3D whole-heart coronary MRI with 3D radial imaging and its convergence properties were studied. The CS reconstruction provides improved image quality (in terms of vessel sharpness and suppression of noise-like artifacts) compared with the conventional 3D gridding algorithm, and the graphics processing unit implementation greatly reduces the execution time of CS reconstruction yielding 34-54 times speed-up compared with C++ implementation. PMID:22392604

  20. Implementation of a real-time software-only image smoothing filter for a block-transform video codec

    NASA Astrophysics Data System (ADS)

    Miaw, Wesley F.; Rowe, Lawrence A.

    2003-05-01

    The JPEG compression standard is a popular image format. However, at high compression ratios JPEG compression, which uses block-transform coding, can produce blocking artifacts, or artificially introduced edges within the image. Several post-processing algorithms have been developed to remove these artifacts. This paper describes an implementation of a post-processing algorithm developed by Ramchandran, Chou, and Crouse (RCC) which is fast enough for real-time software-only video applications. The original implementation of the RCC algorithm involved calculating thresholds to identify artificial edges. These calculations proved too expensive for use in real-time software-only applications. We replaced these calculations with a linear scale approximating ideal threshold values based on a combination of peak signal-to-noise ratio calculations and subjective visual quality. The resulting filter implementation is available in the widely-deployed Open Mash streaming media toolkit.

  1. Radiology Preparedness in Ebola Virus Disease: Guidelines and Challenges for Disinfection of Medical Imaging Equipment for the Protection of Staff and Patients

    PubMed Central

    Palmore, Tara N.; Folio, Les R.; Bluemke, David A.

    2015-01-01

    The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. © RSNA, 2015 PMID:25654616

  2. Four patients with a history of acute exacerbations of COPD: implementing the CHEST/Canadian Thoracic Society guidelines for preventing exacerbations

    PubMed Central

    Tsiligianni, Ioanna; Goodridge, Donna; Marciniuk, Darcy; Hull, Sally; Bourbeau, Jean

    2015-01-01

    The American College of Chest Physicians and Canadian Thoracic Society have jointly produced evidence-based guidelines for the prevention of exacerbations in chronic obstructive pulmonary disease (COPD). This educational article gives four perspectives on how these guidelines apply to the practical management of people with COPD. A current smoker with frequent exacerbations will benefit from support to quit, and from optimisation of his inhaled treatment. For a man with very severe COPD and multiple co-morbidities living in a remote community, tele-health care may enable provision of multidisciplinary care. A woman who is admitted for the third time in a year needs a structured assessment of her care with a view to stepping up pharmacological and non-pharmacological treatment as required. The overlap between asthma and COPD challenges both diagnostic and management strategies for a lady smoker with a history of asthma since childhood. Common threads in all these cases are the importance of advising on smoking cessation, offering (and encouraging people to attend) pulmonary rehabilitation, and the importance of self-management, including an action plan supported by multidisciplinary teams. PMID:25950092

  3. Impact of Implementing the 2013 ACC/AHA Cholesterol Guidelines on Vascular Events in a Statewide Community-Based Practice Registry.

    PubMed

    Egan, Brent M; Li, Jiexiang; Fleming, Douglas O; White, Kellee; Connell, Kenneth; Davis, Robert A; Sinopoli, Angelo

    2016-07-01

    Electronic health record data were analyzed to estimate the number of statin-eligible adults with the 2013 American College of Cardiology/American Heart Association cholesterol guidelines not taking statin therapy and the impact of recommended statin therapy on 10-year atherosclerotic cardiovascular disease (ASCVD10 ) events. Adults aged 21 to 80 years in an outpatient network with ≥1 clinic visit(s) from January 2011 to June 2014 with data to calculate ASCVD10 were eligible. Moderate-intensity statin therapy was assumed to lower low-density lipoprotein cholesterol by 30% and high-intensity therapy was assumed to reduce low-density lipoprotein cholesterol by 50%. ASCVD events were assumed to decline 22% for each 39 mg/dL decline in low-density lipoprotein cholesterol. Among 411,768 adults, 260,434 (63.2%) were not taking statins and 103,478 (39.7%) were eligible for a statin, including 79,069 (76.4%) patients with hypertension. Estimated ASCVD10 events were 18,781 without and 13,328 with statin therapy, a 29.0% relative and 5.3% absolute risk reduction with a number needed to treat of 19. The 2013 cholesterol guidelines are a relatively efficient approach to reducing ASCVD in untreated, statin-eligible adults who often have concomitant hypertension. PMID:26606899

  4. Implementing ethics in the professions: preparing guidelines on scientific communication for the Society for Neuroscience. Commentary on 'Implementing ethics in the professions: examples from environmental epidemiology' (Soskolne and Sieswerda).

    PubMed

    Zigmond, Michael J

    2003-04-01

    In 1994, the governing council of the Society for Neuroscience was asked to make a brief statement on an issue regarding responsible conduct in publishing. The present article reviews how that initial request grew over the next four years into a lengthy document. Drawing on that experience, which was presided over by the author, comments are made about the potential impact of such guidelines, the lessons learned, and the proper role of professional societies in promoting responsible conduct in research. PMID:12774651

  5. Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification, Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

    SciTech Connect

    R. Fink, D. Hill, J. O'Hara

    2004-11-30

    Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.

  6. Real-time imaging implementation of the Army Research Laboratory synchronous impulse reconstruction radar on a graphics processing unit architecture

    NASA Astrophysics Data System (ADS)

    Park, Song Jun; Nguyen, Lam H.; Shires, Dale R.; Henz, Brian J.

    2009-05-01

    High computing requirements for the synchronous impulse reconstruction (SIRE) radar algorithm present a challenge for near real-time processing, particularly the calculations involved in output image formation. Forming an image requires a large number of parallel and independent floating-point computations. To reduce the processing time and exploit the abundant parallelism of image processing, a graphics processing unit (GPU) architecture is considered for the imaging algorithm. Widely available off the shelf, high-end GPUs offer inexpensive technology that exhibits great capacity of computing power in one card. To address the parallel nature of graphics processing, the GPU architecture is designed for high computational throughput realized through multiple computing resources to target data parallel applications. Due to a leveled or in some cases reduced clock frequency in mainstream single and multi-core general-purpose central processing units (CPUs), GPU computing is becoming a competitive option for compute-intensive radar imaging algorithm prototyping. We describe the translation and implementation of the SIRE radar backprojection image formation algorithm on a GPU platform. The programming model for GPU's parallel computing and hardware-specific memory optimizations are discussed in the paper. A considerable level of speedup is available from the GPU implementation resulting in processing at real-time acquisition speeds.

  7. Design and implementation of a calibrated hyperspectral small-animal imager: Practical and theoretical aspects of system optimization

    NASA Astrophysics Data System (ADS)

    Leavesley, Silas Josiah

    Pre-clinical imaging has been an important development within the bioscience and pharmacology fields. A rapidly growing area within these fields is small animal fluorescence imaging, in which molecularly targeted fluorescent probes are used to non-invasively image internal events on a gross anatomical scale. Small-animal fluorescence imaging has transitioned from a research technique to pre-clinical technology very quickly, due to its molecular specificity, low cost, and relative ease of use. In addition, its potential uses in gene therapy and as a translational technology are becoming evident. This thesis outlines the development of an alternative modality for small animal/tissue imaging, using hyperspectral techniques to enable the collection of fluorescence images at different excitation and emission wavelengths. In specific, acousto-optical tunable filters (AOTFs) were used to construct emission-wavelength-scanning and excitation-wavelength-scanning small animal fluorescence imagers. Statistical, classification, and unmixing algorithms have been employed to extract specific fluorescent-dye information from hyperspectral image sets. In this work, we have designed and implemented hyperspectral imaging and analysis techniques to remove background autofluorescence from the desired fluorescence signal, resulting in highly specific and localized fluorescence. Therefore, in practice, it is possible to more accurately pin-point the location and size of diagnostic anatomical markers (e.g. tumors) labeled with fluorescent probes. Furthermore, multiple probes can be individually distinguished. In addition to imaging hardware and acquisition and analysis software, we have designed an optical tissue phantom for quality control and inter-system comparison. The phantom has been modeled using Monte Carlo techniques. The culmination of this work results in an understanding of the advantages and complexities in applying hyperspectral techniques to small animal fluorescence

  8. Development and implementation of a secure, integrated management system for medical images and electronic clinical records for small hospitals.

    PubMed

    Pereira, Javier; Castro, Antonio F; Perez, Juan L; Novoa, Francisco J; Vázquez, Jose M; Teijeiro, Jorge; Pazos, Alejandro; Ezquerra, Norberto

    2007-06-01

    The field of Medical Informatics is currently experiencing increasing demands for new models of the Picture Archiving and Communication Systems (PACS) and Digital Imaging and Communications in Medicine (DICOM) protocols. Despite of the considerable advantages of current systems, implementation in hospitals is remarkably slow, due primarily to difficulties in integration and relatively high costs. Even though the success of DICOM standards has greatly contributed to the development of PACS, many hospitals remain unable to support it or to make full use of its potential because various imaging modalities in use at these sites generate images that cannot be stored in the PACS and cannot be managed in a centralized manner without DICOM standardization modules. Furthermore, the imaging modalities being used in such smaller centers are expensive and unlikely to be replaced, making DICOM compliance untenable. With this in mind, this paper describes the design, development, and implementation of a management system for medical diagnostic imaging, based on the DICOM standard and adapted to the needs of a small hospital. The system is currently being implemented in the San Rafael Hospital at A Coruna in Spain, and integrated with the existing hospital information system (HIS). We have studied the networking infrastructure of the hospital and its available image generation devices, and have subsequently carried out a series of measurements including transmission times, image file size, compression ratios, and many others that allow us to analyze the behavior of the system. Results obtained from these investigations demonstrate both the flexibility of using such a "small-hospital" DICOM-based framework as well as the relative cost-effectiveness of the system. In this regard, the approach, described herein, might serve as a model for other small, and possibly mid-sized, medical centers. PMID:17603833

  9. Architecture, development and implementation of a SWIR to visible integrated up-conversion imaging device

    NASA Astrophysics Data System (ADS)

    Sarusi, Gabby; Templeman, Tzvi; Hechster, Elad; Nissim, Nimrod; Vitenberg, Vladimir; Maman, Nitzan; Tal, Amir; Solodar, Assi; Makov, Guy; Abdulhalim, Ibrahim; Visoly-Fisher, Iris; Golan, Yuval

    2016-04-01

    A new concept of short wavelength infrared (SWIR) to visible upconversion integrated imaging device is proposed, modeled and some initial measured results are presented. The device is a hybrid inorganic-organic device that comprises six nano-metric scale sub-layers grown on n-type GaAs substrates. The first layer is a ~300nm thick PbSe nano-columnar absorber layer grown in (111) orientation to the substrate plan (100), with a diameter of 8- 10nm and therefore exhibit quantum confinement effects parallel to the substrate and bulk properties perpendicular to it. The advantage of this structure is the high oscillator strength and hence absorption to incoming SWIR photons while maintaining the high bulk mobility of photo-excited charges along the columns. The top of the PbSe absorber layer is coated with 20nm thick metal layer that serves as a dual sided mirror, as well as a potentially surface plasmon enhanced absorption in the PbSe nano-columns layer. The photo-excited charges (holes and electrons in opposite directions) are drifted under an external applied field to the OLED section (that is composed of a hole transport layer, an emission layer and an electron transport layer) where they recombine with injected electron from the transparent cathode and emit visible light through this cathode. Due to the high absorption and enhanced transport properties this architecture has the potential of high quantum efficiency, low cost and easy implementation in any optical system. As a bench-mark, alternative concept where InGaAs/InP heterojunction couple to liquid crystal optical spatial light modulator (OSLM) structure was built that shows a full upconversion to visible of 1550nm laser light.

  10. Parallel implementation of linear and nonlinear spectral unmixing of remotely sensed hyperspectral images

    NASA Astrophysics Data System (ADS)

    Plaza, Antonio; Plaza, Javier

    2011-11-01

    Hyperspectral unmixing is a very important task for remotely sensed hyperspectral data exploitation. It addresses the (possibly) mixed nature of pixels collected by instruments for Earth observation, which are due to several phenomena including limited spatial resolution, presence of mixing effects at different scales, etc. Spectral unmixing involves the separation of a mixed pixel spectrum into its pure component spectra (called endmembers) and the estimation of the proportion (abundance) of endmember in the pixel. Two models have been widely used in the literature in order to address the mixture problem in hyperspectral data. The linear model assumes that the endmember substances are sitting side-by-side within the field of view of the imaging instrument. On the other hand, the nonlinear mixture model assumes nonlinear interactions between endmember substances. Both techniques can be computationally expensive, in particular, for high-dimensional hyperspectral data sets. In this paper, we develop and compare parallel implementations of linear and nonlinear unmixing techniques for remotely sensed hyperspectral data. For the linear model, we adopt a parallel unsupervised processing chain made up of two steps: i) identification of pure spectral materials or endmembers, and ii) estimation of the abundance of each endmember in each pixel of the scene. For the nonlinear model, we adopt a supervised procedure based on the training of a parallel multi-layer perceptron neural network using intelligently selected training samples also derived in parallel fashion. The compared techniques are experimentally validated using hyperspectral data collected at different altitudes over a so-called Dehesa (semi-arid environment) in Extremadura, Spain, and evaluated in terms of computational performance using high performance computing systems such as commodity Beowulf clusters.

  11. The implementation of a guideline of care for patients with a Sengstaken-Blakemore tube in situ in a general intensive care unit using transitional change theory.

    PubMed

    Christensen, Teresa; Christensen, Martin

    2007-08-01

    The use of the Sengstaken-Blakemore tube as a life-saving treatment for bleeding oesophageal varices is slowly becoming the least preferred method possibly due to the potential complications associated with its placement. Nursing practice pertaining to the care of this patient group appears ad hoc and reliant on local knowledge and experience as opposed to recognised evidence of best practice. Therefore, this paper focuses on the application of Lewin's transitional change theory used to introduce a change in nursing practice with the application of a guideline to enhance the care of patients with a Sengstaken-Blakemore tube in situ within a general intensive care unit. This method identified some of the complexities surrounding the change process including the driving and restraining forces that must be harnessed and minimised in order for the adoption of change to be successful. PMID:17434309

  12. Better adherence to pre-antiretroviral therapy guidelines after implementing an electronic medical record system in rural Kenyan HIV clinics: a multicenter pre–post study☆

    PubMed Central

    Oluoch, Tom; Kwaro, Daniel; Ssempijja, Victor; Katana, Abraham; Langat, Patrick; Okeyo, Nicky; Abu-Hanna, Ameen; de Keizer, Nicolette

    2016-01-01

    SUMMARY Introduction The monitoring of pre-antiretroviral therapy (pre-ART) is a key indicator of HIV quality of care. This study investigated the association of an electronic medical record system (EMR) with adherence to pre-ART guidelines in rural HIV clinics in Kenya. Methods A retrospective study was carried out to assess the quality of pre-ART care using three indicators: (1) the performance of a baseline CD4 test, (2) time from enrollment in care to first CD4 test, and (3) time from baseline CD4 to second CD4 test. A comparison of these indicators was made pre and post the introduction of an EMR system in 17 rural HIV clinics. Results A total of 18 523 patients were receiving pre-ART care, of whom 38.8% in the paper group had had at least one CD4 test compared to 53.4% in the EMR group (p < 0.001). The adjusted odds of performing a CD4 test in clinics using an EMR was 1.59 (95% confidence interval 1.49–1.69). The median time from enrolment into HIV care to first CD4 test was 1.40 months (interquartile range (IQR) 0.47–4.87) for paper vs. 0.93 months (IQR 0.43–3.37) for EMR. The median time from baseline to first CD4 follow-up was 7.5 months (IQR 5.97–10.73) for paper and 6.53 months (IQR 5.57–7.87) for EMR. Conclusion The use of the EMR system was associated with better compliance to HIV guidelines for pre-ART care. EMRs have a potential positive impact on quality of care for HIV patients in resource-constrained settings. PMID:25281905

  13. Implementation of World Health Organization Integrated Management of Childhood Illnesses (IMCI) Guidelines for the Assessment of Pneumonia in the Under 5s in Rural Malawi.

    PubMed

    Kalu, Ngozi; Lufesi, Norman; Havens, Deborah; Mortimer, Kevin

    2016-01-01

    The Cooking and Pneumonia Study (CAPS) is a pragmatic cluster-level randomized controlled trial of the effect of an advanced cookstove intervention on pneumonia in children under the age of 5 years (under 5s) in Malawi (www.capstudy.org). The primary outcome of the trial is the incidence of pneumonia during a two-year follow-up period, as diagnosed by healthcare providers who are using the World Health Organization (WHO) integrated management of childhood illnesses (IMCI) pneumonia assessment protocol and who are blinded to the trial arms. We evaluated the quality of pneumonia assessment in under 5s in this setting via a cross-sectional study of provider-patient encounters at nine outpatient clinics located within the catchment area of 150 village-level clusters enrolled in the trial across the two study locations of Chikhwawa and Karonga, Malawi, between May and June 2015 using the IMCI guidelines as a benchmark. Data were collected using a key equipment checklist, an IMCI pneumonia knowledge test, and a clinical evaluation checklist. The median number of key equipment items available was 6 (range 4 to 7) out of a possible 7. The median score on the IMCI pneumonia knowledge test among 23 clinicians was 75% (range 60% to 89%). Among a total of 176 consultations performed by 15 clinicians, a median of 9 (range 3 to 13) out of 13 clinical evaluation tasks were performed. Overall, the clinicians were adequately equipped for the assessment of sick children, had good knowledge of the IMCI guidelines, and conducted largely thorough clinical evaluations. We recommend the simple pragmatic approach to quality assurance described herein for similar studies conducted in challenging research settings. PMID:27187773

  14. Implementation of World Health Organization Integrated Management of Childhood Illnesses (IMCI) Guidelines for the Assessment of Pneumonia in the Under 5s in Rural Malawi

    PubMed Central

    Kalu, Ngozi; Lufesi, Norman; Havens, Deborah; Mortimer, Kevin

    2016-01-01

    The Cooking and Pneumonia Study (CAPS) is a pragmatic cluster-level randomized controlled trial of the effect of an advanced cookstove intervention on pneumonia in children under the age of 5 years (under 5s) in Malawi (www.capstudy.org). The primary outcome of the trial is the incidence of pneumonia during a two-year follow-up period, as diagnosed by healthcare providers who are using the World Health Organization (WHO) integrated management of childhood illnesses (IMCI) pneumonia assessment protocol and who are blinded to the trial arms. We evaluated the quality of pneumonia assessment in under 5s in this setting via a cross-sectional study of provider-patient encounters at nine outpatient clinics located within the catchment area of 150 village-level clusters enrolled in the trial across the two study locations of Chikhwawa and Karonga, Malawi, between May and June 2015 using the IMCI guidelines as a benchmark. Data were collected using a key equipment checklist, an IMCI pneumonia knowledge test, and a clinical evaluation checklist. The median number of key equipment items available was 6 (range 4 to 7) out of a possible 7. The median score on the IMCI pneumonia knowledge test among 23 clinicians was 75% (range 60% to 89%). Among a total of 176 consultations performed by 15 clinicians, a median of 9 (range 3 to 13) out of 13 clinical evaluation tasks were performed. Overall, the clinicians were adequately equipped for the assessment of sick children, had good knowledge of the IMCI guidelines, and conducted largely thorough clinical evaluations. We recommend the simple pragmatic approach to quality assurance described herein for similar studies conducted in challenging research settings. PMID:27187773

  15. Agent-based computational model of the prevalence of gonococcal infections after the implementation of HIV pre-exposure prophylaxis guidelines.

    PubMed

    Escobar, Erik; Durgham, Ryan; Dammann, Olaf; Stopka, Thomas J

    2015-01-01

    Recently, the first comprehensive guidelines were published for pre-exposure prophylaxis (PrEP) for the prevention of HIV infection in populations with substantial risk of infection. Guidelines include a daily regimen of emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as well as condom usage during sexual activity. The relationship between the TDF/FTC intake regimen and condom usage is not yet fully understood. If men who have sex with men (MSM,) engage in high-risk sexual activities without using condoms when prescribed TDF/FTC they might be at an increased risk for other sexually transmitted diseases (STD). Our study focuses on the possible occurrence of behavioral changes among MSM in the United States over time with regard to condom usage. In particular, we were interested in creating a model of how increased uptake of TDF/FTC might cause a decline in condom usage, causing significant increases in non-HIV STD incidence, using gonococcal infection incidence as a biological endpoint. We used the agent-based modeling software NetLogo, building upon an existing model of HIV infection. We found no significant evidence for increased gonorrhea prevalence due to increased PrEP usage at any level of sample-wide usage, with a range of 0-90% PrEP usage. However, we did find significant evidence for decreased prevalence of HIV, with a maximal effect being reached when 5% to 10% of the MSM population used PrEP. Our findings appear to indicate that attitudes of aversion, within the medical community, toward the promotion of PrEP due to the potential risk of increased STD transmission are unfounded. PMID:26834937

  16. COASTAL GUIDELINES

    EPA Science Inventory

    Resource Purpose:Developed to support effluent guidelines for the coastal subcategory of the oil and gas extraction industry. Data were used to develop environmental impacts, potential regulatory limits, and the cost of regulation.
    Legislation/Enabling Authority:...

  17. Design, implementation and investigation of an image guide-based optical flip-flop array

    NASA Technical Reports Server (NTRS)

    Griffith, P. C.

    1987-01-01

    Presented is the design for an image guide-based optical flip-flop array created using a Hughes liquid crystal light valve and a flexible image guide in a feedback loop. This design is used to investigate the application of image guides as a communication mechanism in numerical optical computers. It is shown that image guides can be used successfully in this manner but mismatch match between the input and output fiber arrays is extremely limiting.

  18. PCI bus content-addressable-memory (CAM) implementation on FPGA for pattern recognition/image retrieval in a distributed environment

    NASA Astrophysics Data System (ADS)

    Megherbi, Dalila B.; Yan, Yin; Tanmay, Parikh; Khoury, Jed; Woods, C. L.

    2004-11-01

    Recently surveillance and Automatic Target Recognition (ATR) applications are increasing as the cost of computing power needed to process the massive amount of information continues to fall. This computing power has been made possible partly by the latest advances in FPGAs and SOPCs. In particular, to design and implement state-of-the-Art electro-optical imaging systems to provide advanced surveillance capabilities, there is a need to integrate several technologies (e.g. telescope, precise optics, cameras, image/compute vision algorithms, which can be geographically distributed or sharing distributed resources) into a programmable system and DSP systems. Additionally, pattern recognition techniques and fast information retrieval, are often important components of intelligent systems. The aim of this work is using embedded FPGA as a fast, configurable and synthesizable search engine in fast image pattern recognition/retrieval in a distributed hardware/software co-design environment. In particular, we propose and show a low cost Content Addressable Memory (CAM)-based distributed embedded FPGA hardware architecture solution with real time recognition capabilities and computing for pattern look-up, pattern recognition, and image retrieval. We show how the distributed CAM-based architecture offers a performance advantage of an order-of-magnitude over RAM-based architecture (Random Access Memory) search for implementing high speed pattern recognition for image retrieval. The methods of designing, implementing, and analyzing the proposed CAM based embedded architecture are described here. Other SOPC solutions/design issues are covered. Finally, experimental results, hardware verification, and performance evaluations using both the Xilinx Virtex-II and the Altera Apex20k are provided to show the potential and power of the proposed method for low cost reconfigurable fast image pattern recognition/retrieval at the hardware/software co-design level.

  19. Laboratory implementation of edge illumination X-ray phase-contrast imaging with energy-resolved detectors

    NASA Astrophysics Data System (ADS)

    Diemoz, P. C.; Endrizzi, M.; Vittoria, F. A.; Hagen, C. K.; Kallon, G.; Basta, D.; Marenzana, M.; Delogu, P.; Vincenzi, A.; De Ruvo, L.; Spandre, G.; Brez, A.; Bellazzini, R.; Olivo, A.

    2015-03-01

    Edge illumination (EI) X-ray phase-contrast imaging (XPCI) has potential for applications in different fields of research, including materials science, non-destructive industrial testing, small-animal imaging, and medical imaging. One of its main advantages is the compatibility with laboratory equipment, in particular with conventional non-microfocal sources, which makes its exploitation in normal research laboratories possible. In this work, we demonstrate that the signal in laboratory implementations of EI can be correctly described with the use of the simplified geometrical optics. Besides enabling the derivation of simple expressions for the sensitivity and spatial resolution of a given EI setup, this model also highlights the EI's achromaticity. With the aim of improving image quality, as well as to take advantage of the fact that all energies in the spectrum contribute to the image contrast, we carried out EI acquisitions using a photon-counting energy-resolved detector. The obtained results demonstrate that this approach has great potential for future laboratory implementations of EI.

  20. The x-ray light valve: A potentially low-cost, digital radiographic imaging system-concept and implementation considerations

    SciTech Connect

    Webster, Christie Ann; Koprinarov, Ivaylo; Germann, Stephen; Rowlands, J. A.

    2008-03-15

    New x-ray radiographic systems based on large-area flat-panel technology have revolutionized our capability to produce digital x-ray images. However, these imagers are extraordinarily expensive compared to the systems they are replacing. Hence, there is a need for a low-cost digital imaging system for general applications in radiology. A novel potentially low-cost radiographic imaging system based on established technologies is proposed--the X-Ray Light Valve (XLV). This is a potentially high-quality digital x-ray detector made of a photoconducting layer and a liquid-crystal cell, physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected on the surface of the photoconductor. This causes a change in the optical properties of the liquid-crystal cell and a visible image is generated. Subsequently, it is digitized by a scanned optical imager. The image formation is based on controlled modulation of light from an external source. The operation and practical implementation of the XLV system are described. The potential performance of the complete system and issues related to sensitivity, spatial resolution, noise, and speed are discussed. The feasibility of clinical use of an XLV device based on amorphous selenium (a-Se) as the photoconductor and a reflective electrically controlled birefringence cell is analyzed. The results of our analysis indicate that the XLV can potentially be adapted to a wide variety of radiographic tasks.

  1. Implementation and evaluation of ILLIAC 4 algorithms for multispectral image processing

    NASA Technical Reports Server (NTRS)

    Swain, P. H.

    1974-01-01

    Data concerning a multidisciplinary and multi-organizational effort to implement multispectral data analysis algorithms on a revolutionary computer, the Illiac 4, are reported. The effectiveness and efficiency of implementing the digital multispectral data analysis techniques for producing useful land use classifications from satellite collected data were demonstrated.

  2. Feasibility and Implementation of a Literature Information Management System for Human Papillomavirus in Head and Neck Cancers with Imaging

    PubMed Central

    Wu, Dee H; Matthiesen, Chance L; Alleman, Anthony M; Fournier, Aaron L; Gunter, Tyler C

    2014-01-01

    This work examines the feasibility and implementation of information service-orientated architecture (ISOA) on an emergent literature domain of human papillomavirus, head and neck cancer, and imaging. From this work, we examine the impact of cancer informatics and generate a full set of summarizing clinical pearls. Additionally, we describe how such an ISOA creates potential benefits in informatics education, enhancing utility for creating enduring digital content in this clinical domain. PMID:25392683

  3. Equivalence of Gyn GEC-ESTRO guidelines for image guided cervical brachytherapy with EUD-based dose prescription

    PubMed Central

    2013-01-01

    Background To establish a generalized equivalent uniform dose (gEUD) -based prescription method for Image Guided Brachytherapy (IGBT) that reproduces the Gyn GEC-ESTRO WG (GGE) prescription for cervix carcinoma patients on CT images with limited soft tissue resolution. Methods The equivalence of two IGBT planning approaches was investigated in 20 patients who received external beam radiotherapy (EBT) and 5 concomitant high dose rate IGBT treatments. The GGE planning strategy based on dose to the most exposed 2 cm3 (D2cc) was used to derive criteria for the gEUD-based planning of the bladder and rectum. The safety of gEUD constraints in terms of GGE criteria was tested by maximizing dose to the gEUD constraints for individual fractions. Results The gEUD constraints of 3.55 Gy for the rectum and 5.19 Gy for the bladder were derived. Rectum and bladder gEUD-maximized plans resulted in D2cc averages very similar to the initial GGE criteria. Average D2ccs and EUDs from the full treatment course were comparable for the two techniques within both sets of normal tissue constraints. The same was found for the tumor doses. Conclusions The derived gEUD criteria for normal organs result in GGE-equivalent IGBT treatment plans. The gEUD-based planning considers the entire dose distribution of organs in contrast to a single dose-volume-histogram point. PMID:24225184

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

    PubMed Central

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

    2014-01-01

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

  5. The design and implementation of image query system based on color feature

    NASA Astrophysics Data System (ADS)

    Yao, Xu-Dong; Jia, Da-Chun; Li, Lin

    2013-07-01

    ASP.NET technology was used to construct the B/S mode image query system. The theory and technology of database design, color feature extraction from image, index and retrieval in the construction of the image repository were researched. The campus LAN and WAN environment were used to test the system. From the test results, the needs of user queries about related resources were achieved by system architecture design.

  6. Supporting tools for guideline development and dissemination.

    PubMed

    Quaglini, S; Dazzi, L; Gatti, L; Stefanelli, M; Fassino, C; Tondini, C

    1998-01-01

    This paper describes a methodology for representing clinical practice guidelines and facilitating their introduction into the medical routine. Since this methodology can be exploited in a www environment, it can represent the basis for sharing clinical guidelines both between different institutions and between human and software agents cooperating within a clinical context. In addition, the proposed guideline formalization is intended to deal with patient and organization preferences. This goal is achieved by augmenting the guideline with decision analytic models and by linking the guideline with an organizational model of the clinical setting. The designed framework allows guideline development, tailoring and implementation, real-time access to the guideline prescriptions and guideline validation. PMID:9779886

  7. Design and Implementation of a Compact Low-Dose Diffraction Enhanced Medical Imaging System

    SciTech Connect

    Parham, C.; Zhong, Z; Connor, D; Chapman, D; Pisano, E

    2009-01-01

    This paper describes the design, construction, and performance of a new DEI system using a commercially available tungsten anode x-ray tube and includes the first high-quality low-dose diffraction-enhanced images of full-thickness human tissue specimens. Diffraction-enhanced imaging (DEI) is a new x-ray imaging modality that differs from conventional radiography in its use of three physical mechanisms to generate contrast. DEI is able to generate contrast from x-ray absorption, refraction, and ultra-small-angle scatter rejection (extinction) to produce high-contrast images with a much lower radiation dose compared to conventional radiography.

  8. Implementation and assessment of an animal management system for small-animal micro-CT / micro-SPECT imaging

    NASA Astrophysics Data System (ADS)

    Holdsworth, David W.; Detombe, Sarah A.; Chiodo, Chris; Fricke, Stanley T.; Drangova, Maria

    2011-03-01

    Advances in laboratory imaging systems for CT, SPECT, MRI, and PET facilitate routine micro-imaging during pre-clinical investigations. Challenges still arise when dealing with immune-compromised animals, biohazardous agents, and multi-modality imaging. These challenges can be overcome with an appropriate animal management system (AMS), with the capability for supporting and monitoring a rat or mouse during micro-imaging. We report the implementation and assessment of a new AMS system for mice (PRA-3000 / AHS-2750, ASI Instruments, Warren MI), designed to be compatible with a commercial micro-CT / micro-SPECT imaging system (eXplore speCZT, GE Healthcare, London ON). The AMS was assessed under the following criteria: 1) compatibility with the imaging system (i.e. artifact generation, geometric dimensions); 2) compatibility with live animals (i.e. positioning, temperature regulation, anesthetic supply); 3) monitoring capabilities (i.e. rectal temperature, respiratory and cardiac monitoring); 4) stability of co-registration; and 5) containment. Micro-CT scans performed using a standardized live-animal protocol (90 kVp, 40 mA, 900 views, 16 ms per view) exhibited low noise (+/-19 HU) and acceptable artifact from high-density components within the AMS (e.g. ECG pad contacts). Live mice were imaged repeatedly (with removal and replacement of the AMS) and spatial registration was found to be stable to within +/-0.07 mm. All animals tolerated enclosure within the AMS for extended periods (i.e. > one hour) without distress, based on continuous recordings of rectal temperature, ECG waveform and respiratory rate. A sealed AMS system extends the capability of a conventional micro-imaging system to include immune-compromised and biosafety level 2 mouse-imaging protocols.

  9. Design and implementation of control system for range-gated underwater laser imaging

    NASA Astrophysics Data System (ADS)

    Ge, Wei-long; Zhang, Xiao-hui; Han, Hong-wei; Hua, Liang-hong

    2012-01-01

    There is currently considerable in developing underwater target detection, the underwater imaging system can be divided into active imaging system and passive system. The main feature of the active imaging system is that they use light sources to illuminate the targets and collect the reflection from targets. The advantages of active imaging system over passive imaging systems are high contrast and without the affection of environment sources. In this article, a range-gated underwater laser imaging system is built, which consists of laser illumination system, photoelectric imaging system and control system. The laser illumination system includes a light-pumped solid state doubled ND-YAG laser(532nm) which laser power and frequency can be adjusted and an optics expanding system of variable ratio. The photoelectric imaging system includes a gated Intensified CCD(ICCD) cameras which ICCD scheduling, gate width, delay time and gain can be adjusted and a optics received system of variable ratio. In order to acquire effectual target image using range-gated underwater laser imaging system, appropriate control parameters that include laser power and frequency, ICCD scheduling, gate width, delay time and gain, optics expanding system ratio and optics received system ratio must be given accurately. A control system which used C8051F320 and C8051F040 (MCU) as the core is designed, the control system can effectively control seven parameters that given above. The construction of software and hardware of the control system is introduced. And target image of underwater distance 25 m and 40m is given, Experimental results showed that the control system has high control precision, safe and stable operation and good speed adjusting performance can be achieved. It can be satisfied to apply to underwater target detection.

  10. Design and implementation of control system for range-gated underwater laser imaging

    NASA Astrophysics Data System (ADS)

    Ge, Wei-Long; Zhang, Xiao-Hui; Han, Hong-Wei; Hua, Liang-Hong

    2011-11-01

    There is currently considerable in developing underwater target detection, the underwater imaging system can be divided into active imaging system and passive system. The main feature of the active imaging system is that they use light sources to illuminate the targets and collect the reflection from targets. The advantages of active imaging system over passive imaging systems are high contrast and without the affection of environment sources. In this article, a range-gated underwater laser imaging system is built, which consists of laser illumination system, photoelectric imaging system and control system. The laser illumination system includes a light-pumped solid state doubled ND-YAG laser(532nm) which laser power and frequency can be adjusted and an optics expanding system of variable ratio. The photoelectric imaging system includes a gated Intensified CCD(ICCD) cameras which ICCD scheduling, gate width, delay time and gain can be adjusted and a optics received system of variable ratio. In order to acquire effectual target image using range-gated underwater laser imaging system, appropriate control parameters that include laser power and frequency, ICCD scheduling, gate width, delay time and gain, optics expanding system ratio and optics received system ratio must be given accurately. A control system which used C8051F320 and C8051F040 (MCU) as the core is designed, the control system can effectively control seven parameters that given above. The construction of software and hardware of the control system is introduced. And target image of underwater distance 25 m and 40m is given, Experimental results showed that the control system has high control precision, safe and stable operation and good speed adjusting performance can be achieved. It can be satisfied to apply to underwater target detection.

  11. Real-time imaging with radial GRAPPA: Implementation on a Heterogeneous Architecture for Low-Latency Reconstructions

    PubMed Central

    Saybasili, Haris; Herzka, Daniel A.; Seiberlich, Nicole; A.Griswold, Mark

    2014-01-01

    Combination of non-Cartesian trajectories with parallel MRI permits to attain unmatched acceleration rates when compared to traditional Cartesian MRI during real-time imaging.However, computationally demanding reconstructions of such imaging techniques, such as k-space domain radial generalized auto-calibrating partially parallel acquisitions (radial GRAPPA) and image domain conjugate gradient sensitivity encoding (CG-SENSE), lead to longer reconstruction times and unacceptable latency for online real-time MRI on conventional computational hardware. Though CG-SENSE has been shown to work with low-latency using a general purpose graphics processing unit (GPU), to the best of our knowledge, no such effort has been made for radial GRAPPA. radial GRAPPA reconstruction, which is robust even with highly undersampled acquisitions, is not iterative, requiring only significant computation during initial calibration while achieving good image quality for low-latency imaging applications. In this work, we present a very fast, low-latency, reconstruction framework based on a heterogeneous system using multi-core CPUs and GPUs. We demonstrate an implementation of radial GRAPPA that permits reconstruction times on par with or faster than acquisition of highly accelerated datasets in both cardiac and dynamic musculoskeletal imaging scenarios. Acquisition and reconstructions times are reported. PMID:24690453

  12. A Methodology and Implementation for Annotating Digital Images for Context-appropriate Use in an Academic Health Care Environment

    PubMed Central

    Goede, Patricia A.; Lauman, Jason R.; Cochella, Christopher; Katzman, Gregory L.; Morton, David A.; Albertine, Kurt H.

    2004-01-01

    Use of digital medical images has become common over the last several years, coincident with the release of inexpensive, mega-pixel quality digital cameras and the transition to digital radiology operation by hospitals. One problem that clinicians, medical educators, and basic scientists encounter when handling images is the difficulty of using business and graphic arts commercial-off-the-shelf (COTS) software in multicontext authoring and interactive teaching environments. The authors investigated and developed software-supported methodologies to help clinicians, medical educators, and basic scientists become more efficient and effective in their digital imaging environments. The software that the authors developed provides the ability to annotate images based on a multispecialty methodology for annotation and visual knowledge representation. This annotation methodology is designed by consensus, with contributions from the authors and physicians, medical educators, and basic scientists in the Departments of Radiology, Neurobiology and Anatomy, Dermatology, and Ophthalmology at the University of Utah. The annotation methodology functions as a foundation for creating, using, reusing, and extending dynamic annotations in a context-appropriate, interactive digital environment. The annotation methodology supports the authoring process as well as output and presentation mechanisms. The annotation methodology is the foundation for a Windows implementation that allows annotated elements to be represented as structured eXtensible Markup Language and stored separate from the image(s). PMID:14527971

  13. Design and Implementation of a Self-Directed Stereochemistry Lesson Using Embedded Virtual Three-Dimensional Images in a Portable Document Format

    ERIC Educational Resources Information Center

    Cody, Jeremy A.; Craig, Paul A.; Loudermilk, Adam D.; Yacci, Paul M.; Frisco, Sarah L.; Milillo, Jennifer R.

    2012-01-01

    A novel stereochemistry lesson was prepared that incorporated both handheld molecular models and embedded virtual three-dimensional (3D) images. The images are fully interactive and eye-catching for the students; methods for preparing 3D molecular images in Adobe Acrobat are included. The lesson was designed and implemented to showcase the 3D…

  14. WSCLEAN: an implementation of a fast, generic wide-field imager for radio astronomy

    NASA Astrophysics Data System (ADS)

    Offringa, A. R.; McKinley, B.; Hurley-Walker, N.; Briggs, F. H.; Wayth, R. B.; Kaplan, D. L.; Bell, M. E.; Feng, L.; Neben, A. R.; Hughes, J. D.; Rhee, J.; Murphy, T.; Bhat, N. D. R.; Bernardi, G.; Bowman, J. D.; Cappallo, R. J.; Corey, B. E.; Deshpande, A. A.; Emrich, D.; Ewall-Wice, A.; Gaensler, B. M.; Goeke, R.; Greenhill, L. J.; Hazelton, B. J.; Hindson, L.; Johnston-Hollitt, M.; Jacobs, D. C.; Kasper, J. C.; Kratzenberg, E.; Lenc, E.; Lonsdale, C. J.; Lynch, M. J.; McWhirter, S. R.; Mitchell, D. A.; Morales, M. F.; Morgan, E.; Kudryavtseva, N.; Oberoi, D.; Ord, S. M.; Pindor, B.; Procopio, P.; Prabu, T.; Riding, J.; Roshi, D. A.; Shankar, N. Udaya; Srivani, K. S.; Subrahmanyan, R.; Tingay, S. J.; Waterson, M.; Webster, R. L.; Whitney, A. R.; Williams, A.; Williams, C. L.

    2014-10-01

    Astronomical wide-field imaging of interferometric radio data is computationally expensive, especially for the large data volumes created by modern non-coplanar many-element arrays. We present a new wide-field interferometric imager that uses the w-stacking algorithm and can make use of the w-snapshot algorithm. The performance dependences of CASA's w-projection and our new imager are analysed and analytical functions are derived that describe the required computing cost for both imagers. On data from the Murchison Widefield Array, we find our new method to be an order of magnitude faster than w-projection, as well as being capable of full-sky imaging at full resolution and with correct polarization correction. We predict the computing costs for several other arrays and estimate that our imager is a factor of 2-12 faster, depending on the array configuration. We estimate the computing cost for imaging the low-frequency Square Kilometre Array observations to be 60 PetaFLOPS with current techniques. We find that combining w-stacking with the w-snapshot algorithm does not significantly improve computing requirements over pure w-stacking. The source code of our new imager is publicly released.

  15. A new algorithm to reduce noise in microscopy images implemented with a simple program in python.

    PubMed

    Papini, Alessio

    2012-03-01

    All microscopical images contain noise, increasing when (e.g., transmission electron microscope or light microscope) approaching the resolution limit. Many methods are available to reduce noise. One of the most commonly used is image averaging. We propose here to use the mode of pixel values. Simple Python programs process a given number of images, recorded consecutively from the same subject. The programs calculate the mode of the pixel values in a given position (a, b). The result is a new image containing in (a, b) the mode of the values. Therefore, the final pixel value corresponds to that read in at least two of the pixels in position (a, b). The application of the program on a set of images obtained by applying salt and pepper noise and GIMP hurl noise with 10-90% standard deviation showed that the mode performs better than averaging with three-eight images. The data suggest that the mode would be more efficient (in the sense of a lower number of recorded images to process to reduce noise below a given limit) for lower number of total noisy pixels and high standard deviation (as impulse noise and salt and pepper noise), while averaging would be more efficient when the number of varying pixels is high, and the standard deviation is low, as in many cases of Gaussian noise affected images. The two methods may be used serially. PMID:21898664

  16. An implementation of wireless medical image transmission system on mobile devices.

    PubMed

    Lee, SangBock; Lee, Taesoo; Jin, Gyehwan; Hong, Juhyun

    2008-12-01

    The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors' handheld PDA's using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 x 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases. PMID:19058651

  17. A fast and flexible one-dimensional image processing implementation for visual feedback control

    NASA Technical Reports Server (NTRS)

    Richardson, Richard W.; Penix, Wayne A.; Richardson, Russell D.

    1988-01-01

    A simple and efficient image processing system is described which can provide one-dimensional image processing for sample rates approaching video rates. The system is utilized for visual feedback where guidance and process controls are required, such as for arc-welding robots.

  18. Implementation of a new multiple monochromatic x-ray 2D imager at NIF

    NASA Astrophysics Data System (ADS)

    Kyrala, G. A.; Martinson, D.; Polk, P. J.; Gravlin, T.; Schmitt, M. J.; Johnson, R.; Murphy, T. J.; Lopez, F. E.; Oertel, J. A.; House, A.; Wood, R.; Lee, J.; Haugh, M.

    2013-09-01

    We will describe the installation and wavelength calibration of a multiple monochromatic imager [MMI]1 to be used on mix experiments at National Ignition Facility [NIF]2. The imager works between 8 and 13 keV, has a spatial resolution of 16 micrometers and generates many images each with an energy bandwidth of ~80 eV. The images are recorded either on image plates or on gated x-ray detectors. We will describe: how we aligned the instrument on the bench using visible light, how we checked the alignment and determined the energy range using a k-alpha x-ray source, and how we installed and aligned the instrument to the NIF target chamber.

  19. Study on algorithm and real-time implementation of infrared image processing based on FPGA

    NASA Astrophysics Data System (ADS)

    Pang, Yulin; Ding, Ruijun; Liu, Shanshan; Chen, Zhe

    2010-10-01

    With the fast development of Infrared Focal Plane Arrays (IRFPA) detectors, high quality real-time image processing becomes more important in infrared imaging system. Facing the demand of better visual effect and good performance, we find FPGA is an ideal choice of hardware to realize image processing algorithm that fully taking advantage of its high speed, high reliability and processing a great amount of data in parallel. In this paper, a new idea of dynamic linear extension algorithm is introduced, which has the function of automatically finding the proper extension range. This image enhancement algorithm is designed in Verilog HDL and realized on FPGA. It works on higher speed than serial processing device like CPU and DSP. Experiment shows that this hardware unit of dynamic linear extension algorithm enhances the visual effect of infrared image effectively.

  20. The design and implementation of a high-fidelity Raman imaging microscope.

    PubMed

    Goldstein, S R; Kidder, L H; Herne, T M; Levin, I W; Lewis, E N

    1996-10-01

    We describe a Raman imaging microscope that produces high-fidelity, large format Raman images and Raman spectra from samples as small as 1 micron in size. Laser illumination is delivered to the object by means of an infinity corrected microscope objective, either by a galvanometer scanning system or a widefield fibre optic. Wavelength selection of Raman scattered emission is achieved by an acousto-optic tunable filter (AOTF), which maintains image fidelity and provides either continuous or random wavelength selection. The collimated AOTF output is imaged first by a tube lens and then by a projection lens onto a cooled silicon CCD array. Instrument features, including factors that determine the system's spatial and spectral resolution, and design considerations are discussed in detail. Images and spectra of test objects and samples that demonstrate the capability of this imaging spectrometer are presented. The potential of intrinsic chemical imaging is discussed in terms of its use in the analyses of a variety of chemical and biological samples. PMID:8923757