75 FR 38121 - Petroleum Wax Candles From China

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... From China AGENCY: United States International Trade Commission. ACTION: Institution of a five-year review concerning the antidumping duty order on petroleum wax candles from China. SUMMARY: The Commission... petroleum wax candles from China would be likely to lead to continuation or recurrence of material injury...

A CANDLE for a deeper in vivo insight

PubMed Central

Coupé, Pierrick; Munz, Martin; Manjón, Jose V; Ruthazer, Edward S; Louis Collins, D.

2012-01-01

A new Collaborative Approach for eNhanced Denoising under Low-light Excitation (CANDLE) is introduced for the processing of 3D laser scanning multiphoton microscopy images. CANDLE is designed to be robust for low signal-to-noise ratio (SNR) conditions typically encountered when imaging deep in scattering biological specimens. Based on an optimized non-local means filter involving the comparison of filtered patches, CANDLE locally adapts the amount of smoothing in order to deal with the noise inhomogeneity inherent to laser scanning fluorescence microscopy images. An extensive validation on synthetic data, images acquired on microspheres and in vivo images is presented. These experiments show that the CANDLE filter obtained competitive results compared to a state-of-the-art method and a locally adaptive optimized nonlocal means filter, especially under low SNR conditions (PSNR<8dB). Finally, the deeper imaging capabilities enabled by the proposed filter are demonstrated on deep tissue in vivo images of neurons and fine axonal processes in the Xenopus tadpole brain. PMID:22341767

75 FR 80843 - Petroleum Wax Candles From China

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... From China Determination On the basis of the record \\1\\ developed in the subject five-year review, the... candles from China would be likely to lead to continuation or recurrence of material injury to an industry... contained in USITC Publication 4207 (December 2010), entitled Petroleum Wax Candles from China...

Preliminary engineering design of sodium-cooled CANDLE core

NASA Astrophysics Data System (ADS)

Takaki, Naoyuki; Namekawa, Azuma; Yoda, Tomoyuki; Mizutani, Akihiko; Sekimoto, Hiroshi

2012-06-01

The CANDLE burning process is characterized by the autonomous shifting of burning region with constant reactivity and constant spacial power distribution. Evaluations of such critical burning process by using widely used neutron diffusion and burning codes under some realistic engineering constraints are valuable to confirm the technical feasibility of the CANDLE concept and to put the idea into concrete core design. In the first part of this paper, it is discussed that whether the sustainable and stable CANDLE burning process can be reproduced even by using conventional core analysis tools such as SLAROM and CITATION-FBR. As a result, it is certainly possible to demonstrate it if the proper core configuration and initial fuel composition required as CANDLE core are applied to the analysis. In the latter part, an example of a concrete image of sodium cooled, metal fuel, 2000MWt rating CANDLE core has been presented by assuming an emerging inevitable technology of recladding. The core satisfies engineering design criteria including cladding temperature, pressure drop, linear heat rate, and cumulative damage fraction (CDF) of cladding, fast neutron fluence and sodium void reactivity which are defined in the Japanese FBR design project. It can be concluded that it is feasible to design CADLE core by using conventional codes while satisfying some realistic engineering design constraints assuming that recladding at certain time interval is technically feasible.

Candle Flames in Microgravity: USML-1 Results - 1 Year Later

NASA Technical Reports Server (NTRS)

Ross, H. D.; Dietrich, D. L.; Tien, J. S.

1994-01-01

We report on the sustained behavior of a candle flame in microgravity determined in the glovebox facility aboard the First United States Microgravity Labomtofy. In a quiescent, microgmvjfy environment, diffusive transport becomes the dominant mode of heat and mass transfer; whether the diffusive transport rate is fast enough to sustain low-gravity candle flames in air was unknown to this series of about 70 tests. After an initial transient in which soot is observed, the microgravity candle flame in air becomes and remains hemispherical and blue (apparently soot-Ne) with a large flame standoff distance. Near flame extinction, spontaneous flame oscillations are regularly observed; these are explained as a flashback of flame through a premixed combustible gas followed by a retreat owed to flame quenching. The frequency of oscillations can be related to diffusive transport rates, and not to residual buoyant convective flow. The fact that the flame tip is the last point of the flame to survive suggests that it is the location of maximum fuel reactivity; this is unlike normal gravity, where the location of maximum fuel reactivity is the flame base. The flame color, size, and shape behaved in a quasi-steady manner; the finite size of the glovebox, combined with the restricted passages of the candlebox, inhibited the observation of true steady-state burning. Nonetheless, through calculations, and inference from the series of shuttle tests, if is concluded that a candle can burn indefinitely in a large enough ambient of air in microgravity. After igniting one candle, a second candle in close pximity could not be lit. This may be due to wax coating the wick and/or local oxygen depletion around the second, unlit candle. Post-mission testing suggests that simultaneous ignition may overcome these behaviors and enable both candles to be ignited.

Gamma-Ray Burst Supernovae as Standardizable Candles

NASA Astrophysics Data System (ADS)

Cano, Z.

2014-10-01

A long-duration gamma-ray burst (GRB) marks the violent end of a massive star. GRBs are rare in the universe, and their progenitor stars are thought to possess unique physical properties such as low metal content and rapid rotation, while the supernovae (SNe) that are associated with GRBs are expected to be highly aspherical. To date, it has been unclear whether GRB-SNe could be used as standardizable candles, with contrasting conclusions found by different teams. In this paper, I present evidence that GRB-SNe have the potential to be used as standardizable candles and show that a statistically significant relation exists between the brightness and width of their decomposed light curves relative to a template SN. Every single nearby spectroscopically identified GRB-SN for which the rest frame and host contributions have been accurately determined follows this relation. Additionally, it is shown that not only GRB-SNe, but perhaps all SNe whose explosions are powered by a central engine may eventually be used as a standardizable candle. Finally, I suggest that the use of GRB-SNe as standardizable candles likely arises from a combination of the viewing angle and similar explosion geometry in each event, the latter of which is influenced by the explosion mechanism of GRB-SNe.

Candle Flames in Microgravity Video

NASA Technical Reports Server (NTRS)

1997-01-01

This video of a candle flame burning in space was taken by the Candle Flames in Microgravity (CFM) experiment on the Russian Mir space station. It is actually a composite of still photos from a 35mm camera since the video images were too dim. The images show a hemispherically shaped flame, primarily blue in color, with some yellow early int the flame lifetime. The actual flame is quite dim and difficult to see with the naked eye. Nearly 80 candles were burned in this experiment aboard Mir. NASA scientists have also studied how flames spread in space and how to detect fire in microgravity. Researchers hope that what they learn about fire and combustion from the flame ball experiments will help out here on Earth. Their research could help create things such as better engines for cars and airplanes. Since they use very weak flames, flame balls require little fuel. By studying how this works, engineers may be able to design engines that use far less fuel. In addition, microgravity flame research is an important step in creating new safety precautions for astronauts living in space. By understanding how fire works in space, the astronauts can be better prepared to fight it.

Modeling Candle Flame Behavior In Variable Gravity

NASA Technical Reports Server (NTRS)

Alsairafi, A.; Tien, J. S.; Lee, S. T.; Dietrich, D. L.; Ross, H. D.

2003-01-01

The burning of a candle, as typical non-propagating diffusion flame, has been used by a number of researchers to study the effects of electric fields on flame, spontaneous flame oscillation and flickering phenomena, and flame extinction. In normal gravity, the heat released from combustion creates buoyant convection that draws oxygen into the flame. The strength of the buoyant flow depends on the gravitational level and it is expected that the flame shape, size and candle burning rate will vary with gravity. Experimentally, there exist studies of candle burning in enhanced gravity (i.e. higher than normal earth gravity, g(sub e)), and in microgravity in drop towers and space-based facilities. There are, however, no reported experimental data on candle burning in partial gravity (g < g(sub e)). In a previous numerical model of the candle flame, buoyant forces were neglected. The treatment of momentum equation was simplified using a potential flow approximation. Although the predicted flame characteristics agreed well with the experimental results, the model cannot be extended to cases with buoyant flows. In addition, because of the use of potential flow, no-slip boundary condition is not satisfied on the wick surface. So there is some uncertainty on the accuracy of the predicted flow field. In the present modeling effort, the full Navier-Stokes momentum equations with body force term is included. This enables us to study the effect of gravity on candle flames (with zero gravity as the limiting case). In addition, we consider radiation effects in more detail by solving the radiation transfer equation. In the previous study, flame radiation is treated as a simple loss term in the energy equation. Emphasis of the present model is on the gas-phase processes. Therefore, the detailed heat and mass transfer phenomena inside the porous wick are not treated. Instead, it is assumed that a thin layer of liquid fuel coated the entire wick surface during the burning process

Emissions of air pollutants from scented candles burning in a test chamber

NASA Astrophysics Data System (ADS)

Derudi, Marco; Gelosa, Simone; Sliepcevich, Andrea; Cattaneo, Andrea; Rota, Renato; Cavallo, Domenico; Nano, Giuseppe

2012-08-01

Burning of scented candles in indoor environment can release a large number of toxic chemicals. However, in spite of the large market penetration of scented candles, very few works investigated their organic pollutants emissions. This paper investigates volatile organic compounds emissions, with particular reference to the priority indoor pollutants identified by the European Commission, from the burning of scented candles in a laboratory-scale test chamber. It has been found that BTEX and PAHs emission factors show large differences among different candles, possibly due to the raw paraffinic material used, while aldehydes emission factors seem more related to the presence of additives. This clearly evidences the need for simple and cheap methodologies to measure the emission factors of commercial candles in order to foresee the expected pollutant concentration in a given indoor environment and compare it with health safety standards.

Standard Candle in the Wind

NASA Image and Video Library

2011-01-12

NASA Spitzer Space Telescope was able to show that a tandard candle used to measure cosmological distances is shrinking, a finding that affects precise measurements of the age, size and expansion rate of our universe.

Candles in Our Windows

ERIC Educational Resources Information Center

McGrath, Kathryn

2005-01-01

"Candles in Our Windows"--also titled "Nightlights"--is a play developed for elementary and middle school students about how residents in Billings, Montana, took a stand against hate. Last March, the 6th-grade students of Woodland Elementary School in New Jersey performed an early version of the play based on a children's book,…

Improving cardiac operating room to intensive care unit handover using a standardised handover process.

PubMed

Gleicher, Yehoshua; Mosko, Jeffrey David; McGhee, Irene

2017-01-01

Handovers from the cardiovascular operating room (CVOR) to the cardiovascular intensive care unit (CVICU) are complex processes involving the transfer of information, equipment and responsibility, at a time when the patient is most vulnerable. This transfer is typically variable in structure, content and execution. This variability can lead to the omission and miscommunication of critical information leading to patient harm. We set out to improve the quality of patient handover from the CVOR to the CVICU by introducing a standardised handover protocol. This study is an interventional time-series study over a 4-month period at an adult cardiac surgery centre. A standardised handover protocol was developed using quality improvement methodologies. The protocol included a handover content checklist and introduction of a formal 'sterile cockpit' timeout. Implementation of the protocol was refined using monthly iterative Plan-Do-Study-Act. The primary outcome was the quality of handovers, measured by a Handover Score, comprising handover content, teamwork and patient care planning indicators. Secondary outcomes included handover duration, adherence to the standardised handover protocol and handover team satisfaction surveys. 37 handovers were observed (6 pre intervention and 31 post intervention). The mean handover score increased from 6.5 to 14.0 (maximum 18 points). Specific improvements included fewer handover interruptions and more frequent postoperative patient care planning. Average handover duration increased slightly from 2:40 to 2:57 min. Caregivers noted improvements in teamwork, content received and patient care planning. The majority (>95%) agreed that the intervention was a valuable addition to the CVOR to CVICU handover process. Implementation of a standardised handover protocol for postcardiac surgery patients was associated with fewer interruptions during handover, more reliable transfer of critical content and improved patient care planning.

Lighting that One Little Candle.

ERIC Educational Resources Information Center

Scarnati, James T.; Tice, Craig J.

1988-01-01

Describes a lesson in which fifth graders made observations of candles. Discusses the progress of the lesson and the necessity of instructing students in what and how to watch and measure. Stresses that this can be easily accomplished inexpensively with imagination. (CW)

Standardised care plans for in hospital stroke care improve documentation of health care assessments.

PubMed

Pöder, Ulrika; Dahm, Marie Fogelberg; Karlsson, Nina; Wadensten, Barbro

2015-10-01

To compare stroke unit staff members' documentation of care in line with evidence-based guidelines pre- and postimplementation of a multi-professional, evidence-based standardised care plan for stroke care in the electronic health record. Rapid and effective measures for patients with stroke or suspected stroke can limit the extent of damage; it is imperative that patients be observed, assessed and treated in accordance with evidence-based practice in hospital. Quantitative, comparative. Structured retrospective health record reviews were made prior to (n 60) and one and a half years after implementation (n 60) of a multi-professional evidence-based standardised care plan with a quality standard for stroke care in the electronic health record. Significant improvements were found in documentation of assessed vital signs, except for body temperature, Day 1 post compared with preimplementation. Documentation frequency regarding body temperature Day 1 and blood pressure and pulse Day 2 decreased post compared with preimplementation. Improvements were also detected in documented observations of patients' micturition capacity, swallowing capacity and mouth status and the proportion of physiotherapist-documented aid assessments. Observations of blood glucose, mobilisation ability and speech and communication ability were unchanged. An evidence-based standardised care plan in an electronic health record assists staff in improving documentation of health status assessments during the first days after a stroke diagnosis. Use of a standardised care plan seems to have the potential to help staff adhere to evidence-based patient care and, thereby, to increase patient safety. © 2015 John Wiley & Sons Ltd.

9 CFR 590.506 - Candling and transfer-room facilities and equipment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Candling and transfer-room facilities... INSPECTION ACT) Sanitary, Processing, and Facility Requirements § 590.506 Candling and transfer-room... containers are furnished daily. (h) Shell egg conveyors shall be constructed so that they can be thoroughly...

Fabrication of Water Jet Resistant and Thermally Stable Superhydrophobic Surfaces by Spray Coating of Candle Soot Dispersion.

PubMed

Qahtan, Talal F; Gondal, Mohammed A; Alade, Ibrahim O; Dastageer, Mohammed A

2017-08-08

A facile synthesis method for highly stable carbon nanoparticle (CNP) dispersion in acetone by incomplete combustion of paraffin candle flame is presented. The synthesized CNP dispersion is the mixture of graphitic and amorphous carbon nanoparticles of the size range of 20-50 nm and manifested the mesoporosity with an average pore size of 7 nm and a BET surface area of 366 m 2 g -1 . As an application of this material, the carbon nanoparticle dispersion was spray coated (spray-based coating) on a glass surface to fabricate superhydrophobic (water contact angle > 150° and sliding angle < 10 °) surfaces. The spray coated surfaces were found to exhibit much improved water jet resistance and thermal stability up to 400 °C compared to the surfaces fabricated from direct candle flame soot deposition (candle-based coating). This study proved that water jet resistant and thermally stable superhydrophobic surfaces can be easily fabricated by simple spray coating of CNP dispersion gathered from incomplete combustion of paraffin candle flame and this technique can be used for different applications with the potential for the large scale fabrication.

9 CFR 590.506 - Candling and transfer-room facilities and equipment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Candling and transfer-room facilities... INSPECTION ACT) Sanitary, Processing, and Facility Requirements § 590.506 Candling and transfer-room facilities and equipment. (a) The room shall be so constructed that it can be adequately darkened to assure...

9 CFR 590.506 - Candling and transfer-room facilities and equipment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Candling and transfer-room facilities... INSPECTION ACT) Sanitary, Processing, and Facility Requirements § 590.506 Candling and transfer-room facilities and equipment. (a) The room shall be so constructed that it can be adequately darkened to assure...

9 CFR 590.506 - Candling and transfer-room facilities and equipment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Candling and transfer-room facilities... INSPECTION ACT) Sanitary, Processing, and Facility Requirements § 590.506 Candling and transfer-room facilities and equipment. (a) The room shall be so constructed that it can be adequately darkened to assure...

9 CFR 590.506 - Candling and transfer-room facilities and equipment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Candling and transfer-room facilities... INSPECTION ACT) Sanitary, Processing, and Facility Requirements § 590.506 Candling and transfer-room facilities and equipment. (a) The room shall be so constructed that it can be adequately darkened to assure...

Candle Flames in Non-Buoyant Atmospheres

NASA Technical Reports Server (NTRS)

Dietrich, D. L.; Ross, H. D.; Shu, Y.; Tien, J. S.

1999-01-01

This paper addresses the behavior of a candle flame in a long-duration, quiescent microgravity environment both on the space Shuttle and the Mir Orbiting Station (OS). On the Shuttle, the flames became dim blue after an initial transient where there was significant yellow (presumably soot) in the flame. The flame lifetimes were typically less than 60 seconds. The safety-mandated candlebox that contained the candle flame inhibited oxygen transport to the flame and thus limited the flame lifetime. 'Me flames on the Mir OS were similar, except that the yellow luminosity persisted longer into the flame lifetime because of a higher initial oxygen concentration. The Mir flames burned for as long as 45 minutes. The difference in the flame lifetime between the Shuttle and Mir flames was primarily the redesigned candlebox that did not inhibit oxygen transport to the flame. In both environments, the flame intensity and the height-to-width ratio gradually decreased as the ambient oxygen content in the sealed chamber slowly decreased. Both sets of experiments showed spontaneous, axisymmetric flame oscillations just prior to extinction. The paper also presents a numerical model of candle flame. The model is detailed in the gas-phase, but uses a simplified liquid/wick phase. 'Me model predicts a steady flame with a shape and size quantitatively similar to the Shuttle and Mir flames. ne model also predicts pre-extinction flame oscillations if the decrease in ambient oxygen is small enough.

FINE PARTICULATE MATTER EMISSIONS FROM CANDLES

EPA Science Inventory

The paper gives reulst of testing five types of candles, purchased from local stores, for fine particulate matter (PM) emissions under close-to-realistic conditions in a research house. The test method allows for determination of both the emission and deposition rates. Most tes...

Structure analysis and size distribution of particulate matter from candles and kerosene combustion in burning chamber

NASA Astrophysics Data System (ADS)

Baitimirova, M.; Osite, A.; Katkevics, J.; Viksna, A.

2012-08-01

Burning of candles generates particulate matter of fine dimensions that produces poor indoor air quality, so it may cause harmful impact on human health. In this study solid aerosol particles of burning of candles of different composition and kerosene combustion were collected in a closed laboratory system. Present work describes particulate matter collection for structure analysis and the relationship between source and size distribution of particulate matter. The formation mechanism of particulate matter and their tendency to agglomerate also are described. Particles obtained from kerosene combustion have normal size distribution. Whereas, particles generated from the burning of stearin candles have distribution shifted towards finer particle size range. If an additive of stearin to paraffin candle is used, particle size distribution is also observed in range of towards finer particles. A tendency to form agglomerates in a short time is observed in case of particles obtained from kerosene combustion, while in case of particles obtained from burning of candles of different composition such a tendency is not observed. Particles from candles and kerosene combustion are Aitken and accumulation mode particles

76 FR 773 - Petroleum Wax Candles From the People's Republic of China: Continuation of Antidumping Duty Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-06

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-504] Petroleum Wax Candles From... Trade Commission (``ITC'') that revocation of the antidumping duty order on petroleum wax candles from... order on petroleum wax candles from the PRC pursuant to section 751(c)(2) of the Tariff Act of 1930, as...

75 FR 49475 - Petroleum Wax Candles From the People's Republic of China: Preliminary Results of Request for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

... prior scope rulings, refers to candles that are in the shapes of identifiable objects, or are holiday... 30686 (August 28, 1996) (``Order''). Option A: The Department would consider all candle shapes...-related art. All other candle shapes would be considered outside of the scope of the Order. Option B: The...

Investigating the Effect of Cosmic Opacity on Standard Candles

NASA Astrophysics Data System (ADS)

Hu, J.; Yu, H.; Wang, F. Y.

2017-02-01

Standard candles can probe the evolution of dark energy over a large redshift range. But the cosmic opacity can degrade the quality of standard candles. In this paper, we use the latest observations, including Type Ia supernovae (SNe Ia) from the “joint light-curve analysis” sample and Hubble parameters, to probe the opacity of the universe. A joint fitting of the SNe Ia light-curve parameters, cosmological parameters, and opacity is used in order to avoid the cosmological dependence of SNe Ia luminosity distances. The latest gamma-ray bursts are used in order to explore the cosmic opacity at high redshifts. The cosmic reionization process is considered at high redshifts. We find that the sample supports an almost transparent universe for flat ΛCDM and XCDM models. Meanwhile, free electrons deplete photons from standard candles through (inverse) Compton scattering, which is known as an important component of opacity. This Compton dimming may play an important role in future supernova surveys. From analysis, we find that about a few per cent of the cosmic opacity is caused by Compton dimming in the two models, which can be corrected.

Investigating the Effect of Cosmic Opacity on Standard Candles

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

Hu, J.; Yu, H.; Wang, F. Y., E-mail: fayinwang@nju.edu.cn

Standard candles can probe the evolution of dark energy over a large redshift range. But the cosmic opacity can degrade the quality of standard candles. In this paper, we use the latest observations, including Type Ia supernovae (SNe Ia) from the “joint light-curve analysis” sample and Hubble parameters, to probe the opacity of the universe. A joint fitting of the SNe Ia light-curve parameters, cosmological parameters, and opacity is used in order to avoid the cosmological dependence of SNe Ia luminosity distances. The latest gamma-ray bursts are used in order to explore the cosmic opacity at high redshifts. The cosmicmore » reionization process is considered at high redshifts. We find that the sample supports an almost transparent universe for flat ΛCDM and XCDM models. Meanwhile, free electrons deplete photons from standard candles through (inverse) Compton scattering, which is known as an important component of opacity. This Compton dimming may play an important role in future supernova surveys. From analysis, we find that about a few per cent of the cosmic opacity is caused by Compton dimming in the two models, which can be corrected.« less

Parallel Professionalism in an Era of Standardisation

ERIC Educational Resources Information Center

Stone-Johnson, Corrie

2014-01-01

Today's American educational context is characterised by increasing standardisation coupled with heightened accountability. While some view standardisation as a lever for equity, many view it as problematic for the work of teachers. Efforts to improve student achievement by focusing on the activities of teachers have resulted in an over-riding…

Type Ia supernovae, standardizable candles, and gravity

NASA Astrophysics Data System (ADS)

Wright, Bill S.; Li, Baojiu

2018-04-01

Type Ia supernovae (SNe Ia) are generally accepted to act as standardizable candles, and their use in cosmology led to the first confirmation of the as yet unexplained accelerated cosmic expansion. Many of the theoretical models to explain the cosmic acceleration assume modifications to Einsteinian general relativity which accelerate the expansion, but the question of whether such modifications also affect the ability of SNe Ia to be standardizable candles has rarely been addressed. This paper is an attempt to answer this question. For this we adopt a semianalytical model to calculate SNe Ia light curves in non-standard gravity. We use this model to show that the average rescaled intrinsic peak luminosity—a quantity that is assumed to be constant with redshift in standard analyses of Type Ia supernova (SN Ia) cosmology data—depends on the strength of gravity in the supernova's local environment because the latter determines the Chandrasekhar mass—the mass of the SN Ia's white dwarf progenitor right before the explosion. This means that SNe Ia are no longer standardizable candles in scenarios where the strength of gravity evolves over time, and therefore the cosmology implied by the existing SN Ia data will be different when analysed in the context of such models. As an example, we show that the observational SN Ia cosmology data can be fitted with both a model where (ΩM,ΩΛ)=(0.62 ,0.38 ) and Newton's constant G varies as G (z )=G0(1 +z )-1/4 and the standard model where (ΩM,ΩΛ)=(0.3 ,0.7 ) and G is constant, when the Universe is assumed to be flat.

Improving Information Exchange in the Chicken Processing Sector Using Standardised Data Lists

NASA Astrophysics Data System (ADS)

Donnelly, Kathryn Anne-Marie; van der Roest, Joop; Höskuldsson, Stefán Torfi; Olsen, Petter; Karlsen, Kine Mari

Research has shown that to improve electronic communication between companies, universal standardised data lists are necessary. In food supply chains in particular there is an increased need to exchange data in the wake of food safety incidents. Food supply chain companies already record numerous measurements, properties and parameters. These records are necessary for legal reasons, labelling, traceability, profiling desirable characteristics, showing compliance and for meeting customer requirements. Universal standards for name and content of each of these data elements would improve information exchange between buyers, sellers, authorities, consumers and other interested parties. A case study, carried out for the chicken sector, attempted to identify the most relevant parameters including which of these were already communicated to external bodies.

The Persistence of the Candle-and-Cylinder Misconception.

ERIC Educational Resources Information Center

Birk, James P.; Lawson, Anton E.

1999-01-01

Argues that the candle-and-cylinder demonstration does not show that air is composed of 21% oxygen. Finds that the heating of air results in a partial expulsion of air, and that the flame is extinguished by a local, rather than a complete, consumption of oxygen. (WRM)

Standardisation of Gymnema sylvestre R.Br. by high-performance thin-layer chromatography: an improved method.

PubMed

Raju, Valivarthi S R; Kannababu, S; Subbaraju, Gottumukkala V

2006-01-01

An improved high-performance thin-layer chromatographic (HPTLC) method for the standardisation of Gymnema sylvestre is reported. The method involves the initial hydrolysis of gymnemic acids, the active ingredients, to a common aglycone followed by the quantitative estimation of gymnemagenin. The present method rectifies an error found in an HPTLC method reported recently.

New Scientific Aspects of the "Burning Candle" Experiment

ERIC Educational Resources Information Center

Massalha, Taha

2016-01-01

The "burning candle" experiment is used in middle school education programs to prove that air contains a component that is essential to burning (i.e., oxygen). The accepted interpretation taught by teachers in middle school is this: when burning occurs, oxygen is used up, creating an underpressure that causes a rise in water level inside…

Superhydrophobicity of hierarchical nanostructure of candle soot films

NASA Astrophysics Data System (ADS)

Hankhuntond, A.; Singjai, P.; Sakulsermsuk, S.

2017-09-01

Candle soot containing carbon nanoparticles can form hierarchical structure films. We prepared soot films by using glass slides blocking candle flame in the middle of the flame. The hierarchical nanostructures of the carbon nanoparticles films were confirmed by scanning electron microscopy and transmission electron microscopy. Carbon nanoparticle size was 49.2 ± 9.0 nm from SEM, which agrees to 37.9 ± 8.5 nm from TEM. The contact angles of water droplets on these films are more than 150°, indicating superhydrophobic surface. Decrease contact angles of water droplets were observed with an increase deposition time. The decrease of contact angle was saturated at about 150° when the deposition time reaches 180 s. Cassie-Baxter state was attributed to describe superhydrophobicity of carbon nanoparticles films because the hierarchical nanostructures of the surface provide a large fraction of hollows on the surface. We proposed that the contact angle dependence on deposition time was governed by the increase of the distance between nanopillars in carbon nanoparticles films.

16 CFR Table 2 to Part 1512 - Minimum Candlepower per Incident Foot-Candle for Clear Reflector 1

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Minimum Candlepower per Incident Foot-Candle for Clear Reflector 1 2 Table 2 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... 1512—Minimum Candlepower per Incident Foot-Candle for Clear Reflector 1 Observation angle Front, rear...

Candle soot nanoparticles-polydimethylsiloxane composites for laser ultrasound transducers

NASA Astrophysics Data System (ADS)

Chang, Wei-Yi; Huang, Wenbin; Kim, Jinwook; Li, Sibo; Jiang, Xiaoning

2015-10-01

Generation of high power laser ultrasound strongly demands the advanced materials with efficient laser energy absorption, fast thermal diffusion, and large thermoelastic expansion capabilities. In this study, candle soot nanoparticles-polydimethylsiloxane (CSNPs-PDMS) composite was investigated as the functional layer for an optoacoustic transducer with high-energy conversion efficiency. The mean diameter of the collected candle soot carbon nanoparticles is about 45 nm, and the light absorption ratio at 532 nm wavelength is up to 96.24%. The prototyped CSNPs-PDMS nano-composite laser ultrasound transducer was characterized and compared with transducers using Cr-PDMS, carbon black (CB)-PDMS, and carbon nano-fiber (CNFs)-PDMS composites, respectively. Energy conversion coefficient and -6 dB frequency bandwidth of the CSNPs-PDMS composite laser ultrasound transducer were measured to be 4.41 × 10-3 and 21 MHz, respectively. The unprecedented laser ultrasound transduction performance using CSNPs-PDMS nano-composites is promising for a broad range of ultrasound therapy applications.

FTIR Study of Comustion Species in Several Regions of a Candle Flame

NASA Astrophysics Data System (ADS)

White, Allen R.

2013-06-01

The complex chemical structure of the fuel in a candle flame, parafin, is broken down into smaller hydrocarbons in the dark region just above the candle wick during combustion. This creates fuel-rich, fuel-lean, hydrocarbon reaction, and combustion product regions in the flame during combustion that are spectroscopically rich, particularly in the infrared. IR emissions were measured for each reaction region via collection optics focused into an FTIR and used to identify IR active species present in that region and, when possible, temperature of the sampling region. The results of the measurements are useful for combustion reaction modeling as well as for future validation of mass spectroscopy sampling systems.

Comparison of the egg flotation and egg candling techniques for estimating incubation day of Canada Goose nests

USGS Publications Warehouse

Reiter, M.E.; Andersen, D.E.

2008-01-01

Both egg flotation and egg candling have been used to estimate incubation day (often termed nest age) in nesting birds, but little is known about the relative accuracy of these two techniques. We used both egg flotation and egg candling to estimate incubation day for Canada Geese (Branta canadensis interior) nesting near Cape Churchill, Manitoba, from 2000 to 2007. We modeled variation in the difference between estimates of incubation day using each technique as a function of true incubation day, as well as, variation in error rates with each technique as a function of the true incubation day. We also evaluated the effect of error in the estimated incubation day on estimates of daily survival rate (DSR) and nest success using simulations. The mean difference between concurrent estimates of incubation day based on egg flotation minus egg candling at the same nest was 0.85 ?? 0.06 (SE) days. The positive difference in favor of egg flotation and the magnitude of the difference in estimates of incubation day did not vary as a function of true incubation day. Overall, both egg flotation and egg candling overestimated incubation day early in incubation and underestimated incubation day later in incubation. The average difference between true hatch date and estimated hatch date did not differ from zero (days) for egg flotation, but egg candling overestimated true hatch date by about 1 d (true - estimated; days). Our simulations suggested that error associated with estimating the incubation day of nests and subsequently exposure days using either egg candling or egg flotation would have minimal effects on estimates of DSR and nest success. Although egg flotation was slightly less biased, both methods provided comparable and accurate estimates of incubation day and subsequent estimates of hatch date and nest success throughout the entire incubation period. ?? 2008 Association of Field Ornithologists.

Study on core radius minimization for long life Pb-Bi cooled CANDLE burnup scheme based fast reactor

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

Afifah, Maryam, E-mail: maryam.afifah210692@gmail.com; Su’ud, Zaki; Miura, Ryosuke

2015-09-30

Fast Breeder Reactor had been interested to be developed over the world because it inexhaustible source energy, one of those is CANDLE reactor which is have strategy in burn-up scheme, need not control roads for control burn-up, have a constant core characteristics during energy production and don’t need fuel shuffling. The calculation was made by basic reactor analysis which use Sodium coolant geometry core parameter as a reference core to study on minimum core reactor radius of CANDLE for long life Pb-Bi cooled, also want to perform pure coolant effect comparison between LBE and sodium in a same geometry design.more » The result show that the minimum core radius of Lead Bismuth cooled CANDLE is 100 cm and 500 MWth thermal output. Lead-Bismuth coolant for CANDLE reactor enable to reduce much reactor size and have a better void coefficient than Sodium cooled as the most coolant for FBR, then we will have a good point in safety analysis.« less

Improving the evidence base for services working with youth at-risk of involvement in the criminal justice system: developing a standardised program approach.

PubMed

Knight, Alice; Maple, Myfanwy; Shakeshaft, Anthony; Shakehsaft, Bernie; Pearce, Tania

2018-04-16

Young people who engage in multiple risk behaviour (high-risk young people) such as substance abuse, antisocial behaviour, low engagement in education and employment, self-harm or suicide ideation are more likely to experience serious harms later in life including homelessness, incarceration, violence and premature death. In addition to personal disadvantage, these harms represent an avoidable social and economic cost to society. Despite these harms, there is insufficient evidence about how to improve outcomes for high-risk young people. A key reason for this is a lack of standardisation in the way in which programs provided by services are defined and evaluated. This paper describes the development of a standardised intervention model for high-risk young people. The model can be used by service providers to achieve greater standardisation across their programs, outcomes and outcome measures. To demonstrate its feasibility, the model is applied to an existing program for high-risk young people. The development and uptake of a standardised intervention model for these programs will help to more rapidly develop a larger and more rigorous evidence-base to improve outcomes for high-risk young people.

Demonstrating Sound Wave Propagation with Candle Flame and Loudspeaker

ERIC Educational Resources Information Center

Hrepic, Zdeslav; Nettles, Corey; Bonilla, Chelsea

2013-01-01

The motion of a candle flame in front of a loudspeaker has been suggested as a productive demonstration of the longitudinal wave nature of sound. The demonstration has been used also as a research tool to investigate students' understanding about sound. The underpinning of both applications is the expectation of a horizontal, back-and-forth…

The Histological and Immunohistochemical Features of the Skin Lesions in CANDLE Syndrome

PubMed Central

Torrelo, Antonio; Colmenero, Isabel; Requena, Luis; Paller, Amy S.; Ramot, Yuval; Lee, Chyi-Chia Richard; Vera, Angel; Zlotogorski, Abraham; Goldbach-Mansky, Raphaela; Kutzner, Heinz

2015-01-01

Chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome is a newly characterized autoinflammatory disorder, caused by mutations in PSMB8. It is characterized by early-onset fevers, accompanied by a widespread, violaceous and often annular, cutaneous eruption. While the exact pathogenesis of this syndrome is still obscure, it is postulated that the inflammatory disease manifestations stem from excess secretion of interferons. Based on preliminary blood cytokine and gene expression studies, the signature seems to come mostly from type I interferons, which are proposed to lead to the recruitment of immature myeloid cells into the dermis and subcutis. In this study, we systematically analyzed skin biopsies from 6 CANDLE syndrome patients by routine histopathology and immunohistochemistry methods. Skin lesions showed the presence of extensive mixed dermal and subcutaneous inflammatory infiltrate, composed of mononuclear cells, atypical myeloid cells, neutrophils, eosinophils and some mature lymphocytes. Positive LEDER and myeloperoxidase staining supported the presence of myeloid cells. Positive CD68/PMG1 and CD163 staining confirmed the existence of histiocytes and monocytic macrophages in the inflammatory infiltrate. CD123 staining was positive, demonstrating the presence of plasmacytoid dendritic cells. Uncovering the unique histopathologic and immunohistochemical features of CANDLE syndrome provides tools for rapid and specific diagnosis of this disorder as well as further insight into the pathogenesis of this severe, life-threatening condition. PMID:26091509

Filter holder and gasket assembly for candle or tube filters

DOEpatents

Lippert, Thomas Edwin; Alvin, Mary Anne; Bruck, Gerald Joseph; Smeltzer, Eugene E.

1999-03-02

A filter holder and gasket assembly for holding a candle filter element within a hot gas cleanup system pressure vessel. The filter holder and gasket assembly includes a filter housing, an annular spacer ring securely attached within the filter housing, a gasket sock, a top gasket, a middle gasket and a cast nut.

Using slow-release permanganate candles to remove TCE from a low permeable aquifer at a former landfill.

PubMed

Christenson, Mark D; Kambhu, Ann; Comfort, Steve D

2012-10-01

Past disposal of industrial solvents into unregulated landfills is a significant source of groundwater contamination. In 2009, we began investigating a former unregulated landfill with known trichloroethene (TCE) contamination. Our objective was to pinpoint the location of the plume and treat the TCE using in situ chemical oxidation (ISCO). We accomplished this by using electrical resistivity imaging (ERI) to survey the landfill and map the subsurface lithology. We then used the ERI survey maps to guide direct push groundwater sampling. A TCE plume (100-600 μg L(-1)) was identified in a low permeable silty-clay aquifer (K(h)=0.5 md(-1)) that was within 6m of ground surface. To treat the TCE, we manufactured slow-release potassium permanganate candles (SRPCs) that were 91.4 cm long and either 5. cm or 7.6 cm in dia. For comparison, we inserted equal masses of SRPCs (7.6-cm versus 5.1-cm dia) into the low permeable aquifer in staggered rows that intersected the TCE plume. The 5.1-cm dia candles were inserted using direct push rods while the 7.6-cm SRPCs were placed in 10 permanent wells. Pneumatic circulators that emitted small air bubbles were placed below the 7.6-cm SRPCs in the second year. Results 15 months after installation showed significant TCE reductions in the 7.6-cm candle treatment zone (67-85%) and between 10% and 66% decrease in wells impacted by the direct push candles. These results support using slow-release permanganate candles as a means of treating chlorinated solvents in low permeable aquifers. Copyright © 2012 Elsevier Ltd. All rights reserved.

Filter holder and gasket assembly for candle or tube filters

DOEpatents

Lippert, T.E.; Alvin, M.A.; Bruck, G.J.; Smeltzer, E.E.

1999-03-02

A filter holder and gasket assembly are disclosed for holding a candle filter element within a hot gas cleanup system pressure vessel. The filter holder and gasket assembly includes a filter housing, an annular spacer ring securely attached within the filter housing, a gasket sock, a top gasket, a middle gasket and a cast nut. 9 figs.

A chlorate candle/lithium hydroxide personal breathing apparatus

NASA Technical Reports Server (NTRS)

Martin, F. E.

1972-01-01

A portable coal mine rescue and survival equipment is reported that consists of a chlorate candle with a lithium hydroxide carbon-dioxide absorbent for oxygen generation, a breathing bag and tubing to conduct breathing to and from the man. A plastic hood incorporating a mouth piece for communication provides also eye protection and prevents inhalation through the nose. Manned testing of a prototype system demonstrated the feasibility of this closed circuit no-maintenance breathing apparatus that provides for good voice communication.

Standardising the clinical assessment of coronal knee laxity.

PubMed

Clarke, Jon V; Wilson, William T; Wearing, Scott C; Picard, Frederic; Riches, Philip E; Deakin, Angela H

2012-09-01

Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxity through accurate measurement of potential variables during routine clinical examination. The hypothesis was that standardisation of a clinical stress test would result in a repeatable range of laxity measurements. Non-invasive infrared tracking technology with kinematic registration of joint centres gave real-time measurement of both coronal and sagittal mechanical tibiofemoral alignment Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxity examinations on a single volunteer using a target moment of 18 Nm. Standardised laxity measurements had small standard deviations (within 1. 1 degree) for each clinician and similar mean values between clinicians, with the valgus laxity assessment (mean of 3 degrees) being slightly more consistent than varus (means of 4 degrees or 5 degrees). The manual technique of coronal knee laxity assessment was successfully quantified and standardised, leading to a narrow range of measurements (within the accuracy of the measurement system). Minimising the subjective variables of clinical examination could improve current knowledge of soft tissue knee behaviour.

ANALYSIS OF LEAD IN CANDLE PARTICULATE EMISSIONS BY XRF USING UNIQUANT 4

EPA Science Inventory

As part of an extensive program to study the small combustion sources of indoor fine particulate matter (PM), candles with lead-core wicks were burned in a 46-L glass flow- through chamber. The particulate emissions with aerodynamic diameters <10 micrometers (PM10) were captured ...

Global standardisation of HbA1c.

PubMed

Lai, Leslie C

2008-12-01

HbA1c is used for assessing glycaemic control in patients with diabetes. It is also used for treatment goals and as a target for therapeutic intervention. The Direct Control and Complications Trial in the USA showed that HbA1c can be used to predict the risk of complications. Hence, it is important for HbA1c assays to be standardised. The National Glycohemoglobin Standardization Program (NGSP) in the USA was formed in 1996 so that HbA1c results from different laboratories would be comparable to those reported in the DCCT study. There were also HbA1c standardisation programmes in Sweden and Japan. These three standardisation programmes are, in fact, direct comparison methods (DCMs), and yield different HbA1c results. In 1994, the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) established a Working Group on Standardisation of HbA1c. This working group has developed a global HbA1c reference system with very much improved intra-assay and inter-assay coefficients of variation. Recommendations have been made to report HbA1c results as IFCC-HbA1c values in SI units (mmol HbA1c/mol Hb) and NGSP-HbA1c (%) as well as estimated average glucose (eAG), once a tight relationship has been shown to exist between eAG and HbA1c.

Study of hyperspectral characteristics of different types of flares and smoke candles

NASA Astrophysics Data System (ADS)

Farley, Vincent; Chamberland, Martin; Lagueux, Philippe; Kastek, Mariusz; Piatkowski, Tadeusz; Dulski, Rafal

2012-06-01

Modern infrared camouflage and countermeasure technologies used in the context of military operations have evolved rapidly over the last decade. Indeed, some infrared seekers and decoy/flares tend to have spectral sensitivity tailored to closely match the emission signatures of military vehicles (such as aircrafts, tanks) and reject other sources. Similarly, some candles (or smoke bombs) are developed to generate large area screens with very high absorption in the infrared. The Military University of Technology has conducted an intensive field campaign where various types of flares and smoke candles were deployed in different conditions and measured. The high spectral, spatial and temporal resolution acquisition of these thermodynamic events was recorded with the Telops Hyper-Cam. The Hyper-Cam enables simultaneous acquisition of spatial and spectral information at high resolutions in both domains. The ability to study combustion systems with high resolution, co-registered imagery and spectral data is made possible. This paper presents the test campaign concept and definition and the analysis of the recorded measurements.

When a Standard Candle Flickers

NASA Technical Reports Server (NTRS)

Wilson-Hodge, Colleen A.; Cherry, M. L.; Beklen, E.; Bhat, P. N.; Briggs, M. S.; Camero-Arranz, A.; Case, G. L.; Chaplin, V.; Connaughton, V.; Finger, M. H.;

Demonstrating Sound Wave Propagation with Candle Flame and Loudspeaker

NASA Astrophysics Data System (ADS)

Hrepic, Zdeslav; Nettles, Corey; Bonilla, Chelsea

2013-01-01

The motion of a candle flame in front of a loudspeaker has been suggested as a productive demonstration of the longitudinal wave nature of sound. The demonstration has been used also as a research tool to investigate students' understanding about sound.2-4 The underpinning of both applications is the expectation of a horizontal, back-and-forth vibration of the flame around its upright position. Unlike experts, who regularly anticipate this outcome, students with no previous formal knowledge typically anticipate that the flame will lean away from the speaker.

Burning a Candle in a Vessel, a Simple Experiment with a Long History

NASA Astrophysics Data System (ADS)

Vera, Francisco; Rivera, Rodrigo; Núñez, César

2011-09-01

The experiment in which a candle is burned inside an inverted vessel partially immersed in water has a history of more than 2,200 years, but even nowadays it is common that students and teachers relate the change in volume of the enclosed air to its oxygen content. Contrary to what many people think, Lavoisier concluded that any change in volume in this experiment is negligible; moreover, the explanation relating oxygen consumption in the air with its change in volume is known to be wrong. In this work we briefly review the history behind the candle experiment and its relationship with some typical erroneous explanations. One of the key factors behind Lavoisier's success was the use of experiments carefully designed to test different hypotheses. Following these steps, we performed several closed volume experiments where the candle wick was replaced by a capillary stainless steel cylinder supported and heated by a nichrome filament connected to an external power supply. Our recorded experiments are displayed as web pages, designed with the purpose that the reader can easily visualize and analyze modern versions of Lavoisier's experiments. These experiments clearly show an initial phase of complete combustion, followed by a phase of incomplete combustion with elemental carbon or soot rising to the top of the vessel, and a final phase where the hot artificial wick only evaporates a white steam of wax that cannot ignite because no oxygen is left in the closed atmosphere. After either a complete or incomplete combustion of the oxygen, our experiments show that the final gas volume is nearly equal to the initial air volume.

Building the foundation to generate a fundamental care standardised data set.

PubMed

Jeffs, Lianne; Muntlin Athlin, Asa; Needleman, Jack; Jackson, Debra; Kitson, Alison

2018-06-01

This paper provides an overview of the current state of performance measurement, key trends and a methodological approach to leverage in efforts to generate a standardised data set for fundamental care. Considerable transformation is occurring in health care globally with organisations focusing on achieving the quadruple aim of improving the experience of care, the health of populations, and the experience of providing care while reducing per capita costs of health care. In response, healthcare organisations are employing performance measurement and quality improvement methods to achieve the quadruple aim. Despite the plethora of measures available to health managers, there is no standardised data set and virtually no indicators reflecting how patients actually experience the delivery of fundamental care, such as nutrition, hydration, mobility, respect, education and psychosocial support. Given the linkages of fundamental care to safety and quality metrics, efforts to build the evidence base and knowledge that captures the impact of enacting fundamental care across the healthcare continuum and lifespan should include generating a routinely collected data set of relevant measures. This paper provides an overview of the current state of performance measurement, key trends and a methodological approach to leverage in efforts to generate a standardised data set for fundamental care. Standardised data sets enable comparability of data across clinical populations, healthcare sectors, geographic locations and time and provide data about care to support clinical, administrative and health policy decision-making. © 2018 John Wiley & Sons Ltd.

Pulse cleaning flow models and numerical computation of candle ceramic filters.

PubMed

Tian, Gui-shan; Ma, Zhen-ji; Zhang, Xin-yi; Xu, Ting-xiang

2002-04-01

Analytical and numerical computed models are developed for reverse pulse cleaning system of candle ceramic filters. A standard turbulent model is demonstrated suitably to the designing computation of reverse pulse cleaning system from the experimental and one-dimensional computational result. The computed results can be used to guide the designing of reverse pulse cleaning system, which is optimum Venturi geometry. From the computed results, the general conclusions and the designing methods are obtained.

Shall We Continue to Teach the Candle Burning Experiment at Lower Secondary Level?

ERIC Educational Resources Information Center

Dhindsa, Harkirat S.

2005-01-01

The candle burning experiment is usually conducted in lower secondary classes to prove the (about) 20% oxygen in air. The aim of this paper is to show that teachers misinterpret the results of the experiment to satisfy the objectives of teaching this experiment. However, when the results of this experiment are interpreted correctly, the objectives…

Standardisation of digital human models.

PubMed

Paul, Gunther; Wischniewski, Sascha

2012-01-01

Digital human models (DHM) have evolved as useful tools for ergonomic workplace design and product development, and found in various industries and education. DHM systems which dominate the market were developed for specific purposes and differ significantly, which is not only reflected in non-compatible results of DHM simulations, but also provoking misunderstanding of how DHM simulations relate to real world problems. While DHM developers are restricted by uncertainty about the user need and lack of model data related standards, users are confined to one specific product and cannot exchange results, or upgrade to another DHM system, as their previous results would be rendered worthless. Furthermore, origin and validity of anthropometric and biomechanical data is not transparent to the user. The lack of standardisation in DHM systems has become a major roadblock in further system development, affecting all stakeholders in the DHM industry. Evidently, a framework for standardising digital human models is necessary to overcome current obstructions. Practitioner Summary: This short communication addresses a standardisation issue for digital human models, which has been addressed at the International Ergonomics Association Technical Committee for Human Simulation and Virtual Environments. It is the outcome of a workshop at the DHM 2011 symposium in Lyon, which concluded steps towards DHM standardisation that need to be taken.

Standardised (plain) packaging: the time for implementation has come.

PubMed

Hoek, Janet; Edwards, Richard; Daube A O, Mike

2015-07-03

Although a growing number of countries have passed legislation to introduce standardised (or 'plain') packaging, New Zealand's legislation is currently stalled. The research evidence supporting standardised packaging is strong. Furthermore, evaluations from Australia, the first country to introduce this measure, show standardised packaging is reducing the appeal of smoking. Tobacco consumption in Australia has also fallen since the introduction of standardised packaging. The government should reassert its commitment to New Zealand's Smokefree 2025 goal by recognising the Australian evidence and passing and implementing standardised packaging as soon as possible.

CANDLES AND INCENSE AS POTENTIAL SOURCES OF INDOOR AIR POLLUTION: MARKET ANALYSIS AND LITERATURE SEARCH

EPA Science Inventory

The report summarizes available information on candles and incense as potential sources of indoor air pollution. It covers market information and a review of the scientific literature. The market information collected focuses on production and sales data, typical uses in the U.S....

Impact of New Nuclear Data Libraries on Small Sized Long Life CANDLE HTGR Design Parameters

NASA Astrophysics Data System (ADS)

Liem, Peng Hong; Hartanto, Donny; Tran, Hoai Nam

2017-01-01

The impact of new evaluated nuclear data libraries (JENDL-4.0, ENDF/B-VII.0 and JEFF-3.1) on the core characteristics of small-sized long-life CANDLE High Temperature Gas-Cooled Reactors (HTGRs) with uranium and thorium fuel cycles was investigated. The most important parameters of the CANDLE core characteristics investigated here covered (1) infinite multiplication factor of the fresh fuel containing burnable poison, (2) the effective multiplication factor of the equilibrium core, (3) the moving velocity of the burning region, (4) the attained discharge burnup, and (5) the maximum power density. The reference case was taken from the current JENDL-3.3 results. For the uranium fuel cycle, the impact of the new libraries was small, while significant impact was found for thorium fuel cycle. The findings indicated the needs of more accurate nuclear data libraries for nuclides involved in thorium fuel cycle in the future.

On Calibrations Using the Crab Nebula as a Standard Candle

NASA Technical Reports Server (NTRS)

Weisskopf, Martin; Guainazzi, Matteo; Jahoda, Keith; Shaposhnikov, Nikolai; ODell, Stephen; Zavlin, Vyacheslav; Wilson-Hodge, Colleen; Elsner, Ronald

2009-01-01

Inspired by a recent paper (Kirsch et al. 2005) on possible use of the Crab Nebula as a standard candle for calibrating X-ray response func tions, we examine possible consequences of intrinsic departures from a single (absorbed) power law upon such calibrations. We limited our analyses to three more modern X-ray instruments -- the ROSAT/PSPC, th e RXTE/PCA, and the XMM-Newton/EPIC-pn. The results are unexpected an d indicate a need to refine two of the three response functions studi ed. The implications for Chandra will be discussed.

Standardising Home Range Studies for Improved Management of the Critically Endangered Black Rhinoceros

PubMed Central

Plotz, Roan D.; Grecian, W. James; Kerley, Graham I.H.; Linklater, Wayne L.

2016-01-01

Comparisons of recent estimations of home range sizes for the critically endangered black rhinoceros in Hluhluwe-iMfolozi Park (HiP), South Africa, with historical estimates led reports of a substantial (54%) increase, attributed to over-stocking and habitat deterioration that has far-reaching implications for rhino conservation. Other reports, however, suggest the increase is more likely an artefact caused by applying various home range estimators to non-standardised datasets. We collected 1939 locations of 25 black rhino over six years (2004–2009) to estimate annual home ranges and evaluate the hypothesis that they have increased in size. A minimum of 30 and 25 locations were required for accurate 95% MCP estimation of home range of adult rhinos, during the dry and wet seasons respectively. Forty and 55 locations were required for adult female and male annual MCP home ranges, respectively, and 30 locations were necessary for estimating 90% bivariate kernel home ranges accurately. Average annual 95% bivariate kernel home ranges were 20.4 ± 1.2 km2, 53 ±1.9% larger than 95% MCP ranges (9.8 km2 ± 0.9). When home range techniques used during the late-1960s in HiP were applied to our dataset, estimates were similar, indicating that ranges have not changed substantially in 50 years. Inaccurate, non-standardised, home range estimates and their comparison have the potential to mislead black rhino population management. We recommend that more care be taken to collect adequate numbers of rhino locations within standardized time periods (i.e., season or year) and that the comparison of home ranges estimated using dissimilar procedures be avoided. Home range studies of black rhino have been data deficient and procedurally inconsistent. Standardisation of methods is required. PMID:27028728

Standardising Home Range Studies for Improved Management of the Critically Endangered Black Rhinoceros.

PubMed

Plotz, Roan D; Grecian, W James; Kerley, Graham I H; Linklater, Wayne L

2016-01-01

Comparisons of recent estimations of home range sizes for the critically endangered black rhinoceros in Hluhluwe-iMfolozi Park (HiP), South Africa, with historical estimates led reports of a substantial (54%) increase, attributed to over-stocking and habitat deterioration that has far-reaching implications for rhino conservation. Other reports, however, suggest the increase is more likely an artefact caused by applying various home range estimators to non-standardised datasets. We collected 1939 locations of 25 black rhino over six years (2004-2009) to estimate annual home ranges and evaluate the hypothesis that they have increased in size. A minimum of 30 and 25 locations were required for accurate 95% MCP estimation of home range of adult rhinos, during the dry and wet seasons respectively. Forty and 55 locations were required for adult female and male annual MCP home ranges, respectively, and 30 locations were necessary for estimating 90% bivariate kernel home ranges accurately. Average annual 95% bivariate kernel home ranges were 20.4 ± 1.2 km(2), 53 ± 1.9% larger than 95% MCP ranges (9.8 km(2) ± 0.9). When home range techniques used during the late-1960s in HiP were applied to our dataset, estimates were similar, indicating that ranges have not changed substantially in 50 years. Inaccurate, non-standardised, home range estimates and their comparison have the potential to mislead black rhino population management. We recommend that more care be taken to collect adequate numbers of rhino locations within standardized time periods (i.e., season or year) and that the comparison of home ranges estimated using dissimilar procedures be avoided. Home range studies of black rhino have been data deficient and procedurally inconsistent. Standardisation of methods is required.

Burning a Candle in a Vessel, a Simple Experiment with a Long History

ERIC Educational Resources Information Center

Vera, Francisco; Rivera, Rodrigo; Nunez, Cesar

2011-01-01

The experiment in which a candle is burned inside an inverted vessel partially immersed in water has a history of more than 2,200 years, but even nowadays it is common that students and teachers relate the change in volume of the enclosed air to its oxygen content. Contrary to what many people think, Lavoisier concluded that any change in volume…

75 FR 70713 - Petroleum Wax Candles From the People's Republic of China: Final Results of Expedited Third...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-18

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-504] Petroleum Wax Candles From... Order AGENCY: Import Administration, International Trade Administration, Department of Commerce. DATES: Effective Date: November 18, 2010. SUMMARY: On July 9, 2010, the Department of Commerce (``Department...

Red clump stars and Gaia: calibration of the standard candle using a hierarchical probabilistic model

NASA Astrophysics Data System (ADS)

Hawkins, Keith; Leistedt, Boris; Bovy, Jo; Hogg, David W.

2017-10-01

Distances to individual stars in our own Galaxy are critical in order to piece together the nature of its velocity and spatial structure. Core helium burning red clump (RC) stars have similar luminosities, are abundant throughout the Galaxy and thus constitute good standard candles. We build a hierarchical probabilistic model to quantify the quality of RC stars as standard candles using parallax measurements from the first Gaia data release. A unique aspect of our methodology is to fully account for (and marginalize over) parallax, photometry and dust correction uncertainties, which lead to more robust results than standard approaches. We determine the absolute magnitude and intrinsic dispersion of the RC in 2MASS bands J, H, Ks, Gaia G band and WISE bands W1, W2, W3 and W4. We find that the absolute magnitude of the RC is -1.61 ± 0.01 (in Ks), +0.44 ± 0.01 (in G), -0.93 ± 0.01 (in J), -1.46 ± 0.01 (in H), -1.68 ± 0.02 (in W1), -1.69 ± 0.02 (in W2), -1.67 ± 0.02 (in W3) and -1.76 ± 0.01 mag (in W4). The mean intrinsic dispersion is ˜0.17 ± 0.03 mag across all bands (yielding a typical distance precision of ˜8 per cent). Thus RC stars are reliable and precise standard candles. In addition, we have also re-calibrated the zero-point of the absolute magnitude of the RC in each band, which provides a benchmark for future studies to estimate distances to RC stars. Finally, the parallax error shrinkage in the hierarchical model outlined in this work can be used to obtain more precise parallaxes than Gaia for the most distant RC stars across the Galaxy.

Void effect analysis of Pb-208 of fast reactors with modified CANDLE burn-up scheme

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

Widiawati, Nina, E-mail: nina-widiawati28@yahoo.com; Su’ud, Zaki, E-mail: szaki@fi.itb.ac.id

Void effect analysis of Pb-208 as coolant of fast reactors with modified candle burn-up scheme has been conducted. Lead cooled fast reactor (LFR) is one of the fourth-generation reactor designs. The reactor is designed with a thermal power output of 500 MWt. Modified CANDLE burn-up scheme allows the reactor to have long life operation by supplying only natural uranium as fuel cycle input. This scheme introducing discrete region, the fuel is initially put in region 1, after one cycle of 10 years of burn up it is shifted to region 2 and region 1 is filled by fresh natural uraniummore » fuel. The reactor is designed for 100 years with 10 regions arranged axially. The results of neutronic calculation showed that the void coefficients ranged from −0.6695443 % at BOC to −0.5273626 % at EOC for 500 MWt reactor. The void coefficients of Pb-208 more negative than Pb-nat. The results showed that the reactors with Pb-208 coolant have better level of safety than Pb-nat.« less

Fail Save Shut Off Valve for Filtering Systems Employing Candle Filters

DOEpatents

VanOsdol, John

2006-01-03

The invention relates to an apparatus that acts as a fail save shut off valve. More specifically, the invention relates to a fail save shut off valve that allows fluid flow during normal operational conditions, but prevents the flow of fluids in the event of system failure upstream that causes over-pressurization. The present invention is particularly well suited for use in conjunction with hot gas filtering systems, which utilize ceramic candle filters. Used in such a hot gas system the present invention stops the flow of hot gas and prevents any particulate laden gas from entering the clean side of the system.

Fail save shut off valve for filtering systems employing candle filters

DOEpatents

VanOsdol, John [Fairmont, WV

2006-01-03

The invention relates to an apparatus that acts as a fail save shut off valve. More specifically, the invention relates to a fail save shut off valve that allows fluid flow during normal operational conditions, but prevents the flow of fluids in the event of system failure upstream that causes over-pressurization. The present invention is particularly well suited for use in conjunction with hot gas filtering systems, which utilize ceramic candle filters. Used in such a hot gas system the present invention stops the flow of hot gas and prevents any particulate laden gas from entering the clean side of the system.

Standardisation of crown-rump length measurement.

PubMed

Ioannou, C; Sarris, I; Hoch, L; Salomon, L J; Papageorghiou, A T

2013-09-01

Correct estimation of gestational age is essential for any study of ultrasound biometry and for everyday clinical practice. However, inconsistency in pregnancy dating may occur through differences in measurement methods or errors during measurement. In the INTERGROWTH-21(st) Project, pregnancies are dated by the last menstrual period, provided that it is certain and associated with a regular menstrual cycle, and the gestational age by dates concurs with a first-trimester ultrasound crown-rump length (CRL) estimation. Hence, there was a need to standardise CRL measurement methodology across the study sites in this international, multicentre project to avoid systematic differences in dating. To achieve uniformity we undertook the following steps: the ultrasound technique was standardised by disseminating an illustrated, operating manual describing CRL plane landmarks and calliper application, and posters describing the correct acquisition technique were disseminated for quick reference. To ensure that all ultrasonographers understood the methodology, they forwarded a log-book to the INTERGROWTH-21(st) Ultrasound Coordinating Unit, containing the answers to a written test on the manual material and five images of a correctly acquired CRL. Interpretation of CRL was also standardised by ensuring that the same CRL regression formula was used across all study sites. These methods should minimise potential systematic errors in dating associated with pooling data from different health institutions, and represent a model for standardising CRL measurement in future studies. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

Standardised Library Instruction Assessment: An Institution-Specific Approach

ERIC Educational Resources Information Center

Staley, Shannon M.; Branch, Nicole A.; Hewitt, Tom L.

2010-01-01

Introduction: We explore the use of a psychometric model for locally-relevant, information literacy assessment, using an online tool for standardised assessment of student learning during discipline-based library instruction sessions. Method: A quantitative approach to data collection and analysis was used, employing standardised multiple-choice…

Minority Language Standardisation and the Role of Users

ERIC Educational Resources Information Center

Lane, Pia

2015-01-01

Developing a standard for a minority language is not a neutral process; this has consequences for the status of the language and how the language users relate to the new standard. A potential inherent problem with standardisation is whether the language users themselves will accept and identify with the standard. When standardising minority…

Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.

PubMed

McHugh, S; Tracey, M L; Riordan, F; O'Neill, K; Mays, N; Kearney, P M

2016-07-28

Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme's resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative

Estimating the 'consumer surplus' for branded versus standardised tobacco packaging.

PubMed

Gendall, Philip; Eckert, Christine; Hoek, Janet; Farley, Tessa; Louviere, Jordan; Wilson, Nick; Edwards, Richard

2016-11-01

Tobacco companies question whether standardised (or 'plain') packaging will change smokers' behaviour. We addressed this question by estimating how standardised packaging compared to a proven tobacco control intervention, price increases through excise taxes, thus providing a quantitative measure of standardised packaging's likely effect. We conducted an online study of 311 New Zealand smokers aged 18 years and above that comprised a willingness-to-pay task comparing a branded and a standardised pack at four different price levels, and a choice experiment. The latter used an alternative-specific design, where the alternatives were a branded pack or a standardised pack, with warning theme and price varied for each pack. Respondents had higher purchase likelihoods for the branded pack (with a 30% warning) than the standardised pack (with a 75% warning) at each price level tested, and, on average, were willing to pay approximately 5% more for a branded pack. The choice experiment produced a very similar estimate of 'consumer surplus' for a branded pack. However, the size of the 'consumer surplus' varied between warning themes and by respondents' demographic characteristics. These two experiments suggest standardised packaging and larger warning labels could have a similar overall effect on adult New Zealand smokers as a 5% tobacco price increase. The findings provide further evidence for the efficacy of standardised packaging, which focuses primarily on reducing youth initiation, and suggest this measure will also bring notable benefits to adult smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Protocol-based care: the standardisation of decision-making?

PubMed

Rycroft-Malone, Jo; Fontenla, Marina; Seers, Kate; Bick, Debra

2009-05-01

To explore how protocol-based care affects clinical decision-making. In the context of evidence-based practice, protocol-based care is a mechanism for facilitating the standardisation of care and streamlining decision-making through rationalising the information with which to make judgements and ultimately decisions. However, whether protocol-based care does, in the reality of practice, standardise decision-making is unknown. This paper reports on a study that explored the impact of protocol-based care on nurses' decision-making. Theoretically informed by realistic evaluation and the promoting action on research implementation in health services framework, a case study design using ethnographic methods was used. Two sites were purposively sampled; a diabetic and endocrine unit and a cardiac medical unit. Within each site, data collection included observation, postobservation semi-structured interviews with staff and patients, field notes, feedback sessions and document review. Data were inductively and thematically analysed. Decisions made by nurses in both sites were varied according to many different and interacting factors. While several standardised care approaches were available for use, in reality, a variety of information sources informed decision-making. The primary approach to knowledge exchange and acquisition was person-to-person; decision-making was a social activity. Rarely were standardised care approaches obviously referred to; nurses described following a mental flowchart, not necessarily linked to a particular guideline or protocol. When standardised care approaches were used, it was reported that they were used flexibly and particularised. While the logic of protocol-based care is algorithmic, in the reality of clinical practice, other sources of information supported nurses' decision-making process. This has significant implications for the political goal of standardisation. The successful implementation and judicious use of tools such as

76 FR 46277 - Petroleum Wax Candles From the People's Republic of China: Final Results of Request for Comments...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... (September 3, 1985) (``Petition''), at 7. The Department adopted this same language as the scope in its... candles.'' This scope language carried forward without change through the eventual antidumping duty order and subsequent segments of this proceeding. Due to the fact that the plain language of the scope...

Using standardised patients to measure physicians' practice: validation study using audio recordings

PubMed Central

Luck, Jeff; Peabody, John W

2002-01-01

Objective To assess the validity of standardised patients to measure the quality of physicians' practice. Design Validation study of standardised patients' assessments. Physicians saw unannounced standardised patients presenting with common outpatient conditions. The standardised patients covertly tape recorded their visit and completed a checklist of quality criteria immediately afterwards. Their assessments were compared against independent assessments of the recordings by a trained medical records abstractor. Setting Four general internal medicine primary care clinics in California. Participants 144 randomly selected consenting physicians. Main outcome measures Rates of agreement between the patients' assessments and independent assessment. Results 40 visits, one per standardised patient, were recorded. The overall rate of agreement between the standardised patients' checklists and the independent assessment of the audio transcripts was 91% (κ=0.81). Disaggregating the data by medical condition, site, level of physicians' training, and domain (stage of the consultation) gave similar rates of agreement. Sensitivity of the standardised patients' assessments was 95%, and specificity was 85%. The area under the receiver operator characteristic curve was 90%. Conclusions Standardised patients' assessments seem to be a valid measure of the quality of physicians' care for a variety of common medical conditions in actual outpatient settings. Properly trained standardised patients compare well with independent assessment of recordings of the consultations and may justify their use as a “gold standard” in comparing the quality of care across sites or evaluating data obtained from other sources, such as medical records and clinical vignettes. What is already known on this topicStandardised patients are valid and reliable reporters of physicians' practice in the medical education settingHowever, validating standardised patients' measurements of quality of care in

16 CFR Table 2 to Part 1512 - Minimum Candlepower per Incident Foot-Candle for Clear Reflector 1

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Minimum Candlepower per Incident Foot-Candle for Clear Reflector 1 2 Table 2 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION..., and side reflectors; entrance angle in degrees 30 left/right 40 left/right 50 left/right 0.2 8.0 7.0 6...

Standardisation of neonatal clinical practice.

PubMed

Bhutta, Z A; Giuliani, F; Haroon, A; Knight, H E; Albernaz, E; Batra, M; Bhat, B; Bertino, E; McCormick, K; Ochieng, R; Rajan, V; Ruyan, P; Cheikh Ismail, L; Paul, V

2013-09-01

The International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st) ) is a large-scale, population-based, multicentre project involving health institutions from eight geographically diverse countries, which aims to assess fetal, newborn and preterm growth under optimal conditions. Given the multicentre nature of the project and the expected number of preterm births, it is vital that all centres follow the same standardised clinical care protocols to assess and manage preterm infants, so as to ensure maximum validity of the resulting standards as indicators of growth and nutrition with minimal confounding. Moreover, it is well known that evidence-based clinical practice guidelines can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. The INTERGROWTH-21(st) Neonatal Group produced an operations manual, which reflects the consensus reached by members of the group regarding standardised definitions of neonatal morbidities and the minimum standards of care to be provided by all centres taking part in the project. The operational definitions and summary management protocols were developed by consensus through a Delphi process based on systematic reviews of relevant guidelines and management protocols by authoritative bodies. This paper describes the process of developing the Basic Neonatal Care Manual, as well as the morbidity definitions and standardised neonatal care protocols applied across all the INTERGROWTH-21(st) participating centres. Finally, thoughts about implementation strategies are presented. © 2013 Royal College of Obstetricians and Gynaecologists.

The effectiveness of a standardised positioning tool and bedside education on the developmental positioning proficiency of NICU nurses.

PubMed

Spilker, Arlene; Hill, Constance; Rosenblum, Ruth

2016-08-01

In order to improve the developmental proficiency of neonatal intensive care unit nurses, a standardised infant positioning assessment tool and a bedside education programme were introduced to the registered nurses in a 46 bed level III neonatal intensive care unit in the western United States. A developmental positioning team collected pre-intervention positioning scores on 54 preterm infants. This was followed by a survey of the registered nurses beliefs and attitudes, the introduction of the standardised assessment tool and an informal education programme. Post-intervention positioning scores were collected on 55 preterm infants, and analysis of the data indicated there was a statistically significant change in mean positioning scores. Additionally, the registered nurses identified several barriers to the implementation of developmental positioning. This research indicates the use of a standardised infant positioning assessment tool and bedside education may be useful strategies for improving the developmental positioning proficiency of NICU nurses. Copyright © 2016. Published by Elsevier Ltd.

Flemish Sign Language Standardisation

ERIC Educational Resources Information Center

Van Herreweghe, Mieke; Vermeerbergen, Myriam

2009-01-01

In 1997, the Flemish Deaf community officially rejected standardisation of Flemish Sign Language. It was a bold choice, which at the time was not in line with some of the decisions taken in the neighbouring countries. In this article, we shall discuss the choices the Flemish Deaf community has made in this respect and explore why the Flemish Deaf…

Teacher Autonomy in Times of Standardised Lesson Plans: The Case of a Primary School Language and Mathematics Intervention in South Africa

ERIC Educational Resources Information Center

Shalem, Yael; De Clercq, Francine; Steinberg, Carola; Koornhof, Hannchen

2018-01-01

Standardised curriculum or standardized lesson plans (SLPs) have become an accepted strategy to support and improve instructional practices in schools worldwide. These standardised lesson plans (SLPs) were criticized in the 1970s and 1980s for deskilling the teaching profession and reducing the work of teachers to that of mere technicians. This…

When A Standard Candle Flickers

NASA Technical Reports Server (NTRS)

Wilson-Hodge, Colleen A.; Cherry, Michael L.; Case, Gary L.; Baumgartner, Wayne H.; Beklen Elif; Bhat, P. Narayana; Briggs, Michael S.; Camero-Arranz, Ascension; Chaplin, Vandiver; Connaughton, Valerie;

Using multiple continuous fine particle monitors to characterize tobacco, incense, candle, cooking, wood burning, and vehicular sources in indoor, outdoor, and in-transit settings

NASA Astrophysics Data System (ADS)

Ott, Wayne R.; Siegmann, Hans C.

This study employed two continuous particle monitors operating on different measurement principles to measure concentrations simultaneously from common combustion sources in indoor, outdoor, and in-transit settings. The pair of instruments use (a) photo-charging (PC) operating on the principle ionization of fine particles that responds to surface particulate polycyclic aromatic hydrocarbons (PPAHs), and (b) diffusion charging (DC) calibrated to measure the active surface area of fine particles. The sources studied included: (1) secondhand smoke (cigarettes, cigars, and pipes), (2) incense (stick and cone), (3) candles used as food warmers, (4) cooking (toasting bread and frying meat), (5) fireplaces and ambient wood smoke, and (6) in-vehicle exposures traveling on California arterials and interstate highways. The ratio of the PC to the DC readings, or the PC/DC ratio, was found to be different for major categories of sources. Cooking, burning toast, and using a "canned heat" food warmer gave PC/DC ratios close to zero. Controlled experiments with 10 cigarettes averaged 0.15 ng mm -2 (ranging from 0.11 to 0.19 ng mm -2), which was similar to the PC/DC ratio for a cigar, although a pipe was slightly lower (0.09 ng mm -2). Large incense sticks had PC/DC ratios similar to those of cigarettes and cigars. The PC/DC ratios for ambient wood smoke averaged 0.29 ng mm -2 on 6 dates, or about twice those of cigarettes and cigars, reflecting a higher ratio of PAH to active surface area. The smoke from two artificial logs in a residential fireplace had a PC/DC ratio of 0.33-0.35 ng mm -2. The emissions from candles were found to vary, depending on how the candles were burned. If the candle flickered and generated soot, a higher PC/DC ratio resulted than if the candle burned uniformly in still air. Inserting piece of metal into the candle's flame caused high PPAH emissions with a record PC/DC reading of 1.8 ng mm -2. In-vehicle exposures measured on 43- and 50-min drives on a

Senior physiotherapy students as standardised patients for junior students enhances self-efficacy and satisfaction in both junior and senior students

PubMed Central

2014-01-01

Background Standardised patients are used in medical education to expose students to clinical contexts and facilitate transition to clinical practice, and this approach is gaining momentum in physiotherapy programs. Expense and availability of trained standardised patients are factors limiting widespread adoption, and accessing clinical visits with real patients can be challenging. This study addressed these issues by engaging senior students as standardised patients for junior students. It evaluated how this approach impacted self-reported constructs of both the junior and senior students. Methods Learning activities for undergraduate physiotherapy students were developed in five courses (Neurology, Cardiorespiratory and three Musculoskeletal courses) so that junior students (Year 2 and 3) could develop skills and confidence in patient interview, physical examination and patient management through their interaction with standardised patients played by senior students (Year 4). Surveys were administered before and after the interactions to record junior students’ self-reported confidence, communication, preparedness for clinic, and insight into their abilities; and senior students’ confidence and insight into what it is like to be a patient. Satisfaction regarding this learning approach was surveyed in both the junior and senior students. Results A total of 253 students completed the surveys (mean 92.5% response rate). Across all courses, junior students reported a significant (all P < 0.037) improvement following the standardised patient interaction in their: preparedness for clinic, communication with clients, confidence with practical skills, and understanding of their strengths and weaknesses in relation to the learning activities. Senior students demonstrated a significant improvement in their confidence in providing feedback and insight into their own learning (P < 0.001). All students reported high satisfaction with this learning experience (mean

Senior physiotherapy students as standardised patients for junior students enhances self-efficacy and satisfaction in both junior and senior students.

PubMed

Mandrusiak, Allison M; Isles, Rosemary; Chang, Angela T; Choy, Nancy L Low; Toppenberg, Rowena; McCook, Donna; Smith, Michelle D; O'Leary, Karina; Brauer, Sandra G

2014-05-23

Standardised patients are used in medical education to expose students to clinical contexts and facilitate transition to clinical practice, and this approach is gaining momentum in physiotherapy programs. Expense and availability of trained standardised patients are factors limiting widespread adoption, and accessing clinical visits with real patients can be challenging. This study addressed these issues by engaging senior students as standardised patients for junior students. It evaluated how this approach impacted self-reported constructs of both the junior and senior students. Learning activities for undergraduate physiotherapy students were developed in five courses (Neurology, Cardiorespiratory and three Musculoskeletal courses) so that junior students (Year 2 and 3) could develop skills and confidence in patient interview, physical examination and patient management through their interaction with standardised patients played by senior students (Year 4). Surveys were administered before and after the interactions to record junior students' self-reported confidence, communication, preparedness for clinic, and insight into their abilities; and senior students' confidence and insight into what it is like to be a patient. Satisfaction regarding this learning approach was surveyed in both the junior and senior students. A total of 253 students completed the surveys (mean 92.5% response rate). Across all courses, junior students reported a significant (all P < 0.037) improvement following the standardised patient interaction in their: preparedness for clinic, communication with clients, confidence with practical skills, and understanding of their strengths and weaknesses in relation to the learning activities. Senior students demonstrated a significant improvement in their confidence in providing feedback and insight into their own learning (P < 0.001). All students reported high satisfaction with this learning experience (mean score 8.5/10). This new

Use of standardised patients to assess quality of tuberculosis care: a pilot, cross-sectional study.

PubMed

Das, Jishnu; Kwan, Ada; Daniels, Benjamin; Satyanarayana, Srinath; Subbaraman, Ramnath; Bergkvist, Sofi; Das, Ranendra K; Das, Veena; Pai, Madhukar

2015-11-01

standardised patients' recall correlated highly with audio recordings (r=0·63 [95% CI 0·53-0·79]), with no safety concerns reported. The mean consultation length was 6 min (95% CI 5·5-6·6) with a mean of 6·18 (5·72-6·64) questions or examinations completed, representing 35% (33-38) of essential checklist items. Across all cases, only 52 (21% [16-26]) of 250 were correctly managed. Correct management was higher among MBBS-qualified doctors than other types of health-care provider (adjusted odds ratio 2·41 [95% CI 1·17-4·93]; p=0·0166). Of the 69 providers who completed the vignette, knowledge in the vignettes was more consistent with STCI than their actual clinical practice-eg, 50 (73%) ordered a chest radiograph or sputum test during the vignette compared with seven (10%) during the standardised-patient interaction; OR 0·04 (95% CI 0·02-0·11); p<0·0001. Standardised patients can be successfully implemented to assess tuberculosis care. Our data suggest a big gap between private provider knowledge and practice. Additional work is needed to substantiate our pilot data, understand the know-do gap in provider behaviour, and to identify the best approach to measure and improve the quality of tuberculosis care in India. Grand Challenges Canada, the Bill & Melinda Gates Foundation, Knowledge for Change Program, and the World Bank Development Research Group. Copyright © 2015 Elsevier Ltd. All rights reserved.

Direct risk standardisation: a new method for comparing casemix adjusted event rates using complex models

PubMed Central

2013-01-01

Background Comparison of outcomes between populations or centres may be confounded by any casemix differences and standardisation is carried out to avoid this. However, when the casemix adjustment models are large and complex, direct standardisation has been described as “practically impossible”, and indirect standardisation may lead to unfair comparisons. We propose a new method of directly standardising for risk rather than standardising for casemix which overcomes these problems. Methods Using a casemix model which is the same model as would be used in indirect standardisation, the risk in individuals is estimated. Risk categories are defined, and event rates in each category for each centre to be compared are calculated. A weighted sum of the risk category specific event rates is then calculated. We have illustrated this method using data on 6 million admissions to 146 hospitals in England in 2007/8 and an existing model with over 5000 casemix combinations, and a second dataset of 18,668 adult emergency admissions to 9 centres in the UK and overseas and a published model with over 20,000 casemix combinations and a continuous covariate. Results Substantial differences between conventional directly casemix standardised rates and rates from direct risk standardisation (DRS) were found. Results based on DRS were very similar to Standardised Mortality Ratios (SMRs) obtained from indirect standardisation, with similar standard errors. Conclusions Direct risk standardisation using our proposed method is as straightforward as using conventional direct or indirect standardisation, always enables fair comparisons of performance to be made, can use continuous casemix covariates, and was found in our examples to have similar standard errors to the SMR. It should be preferred when there is a risk that conventional direct or indirect standardisation will lead to unfair comparisons. PMID:24168424

Direct risk standardisation: a new method for comparing casemix adjusted event rates using complex models.

PubMed

Nicholl, Jon; Jacques, Richard M; Campbell, Michael J

2013-10-29

Comparison of outcomes between populations or centres may be confounded by any casemix differences and standardisation is carried out to avoid this. However, when the casemix adjustment models are large and complex, direct standardisation has been described as "practically impossible", and indirect standardisation may lead to unfair comparisons. We propose a new method of directly standardising for risk rather than standardising for casemix which overcomes these problems. Using a casemix model which is the same model as would be used in indirect standardisation, the risk in individuals is estimated. Risk categories are defined, and event rates in each category for each centre to be compared are calculated. A weighted sum of the risk category specific event rates is then calculated. We have illustrated this method using data on 6 million admissions to 146 hospitals in England in 2007/8 and an existing model with over 5000 casemix combinations, and a second dataset of 18,668 adult emergency admissions to 9 centres in the UK and overseas and a published model with over 20,000 casemix combinations and a continuous covariate. Substantial differences between conventional directly casemix standardised rates and rates from direct risk standardisation (DRS) were found. Results based on DRS were very similar to Standardised Mortality Ratios (SMRs) obtained from indirect standardisation, with similar standard errors. Direct risk standardisation using our proposed method is as straightforward as using conventional direct or indirect standardisation, always enables fair comparisons of performance to be made, can use continuous casemix covariates, and was found in our examples to have similar standard errors to the SMR. It should be preferred when there is a risk that conventional direct or indirect standardisation will lead to unfair comparisons.

Standardisation of magnetic nanoparticles in liquid suspension

NASA Astrophysics Data System (ADS)

Wells, James; Kazakova, Olga; Posth, Oliver; Steinhoff, Uwe; Petronis, Sarunas; Bogart, Lara K.; Southern, Paul; Pankhurst, Quentin; Johansson, Christer

2017-09-01

Suspensions of magnetic nanoparticles offer diverse opportunities for technology innovation, spanning a large number of industry sectors from imaging and actuation based applications in biomedicine and biotechnology, through large-scale environmental remediation uses such as water purification, to engineering-based applications such as position-controlled lubricants and soaps. Continuous advances in their manufacture have produced an ever-growing range of products, each with their own unique properties. At the same time, the characterisation of magnetic nanoparticles is often complex, and expert knowledge is needed to correctly interpret the measurement data. In many cases, the stringent requirements of the end-user technologies dictate that magnetic nanoparticle products should be clearly defined, well characterised, consistent and safe; or to put it another way—standardised. The aims of this document are to outline the concepts and terminology necessary for discussion of magnetic nanoparticles, to examine the current state-of-the-art in characterisation methods necessary for the most prominent applications of magnetic nanoparticle suspensions, to suggest a possible structure for the future development of standardisation within the field, and to identify areas and topics which deserve to be the focus of future work items. We discuss potential roadmaps for the future standardisation of this developing industry, and the likely challenges to be encountered along the way.

Standardisation in the field of nanotechnology: some issues of legitimacy.

PubMed

Forsberg, Ellen-Marie

2012-12-01

Nanotechnology will allegedly have a revolutionary impact in a wide range of fields, but has also created novel concerns about health, safety and the environment (HSE). Nanotechnology regulation has nevertheless lagged behind nanotechnology development. In 2004 the International Organization for Standardization established a technical committee for producing nanotechnology standards for terminology, measurements, HSE issues and product specifications. These standards are meant to play a role in nanotechnology development, as well as in national and international nanotechnology regulation, and will therefore have consequences for consumers, workers and the environment. This paper gives an overview of the work in the technical committee on nanotechnology and discusses some challenges with regard to legitimacy in such work. The paper focuses particularly on stakeholder involvement and the potential problems of scientific robustness when standardising in such early stages of the scientific development. The intention of the paper is to raise some important issues rather than to draw strong conclusions. However, the paper will be concluded with some suggestions for improving legitimacy in the TC 229 and a call for increased public awareness about standardisation in the field of nanotechnology.

Machinability of drilling T700/LT-03A carbon fiber reinforced plastic (CFRP) composite laminates using candle stick drill and multi-facet drill

NASA Astrophysics Data System (ADS)

Wang, Cheng-Dong; Qiu, Kun-Xian; Chen, Ming; Cai, Xiao-Jiang

2015-03-01

Carbon Fiber Reinforced Plastic (CFRP) composite laminates are widely used in aerospace and aircraft structural components due to their superior properties. However, they are regarded as difficult-to-cut materials because of bad surface quality and low productivity. Drilling is the most common hole making process for CFRP composite laminates and drilling induced delamination damage usually occurs severely at the exit side of drilling holes, which strongly deteriorate holes quality. In this work, the candle stick drill and multi-facet drill are employed to evaluate the machinability of drilling T700/LT-03A CFRP composite laminates in terms of thrust force, delamination, holes diameter and holes surface roughness. S/N ratio is used to characterize the thrust force while an ellipse-shaped delamination model is established to quantitatively analyze the delamination. The best combination of drilling parameters are determined by full consideration of S/N ratios of thrust force and the delamination. The results indicate that candle stick drill will induce the unexpected ellipse-shaped delamination even at its best drilling parameters of spindle speed of 10,000 rpm and feed rate of 0.004 mm/tooth. However, the multi-facet drill cutting at the relative lower feed rate of 0.004 mm/tooth and lower spindle speed of 6000 rpm can effectively prevent the delamination. Comprehensively, holes quality obtained by multi-facet drill is much more superior to those obtained by candle stick drill.

A combined teamwork training and work standardisation intervention in operating theatres: controlled interrupted time series study.

PubMed

Morgan, Lauren; Pickering, Sharon P; Hadi, Mohammed; Robertson, Eleanor; New, Steve; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

2015-02-01

Teamwork training and system standardisation have both been proposed to reduce error and harm in surgery. Since the approaches differ markedly, there is potential for synergy between them. Controlled interrupted time series with a 3 month intervention and observation phases before and after. Operating theatres conducting elective orthopaedic surgery in a single hospital system (UK Hospital Trust). Teamwork training based on crew resource management plus training and follow-up support in developing standardised operating procedures. Focus of subsequent standardisation efforts decided by theatre staff. Paired observers watched whole procedures together. We assessed non-technical skills using NOTECHS II, technical performance using glitch rate and compliance with WHO checklist using a simple quality tool. We measured complication and readmission rates and hospital stay using hospital administrative records. Before/after change was compared in the active and control groups using two-way ANOVA and regression models. 1121 patients were operated on before and 1100 after intervention. 44 operations were observed before and 50 afterwards. Non-technical skills (p=0.002) and WHO compliance (p<0.001) improved significantly after the intervention in the active versus the control group. Glitch count improved in both groups and there was no significant effect on clinical outcomes. Combined training in teamwork and system improvement causes marked improvements in team behaviour and WHO performance, but not technical performance or outcome. These findings are consistent with the synergistic hypothesis, but larger controlled studies with a strong implementation strategy are required to test potential outcome effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Surgical History Taking and Clinical Examination: Establishing a Standardised System by Means of a Nation-Wide Academic Teaching Project].

PubMed

von Bernstorff, W; Irmer, H; Menges, P; Peters, S; Heidecke, C-D; Busemann, A

2017-02-01

Background: History taking and systematic clinical examination are central techniques of physicians. Medicine in general and surgery in particular frequently require immediate decisions and start of therapies. So far, a standardised surgical system for history taking and clinical examination in teaching has been lacking at our faculty. A consensus of all medical faculties on a standardised system could be a tool to improve the medical teaching and education at our teaching institutions. Methods: The established Anglo-Saxonian system of history taking and clinical examination was adapted to our own clinical needs. Thereafter, this system was sent out to all chairmen of general and visceral surgery departments in German University Hospitals asking for evaluation and improvements. We adapted the system according to the chairmen's comments and suggestions. Since winter semester 2011 this system has been integrated into the clinical course of history taking and examination. It is compulsory for all 5th semester students (first clinical year/graduate course) at the Universitätsmedizin Greifswald. In addition, a video was produced demonstrating all major techniques of clinical examination. This video is available for all students on a password blocked site of the World Wide Web. Results: Altogether, 89 % of all contacted chairmen returned their comments and suggestions for improvements. After implementation of the new system, positive evaluations of students increased significantly from 63.5 to 77.0 % in general and abdominal surgery (p < 0.0001) and from 76.4 to 83.5 % in vascular and thoracic surgery (p < 0.0001). Conclusions: The presented system is a standardised tool of history taking and clinical examination applicable for students as well as qualified surgeons in daily routine work. It has been approved by the majority of the departments of surgery of all German university hospitals. Furthermore, it can be applied by other medical specialties, in

How Beatrice Tinsley Destroyed Sandage's Quest for a Standard Candle

NASA Astrophysics Data System (ADS)

Mitton, Simon

2014-01-01

The goal of cosmology and most extragalactic optical astronomy during the heroic period spanning the half century from Hubble to Sandage (1920s - 1970s) was a search for two numbers, the Hubble constant and the deceleration parameter. Standard candles were needed to establish the measure of the universe. In 1968, Beatrice Tinsley, then a postdoctoral fellow in the astronomy department of the University of Texas at Austin showed that the great enterprise at Palomar of calibrating the galaxies was in need of major revision. At the 132nd AAS Meeting (June 1970, Boulder, Colorado) she presented a paper on galactic evolution on the magnitude-redshift relation. In her Abstract she boldly wrote: "My present conclusion is opposite to that reached by most cosmologists." In fact her claims caused great consternation among cosmologists. In 1972 she published eight papers on the evolution of galaxies, and the effects of that evolution for observational cosmology and the origin of structure.

Nurse's use of power to standardise nursing terminology in electronic health records.

PubMed

Ali, Samira; Sieloff, Christina L

2017-07-01

To describe nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. Little is known about nurses' potential use of power to influence the incorporation of standardised nursing terminology within electronic health records. The theory of group power within organisations informed the design of the descriptive, cross-sectional study used a survey method to assess nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. The Sieloff-King Assessment of Group Power within Organizations © and Nursing Power Scale was used. A total of 232 nurses responded to the survey. The mean power capability score was moderately high at 134.22 (SD 18.49), suggesting that nurses could use power to achieve the incorporation of standardised nursing terminology within electronic health records. The nurses' power capacity was significantly correlated with their power capability (r = 0.96, P < 0.001). Nurses may use power to achieve their goals, such as the incorporation of standardised nursing terminology within electronic health records. Nurse administrators may use their power to influence the incorporation of standardised nursing terminology within electronic health records. If nurses lack power, this could decrease nurses' ability to achieve their goals and contribute to the achievement of effective patient outcomes. © 2017 John Wiley & Sons Ltd.

[Body plethysmography (I): Standardisation and quality criteria].

PubMed

de Mir Messa, I; Sardón Prado, O; Larramona, H; Salcedo Posadas, A; Villa Asensi, J R

2015-08-01

Whole body plethysmography is used to measure lung volumes, capacities and resistances. It is a well standardised technique, and although it is widely used in paediatric chest diseases units, it requires specific equipment, specialist staff, and some cooperation by the patient. Plethysmography uses Boyle's law in order to measure the intrathoracic gas volume or functional residual capacity, and once this is determined, the residual volume and total lung capacity is extrapolated. The measurement of total lung capacity is necessary for the diagnosis of restrictive diseases. Airway resistance is a measurement of obstruction, with the total resistance being able to be measured, which includes chest wall, lung tissue and airway resistance, as well as the specific airway resistance, which is a more stable parameter that is determined by multiplying the measured values of airway resistance and functional residual capacity. The complexity of this technique, the reference equations, the differences in the equipment and their variability, and the conditions in which it is performed, has led to the need for its standardisation. Throughout this article, the practical aspects of plethysmography are analysed, specifying recommendations for performing it, its systematic calibration and the calculations that must be made, as well as the interpretation of the results obtained. The aim of this article is to provide a better understanding of the principles of whole body plethysmography with the aim of optimising the interpretation of the results, leading to improved management of the patient, as well as a consensus among the speciality. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Thirty-minute compared to standardised office blood pressure measurement in general practice

PubMed Central

Scherpbier-de Haan, Nynke; van der Wel, Mark; Schoenmakers, Gijs; Boudewijns, Steve; Peer, Petronella; van Weel, Chris; Thien, Theo; Bakx, Carel

2011-01-01

Background Although blood pressure measurement is one of the most frequently performed measurements in clinical practice, there are concerns about its reliability. Serial, automated oscillometric blood pressure measurement has the potential to reduce measurement bias and white-coat effect' Aim To study agreement of 30-minute office blood pressure measurement (OBPM) with standardised OBPM, and to compare repeatability Design and setting Method comparison study in two general practices in the Netherlands Method Thirty-minute and standardised OBPM was carried out with the same, validated device in 83 adult patients, and the procedure was repeated after 2 weeks. During 30-minute OBPM, blood pressure was measured automatically every 3 minutes, with the patient in a sitting position, alone in a quiet room. Agreement between 30-minute and standardised OBPM was assessed by Bland–Altman analysis. Repeatability of the blood pressure measurement methods after 2 weeks was expressed as the mean difference in combination with the standard deviation of difference (SDD) Results Mean 30-minute OBPM readings were 7.6/2.5 mmHg (95% confidence interval [CI] = 6.1 to 9.1/1.5 to 3.4 mmHg) lower than standardised OBPM readings. The mean difference and SDD between repeated 30-minute OBPMs (mean difference = 3/1 mmHg, 95% CI = 1 to 5/0 to 2 mmHg; SDD 9.5/5.3 mmHg) were lower than those of standardised OBPMs (mean difference = 6/2 mmHg, 95% CI = 4 to 8/1 to 4 mmHg; SDD 10.9/6.3 mmHg). Conclusion Thirty-minute OBPM resulted in lower readings than standardised OBPM and had a better repeatability. These results suggest that 30-minute OBPM better reflects the patient's true blood pressure than standardised OBPM does. PMID:22152748

Power flattening on modified CANDLE small long life gas-cooled fast reactor

NASA Astrophysics Data System (ADS)

Monado, Fiber; Su'ud, Zaki; Waris, Abdul; Basar, Khairul; Ariani, Menik; Sekimoto, Hiroshi

2014-09-01

Gas-cooled Fast Reactor (GFR) is one of the candidates of next generation Nuclear Power Plants (NPPs) that expected to be operated commercially after 2030. In this research conceptual design study of long life 350 MWt GFR with natural uranium metallic fuel as fuel cycle input has been performed. Modified CANDLE burn-up strategy with first and second regions located near the last region (type B) has been applied. This reactor can be operated for 10 years without refuelling and fuel shuffling. Power peaking reduction is conducted by arranging the core radial direction into three regions with respectively uses fuel volume fraction 62.5%, 64% and 67.5%. The average power density in the modified core is about 82 Watt/cc and the power peaking factor decreased from 4.03 to 3.43.

A method for developing standardised interactive education for complex clinical guidelines

PubMed Central

2012-01-01

Background Although systematic use of the Perinatal Society of Australia and New Zealand internationally endorsed Clinical Practice Guideline for Perinatal Mortality (PSANZ-CPG) improves health outcomes, implementation is inadequate. Its complexity is a feature known to be associated with non-compliance. Interactive education is effective as a guideline implementation strategy, but lacks an agreed definition. SCORPIO is an educational framework containing interactive and didactic teaching, but has not previously been used to implement guidelines. Our aim was to transform the PSANZ-CPG into an education workshop to develop quality standardised interactive education acceptable to participants for learning skills in collaborative interprofessional care. Methods The workshop was developed using the construct of an educational framework (SCORPIO), the PSANZ-CPG, a transformation process and tutor training. After a pilot workshop with key target and stakeholder groups, modifications were made to this and subsequent workshops based on multisource written observations from interprofessional participants, tutors and an independent educator. This participatory action research process was used to monitor acceptability and educational standards. Standardised interactive education was defined as the attainment of content and teaching standards. Quantitative analysis of positive expressed as a percentage of total feedback was used to derive a total quality score. Results Eight workshops were held with 181 participants and 15 different tutors. Five versions resulted from the action research methodology. Thematic analysis of multisource observations identified eight recurring education themes or quality domains used for standardisation. The two content domains were curriculum and alignment with the guideline and the six teaching domains; overload, timing, didacticism, relevance, reproducibility and participant engagement. Engagement was the most challenging theme to resolve

A method for developing standardised interactive education for complex clinical guidelines.

PubMed

Vaughan, Janet I; Jeffery, Heather E; Raynes-Greenow, Camille; Gordon, Adrienne; Hirst, Jane; Hill, David A; Arbuckle, Susan

2012-11-06

Although systematic use of the Perinatal Society of Australia and New Zealand internationally endorsed Clinical Practice Guideline for Perinatal Mortality (PSANZ-CPG) improves health outcomes, implementation is inadequate. Its complexity is a feature known to be associated with non-compliance. Interactive education is effective as a guideline implementation strategy, but lacks an agreed definition. SCORPIO is an educational framework containing interactive and didactic teaching, but has not previously been used to implement guidelines. Our aim was to transform the PSANZ-CPG into an education workshop to develop quality standardised interactive education acceptable to participants for learning skills in collaborative interprofessional care. The workshop was developed using the construct of an educational framework (SCORPIO), the PSANZ-CPG, a transformation process and tutor training. After a pilot workshop with key target and stakeholder groups, modifications were made to this and subsequent workshops based on multisource written observations from interprofessional participants, tutors and an independent educator. This participatory action research process was used to monitor acceptability and educational standards. Standardised interactive education was defined as the attainment of content and teaching standards. Quantitative analysis of positive expressed as a percentage of total feedback was used to derive a total quality score. Eight workshops were held with 181 participants and 15 different tutors. Five versions resulted from the action research methodology. Thematic analysis of multisource observations identified eight recurring education themes or quality domains used for standardisation. The two content domains were curriculum and alignment with the guideline and the six teaching domains; overload, timing, didacticism, relevance, reproducibility and participant engagement. Engagement was the most challenging theme to resolve. Tutors identified all themes for

Planetary nebulae as standard candles. IV - A test in the Leo I group

NASA Technical Reports Server (NTRS)

Ciardullo, Robin; Jacoby, George H.; Ford, Holland C.

1989-01-01

In this paper, PN are used to determine accurate distances to three galaxies in the Leo I group - The E0 giant elliptical NGC 3379, its optical companion, the SB0 spiral NGC 3384, and the smaller E6 elliptical NGC 3377. In all three galaxies, the luminosity-specific PN number densities are roughly the same, and the derived stellar death rates are in remarkable agreement with the predictions of stellar evolution theory. It is shown that the shape of the forbidden O III 5007 A PN luminosity function is the same in each galaxy and indistinguishable from that observed in M31 and M81. It is concluded that the PN luminosity function is an excellent standard candle for early-type galaxies.

Standardised metrics for global surgical surveillance.

PubMed

Weiser, Thomas G; Makary, Martin A; Haynes, Alex B; Dziekan, Gerald; Berry, William R; Gawande, Atul A

2009-09-26

Public health surveillance relies on standardised metrics to evaluate disease burden and health system performance. Such metrics have not been developed for surgical services despite increasing volume, substantial cost, and high rates of death and disability associated with surgery. The Safe Surgery Saves Lives initiative of WHO's Patient Safety Programme has developed standardised public health metrics for surgical care that are applicable worldwide. We assembled an international panel of experts to develop and define metrics for measuring the magnitude and effect of surgical care in a population, while taking into account economic feasibility and practicability. This panel recommended six measures for assessing surgical services at a national level: number of operating rooms, number of operations, number of accredited surgeons, number of accredited anaesthesia professionals, day-of-surgery death ratio, and postoperative in-hospital death ratio. We assessed the feasibility of gathering such statistics at eight diverse hospitals in eight countries and incorporated them into the WHO Guidelines for Safe Surgery, in which methods for data collection, analysis, and reporting are outlined.

Standardising Assessment to Meet Student Needs in Foreign Language Modules in a University Context: Is Standardisation Possible?

ERIC Educational Resources Information Center

Nunan, Anna

2014-01-01

The Applied Language Centre at University College Dublin offers foreign language modules to students in ten languages at CEFR [Common European Framework of Reference for Languages] levels ranging from A1 to B2. Efforts have been underway in the Centre to standardise the assessment components across languages to ensure parity between module credits…

Standardised simulation-based emergency and intensive care nursing curriculum to improve nursing students' performance during simulated resuscitation: A quasi-experimental study.

PubMed

Chen, Jie; Yang, Jian; Hu, Fen; Yu, Si-Hong; Yang, Bing-Xiang; Liu, Qian; Zhu, Xiao-Ping

2018-06-01

Simulation-based curriculum has been demonstrated as crucial to nursing education in the development of students' critical thinking and complex clinical skills during a resuscitation simulation. Few studies have comprehensively examined the effectiveness of a standardised simulation-based emergency and intensive care nursing curriculum on the performance of students in a resuscitation simulation. To evaluate the impact of a standardised simulation-based emergency and intensive care nursing curriculum on nursing students' response time in a resuscitation simulation. Two-group, non-randomised quasi-experimental design. A simulation centre in a Chinese University School of Nursing. Third-year nursing students (N = 39) in the Emergency and Intensive Care course were divided into a control group (CG, n = 20) and an experimental group (EG, n = 19). The experimental group participated in a standardised high-technology, simulation-based emergency and intensive care nursing curriculum. The standardised simulation-based curriculum for third-year nursing students consists of three modules: disaster response, emergency care, and intensive care, which include clinical priorities (e.g. triage), basic resuscitation skills, airway/breathing management, circulation management and team work with eighteen lecture hours, six skill-practice hours and twelve simulation hours. The control group took part in the traditional curriculum. This course included the same three modules with thirty-four lecture hours and two skill-practice hours (trauma). Perceived benefits included decreased median (interquartile ranges, IQR) seconds to start compressions [CG 32 (25-75) vs. EG 20 (18-38); p < 0.001] and defibrillation [CG 204 (174-240) vs. EG 167 (162-174); p < 0.001] at the end of the course, compared with compressions [CG 41 (32-49) vs. EG 42 (33-46); p > 0.05] and defibrillation [CG 222 (194-254) vs. EG 221 (214-248); p > 0.05] at the beginning of the course. A

Additive loss-of-function proteasome subunit mutations in CANDLE/PRAAS patients promote type I IFN production

PubMed Central

Brehm, Anja; Liu, Yin; Sheikh, Afzal; Marrero, Bernadette; Omoyinmi, Ebun; Zhou, Qing; Montealegre, Gina; Biancotto, Angelique; Reinhardt, Adam; Almeida de Jesus, Adriana; Pelletier, Martin; Tsai, Wanxia L.; Remmers, Elaine F.; Kardava, Lela; Hill, Suvimol; Kim, Hanna; Lachmann, Helen J.; Megarbane, Andre; Chae, Jae Jin; Brady, Jilian; Castillo, Rhina D.; Brown, Diane; Casano, Angel Vera; Gao, Ling; Chapelle, Dawn; Huang, Yan; Stone, Deborah; Chen, Yongqing; Sotzny, Franziska; Lee, Chyi-Chia Richard; Kastner, Daniel L.; Torrelo, Antonio; Zlotogorski, Abraham; Moir, Susan; Gadina, Massimo; McCoy, Phil; Wesley, Robert; Rother, Kristina; Hildebrand, Peter W.; Brogan, Paul; Krüger, Elke; Aksentijevich, Ivona; Goldbach-Mansky, Raphaela

2015-01-01

Autosomal recessive mutations in proteasome subunit β 8 (PSMB8), which encodes the inducible proteasome subunit β5i, cause the immune-dysregulatory disease chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE), which is classified as a proteasome-associated autoinflammatory syndrome (PRAAS). Here, we identified 8 mutations in 4 proteasome genes, PSMA3 (encodes α7), PSMB4 (encodes β7), PSMB9 (encodes β1i), and proteasome maturation protein (POMP), that have not been previously associated with disease and 1 mutation in PSMB8 that has not been previously reported. One patient was compound heterozygous for PSMB4 mutations, 6 patients from 4 families were heterozygous for a missense mutation in 1 inducible proteasome subunit and a mutation in a constitutive proteasome subunit, and 1 patient was heterozygous for a POMP mutation, thus establishing a digenic and autosomal dominant inheritance pattern of PRAAS. Function evaluation revealed that these mutations variably affect transcription, protein expression, protein folding, proteasome assembly, and, ultimately, proteasome activity. Moreover, defects in proteasome formation and function were recapitulated by siRNA-mediated knockdown of the respective subunits in primary fibroblasts from healthy individuals. Patient-isolated hematopoietic and nonhematopoietic cells exhibited a strong IFN gene-expression signature, irrespective of genotype. Additionally, chemical proteasome inhibition or progressive depletion of proteasome subunit gene transcription with siRNA induced transcription of type I IFN genes in healthy control cells. Our results provide further insight into CANDLE genetics and link global proteasome dysfunction to increased type I IFN production. PMID:26524591

Development of a methodology for the standardisation and improvement of 'Smartphone' photography of patterned bruises and other cutaneous injuries.

PubMed

Biggs, Paul R; Evans, Samuel T; Jones, Michael D; Theobald, Peter S

2013-09-01

Human bite-mark analyses can play a prominent role in forensic case investigations, including those involving sexual assault. High-quality photographs routinely secure a link between a bite-mark and an individual's dentition. Access to around the clock forensic photography, however, is often limited, resulting in delay and/or missed opportunities to record valuable evidence. The emergence of Smartphone high-quality photographic technology now provides a previously unimagined opportunity to gather timely forensic photographic evidence. Problems can arise, however, due to the relatively poor quality of the photographs, as a result of many of those taking photographs having received little or no forensic photography training. This study compares unassisted photography with assisted photography, by a specifically developed camera application (App), to provide a standardised method for taking forensic photographs. An App, written in Java, was hosted on the Google Android Operating System, on a Samsung Galaxy SII Smartphone. Twenty-four volunteers participated in a study to photograph a pseudo bite-mark using three methods, (1) unassisted (as a control), (2) assisted by an ABFO No.2 right-angled photographic reference scale and (3) assisted by the App. The App, method (3), was shown to consistently outperform methods (1) and (2), demonstrating greater standardisation and precision (p<0.001). Analysis of the data showed the extent to which acquiring an accurate photograph depends on the image being orthogonal to the camera. It appears likely that the relatively inaccurate photographs acquired by methods (1) and (2), were as a result of deviation from the plane, orthogonal to the bite-mark. Therefore, the App was successful in ensuring that the camera was both orthogonal and at an appropriate distance, relative to the bite-mark. Thus, the App enhanced the abilities of non-experts to acquire more accurate photographs and created the potential to significantly improve the

Standardised surface electromyography allows effective submental muscles assessment.

PubMed

Musto, Federica; Rosati, Riccardo; Sforza, Chiarella; Toma, Marilisa; Dellavia, Claudia

2017-06-01

The aims of this pilot study were to evaluate: (i) the reproducibility and variability of an electromyographical protocol developed for the assessment of submental muscles (SM) (ii) to apply the new protocol to maximal teeth clenching, a simple and largely studied static task in order to quantify the relative contribution of submental muscles. In 20 healthy subjects, aged 19-35years, surface electromyography of SM, masseter (MM) and anterior temporalis (TA) muscles was performed during maximal voluntary clenching (MVC) with and without cotton rolls and the pushing of the tongue against the palate. Clenching on cotton rolls and pushing the tongue against the palate were used to standardise respectively MM and TA, and SM muscular potentials. The exercises were repeated in two appointments (T1-T2); submental muscles standardisation was also repeated twice (A-B) in each session to assess repeatability. Symmetry and activity were calculated for each couple of muscles. A two-way analysis of variance was computed for SM: no Factor 1 (T1 vs T2) or Factor 2 (A vs B) or F1×F2 significant effects were found. SM recruitment was 31% of the maximal activity, with symmetry values larger than 80%. In conclusion, standardised electromyography allows a reliable assessment of Submental muscles activity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Dissuasive cigarette sticks: the next step in standardised ('plain') packaging?

PubMed

Hoek, Janet; Gendall, Philip; Eckert, Christine; Louviere, Jordan

2016-11-01

Standardised (or 'plain') packaging has reduced the appeal of smoking by removing imagery that smokers use to affiliate themselves with the brand they smoke. We examined whether changing the appearance of cigarette sticks could further denormalise smoking and enhance the negative impact of standardised packaging. We conducted an online study of 313 New Zealand smokers who comprised a Best-Worst Choice experiment and a rating task. The Best-Worst experiment used a 2×3×3×6 orthogonal design to test the following attributes: on-pack warning message, branding level, warning size and stick appearance. We identified three segments whose members' choice patterns were strongly influenced by the stick design, warning theme and size, and warning theme, respectively. Each of the dissuasive sticks tested was less preferred and rated as less appealing than the most common stick in use; a 'minutes of life lost' stick was the most aversive of the stimuli tested. Dissuasive sticks could enhance the effect of standardised packaging, particularly among older smokers who are often more heavily addicted and resistant to change. Countries introducing standardised packaging legislation should take the opportunity to denormalise the appearance of cigarette sticks, in addition to removing external tobacco branding from packs and increasing the warning size. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Impact of Microlensing on the Standardisation of Strongly Lensed Type Ia Supernovae

NASA Astrophysics Data System (ADS)

Foxley-Marrable, Max; Collett, Thomas E.; Vernardos, Georgios; Goldstein, Daniel A.; Bacon, David

2018-05-01

We investigate the effect of microlensing on the standardisation of strongly lensed Type Ia supernovae (GLSNe Ia). We present predictions for the amount of scatter induced by microlensing across a range of plausible strong lens macromodels. We find that lensed images in regions of low convergence, shear and stellar density are standardisable, where the microlensing scatter is ≲ 0.15 magnitudes, comparable to the intrinsic dispersion of for a typical SN Ia. These standardisable configurations correspond to asymmetric lenses with an image located far outside the Einstein radius of the lens. Symmetric and small Einstein radius lenses (≲ 0.5 arcsec) are not standardisable. We apply our model to the recently discovered GLSN Ia iPTF16geu and find that the large discrepancy between the observed flux and the macromodel predictions from More et al. (2017) cannot be explained by microlensing alone. Using the mock GLSNe Ia catalogue of Goldstein et al. (2017), we predict that ˜ 22% of GLSNe Ia discovered by LSST will be standardisable, with a median Einstein radius of 0.9 arcseconds and a median time-delay of 41 days. By breaking the mass-sheet degeneracy the full LSST GLSNe Ia sample will be able to detect systematics in H0 at the 0.5% level.

Striving for best practice: standardising New Zealand nursing procedures, 1930-1960.

PubMed

Wood, Pamela J; Nelson, Katherine

2013-11-01

To identify how nurses in the past determined best practice, using the context of New Zealand, 1930-1960. In the current context of evidence-based practice, nurses strive to provide the best care, based on clinical research. We cannot assume that nurses in the past, prior to the evidence-based practice movement, did not also have a deliberate process for pursuing best practice. Discovering historical approaches to determining best practice will enrich our understanding of how nurses' current efforts are part of a continuing commitment to ensuring quality care. Historical research. The records of the Nursing Education Committee of the New Zealand Registered Nurses' Association, 1940-1959, and the 309 issues of New Zealand's nursing journal, Kai Tiaki, 1930-1960, were analysed to identify the profession's approach to ensuring best practice. This approach was then interpreted within the international context, particularly Canada and the USA. For nearly 30 years, nurse leaders collaborated in undertaking national surveys of training hospitals requesting information on different nursing practices. They subsequently distributed instructions for a range of procedures and other aspects of nursing care to standardise practice. Standardising nursing care was an effective way to ensure quality nursing at a time when hospital care was delivered mostly by nurses in training. The reasons for and timing of standardisation of nursing care in New Zealand differed from the international move towards standardisation, particularly in the USA. Historically, nurses also pursued best practice, based on standardising nursing procedures. Examining the antecedents of the present evidence-based approach to care reminds us that the process and reasons for determining best practice change through time. As knowledge and practice continually change, current confident assertions of best practice should and will continue to be challenged in future. © 2013 John Wiley & Sons Ltd.

Standardisation of the FAERS database: a systematic approach to manually recoding drug name variants.

PubMed

Wong, Carmen K; Ho, Samuel S; Saini, Bandana; Hibbs, David E; Fois, Romano A

2015-07-01

The US Food and Drug Administration Adverse Event Reporting System (FAERS), one of the world's largest spontaneous reporting systems, is difficult to use because of report duplication and a lack of standardisation in the recording of drug names. Unresolved data quality issues may distort statistical analyses, rendering the results difficult to interpret when detecting and monitoring adverse effects of pharmaceutical products. The aim of this study was to develop and implement a data cleaning protocol to identify and resolve drug nomenclature issues. The key 'data treatment' plan involved standardising drug names held in the FAERS database. Four million five hundred and six thousand five hundred and seventy-seven. Individual Safety Reports submitted to the FAERS between 1 January 2003 and 31 August 2012 were included for this study. OpenRefine was used to standardise drug name variants in the database such that they were consistent with international non-proprietary nomenclature defined by the World Health Organisation Anatomical Therapeutic Chemical classification. Drug variants where generic constituents could not be confidently determined, undecipherable drug names and non-medicinal products were retained verbatim. After the standardisation process, more than 16 611 916 drug entries were cleaned to their relevant international non-proprietary name. The cleaned drug table comprised 71 858 drug name variants and includes both standardised and original terms. Ninety-nine per cent of drug names was standardised using this method. The millions of reports enclosed in the FAERS contain valuable information that is of interest to pharmacovigilance, toxicology and post-marketing surveillance researchers. With the standardisation of the drug nomenclature, the database can be better utilised by research groups around the world. Copyright © 2015 John Wiley & Sons, Ltd.

GRBs as standard candles: There is no “circularity problem” (and there never was)

NASA Astrophysics Data System (ADS)

Graziani, Carlo

2011-02-01

Beginning with the 2002 discovery of the "Amati Relation" of GRB spectra, there has been much interest in the possibility that this and other correlations of GRB phenomenology might be used to make GRBs into standard candles. One recurring apparent difficulty with this program has been that some of the primary observational quantities to be fit as "data" - to wit, the isotropic-equivalent prompt energy Eiso and the collimation-corrected "total" prompt energy Eγ - depend for their construction on the very cosmological models that they are supposed to help constrain. This is the so-called "circularity problem" of standard candle GRBs. This paper is intended to point out that the circularity problem is not in fact a problem at all, except to the extent that it amounts to a self-inflicted wound. It arises essentially because of an unfortunate choice of data variables - "source-frame" variables such as Eiso, which are unnecessarily encumbered by cosmological considerations. If, instead, the empirical correlations of GRB phenomenology which are formulated in source-variables are mapped to the primitive observational variables (such as fluence) and compared to the observations in that space, then all taint of circularity disappears. I also indicate here a set of procedures for encoding high-dimensional empirical correlations (such as between Eiso, Epk(src),tjet(src), and T45(src)) in a "Gaussian Tube" smeared model that includes both the correlation and its intrinsic scatter, and how that source-variable model may easily be mapped to the space of primitive observables, to be convolved with the measurement errors and fashioned into a likelihood. I discuss the projections of such Gaussian tubes into sub-spaces, which may be used to incorporate data from GRB events that may lack some element of the data (for example, GRBs without ascertained jet-break times). In this way, a large set of inhomogeneously observed GRBs may be assimilated into a single analysis, so long as each

Bioboxes: standardised containers for interchangeable bioinformatics software.

PubMed

Belmann, Peter; Dröge, Johannes; Bremges, Andreas; McHardy, Alice C; Sczyrba, Alexander; Barton, Michael D

2015-01-01

Software is now both central and essential to modern biology, yet lack of availability, difficult installations, and complex user interfaces make software hard to obtain and use. Containerisation, as exemplified by the Docker platform, has the potential to solve the problems associated with sharing software. We propose bioboxes: containers with standardised interfaces to make bioinformatics software interchangeable.

Compilation of Published PM2.5 Emission Rates for Cooking, Candles and Incense for Use in Modeling of Exposures in Residences

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

Hu, Tianchao; Singer, Brett C.; Logue, Jennifer M.

2012-08-01

recent analysis of health impacts from air pollutant inhalation in homes found that PM2.5 is the most damaging at the population level. Chronic exposure to elevated PM2.5 has the potential to damage human respiratory systems, and may result in premature death. PM2.5 exposures in homes can be mitigated through various approaches including kitchen exhaust ventilation, filtration, indoor pollutant source reduction and designing ventilation systems to reduce the entry of PM2.5 from outdoors. Analysis of the potential benefits and costs of various approaches can be accomplished using computer codes that simulate the key physical processes including emissions, dilution and ventilation. Themore » largest sources of PM2.5 in residences broadly are entry from outdoors and emissions from indoor combustion. The largest indoor sources are tobacco combustion (smoking), cooking and the burning of candles and incense. Data on the magnitude of PM2.5 and other pollutant emissions from these events and processes are required to conduct simulations for analysis. The goal of this study was to produce a database of pollutant emission rates associated with cooking and the burning of candles and incense. The target use of these data is for indoor air quality modeling.« less

Dialogic Teaching to the High-Stakes Standardised Test?

ERIC Educational Resources Information Center

Segal, Aliza; Snell, Julia; Lefstein, Adam

2017-01-01

Within current educational discourse, dialogic pedagogy is diametrically opposed to "teaching to the test", especially the high-stakes standardised test. While dialogic pedagogy is about critical thinking, authenticity and freedom, test preparation evokes all that is narrow, instrumental and cynical in education. In this paper, we argue…

Standardised tobacco packaging: a health policy case study of corporate conflict expansion and adaptation

PubMed Central

Hatchard, Jenny L; Fooks, Gary J; Gilmore, Anna B

2016-01-01

Objectives To investigate opposition to standardised tobacco packaging in the UK. To increase understanding of how transnational corporations are adapting to changes in their access to policymakers precipitated by Article 5.3 of the Framework Convention on Tobacco Control (FCTC). Design Case study web-based documentary analysis, using NVivo V.10. Examination of relationships between opponents of standardised packaging and transnational tobacco companies (TTCs) and of the volume, nature, transparency and timing of their activities. Setting UK standardised packaging policy debate 2011–2013. Participants Organisations selected on basis of opposition to, or facilitation thereof, standardised tobacco packaging in the UK; 422 associated documents. Results Excluding tobacco manufacturing and packaging companies (n=12), 109 organisations were involved in opposing standardised packaging, 82 (75%) of which had a financial relationship with 1 or more TTC. These 82 organisations (43 actively opposing the measure, 39 facilitating opposition) were responsible for 60% of the 404 activities identified, including the majority of public communications and research production. TTCs were directly responsible for 28% of total activities, predominantly direct lobbying, but also financially underwrote third party research, communication, mass recruitment and lobbying. Active organisations rarely reported any financial relationship with TTCs when undertaking opposition activities. Conclusions The multifaceted opposition to standardised packaging was primarily undertaken by third parties with financial relationships with major tobacco manufacturers. Low levels of transparency regarding these links created a misleading impression of diverse and widespread opposition. Countries should strengthen implementation of Article 5.3 of the FCTC by systematically requiring conflict of interest declarations from all organisations participating in political or media debates on tobacco control. PMID

Drought characterisation based on an agriculture-oriented standardised precipitation index

NASA Astrophysics Data System (ADS)

Tigkas, Dimitris; Vangelis, Harris; Tsakiris, George

2018-03-01

Drought is a major natural hazard with significant effects in the agricultural sector, especially in arid and semi-arid regions. The accurate and timely characterisation of agricultural drought is crucial for devising contingency plans, including the necessary mitigation measures. Many drought indices have been developed during the last decades for drought characterisation and analysis. One of the most widely used indices worldwide is the Standardised Precipitation Index (SPI). Although other comprehensive indices have been introduced over the years, SPI remains the most broadly accepted index due to a number of reasons, the most important of which are its simple structure and the fact that it uses only precipitation data. In this paper, a modified version of SPI is proposed, namely the Agricultural Standardised Precipitation Index (aSPI), based on the substitution of the total precipitation by the effective precipitation, which describes more accurately the amount of water that can be used productively by the plants. Further, the selection of the most suitable reference periods and time steps for agricultural drought identification using aSPI is discussed. This conceptual enhancement of SPI aims at improving the suitability of the index for agricultural drought characterisation, while retaining the advantages of the original index, including its dependence only on precipitation data. The evaluation of the performance of both SPI and aSPI in terms of correlating drought magnitude with crop yield response in four regions of Greece under Mediterranean conditions indicated that aSPI is more robust than the original index in identifying agricultural drought.

The Effect Direction Plot: Visual Display of Non-Standardised Effects across Multiple Outcome Domains

ERIC Educational Resources Information Center

Thomson, Hilary J.; Thomas, Sian

2013-01-01

Visual display of reported impacts is a valuable aid to both reviewers and readers of systematic reviews. Forest plots are routinely prepared to report standardised effect sizes, but where standardised effect sizes are not available for all included studies a forest plot may misrepresent the available evidence. Tabulated data summaries to…

Intensity standardisation of 7T MR images for intensity-based segmentation of the human hypothalamus

PubMed Central

Schreiber, Jan; Bazin, Pierre-Louis; Trampel, Robert; Anwander, Alfred; Geyer, Stefan; Schönknecht, Peter

2017-01-01

The high spatial resolution of 7T MRI enables us to identify subtle volume changes in brain structures, providing potential biomarkers of mental disorders. Most volumetric approaches require that similar intensity values represent similar tissue types across different persons. By applying colour-coding to T1-weighted MP2RAGE images, we found that the high measurement accuracy achieved by high-resolution imaging may be compromised by inter-individual variations in the image intensity. To address this issue, we analysed the performance of five intensity standardisation techniques in high-resolution T1-weighted MP2RAGE images. Twenty images with extreme intensities in the GM and WM were standardised to a representative reference image. We performed a multi-level evaluation with a focus on the hypothalamic region—analysing the intensity histograms as well as the actual MR images, and requiring that the correlation between the whole-brain tissue volumes and subject age be preserved during standardisation. The results were compared with T1 maps. Linear standardisation using subcortical ROIs of GM and WM provided good results for all evaluation criteria: it improved the histogram alignment within the ROIs and the average image intensity within the ROIs and the whole-brain GM and WM areas. This method reduced the inter-individual intensity variation of the hypothalamic boundary by more than half, outperforming all other methods, and kept the original correlation between the GM volume and subject age intact. Mixed results were obtained for the other four methods, which sometimes came at the expense of unwarranted changes in the age-related pattern of the GM volume. The mapping of the T1 relaxation time with the MP2RAGE sequence is advertised as being especially robust to bias field inhomogeneity. We found little evidence that substantiated the T1 map’s theoretical superiority over the T1-weighted images regarding the inter-individual image intensity homogeneity. PMID

Reducing severe hypoglycaemia in hospitalised patients with diabetes: Early outcomes of standardised reporting and management.

PubMed

Araque, Katherine A; Kadayakkara, Deepak K; Gigauri, Nino; Sheehan, Diane; Majumdar, Sachin; Buller, Gregory; Flannery, Clare A

2018-01-01

Severe hypoglycaemic events (HGEs) in hospitalised patients are associated with poor outcomes and prolonged hospitalization. Systematic, coordinated care is required for acute management and prevention of HGEs; however, studies evaluating quality control efforts are scarce. To investigate the effectiveness of system-based interventions to improve management response to HGEs. System-based interventions were designed and implemented following a root cause analysis of HGE in adult patients with diabetes from two general medical wards with the highest incidence of HGE. Interventions included electronic medical record programming for a standardised order set for basal-bolus insulin regimen and hypoglycemia protocol, automated dextrose order, automated MD notification, and recommendation for endocrine consultation after two critical HGEs. The Pyxis MedStation was programmed to alert nurses to recheck blood glucose 15 min after the treatment. A card with the HGE management protocol was attached to each provider's ID badge and educational seminars were given to all providers. Primary outcomes were to evaluate median time from HGE (glucose <50 mg/dL) to euglycemia (>100 mg/dL), and time from HGE to follow-up finger-stick (FS) testing preintervention and postintervention. Secondary outcomes were cumulative incidence of HGEs, recurrent hypoglycemia, rate of physician notification and use of standardised treatments among adults with diabetes on the two general medical wards. Among hospitalised adults with diabetes and HGE, median time from HGE to euglycemia declined from 225±46 min preintervention to 87±26 min postintervention (p=0.03). Median time from HGE to next FS testing also declined (76±14 min to 28±10 min, p<0.001). Standardised treatment administration for HGE improved significantly from 34% (12/35) to 97% (36/37); physician notification rate improved significantly from 51% (18/35) to 78% (29/37).Among hospitalised adults with diabetes, incidence of

Medical practice, procedure manuals and the standardisation of hospital death.

PubMed

Hadders, Hans

2009-03-01

This paper examines how death is managed in a larger regional hospital within the Norwegian health-care. The central focus of my paper concerns variations in how healthcare personnel enact death and handle the dead patient. Over several decades, modern standardised hospital death has come under critique in the western world. Such critique has resulted in changes in the standardisation of hospital deaths within Norwegian health-care. In the wake of the hospice movement and with greater focus on palliative care, doors have gradually been opened and relatives of the deceased are now more often invited to participate. I explore how the medical practice around death along with the procedure manual of post-mortem care at Trondheim University Hospital has changed. I argue that in the late-modern context, standardisation of hospital death is a multidimensional affair, embedded in a far more comprehensive framework than the depersonalized medico-legal. In the late-modern Norwegian hospital, interdisciplinary negotiation and co-operation has allowed a number of different agendas to co-exist, without any ensuing loss of the medical power holder's authority to broker death. I follow Mol's notion of praxiographic orientation of the actor-network approach while exploring this medical practice.

Standardised neonatal parenteral nutrition formulations – an Australasian group consensus 2012

PubMed Central

2014-01-01

Standardised parenteral nutrition formulations are routinely used in the neonatal intensive care units in Australia and New Zealand. In 2010, a multidisciplinary group was formed to achieve a consensus on the formulations acceptable to majority of the neonatal intensive care units. Literature review was undertaken for each nutrient and recommendations were developed in a series of meetings held between November 2010 and April 2011. Three standard and 2 optional amino acid/dextrose formulations and one lipid emulsion were agreed by majority participants in the consensus. This has a potential to standardise neonatal parenteral nutrition guidelines, reduce costs and prescription errors. PMID:24548745

Calibration of Post-AGB Supergiants as Standard Extragalactic Candles for HST

NASA Technical Reports Server (NTRS)

Bond, Howard E.

1998-01-01

This report summarizes activities carried out with support from the NASA Ultraviolet, Visible, and Gravitational Astrophysics Research and Analysis Program. The aim of the program is to calibrate the absolute magnitudes of post-asymptotic-giant-branch (post-AGB or PAGB) stars, which we believe will be an excellent new "standard candle" for measuring extragalactic distances. The reason for this belief is that in old populations, the stars that are evolving through the PAGB region of the HR (Hertzsprung-Russell) diagram arise from only a single main-sequence turnoff mass. In addition, the theoretical PAGB evolutionary tracks show that they evolve through this region at constant luminosity; hence the PAGB stars should have an extremely narrow luminosity function. Moreover, as the PAGB stars evolve through spectral types F and A (en route from the AGB to hot stellar remnants and white dwarfs), they have the highest luminosities attained by old stars (both bolometrically and in the visual band). Finally, the PAGB stars of these spectral types are very easily identified, due to their large Balmer jumps, which are due to their very low surface gravities.

Standardised tobacco packaging: a health policy case study of corporate conflict expansion and adaptation.

PubMed

Hatchard, Jenny L; Fooks, Gary J; Gilmore, Anna B

2016-10-07

To investigate opposition to standardised tobacco packaging in the UK. To increase understanding of how transnational corporations are adapting to changes in their access to policymakers precipitated by Article 5.3 of the Framework Convention on Tobacco Control (FCTC). Case study web-based documentary analysis, using NVivo V.10. Examination of relationships between opponents of standardised packaging and transnational tobacco companies (TTCs) and of the volume, nature, transparency and timing of their activities. UK standardised packaging policy debate 2011-2013. Organisations selected on basis of opposition to, or facilitation thereof, standardised tobacco packaging in the UK; 422 associated documents. Excluding tobacco manufacturing and packaging companies (n=12), 109 organisations were involved in opposing standardised packaging, 82 (75%) of which had a financial relationship with 1 or more TTC. These 82 organisations (43 actively opposing the measure, 39 facilitating opposition) were responsible for 60% of the 404 activities identified, including the majority of public communications and research production. TTCs were directly responsible for 28% of total activities, predominantly direct lobbying, but also financially underwrote third party research, communication, mass recruitment and lobbying. Active organisations rarely reported any financial relationship with TTCs when undertaking opposition activities. The multifaceted opposition to standardised packaging was primarily undertaken by third parties with financial relationships with major tobacco manufacturers. Low levels of transparency regarding these links created a misleading impression of diverse and widespread opposition. Countries should strengthen implementation of Article 5.3 of the FCTC by systematically requiring conflict of interest declarations from all organisations participating in political or media debates on tobacco control. Published by the BMJ Publishing Group Limited. For permission to

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale

PubMed Central

Steele, Catriona M.; Namasivayam-MacDonald, Ashwini M.; Guida, Brittany T.; Cichero, Julie A.; Duivestein, Janice; MRSc; Hanson, Ben; Lam, Peter; Riquelme, Luis F.

2018-01-01

Objective To assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient. Design Participants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Interrater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use. Setting Web-based survey. Participants Respondents (NZ170) from 29 countries. Interventions Not applicable. Main Outcome Measures Consensual validity (percent agreement and Kendall t), criterion validity (Spearman rank correlation), and interrater reliability (Kendall concordance and intraclass coefficients). Results The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed strong consensual validity, criterion validity, and interrater reliability. Scenarios involving liquid-only diets, transition from nonoral feeding, or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed greater sensitivity than the FOIS to specific changes in diet. Most (>70%) respondents indicated enthusiasm for implementing the International Dysphagia Diet Standardisation Initiative Functional Diet Scale. Conclusions This initial validation study suggests that the International Dysphagia Diet Standardisation Initiative Functional

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale.

PubMed

Steele, Catriona M; Namasivayam-MacDonald, Ashwini M; Guida, Brittany T; Cichero, Julie A; Duivestein, Janice; Hanson, Ben; Lam, Peter; Riquelme, Luis F

2018-05-01

To assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient. Participants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Interrater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use. Web-based survey. Respondents (N=170) from 29 countries. Not applicable. Consensual validity (percent agreement and Kendall τ), criterion validity (Spearman rank correlation), and interrater reliability (Kendall concordance and intraclass coefficients). The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed strong consensual validity, criterion validity, and interrater reliability. Scenarios involving liquid-only diets, transition from nonoral feeding, or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed greater sensitivity than the FOIS to specific changes in diet. Most (>70%) respondents indicated enthusiasm for implementing the International Dysphagia Diet Standardisation Initiative Functional Diet Scale. This initial validation study suggests that the International Dysphagia Diet Standardisation Initiative Functional Diet Scale has strong consensual and criterion validity and can be used reliably by clinicians

Facile Fabrication and Characterization of a PDMS-Derived Candle Soot Coated Stable Biocompatible Superhydrophobic and Superhemophobic Surface.

PubMed

Iqbal, R; Majhy, B; Sen, A K

2017-09-13

We report a simple, inexpensive, rapid, and one-step method for the fabrication of a stable and biocompatible superhydrophobic and superhemophobic surface. The proposed surface comprises candle soot particles embedded in a mixture of PDMS+n-hexane serving as the base material. The mechanism responsible for the superhydrophobic behavior of the surface is explained, and the surface is characterized based on its morphology and elemental composition, wetting properties, mechanical and chemical stability, and biocompatibility. The effect of %n-hexane in PDMS, the thickness of the PDMS+n-hexane layer (in terms of spin coating speed) and sooting time on the wetting property of the surface is studied. The proposed surface exhibits nanoscale surface asperities (average roughness of 187 nm), chemical compositions of soot particles, very high water and blood repellency along with excellent mechanical and chemical stability and excellent biocompatibility against blood sample and biological cells. The water contact angle and roll-off angle is measured as 160° ± 1° and 2°, respectively, and the blood contact angle is found to be 154° ± 1°, which indicates that the surface is superhydrophobic and superhemophobic. The proposed superhydrophobic and superhemophobic surface offers significantly improved (>40%) cell viability as compared to glass and PDMS surfaces.

Standardisation of costs: the Dutch Manual for Costing in economic evaluations.

PubMed

Oostenbrink, Jan B; Koopmanschap, Marc A; Rutten, Frans F H

2002-01-01

The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements for studies to be considered when deciding on the reimbursement of new medical therapies. Recently, the Dutch Manual for Costing: Methods and Standard Costs for Economic Evaluations in Health Care (further referred to as "the manual") has been published, in addition to the Dutch guidelines for pharmacoeconomic research. The objectives of this article are to describe the main content of the manual and to discuss some key issues of the manual in relation to the standardisation of costs. The manual introduces a six-step procedure for costing. These steps concern: the scope of the study;the choice of cost categories;the identification of units;the measurement of resource use;the monetary valuation of units; andthe calculation of unit costs. Each step consists of a number of choices and these together define the approach taken. In addition to a description of the costing process, five key issues regarding the standardisation of costs are distinguished. These are the use of basic principles, methods for measurement and valuation, standard costs (average prices of healthcare services), standard values (values that can be used within unit cost calculations), and the reporting of outcomes. The use of the basic principles, standard values and minimal requirements for reporting outcomes, as defined in the manual, are obligatory in studies that support submissions to acquire reimbursement for new pharmaceuticals. Whether to use standard costs, and the choice of a particular method to measure or value costs, is left mainly to the investigator, depending on the specific study setting. In conclusion, several instruments are available to increase standardisation in

Development of CANDLES low background HPGe detector and half-life measurement of 180Tam

NASA Astrophysics Data System (ADS)

Chan, W. M.; Kishimoto, T.; Umehara, S.; Matsuoka, K.; Suzuki, K.; Yoshida, S.; Nakajima, K.; Iida, T.; Fushimi, K.; Nomachi, M.; Ogawa, I.; Tamagawa, Y.; Hazama, R.; Takemoto, Y.; Nakatani, N.; Takihira, Y.; Tozawa, M.; Kakubata, H.; Trang, V. T. T.; Ohata, T.; Tetsuno, K.; Maeda, T.; Khai, B. T.; Li, X. L.; Batpurev, T.

2018-01-01

A low background HPGe detector system was developed at CANDLES Experimental Hall for multipurpose use. Various low background techniques were employed, including hermatic shield design, radon gas suppression, and background reduction analysis. A new pulse shape discrimination (PSD) method was specially created for coaxial Ge detector. Using this PSD method, microphonics noise and background event at low energy region less than 200 keV can be rejected effectively. Monte Carlo simulation by GEANT4 was performed to acquire the detection efficiency and study the interaction of gamma-rays with detector system. For rare decay measurement, the detector was utilized to detect the nature's most stable isomer tantalum-180m (180Tam) decay. Two phases of tantalum physics run were completed with total livetime of 358.2 days, which Phase II has upgraded shield configuration. The world most stringent half-life limit of 180Tam has been successfully achieved.

Models of care for musculoskeletal health: a cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation.

PubMed

Briggs, Andrew M; Jordan, Joanne E; Speerin, Robyn; Jennings, Matthew; Bragge, Peter; Chua, Jason; Slater, Helen

2015-11-16

The prevalence and impact of musculoskeletal conditions are predicted to rapidly escalate in the coming decades. Effective strategies are required to minimise 'evidence-practice', 'burden-policy' and 'burden-service' gaps and optimise health system responsiveness for sustainable, best-practice healthcare. One mechanism by which evidence can be translated into practice and policy is through Models of Care (MoCs), which provide a blueprint for health services planning and delivery. While evidence supports the effectiveness of musculoskeletal MoCs for improving health outcomes and system efficiencies, no standardised national approach to evaluation in terms of their 'readiness' for implementation and 'success' after implementation, is yet available. Further, the value assigned to MoCs by end users is uncertain. This qualitative study aimed to explore end users' views on the relevance of musculoskeletal MoCs to their work and value of a standardised evaluation approach. A cross-sectional qualitative study was undertaken. Subject matter experts (SMEs) with health, policy and administration and consumer backgrounds were drawn from three Australian states. A semi-structured interview schedule was developed and piloted to explore perceptions about musculoskeletal MoCs including: i) aspects important to their work (or life, for consumers) ii) usefulness of standardised evaluation frameworks to judge 'readiness' and 'success' and iii) challenges associated with standardised evaluation. Verbatim transcripts were analysed by two researchers using a grounded theory approach to derive key themes. Twenty-seven SMEs (n = 19; 70.4 % female) including five (18.5 %) consumers participated in the study. MoCs were perceived as critical for influencing and initiating changes to best-practice healthcare planning and delivery and providing practical guidance on how to implement and evaluate services. A 'readiness' evaluation framework assessing whether critical components across the

Opportunities for Integrated Ecological Analysis across Inland Australia with Standardised Data from Ausplots Rangelands.

PubMed

Guerin, Greg R; Sparrow, Ben; Tokmakoff, Andrew; Smyth, Anita; Leitch, Emrys; Baruch, Zdravko; Lowe, Andrew J

2017-01-01

Australian rangelands ecosystems cover 81% of the continent but are understudied and continental-scale research has been limited in part by a lack of precise data that are standardised between jurisdictions. We present a new dataset from AusPlots Rangelands that enables integrative rangelands analysis due to its geographic scope and standardised methodology. The method provides data on vegetation and soils, enabling comparison of a suite of metrics including fractional vegetation cover, basal area, and species richness, diversity, and composition. Cover estimates are robust and repeatable, allowing comparisons among environments and detection of modest change. The 442 field plots presented here span a rainfall gradient of 129-1437 mm Mean annual precipitation with varying seasonality. Vegetation measurements include vouchered vascular plant species, growth form, basal area, height, cover and substrate type from 1010 point intercepts as well as systematically recorded absences, which are useful for predictive modelling and validation of remote sensing applications. Leaf and soil samples are sampled for downstream chemical and genomic analysis. We overview the sampling of vegetation parameters and environments, applying the data to the question of how species abundance distributions (SADs) vary over climatic gradients, a key question for the influence of environmental change on ecosystem processes. We found linear relationships between SAD shape and rainfall within grassland and shrubland communities, indicating more uneven abundance in deserts and suggesting relative abundance may shift as a consequence of climate change, resulting in altered diversity and ecosystem function. The standardised data of AusPlots enables such analyses at large spatial scales, and the testing of predictions through time with longitudinal sampling. In future, the AusPlots field program will be directed towards improving coverage of space, under-represented environments, vegetation types

Standardised imaging technique for guided M-mode and Doppler echocardiography in the horse.

PubMed

Long, K J; Bonagura, J D; Darke, P G

1992-05-01

Eighteen echocardiographic images useful for diagnostic imaging, M-mode echocardiography, and Doppler echocardiography of the equine heart were standardised by relating the position of the axial beam to various intracardiac landmarks. The transducer orientation required for each image was recorded in 14 adult horses by describing the degree of sector rotation and the orientation of the axial beam relative to the thorax. Repeatable images could be obtained within narrow limits of angulation and rotation for 14 of the 18 standardised images evaluated. Twenty-seven National Hunt horses were subsequently examined using this standardised technique. Selected cardiac dimensions were measured from two-dimensional and guided M-mode studies. Satisfactory results were achieved in 26 of the 27 horses. There was no linear correlation between any of the measured cardiac values and bodyweight. There was no significant difference between measurements taken from the left and the right hemithorax. Six horses were imaged on three consecutive days to assess the repeatability of the measurements. No significant difference was found between measurements obtained on different days. This study demonstrates a method for standardised echocardiographic evaluation of the equine heart that is repeatable, valuable for teaching techniques of equine echocardiography, applicable for diagnostic imaging and quantification of cardiac size, and useful for the evaluation of blood-flow patterns by Doppler ultrasound.

Does standardised structured reporting contribute to quality in diagnostic pathology? The importance of evidence-based datasets.

PubMed

Ellis, D W; Srigley, J

2016-01-01

Key quality parameters in diagnostic pathology include timeliness, accuracy, completeness, conformance with current agreed standards, consistency and clarity in communication. In this review, we argue that with worldwide developments in eHealth and big data, generally, there are two further, often overlooked, parameters if our reports are to be fit for purpose. Firstly, population-level studies have clearly demonstrated the value of providing timely structured reporting data in standardised electronic format as part of system-wide quality improvement programmes. Moreover, when combined with multiple health data sources through eHealth and data linkage, structured pathology reports become central to population-level quality monitoring, benchmarking, interventions and benefit analyses in public health management. Secondly, population-level studies, particularly for benchmarking, require a single agreed international and evidence-based standard to ensure interoperability and comparability. This has been taken for granted in tumour classification and staging for many years, yet international standardisation of cancer datasets is only now underway through the International Collaboration on Cancer Reporting (ICCR). In this review, we present evidence supporting the role of structured pathology reporting in quality improvement for both clinical care and population-level health management. Although this review of available evidence largely relates to structured reporting of cancer, it is clear that the same principles can be applied throughout anatomical pathology generally, as they are elsewhere in the health system.

Towards a standardised representation of a knowledge base for adverse drug event prevention.

PubMed

Koutkias, Vassilis; Lazou, Katerina; de Clercq, Paul; Maglaveras, Nicos

2011-01-01

Knowledge representation is an important part of knowledge engineering activities that is crucial for enabling knowledge sharing and reuse. In this regard, standardised formalisms and technologies play a significant role. Especially for the medical domain, where knowledge may be tacit, not articulated and highly diverse, the development and adoption of standardised knowledge representations is highly challenging and of outmost importance to achieve knowledge interoperability. To this end, this paper presents a research effort towards the standardised representation of a Knowledge Base (KB) encapsulating rule-based signals and procedures for Adverse Drug Event (ADE) prevention. The KB constitutes an integral part of Clinical Decision Support Systems (CDSSs) to be used at the point of care. The paper highlights the requirements at the domain of discourse with respect to knowledge representation, according to which GELLO (an HL7 and ANSI standard) has been adopted. Results of our prototype implementation are presented along with the advantages and the limitations introduced by the employed approach.

The Hubble relation for nonstandard candles and the origin of the redshift of quasars

NASA Technical Reports Server (NTRS)

Petrosian, V.

1974-01-01

It is shown that the magnitude-log (redshift) relation for brightest quasars can have a slope different from the value expected for standard candles. The value of this slope depends on the luminosity function and its evolution. Therefore the difference of this slope from the expected value cannot be used as evidence against the cosmological origin of the redshift of the quasars. It is shown that the observed variation of the luminosity of the brightest objects with redshift is consistent with the cosmological hypothesis and that it agrees with (and perhaps could be used to complement) the luminosity function obtained from V/Vm analysis. It is also shown that the nonzero slope of the magnitude-log (redshift) relation rules out the local quasar hypothesis, where it is assumed that the sources are nearby (less than 500 Mpc), that the bulk of their redshift is intrinsic, and that there is no dependence on distance of the intrinsic properties of the sources.

Assessment of acrylamide toxicity using a battery of standardised bioassays.

PubMed

Zovko, Mira; Vidaković-Cifrek, Željka; Cvetković, Želimira; Bošnir, Jasna; Šikić, Sandra

2015-12-01

Acrylamide is a monomer widely used as an intermediate in the production of organic chemicals, e.g. polyacrylamides (PAMs). Since PAMs are low cost chemicals with applications in various industries and waste- and drinking water treatment, a certain amount of non-polymerised acrylamide is expected to end up in waterways. PAMs are non-toxic but acrylamide induces neurotoxic effects in humans and genotoxic, reproductive, and carcinogenic effects in laboratory animals. In order to evaluate the effect of acrylamide on freshwater organisms, bioassays were conducted on four species: algae Desmodesmus subspicatus and Pseudokirchneriella subcapitata, duckweed Lemna minor and water flea Daphnia magna according to ISO (International Organization for Standardisation) standardised methods. This approach ensures the evaluation of acrylamide toxicity on organisms with different levels of organisation and the comparability of results, and it examines the value of using a battery of low-cost standardised bioassays in the monitoring of pollution and contamination of aquatic ecosystems. These results showed that EC50 values were lower for Desmodesmus subspicatus and Pseudokirchneriella subcapitata than for Daphnia magna and Lemna minor, which suggests an increased sensitivity of algae to acrylamide. According to the toxic unit approach, the values estimated by the Lemna minor and Daphnia magna bioassays, classify acrylamide as slightly toxic (TU=0-1; Class 1). The results obtained from algal bioassays (Desmodesmus subspicatus and Pseudokirchneriella subcapitata) revealed the toxic effect of acrylamide (TU=1-10; Class 2) on these organisms.

An in vitro study of anti-inflammatory activity of standardised Andrographis paniculata extracts and pure andrographolide.

PubMed

Low, Mitchell; Khoo, Cheang S; Münch, Gerald; Govindaraghavan, Suresh; Sucher, Nikolaus J

2015-02-07

The anti-inflammatory activity of Andrographis paniculata (Acanthaceae), a traditional medicine widely used in Asia, is commonly attributed to andrographolide, its main secondary metabolite. Commercial A. paniculata extracts are standardised to andrographolide content. We undertook the present study to investigate 1) how selective enrichment of andrographolide in commercial A. paniculata extracts affects the variability of non-standardised phytochemical components and 2) if variability in the non-standardised components of the extract affects the pharmacological activity of andrographolide itself. We characterized 12 commercial, standardised (≥30% andrographolide) batches of A. paniculata extracts from India by HPLC profiling. We determined the antioxidant capacity of the extracts using 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging, oxygen radical antioxidant capacity (ORAC) and a Folin-Ciocalteu (FC) antioxidant assays. Their anti-inflammatory activity was assessed by assaying their inhibitory effect on the release of tumor necrosis factor alpha (TNF-α) in the human monocytic cell line THP-1. The andrographolide content in the samples was close to the claimed value (32.2 ± 2.1%, range 27.5 to 35.9%). Twenty-one non-standardised constituents exhibited more than 2-fold variation in HPLC peak intensities in the tested batches. The chlorogenic acid content of the batches varied more than 30-fold. The DPPH free radical scavenging activity varied ~3-fold, the ORAC and FC antioxidant capacity varied ~1.5 fold among batches. In contrast, the TNF-α inhibitory activity of the extracts exhibited little variation and comparison with pure andrographolide indicated that it was mostly due to their andrographolide content. Standardised A. paniculata extracts contained the claimed amount of andrographolide but exhibited considerable phytochemical background variation. DPPH radical scavenging activity of the extracts was mostly due to the flavonoid

Standardised versus individualised multiherb Chinese herbal medicine for oligomenorrhoea and amenorrhoea in polycystic ovary syndrome: a randomised feasibility and pilot study in the UK

PubMed Central

Flower, Andrew; Prescott, Philip; Wing, Trevor; Moore, Michael; Lewith, George

2017-01-01

Objectives To explore feasibility of a randomised study using standardised or individualised multiherb Chinese herbal medicine (CHM) for oligomenorrhoea and amenorrhoea in women with polycystic ovary syndrome (PCOS), to pilot study methods and to obtain clinical data to support sample size calculations. Design Prospective, pragmatic, randomised feasibility and pilot study with participant and practitioner blinding. Setting 2 private herbal practices in the UK. Participants 40 women diagnosed with PCOS and oligomenorrhoea or amenorrhoea following Rotterdam criteria. Intervention 6 months of either standardised CHM or individualised CHM, 16 g daily taken orally as a tea. Main outcome measures Our primary objective was to determine whether oligomenorrhoea and amenorrhoea were appropriate as the primary outcome measures for the main study. Estimates of treatment effects were obtained for menstrual rate, body mass index (BMI), weight and hirsutism. Data were collected regarding safety, feasibility and acceptability. Results Of the 40 participants recruited, 29 (72.5%) completed the study. The most frequently cited symptoms of concern were hirsutism, weight and menstrual irregularity. Statistically significant improvements in menstrual rates were found at 6 months within group for both standardised CHM (mean difference (MD) 0.18±0.06, 95% CI 0.06 to 0.29; p=0.0027) and individualised CHM (MD 0.27±0.06, 95% CI 0.15 to 0.39; p<0.001), though not between group (p=0.26). No improvements were observed for BMI nor for weight in either group. Improvements in hirsutism scores found within group for both groups were not statistically significant between group (p=0.09). Liver and kidney function and adverse events data were largely normal. Participant feedback suggests changing to tablet administration could facilitate adherence. Conclusions A CHM randomised controlled trial for PCOS is feasible and preliminary data suggest that both individualised and standardised

Measuring the Hubble constant with Type Ia supernovae as near-infrared standard candles

NASA Astrophysics Data System (ADS)

Dhawan, Suhail; Jha, Saurabh W.; Leibundgut, Bruno

2018-01-01

The most precise local measurements of H0 rely on observations of Type Ia supernovae (SNe Ia) coupled with Cepheid distances to SN Ia host galaxies. Recent results have shown tension comparing H0 to the value inferred from CMB observations assuming ΛCDM, making it important to check for potential systematic uncertainties in either approach. To date, precise local H0 measurements have used SN Ia distances based on optical photometry, with corrections for light curve shape and colour. Here, we analyse SNe Ia as standard candles in the near-infrared (NIR), where luminosity variations in the supernovae and extinction by dust are both reduced relative to the optical. From a combined fit to 9 nearby calibrator SNe with host Cepheid distances from Riess et al. (2016) and 27 SNe in the Hubble flow, we estimate the absolute peak J magnitude MJ = -18.524 ± 0.041 mag and H0 = 72.8 ± 1.6 (statistical) ±2.7 (systematic) km s-1 Mpc-1. The 2.2% statistical uncertainty demonstrates that the NIR provides a compelling avenue to measuring SN Ia distances, and for our sample the intrinsic (unmodeled) peak J magnitude scatter is just 0.10 mag, even without light curve shape or colour corrections. Our results do not vary significantly with different sample selection criteria, though photometric calibration in the NIR may be a dominant systematic uncertainty. Our findings suggest that tension in the competing H0 distance ladders is likely not a result of supernova systematics that could be expected to vary between optical and NIR wavelengths, like dust extinction. We anticipate further improvements in H0 with a larger calibrator sample of SNe Ia with Cepheid distances, more Hubble flow SNe Ia with NIR light curves, and better use of the full NIR photometric data set beyond simply the peak J-band magnitude.

Temperature and Electron Density Diagnostics of a Candle-Flame Shaped Flare. Asymmetric Reconnection Evidence

NASA Astrophysics Data System (ADS)

Guidoni, Silvina E.; McKenzie, David E.; Longcope, Dana W.; Plowman, Joseph E.; Yoshimura, Keiji

2013-03-01

Candle-flame shaped flares are archetypical structures that represent indirect evidence of magnetic reconnection. For long-lived events, most of their observed features can be explained with the classic magnetic reconnection model of solar flares, the CSHKP model. A flare resembling 1992 Tsuneta's famous candle-flame flare occurred on January 28 2011; we present its temperature and electron density diagnostics. This flare was observed with Hinode/XRT, SDO/AIA, and STEREO (A)/EUVI, resulting in high resolution, broad temperature coverage, and stereoscopic views of this iconic structure. Our XRT filter-ratio temperature and density maps corroborate the general reconnection scenario. The high temperature images reveal a brightening that grows in size to form a tower-like structure at the top of the post-flare arcade, a feature that has been observed in other long duration events. This tower is a localized density increase, as shown by our XRT electron density maps. Despite the extensive work on the standard reconnection scenario, there is no complete agreement among models regarding the nature of this tower-like structure. The XRT maps also reveal that reconnected loops that are successively connected at their tops to this tower develop a density increase in one of their legs that can reach over 2 times the density value of the other leg, giving the appearance of ``half-loops''. Their density is nevertheless still lower than at the tower. These jumps in density last longer than several acoustic transit times along the loops. We use STEREO images to show that the half-loop brightening is not a line-of- sight projection effect of the type suggested by Forbes and Acton (1996). This would indicate that asymmetric reconnection took place between loops originally belonging to systems with different magnetic field strengths, densities, and temperatures. We hypothesize that the heat generated by reconnection's slow shocks is then transferred to each leg of the loop at

Comparison of four methods for deriving hospital standardised mortality ratios from a single hierarchical logistic regression model.

PubMed

Mohammed, Mohammed A; Manktelow, Bradley N; Hofer, Timothy P

2016-04-01

There is interest in deriving case-mix adjusted standardised mortality ratios so that comparisons between healthcare providers, such as hospitals, can be undertaken in the controversial belief that variability in standardised mortality ratios reflects quality of care. Typically standardised mortality ratios are derived using a fixed effects logistic regression model, without a hospital term in the model. This fails to account for the hierarchical structure of the data - patients nested within hospitals - and so a hierarchical logistic regression model is more appropriate. However, four methods have been advocated for deriving standardised mortality ratios from a hierarchical logistic regression model, but their agreement is not known and neither do we know which is to be preferred. We found significant differences between the four types of standardised mortality ratios because they reflect a range of underlying conceptual issues. The most subtle issue is the distinction between asking how an average patient fares in different hospitals versus how patients at a given hospital fare at an average hospital. Since the answers to these questions are not the same and since the choice between these two approaches is not obvious, the extent to which profiling hospitals on mortality can be undertaken safely and reliably, without resolving these methodological issues, remains questionable. © The Author(s) 2012.

Is social class standardisation appropriate in occupational studies?

PubMed Central

Brisson, C; Loomis, D; Pearce, N

1987-01-01

Social class standardisation has been proposed as a method for separating the effects of occupation and "social" or "lifestyle" factors in epidemiological studies, by comparing workers in a particular occupation with other workers in the same social class. The validity of this method rests upon two assumptions: (1) that social factors have the same effect in all occupational groups in the same social class, and (2) that other workers in the same social class as the workers being studied are free of occupational risk factors for the disease of interest. These assumptions will not always be satisfied. In particular, the effect of occupation will be underestimated when the comparison group also has job-related exposures which cause the disease under study. Thus, although adjustment for social class may minimise bias due to social factors, it may introduce bias due to unmeasured occupational factors. This difficulty may be magnified when occupational category is used as the measure of social class. Because of this potential bias, adjustment for social class should be done only after careful consideration of the exposures and disease involved and should be based on an appropriate definition of social class. Both crude and standardised results should be presented when such adjustments are made. PMID:3455422

A Unified Model for GRB Prompt Emission from Optical to Gamma-Rays; Exploring GRBs as Standard Candles

NASA Technical Reports Server (NTRS)

Guiriec, S.; Kouveliotou, C.; Hartmann, D. H.; Granot, J.; Asano, K.; Meszaros, P.; Gill, R.; Gehrels, N.; McEnery, J.

2016-01-01

The origin of prompt emission from gamma-ray bursts (GRBs) remains to be an open question. Correlated prompt optical and gamma-ray emission observed in a handful of GRBs strongly suggests a common emission region, but failure to adequately fit the broadband GRB spectrum prompted the hypothesis of different emission mechanisms for the low- and high-energy radiations. We demonstrate that our multi-component model for GRB -ray prompt emission provides an excellent fit to GRB 110205A from optical to gamma-ray energies. Our results show that the optical and highest gamma-ray emissions have the same spatial and spectral origin, which is different from the bulk of the X- and softest gamma-ray radiation. Finally, our accurate redshift estimate for GRB 110205A demonstrates promise for using GRBs as cosmological standard candles.

Evaluating a standardised tool to explore the nature and extent of foot and ankle injuries in amateur and semi-professional footballers.

PubMed

Evans, S; Walker-Bone, K; Otter, S

2015-03-01

Most studies of football injuries include professional players and data have been collected in without a single validated, standardised tool. We aimed to develop a new standardised questionnaire for assessing injuries among non-professional footballers and pilot its use. A questionnaire was developed using input from footballers, healthcare professionals and triangulation from the literature. The new tool was piloted among players representing amateurs and semi-professionals. Their comments were used iteratively to improve the instrument. The development phase produced a 33-item questionnaire collecting quantitative and qualitative data. In the pilot phase, 42 questionnaires were distributed, 34 (81%) returned. Respondents reported total of 273 football-related injuries, 114 affecting the foot/ankle (70 at the ankle and 44 at the foot). In total, 44% of respondents had suffered one or more foot/ankle injuries in the past 12 months. We developed a new standardised tool which we found to be well-completed by young male footballers in semi-professional and amateur settings with an excellent response rate. Our results suggested that foot/ankle injuries were common, larger studies in non-professionals are needed to identify risk factors for injury and develop pragmatic advice for prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

A qualitative analysis of New Zealand retailers’ responses to standardised packaging legislation and tobacco industry opposition

PubMed Central

Guthrie, John; Hoek, Janet; Darroch, Ella; Wood, Zoë

2015-01-01

Objectives Many of the approximately 8000 New Zealand retailers selling tobacco are small stores that tobacco companies have represented as victims of policy measures designed to reduce smoking. Despite this depiction, many retailers experience considerable ambivalence in selling tobacco, a product they know harms their customers. We explored how retailers perceived the proposed introduction of standardised (or ‘plain’) packaging and their assessment of arguments made by tobacco companies in submissions on proposed standardised packaging legislation. Participants Using qualitative in-depth interviews, we recruited and interviewed 23 retailers of dairies (small convenience stores), small supermarkets, and service stations. Analyses Data were analysed using a protocol-driven approach; this stance enabled direct analysis of tobacco companies’ arguments, particularly those purporting to represent retailers’ concerns. Results Retailers were concerned about the financial implications of standardised packaging and the effects it may have on their ability to provide rapid and efficient customer service. However, few thought standardised packaging would foster illicit trade or spawn further regulation; most placed public health goals ahead of tobacco companies’ ‘rights’, and many supported government intervention to protect population health. Conclusions Retailers held ambivalent views on standardised packaging; while they were concerned about short-term effects on their business, they recognised the harm smoking causes. Policymakers and health researchers could collaborate more effectively with retailers by assisting them to create financially viable roles more compatible with public health objectives. PMID:26553840

Improving hospital weekend handover: a user-centered, standardised approach.

PubMed

Mehra, Avi; Henein, Christin

2014-01-01

Clinical Handover remains one of the most perilous procedures in medicine (1). Weekend handover has emerged as a key area of concern with high variability in handover processes across hospitals (1,2,4, 5-10). Studying weekend handover processes within medicine at an acute teaching hospital revealed huge variability in documented content and structure. A total of 12 different pro formas were in use by the medical day-team to handover to the weekend team on-call. A Likert-survey of doctors revealed 93% felt the current handover system needed improvement with 71% stating that it did not ensure patient safety (Chi-squared, p-value <0.001, n=32). Semi-structured interviews of doctors identified common themes including "a lack of consistency in approach" "poor standardization" and "high variability". Seeking to address concerns of standardization, a standardized handover pro forma was developed using Royal College of Physician (RCP) guidelines (2), with direct end-user input. Results following implementation revealed a considerable improvement in documented ceiling of care, urgency of task and team member assignment with 100% uptake of the new proforma at both 4-week and 6-month post-implementation analyses. 88% of doctors surveyed perceived that the new proforma improved patient safety (p<0.01, n=25), with 62% highlighting that it allowed doctors to work more efficiently. Results also revealed that 44% felt further improvements were needed and highlighted electronic solutions and handover training as main priorities. Handover briefing was subsequently incorporated into junior doctor induction and education modules delivered, with good feedback. Following collaboration with key stakeholders and with end-user input, integrated electronic handover software was designed and funding secured. The software is currently under final development. Introducing a standardized handover proforma can be an effective initial step in improving weekend handover. Handover education and end

Improving hospital weekend handover: a user-centered, standardised approach

PubMed Central

Mehra, Avi; Henein, Christin

2014-01-01

Clinical Handover remains one of the most perilous procedures in medicine (1). Weekend handover has emerged as a key area of concern with high variability in handover processes across hospitals (1,2,4, 5–10). Studying weekend handover processes within medicine at an acute teaching hospital revealed huge variability in documented content and structure. A total of 12 different pro formas were in use by the medical day-team to handover to the weekend team on-call. A Likert-survey of doctors revealed 93% felt the current handover system needed improvement with 71% stating that it did not ensure patient safety (Chi-squared, p-value <0.001, n=32). Semi-structured interviews of doctors identified common themes including “a lack of consistency in approach” “poor standardization” and “high variability”. Seeking to address concerns of standardization, a standardized handover pro forma was developed using Royal College of Physician (RCP) guidelines (2), with direct end-user input. Results following implementation revealed a considerable improvement in documented ceiling of care, urgency of task and team member assignment with 100% uptake of the new proforma at both 4-week and 6-month post-implementation analyses. 88% of doctors surveyed perceived that the new proforma improved patient safety (p<0.01, n=25), with 62% highlighting that it allowed doctors to work more efficiently. Results also revealed that 44% felt further improvements were needed and highlighted electronic solutions and handover training as main priorities. Handover briefing was subsequently incorporated into junior doctor induction and education modules delivered, with good feedback. Following collaboration with key stakeholders and with end-user input, integrated electronic handover software was designed and funding secured. The software is currently under final development. Introducing a standardized handover proforma can be an effective initial step in improving weekend handover. Handover

Regional differences of standardised mortality rates for ischemic heart diseases in the Slovak Republic for the period 1996-2013 in the context of income inequality.

PubMed

Gavurová, Beáta; Vagašová, Tatiana

2016-12-01

The aim of paper is to analyse the development of standardised mortality rates for ischemic heart diseases in relation to the income inequality in the regions of Slovakia. This paper assesses different types of income indicators, such as mean equivalised net income per household, Gini coefficient, unemployment rate, at risk of poverty threshold (60 % of national median), S80/S20 and their effect on mortality. Using data from the Slovak mortality database 1996-2013, the method of direct standardisation was applied to eliminate variances resulted from differences in age structures of the population across regions and over time. To examine the relationships between income indicators and standardised mortality rates, we used the tools of descriptive statistics and methods of correlation and regression analysis. At first, we show that Slovakia has the worst values of standardised mortality rates for ischemic heart diseases in EU countries. Secondly, mortality rates are significantly higher for males compared with females. Thirdly, mortality rates are improving from Eastern Slovakia to Western Slovakia; additionally, high differences in the results of variability are seen among Slovak regions. Finally, the unemployment rate, the poverty rate and equivalent disposable income were statistically significant income indicators. Main contribution of paper is to demonstrate regional differences between mortality and income inequality, and to point out the long-term unsatisfactory health outcomes.

Management of acute paracetamol (acetaminophen) toxicity: a standardised proforma improves risk assessment and overall risk stratification by emergency medicine doctors.

PubMed

McQuade, David J; Aknuri, Srikanth; Dargan, Paul I; Wood, David M

2012-12-01

Paracetamol (acetaminophen) poisoning is the most common toxicological presentation in the UK. Doctors managing patients with paracetamol poisoning need to assess the risk of their patient developing hepatotoxicity before determining appropriate treatment. Patients deemed to be at 'high risk' of hepatotoxicity have lower treatment thresholds than those deemed to be at 'normal risk'. Errors in this process can lead to harmful or potentially fatal under or over treatment. To determine how well treating doctors assess risk factor status and whether a standardised proforma is useful in the risk stratification process. Retrospective 12-month case note review of all patients presenting with paracetamol poisoning to our large inner-city emergency department. Data were collected on the documentation of risk factors, the presence of a local hospital proforma and treatment outcomes. 249 presentations were analysed and only 59 (23.7%) had full documentation of all the risk factors required to make a complete risk assessment. 56 of the 59 (94.9%) had the local hospital proforma included in the notes; the remaining 3 (5.1%) had full documentation of risk factors despite the absence of a proforma. A local hospital proforma was more likely to be included in the emergency department notes in those with 'adequate documentation' (78 out of 120 (65%)) than for those with 'inadequate documentation' (16 out of 129 (12.4%)); X(2), p<0.001. Despite a low overall uptake of the proforma, use of a standardised proforma significantly increased the likelihood of documentation of the risk factors which increase risk for hepatotoxicity following paracetamol poisoning.

Usefulness and acceptability of a standardised orientation and mobility training for partially-sighted older adults using an identification cane

PubMed Central

2012-01-01

Background Orientation and mobility (O&M) training in using an identification (ID) cane is provided to partially-sighted older adults to facilitate independent functioning and participation in the community. Recently, a protocolised standardised O&M-training in the use of the ID cane was developed in The Netherlands. The purpose of this study is to assess the usefulness and acceptability of both the standardised training and the regular training for participants and O&M-trainers in a randomised controlled trial (NCT00946062). Methods The standardised O&M-training consists of two structured face-to-face sessions and one telephone follow-up, in which, in addition to the regular training, self-management and behavioural change techniques are applied. Questionnaires and interviews were used to collect data on the training’s usefulness, e.g. the population reached, self-reported benefits or achievements, and acceptability, e.g. the performance of the intervention according to protocol and participants’ exposure to and engagement in the training. Results Data was collected from 29 O&M-trainers and 68 participants. Regarding the self-reported benefits, outcomes were comparable for the standardised training and the regular training according the trainers and participants e.g., about 85% of the participants in both groups experienced benefits of the cane and about 70% gained confidence in their capabilities. Participants were actively involved in the standardised training. Nearly 40% of the participants in the standardised training group was not exposed to the training according to protocol regarding the number of sessions scheduled and several intervention elements, such as action planning and contracting. Conclusions The standardised and regular O&M-training showed to be useful and mostly acceptable for the partially-sighted older adults and trainers. Yet, a concern is the deviation from the protocol of the standardised O&M-training by the O&M-trainers regarding

A qualitative analysis of New Zealand retailers' responses to standardised packaging legislation and tobacco industry opposition.

PubMed

Guthrie, John; Hoek, Janet; Darroch, Ella; Wood, Zoë

2015-11-09

Many of the approximately 8000 New Zealand retailers selling tobacco are small stores that tobacco companies have represented as victims of policy measures designed to reduce smoking. Despite this depiction, many retailers experience considerable ambivalence in selling tobacco, a product they know harms their customers. We explored how retailers perceived the proposed introduction of standardised (or 'plain') packaging and their assessment of arguments made by tobacco companies in submissions on proposed standardised packaging legislation. Using qualitative in-depth interviews, we recruited and interviewed 23 retailers of dairies (small convenience stores), small supermarkets, and service stations. Data were analysed using a protocol-driven approach; this stance enabled direct analysis of tobacco companies' arguments, particularly those purporting to represent retailers' concerns. Retailers were concerned about the financial implications of standardised packaging and the effects it may have on their ability to provide rapid and efficient customer service. However, few thought standardised packaging would foster illicit trade or spawn further regulation; most placed public health goals ahead of tobacco companies' 'rights', and many supported government intervention to protect population health. Retailers held ambivalent views on standardised packaging; while they were concerned about short-term effects on their business, they recognised the harm smoking causes. Policymakers and health researchers could collaborate more effectively with retailers by assisting them to create financially viable roles more compatible with public health objectives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Standard rulers, candles, and clocks from the low-redshift universe.

PubMed

Heavens, Alan; Jimenez, Raul; Verde, Licia

2014-12-12

We measure the length of the baryon acoustic oscillation (BAO) feature, and the expansion rate of the recent Universe, from low-redshift data only, almost model independently. We make only the following minimal assumptions: homogeneity and isotropy, a metric theory of gravity, a smooth expansion history, and the existence of standard candles (supernovæ) and a standard BAO ruler. The rest is determined by the data, which are compilations of recent BAO and type IA supernova results. Making only these assumptions, we find for the first time that the standard ruler has a length of 103.9±2.3h⁻¹ Mpc. The value is a measurement, in contrast to the model-dependent theoretical prediction determined with model parameters set by Planck data (99.3±2.1h⁻¹ Mpc). The latter assumes the cold dark matter model with a cosmological constant, and that the ruler is the sound horizon at radiation drag. Adding passive galaxies as standard clocks or a local Hubble constant measurement allows the absolute BAO scale to be determined (142.8±3.7 Mpc), and in the former case the additional information makes the BAO length determination more precise (101.9±1.9h⁻¹ Mpc). The inverse curvature radius of the Universe is weakly constrained and consistent with zero, independently of the gravity model, provided it is metric. We find the effective number of relativistic species to be N(eff)=3.53±0.32, independent of late-time dark energy or gravity physics.

Internationalisation and Standardisation of European Environmental Assessment. Relevance to India

ERIC Educational Resources Information Center

Gazzola, Paola; Jha-Thakur, Urmila

2009-01-01

This paper discusses the rationale underlying "PENTA", an EU funded Erasmus Mundus project. In doing so, it explores the challenges of internationalising and standardising European environmental assessment (EA) practice and education to a third country audience, looking at India as a case study. It is argued that the EU EA Directives are…

Standardised versus individualised multiherb Chinese herbal medicine for oligomenorrhoea and amenorrhoea in polycystic ovary syndrome: a randomised feasibility and pilot study in the UK.

PubMed

Lai, Lily; Flower, Andrew; Prescott, Philip; Wing, Trevor; Moore, Michael; Lewith, George

2017-02-03

To explore feasibility of a randomised study using standardised or individualised multiherb Chinese herbal medicine (CHM) for oligomenorrhoea and amenorrhoea in women with polycystic ovary syndrome (PCOS), to pilot study methods and to obtain clinical data to support sample size calculations. Prospective, pragmatic, randomised feasibility and pilot study with participant and practitioner blinding. 2 private herbal practices in the UK. 40 women diagnosed with PCOS and oligomenorrhoea or amenorrhoea following Rotterdam criteria. 6 months of either standardised CHM or individualised CHM, 16 g daily taken orally as a tea. Our primary objective was to determine whether oligomenorrhoea and amenorrhoea were appropriate as the primary outcome measures for the main study. Estimates of treatment effects were obtained for menstrual rate, body mass index (BMI), weight and hirsutism. Data were collected regarding safety, feasibility and acceptability. Of the 40 participants recruited, 29 (72.5%) completed the study. The most frequently cited symptoms of concern were hirsutism, weight and menstrual irregularity. Statistically significant improvements in menstrual rates were found at 6 months within group for both standardised CHM (mean difference (MD) 0.18±0.06, 95% CI 0.06 to 0.29; p=0.0027) and individualised CHM (MD 0.27±0.06, 95% CI 0.15 to 0.39; p<0.001), though not between group (p=0.26). No improvements were observed for BMI nor for weight in either group. Improvements in hirsutism scores found within group for both groups were not statistically significant between group (p=0.09). Liver and kidney function and adverse events data were largely normal. Participant feedback suggests changing to tablet administration could facilitate adherence. A CHM randomised controlled trial for PCOS is feasible and preliminary data suggest that both individualised and standardised multiherb CHMs have similar safety profiles and clinical effects on promoting menstrual regularity

Testing and Improving the Luminosity Relations for Gamma-Ray Bursts

NASA Astrophysics Data System (ADS)

Collazzi, Andrew

2011-08-01

Gamma Ray Bursts (GRBs) have several luminosity relations where a measurable property of a burst light curve or spectrum is correlated with the burst luminosity. These luminosity relations are calibrated for the fraction of bursts with spectroscopic redshifts and hence the known luminosities. GRBs have thus become known as a type of 'standard candle'; where standard candle is meant in the usual sense that their luminosities can be derived from measurable properties of the bursts. GRBs can therefore be used for the same cosmology applications as Type Ia supernovae, including the construction of the Hubble Diagram and measuring massive star formation rate. The greatest disadvantage of using GRBs as standard candles is that their accuracy is lower than desired. With the recent advent of GRBs as a new standard candle, every effort must be made to test and improve the distance measures. Here, several methods are employed to do just that. First, generalized forms of two tests are performed on all of the luminosity relations. All the luminosity relations pass the second of these tests, and all but two pass the first. Even with this failure, the redundancy in using multiple luminosity relations allows all the luminosity relations to retain value. Next, the 'Firmani relation' is shown to have poorer accuracy than first advertised. In addition, it is shown to be exactly derivable from two other luminosity relations. For these reasons, the Firmani relation is useless for cosmology. The Amati relation is then revisited and shown to be an artifact of a combination of selection effects. Therefore, the Amati relation is also not good for cosmology. Fourthly, the systematic errors involved in measuring a popular luminosity indicator (Epeak ) are measured. The result is that an irreducible systematic error of 28% exists. After that, a preliminary investigation into the usefulness of breaking GRBs into individual pulses is conducted. The results of an 'ideal' set of data do not

Walking and Talking with Living Texts: Breathing Life against Static Standardisation

ERIC Educational Resources Information Center

Phillips, Louise Gwenneth; Willis, Linda-Dianne

2014-01-01

Current educational reform, policy and public discourse emphasise standardisation of testing, curricula and professional practice, yet the landscape of literacy practices today is fluid, interactive, multimodal, ever-changing, adaptive and collaborative. How then can English and literacy educators negotiate these conflicting terrains? The nature…

More than Standardisation: Teacher's Professional Literacy Learning in Australia?

ERIC Educational Resources Information Center

Gardiner, Veronica; Cumming-Potvin, Wendy; Glass, Christine Kay

2017-01-01

Current policies guiding literacy and teacher professional learning in Australia, tend to foreground the importance of standardised practice and assessment in classrooms and schools. However, enactments of print-oriented literacy and professional learning in alignment with this emphasis stand in contradiction with contemporary approaches, which…

The use of standardised short-term and working memory tests in aphasia research: a systematic review

PubMed Central

Murray, Laura; Salis, Christos; Martin, Nadine; Dralle, Jenny

2017-01-01

Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures. PMID:27143500

Effects of standardised cigarette packaging on craving, motivation to stop and perceptions of cigarettes and packs.

PubMed

Brose, Leonie S; Chong, Chwen B; Aspinall, Emily; Michie, Susan; McEwen, Andy

2014-01-01

To assess whether standardised packs of the form introduced in Australia are associated with a reduction in acute craving and/or an increase in motivation to stop, and to replicate previous findings on perceptions of packaging, perceptions of smokers using it and perceived effects on behaviour. Following abstinence of at least 12 h, 98 regular and occasional smokers were randomised to exposure to their own cigarette package, another branded package or a standardised package. Craving (QSU-brief), motivation to stop, both at baseline and post-exposure. Ratings of 10 attributes concerning package design, perceived smoker characteristics and effects on behaviour, post-exposure only. For craving, a mixed model ANCOVA showed a significant interaction of packaging and time of measurement (F(2,94) = 8.77, p < .001, partial η(2) = .16). There was no significant main effect or interaction for motivation to stop smoking (p = .9). The standardised pack was perceived to be significantly less appealing and less motivating to buy cigarettes, smokers using them were perceived as less popular and cigarettes from them expected to taste worse. Standardised cigarette packaging may reduce acute (hedonic) craving and is associated with more negative perceptions than branded packaging with less prominent health warnings.

The use of standardised short-term and working memory tests in aphasia research: a systematic review.

PubMed

Murray, Laura; Salis, Christos; Martin, Nadine; Dralle, Jenny

2018-04-01

Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures.

Standardisation and half-life of 89Zr.

PubMed

García-Toraño, E; Peyrés, V; Roteta, M; Mejuto, M; Sánchez-Cabezudo, A; Romero, E

2018-04-01

The nuclide 89 Zr is being tested for the labelling of compounds with long blood circulation times. It decays by beta plus emission (22.8%) and by electron capture (77.2%) to 89 Y. Its half-life has been determined by following the decay rate with two measurement systems; an Ionisation Chamber and an HPGe detector. The combination of six results gives a value of T 1/2 = 78.333 (38) h, slightly lower than the DDEP recommended value of 78.42 (13) h. This radionuclide has also been standardised by liquid scintillation counting, 4πγ counting and coincidence techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tracking the Topological: The Effects of Standardised Data upon Teachers' Practice

ERIC Educational Resources Information Center

Lewis, Steven; Hardy, Ian

2017-01-01

This article draws upon recent theorising of the "becoming topological" of space--specifically, how new social spaces are constituted through relations rather than physical locations--to explore how standardised data, and specifically test data, have influenced teachers' work and learning. We outline the varied ways in which teacher…

Preliminary safety analysis of Pb-Bi cooled 800 MWt modified CANDLE burn-up scheme based fast reactors

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

Su'ud, Zaki, E-mail: szaki@fi.itba.c.id; Sekimoto, H., E-mail: hsekimot@gmail.com

2014-09-30

Pb-Bi Cooled fast reactors with modified CANDLE burn-up scheme with 10 regions and 10 years cycle length has been investigated from neutronic aspects. In this study the safety aspect of such reactors have been investigated and discussed. Several condition of unprotected loss of flow (ULOF) and unprotected rod run-out transient over power (UTOP) have been simulated and the results show that the reactors excellent safety performance. At 80 seconds after unprotected loss of flow condition, the core flow rate drop to about 25% of its initial flow and slowly move toward its natural circulation level. The maximum fuel temperature canmore » be managed below 1000°C and the maximum cladding temperature can be managed below 700°C. The dominant reactivity feedback is radial core expansion and Doppler effect, followed by coolant density effect and fuel axial expansion effect.« less

The Misdirection of Public Policy: Comparing and Combining Standardised Effect Sizes

ERIC Educational Resources Information Center

Simpson, Adrian

2017-01-01

Increased attention on "what works" in education has led to an emphasis on developing policy from evidence based on comparing and combining a particular statistical summary of intervention studies: the standardised effect size. It is assumed that this statistical summary provides an estimate of the educational impact of interventions and…

Standardising the Chinese Language in Singapore: Issues of Policy and Practice

ERIC Educational Resources Information Center

Shang, Guowen; Zhao, Shouhui

2017-01-01

The selection of standards and norms constitutes the first and most important step for language standardisation. In this paper, we examine the standard establishment for Huayu (or Singapore Mandarin), a new Chinese variety that has emerged in Singapore as a result of centralised planning and inter-linguistic contact. Huayu is the officially…

Recommendations for standardised description of, and nomenclature concerning, oxidatively damaged nucleobases in DNA

PubMed Central

Cooke, Marcus S.; Loft, Steffen; Olinski, Ryszard; Evans, Mark D.; Bialkowski, Karol; Wagner, J. Richard; Dedon, Peter C.; Møller, Peter; Greenberg, Marc M.; Cadet, Jean

2013-01-01

The field of oxidative stress, and the study of oxidatively damaged DNA, in particular, is a subject of intense, and growing interest. This has, in part, benefited from the availability of kits from commercial suppliers which are advertised as reporting on markers of oxidative stress. Such widespread use has inevitably led to an increase in the number of concerns, amongst experts in the field, editors and referees, over appropriateness of terminology and methodology. Thus, the widely used term “oxidative DNA damage” is misleading as it implies that the damage, i.e. the lesion per se, is oxidative and thus capable of oxidising other substrates. We would encourage the use of such terms as ‘oxidatively damaged DNA’, ‘oxidatively generated DNA damage’, ‘oxidatively-derived damage to DNA’ or ‘oxidation-induced DNA damage’ to describe the consequence of the interaction of reactive oxygen species with DNA. One of the most studied nucleic acid-derived biomarkers of oxidative stress is 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG). Yet, in the literature, this compound has been referred to using a number of different terms, sometimes leading to confusion over the designation of the modified nucleobase or (2′-deoxy)ribonucleoside. Standardisation of nomenclature would not only simplify literature searches, but also clarify the lesion in question. Herein, we provide justification for our preferred nomenclature, and suggest a number of steps by which we may work towards standardisation of calibration, and with it improved inter-laboratory agreement, for assays of 8-oxodG, in order to achieve accurate measurements. PMID:20235554

Testing and Improving the Luminosity Relations for Gamma-Ray Bursts

NASA Astrophysics Data System (ADS)

Collazzi, Andrew C.

2012-01-01

Gamma Ray Bursts (GRBs) have several luminosity relations where a measurable property of a burst light curve or spectrum is correlated with the burst luminosity. These luminosity relations are calibrated for the fraction of bursts with spectroscopic redshifts and hence the known luminosities. GRBs have thus become known as a type of "standard candle” where standard candle is meant in the usual sense that luminosities can be derived from measurable properties of the bursts. GRBs can therefore be used for the same cosmology applications as Type Ia supernovae, including the construction of the Hubble Diagram and measuring massive star formation rate. The greatest disadvantage of using GRBs as standard candles is that their accuracy is lower than desired. With the recent advent of GRBs as a new standard candle, every effort must be made to test and improve the distance measures. Here, methods are employed to do just that. First, generalized forms of two tests are performed on the luminosity relations. All the luminosity relations pass one of these tests, and all but two pass the other. Even with this failure, redundancies in using multiple luminosity relations allows all the luminosity relations to retain value. Next, the "Firmani relation” is shown to have poorer accuracy than first advertised. It is also shown to be derivable from two other luminosity relations. For these reasons, the Firmani relation is useless for cosmology. The Amati relation is then revisited and shown to be an artifact of a combination of selection effects. Therefore, the Amati relation is also not good for cosmology. Fourthly, the systematic errors involved in measuring a luminosity indicator (Epeak) are measured. The result is an irreducible systematic error of 28%. Finally, the work concludes with a discussion about the impact of the work and the future of GRB luminosity relations.

Effects of pre-conditioning on behavior and physiology of horses during a standardised learning task

PubMed Central

Webb, Holly; Starling, Melissa J.; Freire, Rafael; Buckley, Petra; McGreevy, Paul D.

2017-01-01

Rein tension is used to apply pressure to control both ridden and unridden horses. The pressure is delivered by equipment such as the bit, which may restrict voluntary movement and cause changes in behavior and physiology. Managing the effects of such pressure on arousal level and behavioral indicators will optimise horse learning outcomes. This study examined the effect of training horses to turn away from bit pressure on cardiac outcomes and behavior (including responsiveness) over the course of eight trials in a standardised learning task. The experimental procedure consisted of a resting phase, treatment/control phase, standardised learning trials requiring the horses (n = 68) to step backwards in response to bit pressure and a recovery phase. As expected, heart rate increased (P = 0.028) when the handler applied rein tension during the treatment phase. The amount of rein tension required to elicit a response during treatment was higher on the left than the right rein (P = 0.009). Total rein tension required for trials reduced (P < 0.001) as they progressed, as did time taken (P < 0.001) and steps taken (P < 0.001). The incidence of head tossing decreased (P = 0.015) with the progression of the trials and was higher (P = 0.018) for the control horses than the treated horses. These results suggest that preparing the horses for the lesson and slightly raising their arousal levels, improved learning outcomes. PMID:28358892

Standardisation a Considerable Force behind Language Death: A Case of Shona

ERIC Educational Resources Information Center

Mhute, Isaac

2016-01-01

The paper assesses the contribution of standardisation towards language death taking Clement Doke's resolutions on the various Shona dialects as a case study. It is a qualitative analysis of views gathered from speakers of the language situated in various provinces of Zimbabwe, the country in which the language is spoken by around 75% of the…

Analysis of the logic and framing of a tobacco industry campaign opposing standardised packaging legislation in New Zealand.

PubMed

Waa, Andrew Morehu; Hoek, Janet; Edwards, Richard; Maclaurin, James

2017-11-01

The tobacco industry routinely opposes tobacco control policies, often using a standard repertoire of arguments. Following proposals to introduce standardised packaging in New Zealand (NZ), British American Tobacco New Zealand (BATNZ) launched the 'Agree-Disagree' mass media campaign, which coincided with the NZ government's standardised packaging consultations. This study examined the logic of the arguments presented and rhetorical strategies employed in the campaign. We analysed each advertisement to identify key messages, arguments and rhetorical devices, then examined the arguments' structure and assessed their logical soundness and validity. All advertisements attempted to frame BATNZ as reasonable, and each contained flawed arguments that were either unsound or based on logical fallacies. Flawed arguments included misrepresenting the intent of the proposed legislation (straw man), claiming standardised packaging would harm all NZ brands (false dilemma), warning NZ not to adopt standardised packaging because of its Australian origins (an unsound argument) or using vague premises as a basis for claiming negative outcomes (equivocation). BATNZ's Agree-Disagree campaign relied on unsound arguments, logical fallacies and rhetorical devices. Given the industry's frequent recourse to these tactics, we propose strategies based on our study findings that can be used to assist the tobacco control community to counter industry opposition to standardised packaging. Greater recognition of logical fallacies and rhetorical devices employed by the tobacco industry will help maintain focus on the health benefits proposed policies will deliver. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Impact of the introduction of a standardised ICD programming protocol: real-world data from a single centre.

PubMed

Sunderland, Nicholas; Kaura, Amit; Li, Anthony; Kamdar, Ravi; Petzer, Ed; Dhillon, Para; Murgatroyd, Francis; Scott, Paul A

2016-09-01

Randomised trials have shown that empiric ICD programming, using long detection times and high detection zones, reduces device therapy in ICD recipients. However, there is less data on its effectiveness in a "real-world" setting, especially secondary prevention patients. Our aim was to evaluate the introduction of a standardised programming protocol in a real-world setting of unselected ICD recipients. We analysed 270 consecutive ICD recipients implanted in a single centre-135 implanted prior to protocol implementation (physician-led group) and 135 after (standardised group). The protocol included long arrhythmia detection times (30/40 or equivalent) and high rate detection zones (primary prevention lower treatment zone 200 bpm). Programming in the physician-led group was at the discretion of the implanter. The primary endpoint was time-to-any therapy (ATP or shocks). Secondary endpoints were time-to-inappropriate therapy and time-to-appropriate therapy. The safety endpoints were syncopal episodes, hospital admissions and death. At 12 months follow-up, 47 patients had received any ICD therapy (physician-led group, n = 31 vs. standardised group, n = 16). There was a 47 % risk reduction in any device therapy (p = 0.04) and an 86 % risk reduction in inappropriate therapy (p = 0.009) in the standardised compared to the physician-led group. There was a non-significant 30 % risk reduction in appropriate therapy (p = 0.32). Results were consistent across primary and secondary prevention patients. There were no significant differences in the rates of syncope, hospitalisation, and death. In unselected patients in a real-world setting, introduction of a standardised programming protocol, using long detection times and high detection zones, significantly reduces the burden of ICD therapy without an increase in adverse outcomes.

Problematising the Standardisation of Leadership and Management Development in South African Schools

ERIC Educational Resources Information Center

Williams, Clarence

2015-01-01

In 2007 the Department of Education introduced the standards-based Advanced Certificate in Education: School Management and Leadership. The standardisation of leadership and management development in South African schools has been uncritically accepted by most academics and professionals. The purpose of this article is to problematise the…

The Political Economy of E-Learning Educational Development Strategies, Standardisation and Scalability

ERIC Educational Resources Information Center

Kenney, Jacqueline; Hermens, Antoine; Clarke, Thomas

2004-01-01

The development of e-learning by government through policy, funding allocations, research-based collaborative projects and alliances has increased recently in both developed and under-developed nations. The paper notes that government, industry and corporate users are increasingly focusing on standardisation issues and the scalability of…

A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products.

PubMed

Hatchard, Jenny L; Fooks, Gary J; Evans-Reeves, Karen A; Ulucanlar, Selda; Gilmore, Anna B

2014-02-12

To examine the volume, relevance and quality of transnational tobacco corporations' (TTCs) evidence that standardised packaging of tobacco products 'won't work', following the UK government's decision to 'wait and see' until further evidence is available. Content analysis. We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging 'won't work'. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging 'won't work' lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria-subject matter, independence and peer-review status-to critically assess evidence submitted to them by corporate interests via Better Regulation

Managing EEE part standardisation and procurement

NASA Astrophysics Data System (ADS)

Serieys, C.; Bensoussan, A.; Petitmangin, A.; Rigaud, M.; Barbaresco, P.; Lyan, C.

2002-12-01

This paper presents the development activities in space components selection and procurement dealing with a new data base tool implemented at Alcatel Space using TransForm softwaa re configurator developed by Techform S.A. Based on TransForm, Access Ingenierie has devv eloped a software product named OLG@DOS which facilitate the part nomenclatures analyses for new equipment design and manufacturing in term of ACCESS data base implementation. Hi-Rel EEE part type technical, production and quality information are collected and compiled usingproduction data base issued from production tools implemented for equipment definition, description and production based on Manufacturing Resource Planning (MRP II Control Open) and Parametric Design Manager (PDM Work Manager). The analysis of any new equipment nomenclature may be conducted through this means for standardisation purpose, cost containment program and management procurement activities as well as preparation of Component reviews as Part Approval Document and Declared Part List validation.

Background studies of high energy γ rays from (n,γ) reactions in the CANDLES experiment

NASA Astrophysics Data System (ADS)

Nakajima, K.; Iida, T.; Akutagawa, K.; Batpurev, T.; Chan, W. M.; Dokaku, F.; Fushimi, K.; Kakubata, H.; Kanagawa, K.; Katagiri, S.; Kawasaki, K.; Khai, B. T.; Kino, H.; Kinoshita, E.; Kishimoto, T.; Hazama, R.; Hiraoka, H.; Hiyama, T.; Ishikawa, M.; Li, X.; Maeda, T.; Matsuoka, K.; Moser, M.; Nomachi, M.; Ogawa, I.; Ohata, T.; Sato, H.; Shamoto, K.; Shimada, M.; Shokati, M.; Takahashi, N.; Takemoto, Y.; Takihira, Y.; Tamagawa, Y.; Tozawa, M.; Teranishi, K.; Tetsuno, K.; Trang, V. T. T.; Tsuzuki, M.; Umehara, S.; Wang, W.; Yoshida, S.; Yotsunaga, N.

2018-07-01

High energy γ rays with several MeV produced by (n,γ) reactions can be a trouble for low background measurements in the underground laboratories such as double beta decay experiments. In the CANDLES project, which aimed to observe the neutrino-less double beta decay from 48Ca, γ rays caused by (n,γ) reactions were found to be the most significant background. The profile of the background was studied by measurements with a neutron source and a simulation with a validity check of neutron processes in Geant4. The observed spectrum of γ rays from (n,γ) reactions was well reproduced by the simulated spectra, which were originated from the surrounding rock and a detector tank made of stainless steel. The environmental neutron flux was derived by the observed event rate of γ rays from (n,γ) reactions using the simulation. The thermal and non-thermal neutron flux were found to be (1.3 ± 0.6) ×10-6 cm-2s-1 and (1.1 ± 0.5) ×10-5 cm-2s-1 , respectively. It is necessary to install an additional shield to reduce the background from (n,γ) reaction to the required level.

Vocational Training and European Standardisation of Qualifications: The Case of Aircraft Maintenance

ERIC Educational Resources Information Center

Haas, Joachim; Ourtau, Maurice

2009-01-01

Initiatives to standardise the conditions for practising certain regulated activities are being taken at European level, particularly in light of the free movement of people and the recognition of qualifications in Member states. This paper looks at the introduction of european licences for aircraft maintenance engineers. It follows an in-depth…

Is Consumer Response to Plain/Standardised Tobacco Packaging Consistent with Framework Convention on Tobacco Control Guidelines? A Systematic Review of Quantitative Studies

PubMed Central

Stead, Martine; Moodie, Crawford; Angus, Kathryn; Bauld, Linda; McNeill, Ann; Thomas, James; Hastings, Gerard; Hinds, Kate; O'Mara-Eves, Alison; Kwan, Irene; Purves, Richard I.; Bryce, Stuart L.

2013-01-01

Background and Objectives Standardised or ‘plain’ tobacco packaging was introduced in Australia in December 2012 and is currently being considered in other countries. The primary objective of this systematic review was to locate, assess and synthesise published and grey literature relating to the potential impacts of standardised tobacco packaging as proposed by the guidelines for the international Framework Convention on Tobacco Control: reduced appeal, increased salience and effectiveness of health warnings, and more accurate perceptions of product strength and harm. Methods Electronic databases were searched and researchers in the field were contacted to identify studies. Eligible studies were published or unpublished primary research of any design, issued since 1980 and concerning tobacco packaging. Twenty-five quantitative studies reported relevant outcomes and met the inclusion criteria. A narrative synthesis was conducted. Results Studies that explored the impact of package design on appeal consistently found that standardised packaging reduced the appeal of cigarettes and smoking, and was associated with perceived lower quality, poorer taste and less desirable smoker identities. Although findings were mixed, standardised packs tended to increase the salience and effectiveness of health warnings in terms of recall, attention, believability and seriousness, with effects being mediated by the warning size, type and position on pack. Pack colour was found to influence perceptions of product harm and strength, with darker coloured standardised packs generally perceived as containing stronger tasting and more harmful cigarettes than fully branded packs; lighter coloured standardised packs suggested weaker and less harmful cigarettes. Findings were largely consistent, irrespective of location and sample. Conclusions The evidence strongly suggests that standardised packaging will reduce the appeal of packaging and of smoking in general; that it will go some way

Is consumer response to plain/standardised tobacco packaging consistent with framework convention on tobacco control guidelines? A systematic review of quantitative studies.

PubMed

Stead, Martine; Moodie, Crawford; Angus, Kathryn; Bauld, Linda; McNeill, Ann; Thomas, James; Hastings, Gerard; Hinds, Kate; O'Mara-Eves, Alison; Kwan, Irene; Purves, Richard I; Bryce, Stuart L

2013-01-01

Standardised or 'plain' tobacco packaging was introduced in Australia in December 2012 and is currently being considered in other countries. The primary objective of this systematic review was to locate, assess and synthesise published and grey literature relating to the potential impacts of standardised tobacco packaging as proposed by the guidelines for the international Framework Convention on Tobacco Control: reduced appeal, increased salience and effectiveness of health warnings, and more accurate perceptions of product strength and harm. Electronic databases were searched and researchers in the field were contacted to identify studies. Eligible studies were published or unpublished primary research of any design, issued since 1980 and concerning tobacco packaging. Twenty-five quantitative studies reported relevant outcomes and met the inclusion criteria. A narrative synthesis was conducted. Studies that explored the impact of package design on appeal consistently found that standardised packaging reduced the appeal of cigarettes and smoking, and was associated with perceived lower quality, poorer taste and less desirable smoker identities. Although findings were mixed, standardised packs tended to increase the salience and effectiveness of health warnings in terms of recall, attention, believability and seriousness, with effects being mediated by the warning size, type and position on pack. Pack colour was found to influence perceptions of product harm and strength, with darker coloured standardised packs generally perceived as containing stronger tasting and more harmful cigarettes than fully branded packs; lighter coloured standardised packs suggested weaker and less harmful cigarettes. Findings were largely consistent, irrespective of location and sample. The evidence strongly suggests that standardised packaging will reduce the appeal of packaging and of smoking in general; that it will go some way to reduce consumer misperceptions regarding product harm

484 Allergen Standardisation in Allergens and Allergoids—Challenges and Considerations

PubMed Central

Skinner, Murray; Bullimore, Alan; Hewings, Simon; Swan, Nicola

2012-01-01

Background The range of therapeutics and dosing schedules for allergen preparations and allergoids produced and used clinically are considerable. Standardisation of allergy immunotherapies is considered a positive step; however there are difficulties in identifying universal metrics for standardisation. Many advocate the use of major allergen content whilst others advocate total allergenicity. Additionally as a compounding argument, where major allergen is used, many disagree on what the major allergen is for certain species. Methods Major allergen content measurement allows a consistent recognised measure, and IgE responses of a serum pool are often dominated by IgE against major allergens. However issues such as specificity of different assays toward isoforms and other variants of single allergens often results in diverging allergen contents that can cause unexpected and misleading disparity. Other aspects that increase complication are the relevance to modified allergens, use of adjuvants and differing dosing regimes. Results The major allergen content of key products in different therapeutic formats has been measured. Conclusions This has been performed in conjunction with techniques such as total allergenicity, as allergy treatments and therapeutics require careful characterisation to allow supply of consistent, safe and efficacious products.

How tobacco companies in the UK prepared for and responded to standardised packaging of cigarettes and rolling tobacco.

PubMed

Moodie, Crawford; Angus, Kathryn; Mitchell, Danielle; Critchlow, Nathan

2018-01-10

As a result of the Standardised Packaging of Tobacco Products Regulations and Tobacco Products Directive, all packs of cigarettes (factory-made and hand-rolled) in the UK must be drab brown, display pictorial warnings on the principal display areas and contain no less than 20 cigarettes or 30 g of tobacco. The legislation was phased in between May 2016 and May 2017. Our objective was to monitor pack, brand and product changes preimplementation and postimplementation. Our surveillance of the cigarette market involved a review of the trade press, a monthly monitor of online supermarkets and regular visits to stores, from May 2015 to June 2017. Before standardised packaging there were changes to the pack graphics (eg, redesigned packs and limited editions) and pack structure (eg, resealable inner foil) and the issue of a number of reusable tins. After standardised packaging, changes included newer cigarette pack sizes for some brand variants (eg, 23 and 24 packs). Changes to the branding prestandardised packaging included brand extensions, and poststandardised packaging included brand and/or variant name change, often with the inclusion of colour descriptors and brand migrations. Product changes prestandardised packaging included the introduction of novel filters (eg, filters with two flavour-changing capsules, tube filters, firmer filters and filters with granular additives). There was non-compliance with the legislation, with slim packs, which are not permitted, on sale after standardised packaging was implemented. Our findings highlight the need to monitor developments in markets introducing standardised packaging and have policy implications for countries considering this measure. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Implementation of a lung cancer multidisciplinary team standardised template for reporting to general practitioners: a mixed-method study

PubMed Central

Collett, Gemma K; Brown, Clare M; Shaw, Tim J; White, Kahren M; Beale, Philip J; Anderiesz, Cleola; Barnes, David J

2017-01-01

Objectives Few interventions have been designed that provide standardised information to primary care clinicians about the diagnostic and treatment recommendations resulting from cancer multidisciplinary team (MDT) (tumour board) meetings. This study aimed to develop, implement and evaluate a standardised template for lung cancer MDTs to provide clinical information and treatment recommendations to general practitioners (GPs). Specific objectives were to (1) evaluate template feasibility (acceptability, appropriateness and timeliness) with GPs and (2) document processes of preimplementation, implementation and evaluation within the MDT setting. Design A mixed-method study design using structured interviews with GPs and qualitative documentation of project logs about implementation processes. Setting Two hospitals in Central Sydney, New South Wales, Australia. Participants: 61 GPs evaluated the template. Two lung cancer MDTs, consisting of 33 clinicians, and eight researchers participated in template development and implementation strategy. Results The MDT-reporting template appears to be a feasible way of providing clinical information to GPs following patient presentation at a lung cancer MDT meeting. Ninety-five per cent of GPs strongly agreed or agreed that the standardised template provided useful and relevant information, that it was received in a timely manner (90%) and that the information was easy to interpret and communicate to the patient (84%). Implementation process data show that the investment made in the preimplementation stage to integrate the template into standard work practices was a critical factor in successful implementation. Conclusions This study demonstrates that it is feasible to provide lung cancer MDT treatment recommendations to GPs through implementation of a standardised template. A simple intervention, such as a standardised template, can help to address quality gaps and ensure that timely information is communicated between tertiary

Survey of neurodevelopmental allied health teams in Australian and New Zealand neonatal nurseries: Staff profile and standardised neurobehavioural/neurological assessment.

PubMed

Allinson, Leesa G; Doyle, Lex W; Denehy, Linda; Spittle, Alicia J

2017-06-01

The primary aim of this study was to establish how many neonatal nurseries in Australia and New Zealand had a neurodevelopmental allied health team, to ascertain the disciplines involved, their qualifications and experience. The secondary aim was to evaluate which standardised neurobehavioural/neurological assessments were currently being implemented, and the existing practice in relation to their use. A descriptive cross-sectional survey, sampling 179 eligible public and private hospital neonatal intensive care units (NICUs) and special care nurseries (SCNs) throughout Australia and New Zealand, was purpose-developed and administered electronically from the 5th April to 23rd July 2013. A total of 117 units (65%) overall, and 26 of 26 (100%) NICUs responded to the survey. NICUs had more neurodevelopmental allied health staff than SCNs, with physiotherapists and speech pathologists the most common disciplines. Physiotherapists were more likely to administer standardised neurobehavioural/neurological assessments in NICUs, while medical staff were more likely to do so in SCNs. A wide variety of standardised neurobehavioural/neurological assessment tools were used, with Prechtl's General Movements Assessment the most common in the NICUs (50%) and the Hammersmith Neonatal Neurological Examination the most common in the special care units (25%). Standardised neurobehavioural assessments were not administered in 22% of SCNs. Although neurodevelopmental allied health teams and standardised neurobehavioural/neurological assessments are valued by many, there was little consistency across Australian and New Zealand neonatal nurseries. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products

PubMed Central

Hatchard, Jenny L; Fooks, Gary J; Evans-Reeves, Karen A; Ulucanlar, Selda; Gilmore, Anna B

2014-01-01

Objectives To examine the volume, relevance and quality of transnational tobacco corporations’ (TTCs) evidence that standardised packaging of tobacco products ‘won't work’, following the UK government's decision to ‘wait and see’ until further evidence is available. Design Content analysis. Setting We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. Outcome measures The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. Results 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging ‘won't work’. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). Conclusions With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging ‘won't work’ lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria—subject matter, independence and peer-review status�

Improving site selection in clinical studies: a standardised, objective, multistep method and first experience results.

PubMed

Hurtado-Chong, Anahí; Joeris, Alexander; Hess, Denise; Blauth, Michael

2017-07-12

A considerable number of clinical studies experience delays, which result in increased duration and costs. In multicentre studies, patient recruitment is among the leading causes of delays. Poor site selection can result in low recruitment and bad data quality. Site selection is therefore crucial for study quality and completion, but currently no specific guidelines are available. Selection of sites adequate to participate in a prospective multicentre cohort study was performed through an open call using a newly developed objective multistep approach. The method is based on use of a network, definition of objective criteria and a systematic screening process. Out of 266 interested sites, 24 were shortlisted and finally 12 sites were selected to participate in the study. The steps in the process included an open call through a network, use of selection questionnaires tailored to the study, evaluation of responses using objective criteria and scripted telephone interviews. At each step, the number of candidate sites was quickly reduced leaving only the most promising candidates. Recruitment and quality of data went according to expectations in spite of the contracting problems faced with some sites. The results of our first experience with a standardised and objective method of site selection are encouraging. The site selection method described here can serve as a guideline for other researchers performing multicentre studies. ClinicalTrials.gov: NCT02297581. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Knowledge Work of Professional Associations: Approaches to Standardisation and Forms of Legitimisation

ERIC Educational Resources Information Center

Nerland, Monika; Karseth, Berit

2015-01-01

This paper examines how professional associations engage themselves in efforts to develop, regulate and secure knowledge in their respective domains, with special emphasis on standardisation. The general emphasis on science in society brings renewed attention to the knowledge base of professionals, and positions professional bodies as key…

Multicentre standardisation of chest MRI as radiation-free outcome measure of lung disease in young children with cystic fibrosis.

PubMed

Wielpütz, Mark O; von Stackelberg, Oyunbileg; Stahl, Mirjam; Jobst, Bertram J; Eichinger, Monika; Puderbach, Michael U; Nährlich, Lutz; Barth, Sandra; Schneider, Christian; Kopp, Matthias V; Ricklefs, Isabell; Buchholz, Michael; Tümmler, Burkhard; Dopfer, Christian; Vogel-Claussen, Jens; Kauczor, Hans-Ulrich; Mall, Marcus A

2018-05-24

A recent single-centre study demonstrated that MRI is sensitive to detect early abnormalities in the lung and response to therapy in infants and preschool children with cystic fibrosis (CF) supporting MRI as an outcome measure of early CF lung disease. However, the feasibility of multicentre standardisation remains unknown. To determine the feasibility of multicentre standardisation of chest MRI in infants and preschool children with CF. A standardised chest 1.5 T MRI protocol was implemented across four specialised CF centres. Following training and initiation visits, 42 infants and preschool children (mean age 3.2 ± 1.5 years, range 0-6 years) with clinically stable CF underwent MRI and chest X-ray (CXR). Image quality and lung abnormalities were assessed using a standardised questionnaire and an established CF MRI and CXR score. MRI was successfully performed with diagnostic quality in all patients (100%). Incomplete lung coverage was observed in 6% and artefacts also in 6% of sequence acquisitions, but these were compensated by remaining sequences in all patients. The range of the MRI score in CF patients was similar across centres with a mean global MRI score of 13.3 ± 5.8. Cross-validation of the MRI against the CXR score revealed a moderate correlation (r = 0.43-0.50, p < 0.01). Our results demonstrate that multicentre standardisation of chest MRI is feasible and support its use as radiation-free outcome measure of lung disease in infants and preschool children with CF. Copyright © 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Standardised animal models of host microbial mutualism

PubMed Central

Macpherson, A J; McCoy, K D

2015-01-01

An appreciation of the importance of interactions between microbes and multicellular organisms is currently driving research in biology and biomedicine. Many human diseases involve interactions between the host and the microbiota, so investigating the mechanisms involved is important for human health. Although microbial ecology measurements capture considerable diversity of the communities between individuals, this diversity is highly problematic for reproducible experimental animal models that seek to establish the mechanistic basis for interactions within the overall host-microbial superorganism. Conflicting experimental results may be explained away through unknown differences in the microbiota composition between vivaria or between the microenvironment of different isolated cages. In this position paper, we propose standardised criteria for stabilised and defined experimental animal microbiotas to generate reproducible models of human disease that are suitable for systematic experimentation and are reproducible across different institutions. PMID:25492472

Gait and Lower Limb Observation of Paediatrics (GALLOP): development of a consensus based paediatric podiatry and physiotherapy standardised recording proforma.

PubMed

Cranage, Simone; Banwell, Helen; Williams, Cylie M

2016-01-01

Paediatric gait and lower limb assessments are frequently undertaken in podiatry and physiotherapy clinical practice and this is a growing area of expertise within Australia. No concise paediatric standardised recording proforma exists to assist clinicians in clinical practice. The aim of this study was to develop a gait and lower limb standardised recording proforma guided by the literature and consensus, for assessment of the paediatric foot and lower limb in children aged 0-18 years. Expert Australian podiatrists and physiotherapists were invited to participate in a three round Delphi survey panel using the online Qualtrics(©) survey platform. The first round of the survey consisted of open-ended questions on paediatric gait and lower limb assessment developed from existing templates and a literature search of standardised lower limb assessment methods. Rounds two and three consisted of statements developed from the first round responses. Questions and statements were included in the final proforma if 70 % or more of the participants indicated consensus or agreement with the assessment method and if there was support within the literature for paediatric age-specific normative data with acceptable reliability of outcome measures. There were 17 of the 21 (81 %) participants who completed three rounds of the survey. Consensus was achieved for 41 statements in Round one, 54 statements achieved agreement in two subsequent rounds. Participants agreed on 95 statements relating to birth history, developmental history, hip measurement, rotation of the lower limb, ankle range of motion, foot posture, balance and gait. Assessments with acceptable validity and reliability were included within the final Gait and Lower Limb Observation of Paediatrics (GALLOP) proforma. The GALLOP proforma is a consensus based, systematic and standardised way to collect information and outcome measures in paediatric lower limb assessment. This standardised recording proforma will assist

Standardised (plain) cigarette packaging increases attention to both text-based and graphical health warnings: experimental evidence.

PubMed

Shankleman, M; Sykes, C; Mandeville, K L; Di Costa, S; Yarrow, K

2015-01-01

To investigate whether standardised cigarette packaging increases the time spent looking at health warnings, regardless of the format of those warnings. A factorial (two pack styles x three warning types) within-subject experiment, with participants randomised to different orders of conditions, completed at a university in London, UK. Mock-ups of cigarette packets were presented to participants with their branded portion in either standardised (plain) or manufacturer-designed (branded) format. Health warnings were present on all packets, representing all three types currently in use in the UK: black & white text, colour text, or colour images with accompanying text. Gaze position was recorded using a specialised eye tracker, providing the main outcome measure, which was the mean proportion of a five-second viewing period spent gazing at the warning-label region of the packet. An opportunity sample of 30 (six male, mean age = 23) young adults met the following inclusion criteria: 1) not currently a smoker; 2) <100 lifetime cigarettes smoked; 3) gaze position successfully tracked for > 50% viewing time. These participants spent a greater proportion of the available time gazing at the warning-label region when the branded section of the pack was standardised (following current Australian guidelines) rather than containing the manufacturer's preferred design (mean difference in proportions = 0.078, 95% confidence interval 0.049 to 0.106, p < 0.001). There was no evidence that this effect varied based on the type of warning label (black & white text vs. colour text vs. colour image & text; interaction p = 0.295). During incidental viewing of cigarette packets, young adult never-smokers are likely to spend more time looking at health warnings if manufacturers are compelled to use standardised packaging, regardless of the warning design. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Reviewing subchondral cartilage surgery: considerations for standardised and outcome predictable cartilage remodelling: a technical note.

PubMed

Benthien, Jan P; Behrens, Peter

2013-11-01

The potential of subchondral mesenchymal stem cell stimulation (MSS) for cartilage repair has led to the widespread use of microfracture as a first line treatment for full thickness articular cartilage defects. Recent focus on the effects of subchondral bone during cartilage injury and repair has expanded the understanding of the strengths and limitations in MSS and opened new pathways for potential improvement. Comparative studies have shown that bone marrow access has positive implications for pluripotential cell recruitment, repair quality and quantity, i.e. deeper channels elicited better cartilage fill, more hyaline cartilage character with higher type II collagen content and lower type I collagen content compared to shallow marrow access. A subchondral needling procedure using standardised and thin subchondral perforations deep into the subarticular bone marrow making the MSS more consistent with the latest developments in subchondral cartilage remodelling is proposed. As this is a novel method clinical studies have been initiated to evaluate the procedure especially compared to microfracturing. However, the first case studies and follow-ups indicate that specific drills facilitate reaching the subchondral bone marrow while the needle size makes perforation of the subchondral bone easier and more predictable. Clinical results of the first group of patients seem to compare well to microfracturing. The authors suggest a new method for a standardised procedure using a new perforating device. Advances in MSS by subchondral bone marrow perforation are discussed. It remains to be determined by clinical studies how this method compares to microfracturing. The subchondral needling offers the surgeon and the investigator a method that facilitates comparison studies because of its defined depth of subchondral penetration and needle size.

Standardisation of radiation portal monitor controls and readouts.

PubMed

Tinker, M

2010-10-01

There is an urgent need to standardise the numbering configuration of radiation portal monitor sensing panels. Currently, manufacturers use conflicting numbering schemes that may confuse operators of these varied systems. There is a similar problem encountered with the varied choices of coloured indicator lights and coloured print lines designated for gamma and neutron alarms. In addition, second-party software that changes the alarm colour scheme may also have been installed. Furthermore, no provision exists for the colour blind or to provide work stations with only black ink on alarm printouts. These inconsistencies and confusing set-ups could inadvertently cause a misinterpretation of the alarm, resulting in the potential release of a radiological hazard into a sovereign country. These issues are discussed, and a proposed solution is offered.

Standardised method for reporting exercise programmes: protocol for a modified Delphi study.

PubMed

Slade, Susan C; Dionne, Clermont E; Underwood, Martin; Buchbinder, Rachelle

2014-12-30

Exercise is integral to health across the lifespan and important for people with chronic health conditions. A systematic review of exercise trials for chronic conditions reported suboptimal descriptions of the evaluated interventions and concluded that this hinders interpretation and replication. The aim of this project is to develop a standardised method for reporting essential exercise programme details being evaluated in clinical trials. A modified Delphi technique will be used to gain consensus among international exercise experts. We will use three sequential rounds of anonymous online questionnaires to refine a standardised checklist. A draft checklist of potentially relevant items was developed based on the results of a systematic review of exercise systematic reviews. An international panel of experts was identified by exercise systematic review authorship, established international profile in exercise research and practice and by peer referral. In round 1, the international panel of experts will be asked to rate the importance of each draft item and provide additional suggestions for revisions or new items. Consensus will be considered reached if at least 70% of the panel strongly agree/disagree that an item should be included or excluded. Where agreement is not reached or there are suggestions for altered or new items, these will be taken to round 2 together with an aggregated summary of round 1 responses. Following the second round, a ranking of item importance will be made to rationalise the number of items. The final template will be distributed to panel members for approval. Ethics approval was received from The Cabrini Institute Ethics Committee, Melbourne, Australia (HREC 02-07-04-14). We plan to use a stepwise process to develop and refine a standardised and internationally agreed template for explicit reporting of exercise programmes. The template will be generalisable across all types of exercise interventions. The findings will be disseminated

Identification of predominant odorants in thai desserts flavored by smoking with "Tian Op", a traditional Thai scented candle.

PubMed

Watcharananun, Wanwarang; Cadwallader, Keith R; Huangrak, Kittiphong; Kim, Hun; Lorjaroenphon, Yaowapa

2009-02-11

"Tian Op", a traditional Thai scented candle, is used for the smoking and flavoring of sweets, cakes, and other desserts for the purpose of adding a unique aroma to the final product. Gas chromatography-olfactometry, aroma extract dilution analysis, and GC-MS were applied to identify the potent odorants in two types of traditional Thai desserts ("num dok mai" and "gleep lum duan") prepared using a Tian Op smoking process. On the basis of the results of AEDA and calculated odor-activity values, the predominant odorants in the Tian Op flavored desserts were vinyl ketones (C(5)-C(9)), n-aldehydes (C(5)-C(11)), (E)-2-unsaturated aldehydes (C(8)-C(11)), and omega-1-unsaturated aldehydes (C(8) and C(9)). Sensory studies of model mixtures confirmed the importance of n-aldehydes, omega-1-unsaturated aldehydes, and guaiacol as predominant odorants; however, the results showed that vinyl ketones and (E)-2-unsaturated aldehydes, despite having high odor-activity values, may be of only minor importance in the typical aroma profiles of traditional Tian Op smoked desserts.

Standardised Observation Analogue Procedure (SOAP) for Assessing Parent and Child Behaviours in Clinical Trials

ERIC Educational Resources Information Center

Johnson, Cynthia R.; Butter, Eric M.; Handen, Benjamin L.; Sukhodolsky, Denis G.; Mulick, James; Lecavalier, Luc; Aman, Michael G.; Arnold, Eugene L.; Scahill, Lawrence; Swiezy, Naomi; Sacco, Kelley; Stigler, Kimberly A.; McDougle, Christopher J.

2009-01-01

Background: Observational measures of parent and child behaviours have a long history in child psychiatric and psychological intervention research, including the field of autism and developmental disability. We describe the development of the Standardised Observational Analogue Procedure (SOAP) for the assessment of parent-child behaviour before…

STEREOSCOPIC OBSERVATION OF SLIPPING RECONNECTION IN A DOUBLE CANDLE-FLAME-SHAPED SOLAR FLARE

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

Gou, Tingyu; Liu, Rui; Wang, Yuming

2016-04-20

The 2011 January 28 M1.4 flare exhibits two side-by-side candle-flame-shaped flare loop systems underneath a larger cusp-shaped structure during the decay phase, as observed at the northwestern solar limb by the Solar Dynamics Observatory . The northern loop system brightens following the initiation of the flare within the southern loop system, but all three cusp-shaped structures are characterized by ∼10 MK temperatures, hotter than the arch-shaped loops underneath. The “Ahead” satellite of the Solar Terrestrial Relations Observatory provides a top view, in which the post-flare loops brighten sequentially, with one end fixed while the other apparently slipping eastward. By performingmore » stereoscopic reconstruction of the post-flare loops in EUV and mapping out magnetic connectivities, we found that the footpoints of the post-flare loops are slipping along the footprint of a hyperbolic flux tube (HFT) separating the two loop systems and that the reconstructed loops share similarity with the magnetic field lines that are traced starting from the same HFT footprint, where the field lines are relatively flexible. These results argue strongly in favor of slipping magnetic reconnection at the HFT. The slipping reconnection was likely triggered by the flare and manifested as propagative dimmings before the loop slippage is observed. It may contribute to the late-phase peak in Fe xvi 33.5 nm, which is even higher than its main-phase counterpart, and may also play a role in the density and temperature asymmetry observed in the northern loop system through heat conduction.« less

Wastage of standardised parenteral nutrition solution - a challenge for neonatal units.

PubMed

Deshmukh, Mangesh; Grzejszczyk, Jessica; Mehta, Shailender; Patole, Sanjay

2018-04-01

Standardised parental nutrition (PN) has been used in many neonatal intensive care unit (NICU). Easy accessibility, better provision of nutrients, reduced prescription errors and cost savings are some of its benefits. Fixed large volume (e.g. 750-1000 mL) and short expiry limit (48 hrs) along with changing metabolic needs of neonates leads to significant wastage of PN solution. To evaluate wastage of PN solution in our 22-bedded NICU. The audit was conducted over 21-month period (July 2015-April 2017). Data on PN use (e.g. type, duration, infused volume, residual after use) was obtained from hospital records. The discarded volume of PN was estimated after subtracting the administered volume based on the rate of infusion from the total volume in the bag. Cumulative "discarded" volume as percentage of the total "supplied" volume was calculated. A total of 305-PN bags (Standardised: Preterm: 222, Term: 83) were used. The estimated total used, discarded, and percentage discarded volumes for standard preterm and term PN were 78.1, 88 L, 53% and 33.5, 49.7 L, and 59.8%, respectively. There was more than 50% wastage of PN solution in our NICU. The estimated cost of this PN wastage was around 21,000 AUD over 21 months. Strategies such as minipack should be explored to prevent such losses.

Respiratory rates measured by a standardised clinical approach, ward staff, and a wireless device.

PubMed

Granholm, A; Pedersen, N E; Lippert, A; Petersen, L F; Rasmussen, L S

2016-11-01

Respiratory rate is among the first vital signs to change in deteriorating patients. The aim was to investigate the agreement between respiratory rate measurements by three different methods. This prospective observational study included acutely admitted adult patients in a medical ward. Respiratory rate was measured by three methods: a standardised approach over 60 s while patients lay still and refrained from talking, by ward staff and by a wireless electronic patch (SensiumVitals). The Bland-Altman method was used to compare measurements and three breaths per minute (BPM) was considered a clinically relevant difference. We included 50 patients. The mean difference between the standardised approach and the electronic measurement was 0.3 (95% CI: -1.4 to 2.0) BPM; 95% limits of agreement were -11.5 (95% CI: -14.5 to -8.6) and 12.1 (95% CI: 9.2 to 15.1) BPM. Removal of three outliers with huge differences lead to a mean difference of -0.1 (95% CI: -0.7 to 0.5) BPM and 95% limits of agreement of -4.2 (95% CI: -5.3 to -3.2) BPM and 4.0 (95% CI: 2.9 to 5.0) BPM. The mean difference between staff and electronic measurements was 1.7 (95% CI: -0.5 to 3.9) BPM; 95% limits of agreement were -13.3 (95% CI: -17.2 to -9.5) BPM and 16.8 (95% CI: 13.0 to 20.6) BPM. A concerning lack of agreement was found between a wireless monitoring system and a standardised clinical approach. Ward staff's measurements also seemed to be inaccurate. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Anthropometric standardisation and quality control protocols for the construction of new, international, fetal and newborn growth standards: the INTERGROWTH-21st Project.

PubMed

Cheikh Ismail, L; Knight, H E; Ohuma, E O; Hoch, L; Chumlea, W C

2013-09-01

The primary aim of the INTERGROWTH-21(st) Project is to construct new, prescriptive standards describing optimal fetal and preterm postnatal growth. The anthropometric measurements include the head circumference, recumbent length and weight of the infants, and the stature and weight of the parents. In such a large, international, multicentre project, it is critical that all study sites follow standardised protocols to ensure maximal validity of the growth and nutrition indicators used. This paper describes in detail the anthropometric training, standardisation and quality control procedures used to collect data for these new standards. The initial standardisation session was in Nairobi, Kenya, using newborns, which was followed by similar sessions in the eight participating study sites in Brazil, China, India, Italy, Kenya, Oman, UK and USA. The intraobserver and inter-observer technical error of measurement values for head circumference range from 0.3 to 0.4 cm, and for recumbent length from 0.3 to 0.5 cm. These standardisation protocols implemented at each study site worldwide ensure that the anthropometric data collected are of the highest quality to construct international growth standards. © 2013 Royal College of Obstetricians and Gynaecologists.

A Standardised Abundance Index from Commercial Spotting Data of Southern Bluefin Tuna (Thunnus maccoyii): Random Effects to the Rescue

PubMed Central

Basson, Marinelle; Farley, Jessica H.

2014-01-01

Commercial aerial spotting of surface schools of juvenile southern bluefin tuna (SBT), Thunnus maccoyii, is conducted as part of fishing operations in the Great Australian Bight in summer. This provides the opportunity to efficiently collect large amounts of data on sightings of SBT. The data can potentially be used to construct a time-series index of relative abundance by standardising the data for issues such as weather, spotter ability and ocean conditions. Unlike a statistically designed survey, the commercial spotting is governed by business considerations and fishing operations. The SBT dataset is therefore highly unbalanced with regard to spotters operating in each season. This complicates the standardisation of the data, particularly with regard to interactions between covariates. We show how a generalized additive model with random effects can simplify both the fitting of the model and the construction of an index, while also avoiding the need to leave out strata or interaction terms that are important. The approach is applicable to standardisation of more traditional catch and effort data. PMID:25541730

A standardised abundance index from commercial spotting data of southern bluefin tuna (Thunnus maccoyii): random effects to the rescue.

PubMed

Basson, Marinelle; Farley, Jessica H

2014-01-01

Commercial aerial spotting of surface schools of juvenile southern bluefin tuna (SBT), Thunnus maccoyii, is conducted as part of fishing operations in the Great Australian Bight in summer. This provides the opportunity to efficiently collect large amounts of data on sightings of SBT. The data can potentially be used to construct a time-series index of relative abundance by standardising the data for issues such as weather, spotter ability and ocean conditions. Unlike a statistically designed survey, the commercial spotting is governed by business considerations and fishing operations. The SBT dataset is therefore highly unbalanced with regard to spotters operating in each season. This complicates the standardisation of the data, particularly with regard to interactions between covariates. We show how a generalized additive model with random effects can simplify both the fitting of the model and the construction of an index, while also avoiding the need to leave out strata or interaction terms that are important. The approach is applicable to standardisation of more traditional catch and effort data.

A cosmology-independent calibration of type Ia supernovae data

NASA Astrophysics Data System (ADS)

Hauret, C.; Magain, P.; Biernaux, J.

2018-06-01

Recently, the common methodology used to transform type Ia supernovae (SNe Ia) into genuine standard candles has been suffering criticism. Indeed, it assumes a particular cosmological model (namely the flat ΛCDM) to calibrate the standardisation corrections parameters, i.e. the dependency of the supernova peak absolute magnitude on its colour, post-maximum decline rate and host galaxy mass. As a result, this assumption could make the data compliant to the assumed cosmology and thus nullify all works previously conducted on model comparison. In this work, we verify the viability of these hypotheses by developing a cosmology-independent approach to standardise SNe Ia data from the recent JLA compilation. Our resulting corrections turn out to be very close to the ΛCDM-based corrections. Therefore, even if a ΛCDM-based calibration is questionable from a theoretical point of view, the potential compliance of SNe Ia data does not happen in practice for the JLA compilation. Previous works of model comparison based on these data do not have to be called into question. However, as this cosmology-independent standardisation method has the same degree of complexity than the model-dependent one, it is worth using it in future works, especially if smaller samples are considered, such as the superluminous type Ic supernovae.

Tensions and Fissures: The Politics of Standardised Testing and Accountability in Ontario, 1995-2015

ERIC Educational Resources Information Center

Pinto, Laura Elizabeth

2016-01-01

While Ontario has received international accolades for its enactment of province-wide standardised testing upon the formation of the Education Quality and Accountability Office (EQAO), a closer look at provincial assessments over a 20-year span reveals successes as well as systemic tensions and fissures. The purpose of this paper is twofold.…

Ultra long period Cepheids: a primary standard candle out to the Hubble flow

NASA Astrophysics Data System (ADS)

Fiorentino, G.; Clementini, G.; Marconi, M.; Musella, I.; Saha, A.; Tosi, M.; Contreras Ramos, R.; Annibali, F.; Aloisi, A.; van der Marel, R.

2012-09-01

The cosmological distance ladder crucially depends on classical Cepheids (with P=3-80 days), which are primary distance indicators up to 33 Mpc. Within this volume, very few SNe Ia have been calibrated through classical Cepheids, with uncertainty related to the non-linearity and the metallicity dependence of their period-luminosity (PL) relation. Although a general consensus on these effects is still not achieved, classical Cepheids remain the most used primary distance indicators. A possible extension of these standard candles to further distances would be important. In this context, a very promising new tool is represented by the ultra-long period (ULP) Cepheids ( P≳80 days), recently identified in star-forming galaxies. Only a small number of ULP Cepheids have been discovered so far. Here we present and analyse the properties of an updated sample of 37 ULP Cepheids observed in galaxies within a very large metallicity range of 12+log(O/H) from ˜7.2 to 9.2 dex. We find that their location in the colour-magnitude ( V- I, V) diagram as well as their Wesenheit ( V- I) index-period (WP) relation suggests that they are the counterparts at high luminosity of the shorter-period ( P≲80 days) classical Cepheids. However, a complete pulsation and evolutionary theoretical scenario is needed to properly interpret the true nature of these objects. We do not confirm the flattening in the studied WP relation suggested by Bird et al. (Astrophys. J. 695:874, 2009). Using the whole sample, we find that ULP Cepheids lie around a WP relation similar to that of the LMC, although with a large spread (˜ 0.4 mag).

Students' Interpersonal Trust and Attitudes towards Standardised Tests: Exploring Affective Variables Related to Student Assessment

ERIC Educational Resources Information Center

Chu, Man-Wai; Guo, Qi; Leighton, Jacqueline P.

2014-01-01

Cognitive and psychometric variables have directed research on student test performance. However, student learning involves a substantial affective component. The objective of this study was to explore the relationship between two kinds of affective variables--interpersonal trust and attitudes towards standardised tests--likely to underlie student…

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach

PubMed Central

MONTANO, Diego

2016-01-01

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach. PMID:26860787

Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach.

PubMed

Montano, Diego

2016-08-05

The present study proposes a set of quality requirements to management practices by taking into account the empirical evidence on their potential effects on health, the systemic nature of social organisations, and the current conceptualisations of management functions within the framework of comprehensive quality management systems. Systematic reviews and meta-analyses focusing on the associations between leadership and/or supervision and health in occupational settings are evaluated, and the core elements of an ISO 9001 standardisation approach are presented. Six major occupational health requirements to high-quality management practices are identified pertaining to communication processes, organisational justice, role clarity, decision making, social influence processes and management support. It is concluded that the quality of management practices may be improved by developing a quality management system of management practices that ensures not only conformity to product but also to occupational safety and health requirements. Further research may evaluate the practicability of the proposed approach.

Standardised mortality rate for cerebrovascular diseases in the Slovak Republic from 1996 to 2013 in the context of income inequalities and its international comparison.

PubMed

Gavurová, Beáta; Kováč, Viliam; Vagašová, Tatiana

2017-12-01

Non-communicable diseases represent one of the greatest challenges for health policymakers. The main objective of this study is to analyse the development of standardised mortality rates for cerebrovascular disease, which is one of the most common causes of deaths, in relation to income inequality in individual regions of the Slovak Republic. Direct standardisation was applied using data from the Slovak mortality database, covering the time period from 1996 to 2013. The standardised mortality rate declined by 4.23% in the Slovak Republic. However, since 1996, the rate has been higher by almost 33% in men than in women. Standardised mortality rates were lower in the northern part of the Slovak Republic than in the southern part. The regression models demonstrated an impact of the observed income-related dimensions on these rates. The income quintile ratio and Gini coefficient appeared to be the most influencing variables. The results of the analysis highlight valuable baseline information for creating new support programmes aimed at eliminating health inequalities in relation to health and social policy.

Simultaneous Synthesis of Treatment Effects and Mapping to a Common Scale: An Alternative to Standardisation

ERIC Educational Resources Information Center

Ades, A. E.; Lu, Guobing; Dias, Sofia; Mayo-Wilson, Evan; Kounali, Daphne

2015-01-01

Objective: Trials often may report several similar outcomes measured on different test instruments. We explored a method for synthesising treatment effect information both within and between trials and for reporting treatment effects on a common scale as an alternative to standardisation Study design: We applied a procedure that simultaneously…

Standardised Benchmarking in the Quest for Orthologs

PubMed Central

Altenhoff, Adrian M.; Boeckmann, Brigitte; Capella-Gutierrez, Salvador; Dalquen, Daniel A.; DeLuca, Todd; Forslund, Kristoffer; Huerta-Cepas, Jaime; Linard, Benjamin; Pereira, Cécile; Pryszcz, Leszek P.; Schreiber, Fabian; Sousa da Silva, Alan; Szklarczyk, Damian; Train, Clément-Marie; Bork, Peer; Lecompte, Odile; von Mering, Christian; Xenarios, Ioannis; Sjölander, Kimmen; Juhl Jensen, Lars; Martin, Maria J.; Muffato, Matthieu; Gabaldón, Toni; Lewis, Suzanna E.; Thomas, Paul D.; Sonnhammer, Erik; Dessimoz, Christophe

2016-01-01

The identification of evolutionarily related genes across different species—orthologs in particular—forms the backbone of many comparative, evolutionary, and functional genomic analyses. Achieving high accuracy in orthology inference is thus essential. Yet the true evolutionary history of genes, required to ascertain orthology, is generally unknown. Furthermore, orthologs are used for very different applications across different phyla, with different requirements in terms of the precision-recall trade-off. As a result, assessing the performance of orthology inference methods remains difficult for both users and method developers. Here, we present a community effort to establish standards in orthology benchmarking and facilitate orthology benchmarking through an automated web-based service (http://orthology.benchmarkservice.org). Using this new service, we characterise the performance of 15 well-established orthology inference methods and resources on a battery of 20 different benchmarks. Standardised benchmarking provides a way for users to identify the most effective methods for the problem at hand, sets a minimal requirement for new tools and resources, and guides the development of more accurate orthology inference methods. PMID:27043882

Standardised studies on Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPM): a need.

PubMed

Elfrink, M E C; Ghanim, A; Manton, D J; Weerheijm, K L

2015-06-01

In November 2014, a review of literature concerning prevalence data of Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPM) was performed. A search of PubMed online databases was conducted for relevant articles published until November 2014. The reference lists of all retrieved articles were hand-searched. Studies were included after assessing the eligibility of the full-text article. Out of 1078 manuscripts, a total of 157 English written publications were selected based on title and abstract. Of these 157, 60 were included in the study and allocated as 52 MIH and 5 HSPM, and 3 for both MIH and HSPM. These studies utilised the European Academy of Paediatric Dentistry judgment criteria, the modified index of developmental defects of enamel (mDDE) and self-devised criteria, and demonstrated a wide variation in the reported prevalence (MIH 2.9-44 %; HSPM 0-21.8 %). Most values mentioned were representative for specific areas. More studies were performed in cities compared with rural areas. A great variation was found in calibration methods, number of participants, number of examiners and research protocols between the studies. The majority of the prevalence studies also investigated possible aetiological factors. To compare MIH and HSPM prevalence and or aetiological data around the world, standardisation of such studies seems essential. Standardisation of the research protocol should include a clearly described sample of children (minimum number of 300 for prevalence and 1000 for aetiology studies) and use of the same calibration sets and methods whereas aetiological studies need to be prospective in nature. A standardised protocol for future MIH and HSPM prevalence and aetiology studies is recommended.

The Person over Standardisation: A Humanistic Framework for Teacher Learning in Diverse School-Based Contexts

ERIC Educational Resources Information Center

Kazanjian, Christopher J.; Choi, Su-Jin

2016-01-01

This paper argues that the purpose of education is to help students realise their unique potentials and pursue inner directions. With this assumption, we critique the inadequacy of the current emphasis on standardisation and provide a theoretical framework for teacher education based on humanistic psychology. Three tenets of humanistic psychology,…

Analysis of incidence, mortality and survival for pancreatic and biliary tract cancers across Europe, with assessment of influence of revised European age standardisation on estimates.

PubMed

Minicozzi, Pamela; Cassetti, Tiziana; Vener, Claudia; Sant, Milena

2018-05-16

Pancreatic (PC) and biliary tract (BTC) cancers have higher incidence and mortality in Europe than elsewhere. We analysed time-trends in PC/BTC incidence, mortality, and survival across Europe. Since the European standard population (ESP) was recently revised to better represent European age structure, we also assessed the effect of adopting the revised ESP to age-standardise incidence and mortality data. We analysed PCs/BTCs (≥15 years) diagnosed in 2000-2007 and followed-up to end of 2008, in 29 European countries across five regions: UK/Ireland, and northern, central, southern, and eastern Europe. Incidence, mortality, and 5-year relative survival were compared between regions, by age, sex, and period of diagnosis. Variation in age-standardised incidence (PC 12-15/100,000; BTC 2-6) and mortality (PC 10-14; BTC 1-5) was modest. Eastern Europe had highest incidence and mortality, and lowest survival; northern and southern Europe had highest age-specific incidence (most age groups) for PC and BTC, respectively. Incidence and survival increased slightly from 2000 to 2007, particularly in elderly patients and women, but survival remained poor (≤8% for PC; 13-18% for BTC). Use of the revised ESP for age-standardisation did not impact European regional incidence and mortality rankings. Poor survival for PC and BTC, together with increasing incidence, indicate that action is required. Countries with higher incidence had higher risk factor frequency, suggesting that prevention initiatives targeting risk factors should be promoted. Improvements in diagnosis and treatment are also required. Our results provide a baseline from which to monitor evolution of the PC/BTC burden in Europe. Copyright © 2018 Elsevier Ltd. All rights reserved.

Measuring fecundity with standardised estimates of expected pregnancies.

PubMed

Mikolajczyk, Rafael T; Stanford, Joseph B

2006-11-01

Approaches to measuring fecundity include the assessment of time to pregnancy and day-specific probabilities of conception (daily fecundities) indexed to a day of ovulation. In this paper, we develop an additional approach of calculating expected pregnancies based on daily fecundities indexed to the last day of the menstrual cycle. Expected pregnancies can thus be calculated while controlling for frequency and timing of coitus. Comparing observed pregnancies with expected pregnancies allows for a standardised comparison of fecundity between studies or groups within studies, and can be used to assess the effects of categorical covariates on the woman or couple level, and also on the cycle level. This can be accomplished in a minimal data set that does not necessarily require hormonal measurement or the explicit identification of ovulation. We demonstrate this approach by examining the effects of age and parity on fecundity in a data set from women monitoring their fertility cycles with the Creighton Model FertilityCare System.

The Impact of Mobile Learning on Student Performance as Gauged by Standardised Test (NAPLAN) Scores

ERIC Educational Resources Information Center

Males, Steven; Bate, Frank; Macnish, Jean

2017-01-01

This paper discusses the National Assessment Program for Literacy and Numeracy (NAPLAN) performance of Years Five, Seven and Nine students in standardised tests prior and post the implementation of a mobile learning initiative in a Western Australian school for boys. The school sees the use of ICT as important in enhancing its potential to deliver…

Distinguishing the cognitive processes of mindfulness: Developing a standardised mindfulness technique for use in longitudinal randomised control trials.

PubMed

Isbel, Ben; Summers, Mathew J

2017-07-01

A capacity model of mindfulness is adopted to differentiate the cognitive faculty of mindfulness from the metacognitive processes required to cultivate this faculty in mindfulness training. The model provides an explanatory framework incorporating both the developmental progression from focussed attention to open monitoring styles of mindfulness practice, along with the development of equanimity and insight. A standardised technique for activating these processes without the addition of secondary components is then introduced. Mindfulness-based interventions currently available for use in randomised control trials introduce components ancillary to the cognitive processes of mindfulness, limiting their ability to draw clear causative inferences. The standardised technique presented here does not introduce such ancillary factors, rendering it a valuable tool with which to investigate the processes activated in mindfulness practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Standardised evaluation of the performance of a simple membrane filtration-elution method to concentrate bacteriophages from drinking water.

PubMed

Méndez, Javier; Audicana, Ana; Isern, Ana; Llaneza, Julián; Moreno, Belén; Tarancón, María Luisa; Jofre, Juan; Lucena, Francisco

2004-04-01

The bacteriophage elution procedure described further after adsorption to acetate-nitrate cellulose membrane filters allows better recovery of phages concentrated from 1l of water than elution procedures used previously. The improvement is due to the combined effect of the eluent (3% (w/v) beef extract, 3% (v/v) Tween 80, 0.5M NaCl, pH 9.0) and the application of ultrasound instead of agitation or swirling. Average recovery of somatic coliphages, 82 +/- 7%, was the greatest, and that of phages infecting Bacteroides fragilis, 56 +/- 8%, the lowest, with intermediate values for F-specific and F-specific RNA bacteriophages. Thus, the method allowed recovery of over 56% for all the phages suggested as surrogate indicators. The method was then validated according to an International Standardisation Organisation validation standard procedure and implemented in routine laboratories, which obtained reproducible results.

References for scientific papers: why not standardise to one global style?

PubMed Central

Kumar, A. M. V.; Satyanarayana, S.; Bissell, K.; Hinderaker, S. G.; Edginton, M.; Reid, A. J.; Zachariah, R.

2013-01-01

The different reference styles demanded by journals, both for in-text citations and manuscript bibliographies, require that significant time and attention be paid to minute detail that constitute a tedious obstacle on the road to publication for all authors, but especially for those from resource-limited countries and/or writing in a second language. To illustrate this, we highlight different reference styles requested by five popular journals to which operational research papers are often submitted. We call for a simpler, standardised format for in-text and bibliography reference citations, so that researchers can concentrate on the science and its interpretation rather than fonts and punctuation. PMID:26393041

A randomised double blind placebo controlled clinical trial of a standardised extract of fresh Crataegus berries (Crataegisan) in the treatment of patients with congestive heart failure NYHA II.

PubMed

Degenring, F H; Suter, A; Weber, M; Saller, R

2003-01-01

A placebo controlled, randomised, parallel group, multicentre trial conducted in accordance with the guidelines of Good Clinical Practice (GCP) shows the efficacy and safety of a standardised extract of fresh berries of Crataegus oxyacantha L. and monogyna Jacq. (Crataegisan) in patients with cardiac failure NYHA class II. A total of 143 patients (72 men, 71 women, mean age of 64.8 (8.0 years) were recruited and treated with 3 times 30 drops of the extract (n = 69) or placebo (n = 74) for 8 weeks. The primary variable for the evaluation of efficacy was the change in exercise tolerance determined with bicycle exercise testing, secondary variables included the blood pressure-heart rate product (BHP). Subjective cardiac symptoms at rest and at higher levels of exertion were assessed by the patient on a categorical rating scale. An overall assessment of efficacy at the final visit was provided by the patient and the investigator. In the ITT population there was a significant increase in exercise tolerance in both groups between visit 1 and visit 3. The difference between the treatment groups was 8.3 watts in favour of the standardised extract of fresh Crataegus berries (p = 0.045). The result is confirmed in the PP population (p = 0.047). Changes in BHP at 50 watts and at comparable maximum load were in favour of Crataegus extract but the results are not statistically significant. The subjective assessment of cardiac symptoms at rest and at higher levels of exertion did not change significantly and the patient and investigator overall assessment of efficacy were similar for the two groups. The medication was well tolerated and had a high level of patient acceptability. The significant improvement, due to the fact that dyspnoea and fatigue do not occur until a significantly higher wattage has been reached in the bicycle exercise testing allows the conclusion that the recruited NYHA II patients may expect an improvement in their heart failure condition under long term

Standardisation of DNA quantitation by image analysis: quality control of instrumentation.

PubMed

Puech, M; Giroud, F

1999-05-01

DNA image analysis is frequently performed in clinical practice as a prognostic tool and to improve diagnosis. The precision of prognosis and diagnosis depends on the accuracy of analysis and particularly on the quality of image analysis systems. It has been reported that image analysis systems used for DNA quantification differ widely in their characteristics (Thunissen et al.: Cytometry 27: 21-25, 1997). This induces inter-laboratory variations when the same sample is analysed in different laboratories. In microscopic image analysis, the principal instrumentation errors arise from the optical and electronic parts of systems. They bring about problems of instability, non-linearity, and shading and glare phenomena. The aim of this study is to establish tools and standardised quality control procedures for microscopic image analysis systems. Specific reference standard slides have been developed to control instability, non-linearity, shading and glare phenomena and segmentation efficiency. Some systems have been controlled with these tools and these quality control procedures. Interpretation criteria and accuracy limits of these quality control procedures are proposed according to the conclusions of a European project called PRESS project (Prototype Reference Standard Slide). Beyond these limits, tested image analysis systems are not qualified to realise precise DNA analysis. The different procedures presented in this work determine if an image analysis system is qualified to deliver sufficiently precise DNA measurements for cancer case analysis. If the controlled systems are beyond the defined limits, some recommendations are given to find a solution to the problem.

Measuring Quality Gaps in TB Screening in South Africa Using Standardised Patient Analysis

PubMed Central

Christian, Carmen S.; Gerdtham, Ulf-G.; Hompashe, Dumisani; Smith, Anja; Burger, Ronelle

2018-01-01

This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management. PMID:29649095

Measuring Quality Gaps in TB Screening in South Africa Using Standardised Patient Analysis.

PubMed

Christian, Carmen S; Gerdtham, Ulf-G; Hompashe, Dumisani; Smith, Anja; Burger, Ronelle

2018-04-12

This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management.

A Large and Pristine Sample of Standard Candles across the Milky Way: ∼100,000 Red Clump Stars with 3% Contamination

NASA Astrophysics Data System (ADS)

Ting, Yuan-Sen; Hawkins, Keith; Rix, Hans-Walter

2018-05-01

Core helium-burning red clump (RC) stars are excellent standard candles in the Milky Way. These stars may have more precise distance estimates from spectrophotometry than from Gaia parallaxes beyond 3 kpc. However, RC stars have values of T eff and {log}g that are very similar to some red giant branch (RGB) stars. Especially for low-resolution spectroscopic studies where T eff, {log}g, and [Fe/H] can only be estimated with limited precision, separating RC stars from RGB through established methods can incur ∼20% contamination. Recently, Hawkins et al. demonstrated that the additional information in single-epoch spectra, such as the C/N ratio, can be exploited to cleanly differentiate RC and RGB stars. In this second paper of the series, we establish a data-driven mapping from spectral flux space to independently determined asteroseismic parameters, the frequency and the period spacing. From this, we identify 210,371 RC stars from the publicly available LAMOST DR3 and APOGEE DR14 data, with ∼9% of contamination. We provide an RC sample of 92249 stars with a contamination of only ∼3%, by restricting the combined analysis to LAMOST stars with S/Npix ≥ 75. This demonstrates that high-signal-to-noise ratio (S/N), low-resolution spectra covering a broad wavelength range can identify RC samples at least as pristine as their high-resolution counterparts. As coming and ongoing surveys such as TESS, DESI, and LAMOST will continue to improve the overlapping training spectroscopic-asteroseismic sample, the method presented in this study provides an efficient and straightforward way to derive a vast yet pristine sample of RC stars to reveal the three-dimensional (3D) structure of the Milky Way.

Fitness to plead: Development and validation of a standardised assessment instrument

PubMed Central

Stahl, Daniel; Appiah-Kusi, Elizabeth; Brewer, Rebecca; Watts, Michael; Peay, Jill; Blackwood, Nigel

2018-01-01

The ability of an individual to participate in courtroom proceedings is assessed by clinicians using legal ‘fitness to plead’ criteria. Findings of ‘unfitness’ are so rare that there is considerable professional unease concerning the utility of the current subjective assessment process. As a result, mentally disordered defendants may be subjected unfairly to criminal trials. The Law Commission in England and Wales has proposed legal reform, as well as the utilisation of a defined psychiatric instrument to assist in fitness to plead assessments. Similar legal reforms are occurring in other jurisdictions. Our objective was to produce and validate a standardised assessment instrument of fitness to plead employing a filmed vignette of criminal proceedings. The instrument was developed in consultation with legal and clinical professionals, and was refined using standard item reduction methods in two initial rounds of testing (n = 212). The factorial structure, test-retest reliability and convergent validity of the resultant instrument were assessed in a further round (n = 160). As a result of this iterative process a 25-item scale was produced, with an underlying two-factor structure representing the foundational and decision-making abilities underpinning fitness to plead. The sub-scales demonstrate good internal consistency (factor 1: 0·76; factor 2: 0·65) and test-retest stability (0·7) as well as excellent convergent validity with scores of intelligence, executive function and mentalising abilities (p≤0·01 in all domains). Overall the standardised Fitness to Plead Assessment instrument has good psychometric properties. It has the potential to ensure that the significant numbers of mentally ill and cognitively impaired individuals who face trial are objectively assessed, and the courtroom process critically informed. PMID:29698396

Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 2: reliability and application to multiple joints of a standardised consensus-based scoring system

PubMed Central

Terslev, Lene; Naredo, Esperanza; Aegerter, Philippe; Wakefield, Richard J; Backhaus, Marina; Balint, Peter; Bruyn, George A W; Iagnocco, Annamaria; Jousse-Joulin, Sandrine; Schmidt, Wolfgang A; Szkudlarek, Marcin; Conaghan, Philip G; Filippucci, Emilio

2017-01-01

Objectives To test the reliability of new ultrasound (US) definitions and quantification of synovial hypertrophy (SH) and power Doppler (PD) signal, separately and in combination, in a range of joints in patients with rheumatoid arthritis (RA) using the European League Against Rheumatisms–Outcomes Measures in Rheumatology (EULAR-OMERACT) combined score for PD and SH. Methods A stepwise approach was used: (1) scoring static images of metacarpophalangeal (MCP) joints in a web-based exercise and subsequently when scanning patients; (2) scoring static images of wrist, proximal interphalangeal joints, knee and metatarsophalangeal joints in a web-based exercise and subsequently when scanning patients using different acquisitions (standardised vs usual practice). For reliability, kappa coefficients (κ) were used. Results Scoring MCP joints in static images showed substantial intraobserver variability but good to excellent interobserver reliability. In patients, intraobserver reliability was the same for the two acquisition methods. Interobserver reliability for SH (κ=0.87) and PD (κ=0.79) and the EULAR-OMERACT combined score (κ=0.86) were better when using a ‘standardised’ scan. For the other joints, the intraobserver reliability was excellent in static images for all scores (κ=0.8–0.97) and the interobserver reliability marginally lower. When using standardised scanning in patients, the intraobserver was good (κ=0.64 for SH and the EULAR-OMERACT combined score, 0.66 for PD) and the interobserver reliability was also good especially for PD (κ range=0.41–0.92). Conclusion The EULAR-OMERACT score demonstrated moderate-good reliability in MCP joints using a standardised scan and is equally applicable in non-MCP joints. This scoring system should underpin improved reliability and consequently the responsiveness of US in RA clinical trials. PMID:28948984

The Power of Numbers: The Adoption and Consequences of National Low-Stakes Standardised Tests in Israel

ERIC Educational Resources Information Center

Feniger, Yariv; Israeli, Mirit; Yehuda, Smadar

2016-01-01

The use of standardised tests as a central tool in education policy has in recent decades become a common feature of many national education systems. In 2002 the Israeli Ministry of Education introduced new mandatory state tests for primary and middle schools. The article describes the adoption of these low-stakes tests and assesses their impact…

Calculable People? Standardising Assessment Guidelines for Alzheimer’s Disease in 1980s Britain

PubMed Central

Wilson, Duncan

2017-01-01

This article shows how funding research on Alzheimer’s disease became a priority for the British Medical Research Council (MRC) in the late 1970s and 1980s, thanks to work that isolated new pathological and biochemical markers and showed that the disease affected a significant proportion of the elderly population. In contrast to histories that focus on the emergence of new and competing theories of disease causation in this period, I argue that concerns over the use of different assessment methods ensured the MRC’s immediate priority was standardising the ways in which researchers identified and recorded symptoms of Alzheimer’s disease in potential research subjects. I detail how the rationale behind the development of standard assessment guidelines was less about arriving at a firm diagnosis and more about facilitating research by generating data that could be easily compared across the disciplines and sites that constitute modern biomedicine. Drawing on criticism of specific tests in the MRC’s guidelines, which some psychiatrists argued were ‘middle class biased’, I also show that debates over standardisation did not simply reflect concerns specific to the fields or areas of research that the MRC sought to govern. Questions about the validity of standard assessment guidelines for Alzheimer’s disease embodied broader concerns about education and social class, which ensured that distinguishing normal from pathological in old age remained a contested and historically contingent process. PMID:28901868

Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries

PubMed Central

den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen

2018-01-01

Background: Integrated palliative care aims at improving coordination of palliative care services around patients’ anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. Aim: To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Design: Qualitative group interview design. Setting/participants: A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses (n = 66; 46%) and physicians (n = 50; 35%). Results: The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Conclusion: Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated

Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries.

PubMed

den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Payne, Sheila; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen

2018-06-01

Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Qualitative group interview design. A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses ( n = 66; 46%) and physicians ( n = 50; 35%). The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings.

CSF Aβ1-42 - an excellent but complicated Alzheimer's biomarker - a route to standardisation.

PubMed

Kuhlmann, Julia; Andreasson, Ulf; Pannee, Josef; Bjerke, Maria; Portelius, Erik; Leinenbach, Andreas; Bittner, Tobias; Korecka, Magdalena; Jenkins, Rand G; Vanderstichele, Hugo; Stoops, Erik; Lewczuk, Piotr; Shaw, Leslie M; Zegers, Ingrid; Schimmel, Heinz; Zetterberg, Henrik; Blennow, Kaj

2017-04-01

The 42 amino acid form of amyloid β (Aβ 1 - 42 ) in cerebrospinal fluid (CSF) has been widely accepted as a central biomarker for Alzheimer's disease. Several immunoassays for CSF Aβ 1-42 are commercially available, but can suffer from between laboratory and batch-to-batch variability as well as lack of standardisation across assays. As a consequence, no general cut-off values have been established for a specific context of use (e.g., clinical diagnostics) and selection of individuals for enrolment in clinical trials (patient stratification) remains challenging. The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) has initiated a working group for CSF proteins (WG-CSF) to facilitate standardisation of CSF Aβ 1-42 measurement results. The efforts of the IFCC WG-CSF include the development of certified reference materials (CRMs) and reference measurement procedures (RMPs) for key biomarkers. Two candidate RMPs for quantification of Aβ 1-42 in CSF based on liquid chromatography tandem mass spectrometry have been developed and tested in two ring trials. Furthermore, two commutability studies including native CSF pools, artificial CSF and spiked materials have been completed. On the basis of these studies, human CSF pools containing only endogenous Aβ 1-42 at three concentrations were selected as the format for future CRMs that are now being processed. Copyright © 2016 Elsevier B.V. All rights reserved.

Drought analysis and water resource availability using standardised precipitation evapotranspiration index

NASA Astrophysics Data System (ADS)

Hui-Mean, Foo; Yusop, Zulkifli; Yusof, Fadhilah

2018-03-01

Trend analysis for potential evapotranspiration (PET) and climatic water balance (CWB) is critical in identifying the wetness or dryness episodes with respect to the water surplus or deficit. The PET is computed based on the monthly average temperature for the entire Peninsular Malaysia using Thornthwaite parameterization. The trends and slope's magnitude for the PET and CWB were then investigated using Mann-Kendall, Spearman's rho tests and Thiel-Sen estimator. The 1-, 3-, 6- and 12-month standardised precipitation evapotranspiration index (SPEI) is applied to determine the drought episodes and the average recurrence interval are calculated based on the SPEI. The results indicate that most of the stations show an upward trend in annual and monthly PET while majority of the regions show an upward trend in annual CWB except for the Pahang state. The increasing trends detected in the CWB describe water is in excess especially during the northeast monsoons while the decreasing trends imply water insufficiency. The excess water is observed mostly in January especially in the west coast, east coast and southwest regions that suggest more water is available for crop requirement. The average recurrence interval for drought episodes is almost the same for the smaller severity with various time scale of SPEI and high probability of drought occurrence is observed for some regions. The findings are useful for policymakers and practitioners to improve water resources planning and management, in particular to minimise drought effects in the future. Future research shall address the influence of topography on drought behaviour using more meteorological stations and to include east Malaysia in the analysis.

Who Pays for Standardised Testing? A Cost-Benefit Study of Mandated Testing in Three Queensland Secondary Schools

ERIC Educational Resources Information Center

Carter, Merilyn Gladys; Klenowski, Valentina; Chalmers, Christina

2016-01-01

This paper reports on an Australian study that explored the costs and benefits of the National Assessment Programme, Literacy and Numeracy (NAPLAN) testing, both tangible and intangible, of Year 9 students in three Queensland schools. The study commenced with a review of pertinent studies and other related material about standardised testing in…

Canadian Open Genetics Repository (COGR): a unified clinical genomics database as a community resource for standardising and sharing genetic interpretations.

PubMed

Lerner-Ellis, Jordan; Wang, Marina; White, Shana; Lebo, Matthew S

2015-07-01

The Canadian Open Genetics Repository is a collaborative effort for the collection, storage, sharing and robust analysis of variants reported by medical diagnostics laboratories across Canada. As clinical laboratories adopt modern genomics technologies, the need for this type of collaborative framework is increasingly important. A survey to assess existing protocols for variant classification and reporting was delivered to clinical genetics laboratories across Canada. Based on feedback from this survey, a variant assessment tool was made available to all laboratories. Each participating laboratory was provided with an instance of GeneInsight, a software featuring versioning and approval processes for variant assessments and interpretations and allowing for variant data to be shared between instances. Guidelines were established for sharing data among clinical laboratories and in the final outreach phase, data will be made readily available to patient advocacy groups for general use. The survey demonstrated the need for improved standardisation and data sharing across the country. A variant assessment template was made available to the community to aid with standardisation. Instances of the GeneInsight tool were provided to clinical diagnostic laboratories across Canada for the purpose of uploading, transferring, accessing and sharing variant data. As an ongoing endeavour and a permanent resource, the Canadian Open Genetics Repository aims to serve as a focal point for the collaboration of Canadian laboratories with other countries in the development of tools that take full advantage of laboratory data in diagnosing, managing and treating genetic diseases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Drugs, doses, and durations of intraperitoneal chemotherapy: standardising HIPEC and EPIC for colorectal, appendiceal, gastric, ovarian peritoneal surface malignancies and peritoneal mesothelioma.

PubMed

Lemoine, Lieselotte; Sugarbaker, Paul; Van der Speeten, Kurt

2017-08-01

Peritoneal surface malignancy (PSM) is a common manifestation of digestive and gynaecologic malignancies alike. At present, patients with isolated PSM are treated with a combination therapy of cytoreductive surgery (CRS) and hyperthermic peroperative intraperitoneal chemotherapy (HIPEC). The combination of CRS and intraperitoneal (IP) chemotherapy should now be considered standard of care for PSM from appendiceal epithelial cancers, colorectal cancer and peritoneal mesothelioma. Although there is a near universal standardisation regarding the CRS, we are still lacking a much-needed standardisation amongst the various IP chemotherapy treatment modalities used today in clinical practice. Pharmacologic evidence should be generated to answer important questions raised by the myriad of variables associated with IP chemotherapy.

Preparation of a standardised faecal slurry for ex-vivo microbiota studies which reduces inter-individual donor bias.

PubMed

O'Donnell, Michelle M; Rea, Mary C; O'Sullivan, Órla; Flynn, Cal; Jones, Beth; McQuaid, Albert; Shanahan, Fergus; Ross, R Paul

2016-10-01

In-vitro gut fermentation systems provide suitable models for studying gut microbiota composition and functionality. However, such methods depend on the availability of donors and the assumption of reproducibility between microbial communities before experimental treatments commence. The aim of this study was to develop a frozen standardised inoculum (FSI) which minimizes inter-individual variation and to determine its stability over time using culture-dependent and culture-independent techniques. A method for the preparation difference of a FSI is described which involves pooling the faecal samples, centrifugation and pelleting of the cell biomass and finally homogenising the cell pellets with phosphate buffer and glycerol. Using this approach, no significant difference in total anaerobe cell viability was observed between the fresh standardised inoculum (before freezing) and the 12days post freezing FSI. Moreover, Quantitative PCR revealed no significant alterations in the estimated bacterial numbers in the FSI preparations for any of the phyla. MiSeq sequencing revealed minute differences in the relative abundance at phylum, family and genus levels between the FSI preparations. Differences in the microbiota denoted as significant were limited between preparations in the majority of cases to changes in percentage relative abundance of ±0.5%. The independently prepared FSIs revealed a high degree of reproducibility in terms of microbial composition between the three preparations. This study provides a method to produce a standardised human faecal inoculum suitable for freezing. Based on culture-dependent and independent analysis, the method ensures a degree of reproducibility between preparations by lessening the effect of inter-individual variation among the donors, thereby making the system more suitable for the accurate interpretation of the effects of experimental treatments. Copyright © 2016 Elsevier B.V. All rights reserved.

CUSUM method for construction of trainee spinal ultrasound learning curves following standardised teaching.

PubMed

Deacon, A J; Melhuishi, N S; Terblanche, N C S

2014-07-01

Spinal ultrasonography is a promising aid for epidural insertion. We aimed to determine the learning curve of spinal ultrasonography tasks and the number of training scans required to reach competency after undergoing standardised step-wise teaching. Trainees were required to complete a minimum of 60 assessed scans on selected non-pregnant models following attendance at two training sessions, with feedback from an expert after each scan. Learning curves were plotted using the non-risk cumulative summation technique and an acceptable failure rate of 20%. Five trainees completed between 65 and 75 scans each. All trainees were competent at identifying a randomly assigned intervertebral space after a median of five scans (range one to nine) and at measuring the depth from skin to the posterior complex after a median of 10 scans (range 1 to 42). Two trainees were competent at marking an ideal needle insertion point after 55 scans, while three trainees did not attain competency. All trainees were competent after 60 scans if the tolerance was changed from five to eight millimetre for marking the needle insertion point. The average time taken to complete a scan was 163 seconds. Our study showed that after a standardised educational intervention, anaesthetic trainees are able to identify a lumbar interlaminar space easily and can measure the depth to the posterior complex after a reasonable number of additional practice scans, but experienced difficulty accurately marking the needle insertion point whilst using spinal ultrasonography. We confirmed that it was hard to achieve competency in all aspects of spinal ultrasonography, based on assessment using our predefined competency criteria.

Use of standardised patients to assess antibiotic dispensing for tuberculosis by pharmacies in urban India: a cross-sectional study.

PubMed

Satyanarayana, Srinath; Kwan, Ada; Daniels, Benjamin; Subbaraman, Ramnath; McDowell, Andrew; Bergkvist, Sofi; Das, Ranendra K; Das, Veena; Das, Jishnu; Pai, Madhukar

2016-11-01

India's total antibiotic use is the highest of any country. Patients often receive prescription-only drugs directly from pharmacies. Here we aimed to assess the medical advice and drug dispensing practices of pharmacies for standardised patients with presumed and confirmed tuberculosis in India. In this cross-sectional study in the three Indian cities Delhi, Mumbai, and Patna, we developed two standardised patient cases: first, a patient presenting with 2-3 weeks of pulmonary tuberculosis symptoms (Case 1); and second, a patient with microbiologically confirmed pulmonary tuberculosis (Case 2). Standardised patients were scheduled to present each case once to sampled pharmacies. We defined ideal management for both cases a priori as referral to a health-care provider without dispensing antibiotics or steroids or both. Between April 1, 2014, and Nov 29, 2015, we sampled 622 pharmacies in Delhi, Mumbai, and Patna. Standardised patients completed 1200 (96%) of 1244 interactions. We recorded ideal management (defined as referrals without the use of antibiotics or steroids) in 80 (13%) of 599 Case 1 interactions (95% CI 11-16) and 372 (62%) of 601 Case 2 interactions (95% CI 58-66). Antibiotic use was significantly lower in Case 2 interactions (98 [16%] of 601, 95% CI 13-19) than in Case 1 (221 [37%] of 599, 95% CI 33-41). First-line anti-tuberculosis drugs were not dispensed in any city. The differences in antibiotic or steroid use and number of medicines dispensed between Case 1 and Case 2 were almost entirely attributable to the difference in referral behaviour. Only some urban Indian pharmacies correctly managed patients with presumed tuberculosis, but most correctly managed a case of confirmed tuberculosis. No pharmacy dispensed anti-tuberculosis drugs for either case. Absence of a confirmed diagnosis is a key driver of antibiotic misuse and could inform antimicrobial stewardship interventions. Grand Challenges Canada, Bill & Melinda Gates Foundation, Knowledge for

Young people's perceptions of tobacco packaging: a comparison of EU Tobacco Products Directive & Ireland's Standardisation of Tobacco Act

PubMed Central

Babineau, Kate; Clancy, Luke

2015-01-01

Objectives To measure young people's perceptions of tobacco packaging according to two current pieces of legislation: The EU Tobacco Products Directive (TPD) and Ireland's Public Health (Standardisation of Tobacco Products) Act. Design Within-subject experimental cross-sectional survey of a representative sample of secondary school students. School-based pen and paper survey. Setting 27 secondary schools across Ireland, randomly stratified for size, geographic location, gender, religious affiliation and school-level socioeconomic status. Data were collected between March and May 2014. Participants 1378 fifth year secondary school students aged 16–17 in Ireland. Main outcome measures Young people's perceptions of attractiveness, health risk and smoker characteristics of packs according to EU and Irish branding and packaging guidelines. Results Packs with more branding elements were thought to be healthier than standardised packs for Silk Cut (χ2=158.58, p<0.001), Marlboro (χ2=113.65, p<0.001), and Benson and Hedges (χ2=137.95, p<0.001) brands. Generalized estimating equation binary regressions found that gender was a significant predictor of pack attractiveness for Silk Cut, with females being more likely to find the EU packs attractive (β=−0.45, p=0.007). Gender was a significant predictor for females with regards to the perceived popularity of the Silk Cut brand (β=−0.37, p=0.03). Conclusions The removal of brand identifiers, including colour, font and embossing, reduces the perceived appeal of cigarette packs for young people across all three tested brands. Packs standardised according to Irish legislation are perceived as less attractive, less healthy and smoked by less popular people than packs which conform to the EU TPD 2014 guidelines. PMID:26048206

Species-specific Standardisation of Licorice by Metabolomic Profiling of Flavanones and Chalcones

PubMed Central

Simmler, Charlotte; Jones, Tristesse; Anderson, Jeffrey R.; Nikolić, Dejan C.; van Breemen, Richard B.; Soejarto, Djaja D.; Chen, Shao-Nong; Pauli, Guido F.

2014-01-01

Introduction Major phenolics from licorice roots (Glycyrrhiza sp.) are glycosides of the flavanone liquiritigenin (F) and its 2′-hydroxychalcone isomer, isoliquiritigenin (C). As the F and C contents fluctuate between batches of licorice, both quality control and standardisation of its preparations become complex tasks. Objective To characterise the F and C metabolome in extracts from Glycyrrhiza glabra L. and Glycyrrhiza uralensis Fisch. ex DC. by addressing their composition in major F–C pairs and defining the total F:C proportion. Material and methods Three types of extracts from DNA-authenticated samples were analysed by a validated UHPLC/UV method to quantify major F and C glycosides. Each extract was characterised by the identity of major F–C pairs and the proportion of Fs among all quantified Fs:Cs. Results The F and C compositions and proportions were found to be constant for all extracts from a Glycyrrhiza species. All G. uralensis extracts contained up to 2.5 more Fs than G. glabra extracts. Major F–C pairs were B-ring glycosidated in G. uralensis, and A-/B-ring apiosyl-glucosidated in the G. glabra extracts. The F:C proportion was found to be linked to the glycosidation site: the more B-ring F-C glycosides were present, the higher was the final F:C proportion in the extract. These results enable the chemical differentiation of extracts from G. uralensis and G. glabra, which are characterised by total F:C proportions of 8.37:1.63 and 7.18:2.82, respectively. Conclusion Extracts from G. glabra and G. uralensis can be differentiated by their respective F and C compositions and proportions, which are both useful for further standardisation of licorice botanicals. PMID:25859589

Understanding the 'Silver Book' - An important reference for standardised nomenclature in clinical laboratory sciences.

PubMed

Flatman, Robert; Férard, Georges; Dybkaer, René

2017-04-01

Clinical laboratories perform a wide menu of testing (examinations). Successful requesting, examination, and ordering in this environment requires clear standardised nomenclature. The Silver Book (SB) is an IUPAC (International Union of Pure and Applied Chemistry) publication, produced with the support of both IUPAC and the IFCC (International Federation of Clinical Chemistry and Laboratory Medicine), that makes recommendations on logical standardised nomenclature, symbols, properties, and units in many disciplines of the clinical laboratory sciences. These recommendations are founded on and in agreement with the principles and work of the International Organization for Standardization (ISO), Bureau International des Poids et Mesures (BIPM), IUPAC, and the IFCC. Practical applications described are based on those scientific principles. The SB recommendations apply to all types of examination, not only to measurement of quantities but also examination of nominal properties where no magnitude is involved. The SB is applicable not only to clinical chemistry, but to many other clinical laboratory disciplines. For examples, reports regarding haemostasis, toxicology, clinical microbiology, reproduction and fertility, clinical pharmacology, clinical allergology, clinical molecular biology, and clinical immunohaematology have been published by the IUPAC and the IFCC. Peak scientific bodies such as the IUPAC and the IFCC have important roles in the development of sound international standards for nomenclature of examinations. Such standards support safe and effective representation of patient health information, foster portability, and empower future decision support systems. Copyright © 2016. Published by Elsevier B.V.

Standardised clients as assessors in a veterinary communication OSCE: a reliability and validity study.

PubMed

Artemiou, E; Adams, C L; Hecker, K G; Vallevand, A; Violato, C; Coe, J B

2014-11-22

In human medicine, standardised patients (SP) have been shown to reliably and accurately assess learners' communication performance in high-stakes certification Objective Structured Clinical Examinations (OSCE), offering a feasible way to reduce the need for recruitment, time commitment and coordination of faculty assessors. In this study, we evaluated the use of standardised clients (SC) as a viable option for assessing veterinary students' communication performance. We designed a four-station, two-track communication skills OSCE. SC assessors used an adapted nine-item Liverpool Undergraduate Communication Assessment Scale (LUCAS). Faculty used a 21-item checklist derived from the Calgary-Cambridge Guide (CCG) and a five-point global rating scale. Participants were second year veterinary students (n=96). For the four stations, intrastation reliability (α) ranged from 0.63 to 0.82 for the LUCAS, and 0.73 to 0.87 for the CCG. The interstation reliability coefficients were 0.85 for the LUCAS and 0.89 for the CGG. The calculated Generalisability (G) coefficients were 0.62 for the LUCAS and 0.60 for the CGG. Supporting construct validity, SC and faculty assessors showed a significant correlation between the LUCAS and CCG total percent scores (r=0.45, P<0.001), and likewise between the LUCAS and global rating scores (r=0.49, P<0.001).Study results support that SC assessors offer a reliable and valid approach for assessing veterinary communication OSCE. British Veterinary Association.

[Some critical remarks on standardised assessment instruments in nursing].

PubMed

Bartholomeyczik, Sabine

2007-08-01

The use of standardised instruments in nursing has rapidly grown and can be seen as a symptom of the necessary comprehensive nursing diagnostics. However, these instruments comprise the risk of misuse, if they are not critically evaluated. Published statements about tests of reliability and validity of an instrument are insufficient. First, the critical evaluation has to ask for the instrument's theoretical and content base: Is the instrument relevant for nursing, suitable for practice and leading to nursing actions? Two examples of well known instruments and different kinds of their utilization in nursing are discussed. Next, the instruments have to be questioned as "bodies with numbers". Studies on reliability and validity have to be as carefully evaluated as other empirical research. The sample, the suitability of agreement indicators (interraterreliability), kind and reason of tests have to be questioned. The same has to be done with tests of validity which comprise an even greater challenge. Methodological studies about these questions are missing; guidelines for test user qualifications need to be developed.

Differences and discrepancies between 2005 and 2008 Abbreviated Injury Scale versions - time to standardise

PubMed Central

2012-01-01

The aim of this letter is to facilitate the standardisation of Abbreviated Injury Scale (AIS) codesets used to code injuries in trauma registries. We have compiled a definitive list of the changes which have been implemented between the AIS 2005 and Update 2008 versions. While the AIS 2008 codeset appears to have remained consistent since its release, we have identified discrepancies between the codesets in copies of AIS 2005 dictionaries. As a result, we recommend that use of the AIS 2005 should be discontinued in favour of the Update 2008 version. PMID:22301065

Differences and discrepancies between 2005 and 2008 Abbreviated Injury Scale versions - time to standardise.

PubMed

Ringdal, Kjetil G; Hestnes, Morten; Palmer, Cameron S

2012-02-02

The aim of this letter is to facilitate the standardisation of Abbreviated Injury Scale (AIS) codesets used to code injuries in trauma registries. We have compiled a definitive list of the changes which have been implemented between the AIS 2005 and Update 2008 versions. While the AIS 2008 codeset appears to have remained consistent since its release, we have identified discrepancies between the codesets in copies of AIS 2005 dictionaries. As a result, we recommend that use of the AIS 2005 should be discontinued in favour of the Update 2008 version.

Proposal for a standardised identification of the mono-exponential terminal phase for orally administered drugs.

PubMed

Scheerans, Christian; Derendorf, Hartmut; Kloft, Charlotte

2008-04-01

The area under the plasma concentration-time curve from time zero to infinity (AUC(0-inf)) is generally considered to be the most appropriate measure of total drug exposure for bioavailability/bioequivalence studies of orally administered drugs. However, the lack of a standardised method for identifying the mono-exponential terminal phase of the concentration-time curve causes variability for the estimated AUC(0-inf). The present investigation introduces a simple method, called the two times t(max) method (TTT method) to reliably identify the mono-exponential terminal phase in the case of oral administration. The new method was tested by Monte Carlo simulation in Excel and compared with the adjusted r squared algorithm (ARS algorithm) frequently used in pharmacokinetic software programs. Statistical diagnostics of three different scenarios, each with 10,000 hypothetical patients showed that the new method provided unbiased average AUC(0-inf) estimates for orally administered drugs with a monophasic concentration-time curve post maximum concentration. In addition, the TTT method generally provided more precise estimates for AUC(0-inf) compared with the ARS algorithm. It was concluded that the TTT method is a most reasonable tool to be used as a standardised method in pharmacokinetic analysis especially bioequivalence studies to reliably identify the mono-exponential terminal phase for orally administered drugs showing a monophasic concentration-time profile.

RECIST 1.1 - Standardisation and disease-specific adaptations: Perspectives from the RECIST Working Group.

PubMed

Schwartz, Lawrence H; Seymour, Lesley; Litière, Saskia; Ford, Robert; Gwyther, Stephen; Mandrekar, Sumithra; Shankar, Lalitha; Bogaerts, Jan; Chen, Alice; Dancey, Janet; Hayes, Wendy; Hodi, F Stephen; Hoekstra, Otto S; Huang, Erich P; Lin, Nancy; Liu, Yan; Therasse, Patrick; Wolchok, Jedd D; de Vries, Elisabeth

2016-07-01

Radiologic imaging of disease sites plays a pivotal role in the management of patients with cancer. Response Evaluation Criteria in Solid Tumours (RECIST), introduced in 2000, and modified in 2009, has become the de facto standard for assessment of response in solid tumours in patients on clinical trials. The RECIST Working Group considers the ability of the global oncology community to implement and adopt updates to RECIST in a timely manner to be critical. Updates to RECIST must be tested, validated and implemented in a standardised, methodical manner in response to therapeutic and imaging technology advances as well as experience gained by users. This was the case with the development of RECIST 1.1, where an expanded data warehouse was developed to test and validate modifications. Similar initiatives are ongoing, testing RECIST in the evaluation of response to non-cytotoxic agents, immunotherapies, as well as in specific diseases. The RECIST Working Group has previously outlined the level of evidence considered necessary to formally and fully validate new imaging markers as an appropriate end-point for clinical trials. Achieving the optimal level of evidence desired is a difficult feat for phase III trials; this involves a meta-analysis of multiple prospective, randomised multicentre clinical trials. The rationale for modifications should also be considered; the modifications may be proposed to improve surrogacy, to provide a more mechanistic imaging technique, or be designed to improve reproducibility of the imaging biomarker. Here, we present the commonly described modifications of RECIST, each of which is associated with different levels of evidence and validation. Copyright © 2016. Published by Elsevier Ltd.

Personal Meaning in the Public Sphere: The Standardisation and Rationalisation of Biodiversity Data in the UK and the Netherlands

ERIC Educational Resources Information Center

Lawrence, Anna; Turnhout, Esther

2010-01-01

The demand for biodiversity data is increasing. Governments require standardised, objective data to underpin planning and conservation decisions. These data are produced by large numbers of (volunteer) natural historians and non-governmental organisations. This article analyses the interface between the state and the volunteer naturalists to…

Young people's perceptions of tobacco packaging: a comparison of EU Tobacco Products Directive & Ireland's Standardisation of Tobacco Act.

PubMed

Babineau, Kate; Clancy, Luke

2015-06-05

To measure young people's perceptions of tobacco packaging according to two current pieces of legislation: The EU Tobacco Products Directive (TPD) and Ireland's Public Health (Standardisation of Tobacco Products) Act. Within-subject experimental cross-sectional survey of a representative sample of secondary school students. School-based pen and paper survey. 27 secondary schools across Ireland, randomly stratified for size, geographic location, gender, religious affiliation and school-level socioeconomic status. Data were collected between March and May 2014. 1378 fifth year secondary school students aged 16-17 in Ireland. Young people's perceptions of attractiveness, health risk and smoker characteristics of packs according to EU and Irish branding and packaging guidelines. Packs with more branding elements were thought to be healthier than standardised packs for Silk Cut (χ(2)=158.58, p<0.001), Marlboro (χ(2)=113.65, p<0.001), and Benson and Hedges (χ(2)=137.95, p<0.001) brands. Generalized estimating equation binary regressions found that gender was a significant predictor of pack attractiveness for Silk Cut, with females being more likely to find the EU packs attractive (β=-0.45, p=0.007). Gender was a significant predictor for females with regards to the perceived popularity of the Silk Cut brand (β=-0.37, p=0.03). The removal of brand identifiers, including colour, font and embossing, reduces the perceived appeal of cigarette packs for young people across all three tested brands. Packs standardised according to Irish legislation are perceived as less attractive, less healthy and smoked by less popular people than packs which conform to the EU TPD 2014 guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Disheartened Teacher: Living in the Age of Standardisation, High-Stakes Assessments, and No Child Left Behind (NCLB)

ERIC Educational Resources Information Center

Rubin, Daniel Ian

2011-01-01

There has been a universal movement towards government-regulated standardisation and high-stakes assessment. In the United States, this has resulted in the No Child Left Behind Act (2001). Because of the predominant focus on high-stakes reading and writing assessments required by NCLB, teachers in the subject area of English/Language Arts (ELA)…

Factors to improve the interobserver agreement for gastric atrophy and intestinal metaplasia: consensus of definition and criteria.

PubMed

Kim, Sung Sun; Kook, Myeong-Cherl; Shin, Ok-Ran; Kim, Hee Sung; Bae, Han-Ik; Seo, An Na; Park, Do Youn; Choi, Il Ju; Kim, Young-Il; Nam, Byung Ho; Kim, Sohee

2018-04-01

Intestinal metaplasia and atrophy of the gastric mucosa are associated with Helicobacter pylori infection and are considered premalignant lesions. The updated Sydney system is used for these parameters, but experienced pathologists and consensus processes are required for interobserver agreement. We sought to determine the influence of the consensus process on the assessment of intestinal metaplasia and atrophy. Two study sets were used: consensus and validation. The consensus set was circulated and five gastrointestinal pathologists evaluated them independently using the updated Sydney system. The consensus of the definitions was then determined at the first consensus meeting. The same set was recirculated to determine the effect of the consensus. The second consensus meeting was held to standardise the grading criteria and the validation set was circulated to determine the influence. Two additional circulations were performed to assess the maintainance of consensus and intraobserver variability. Interobserver agreement of intestinal metaplasia and atrophy was improved through the consensus process (intestinal metaplasia: baseline κ = 0.52 versus final κ = 0.68, P = 0.006; atrophy: baseline κ = 0.19 versus final κ = 0.43, P < 0.001). Higher interobserver agreement in atrophy was observed after consensus regarding the definition (pre-consensus: κ = 0.19 versus post-consensus: κ = 0.34, P = 0.001). There was improved interobserver agreement in intestinal metaplasia after standardisation of the grading criteria (pre-standardisation: κ = 0.56 versus post-standardisation: κ = 0.71, P = 0.010). This study suggests that interobserver variability regarding intestinal metaplasia and atrophy may result from lack of a precise definition and fine criteria, and can be reduced by consensus of definition and standardisation of grading criteria. © 2017 John Wiley & Sons Ltd.

Professional Standards for Teachers: How Do They "Work"? An Experiment in Tracing Standardisation In-the-Making in Teacher Education

ERIC Educational Resources Information Center

Ceulemans, Carlijne; Simons, Maarten; Struyf, Elke

2012-01-01

During the last two decades, professional standards describing competencies for teaching staff have emerged in nation states all around the world. This article reports on a pilot-study that applies a sociotechnological "lens" to examine this standardisation process in educational policy. In line with ethnographic analyses drawing on…

Awareness of Standardised Tobacco Packaging among Adults and Young People during the Final Phase of Policy Implementation in Great Britain.

PubMed

Bogdanovica, Ilze; Opazo Breton, Magdalena; Langley, Tessa; Britton, John

2017-07-31

Background : In May 2016, along with the latest European Tobacco Products Directive (TPD), standardised packaging legislation was implemented in the UK. During the following 12-month transition period, both new and old types of packaging were allowed on the market. This study aimed to assess awareness of standardised packaging and other TPD changes in the UK population in March 2017, when both forms of packaging were in widespread use. Methods : We conducted two surveys-one in adults and one in young people-investigating awareness of plain packaging legislation. In young people, we also measured susceptibility to smoking using previously validated questions. We asked smokers whether they had recently changed the product they used and also whether they used any of the products that are banned by the new legislation. Results : In the adult survey, 73.5% (95% CI: 71.5-75.5%) of the participants were aware of the new legislation and 32.4% (95% CI: 30.3-34.5%) had noticed changes in tobacco packaging, this proportion being considerably higher among smokers (83.7%; 95% CI: 78.9-87.5%) than never smokers (20.7%; 95% CI: 18.2-23.4%). More than half (52.4%; 95% CI: 46.5-58.4%) were using pack sizes or shapes (typically less than 20 cigarettes or 30 g loose tobacco), that would become illegal after full TPD implementation, and 31.4% (95% CI: 26.2-37.1%) reported switching to a different product since October 2016, in most cases to a cheaper brand. Among young people, 20.2% (95% CI: 17.8-22.7%) reported that they had noticed standardised packaging, comprising 16.2% (95% CI: 13.7-19.0%) of non-susceptible never smokers, 25.6% (95% CI: 18.0-35%) of susceptible never smokers, and 49% (95% CI: 37.8-60.2%) of ever smokers. Conclusions : In the final stages of implementation, awareness of the introduction of standardised packs was highest among smokers. The TPD will cause nearly half of adult smokers to purchase larger packs, and may cause many smokers to switch to cheaper brands.

Student self-reported communication skills, knowledge and confidence across standardised patient, virtual and traditional clinical learning environments.

PubMed

Quail, Michelle; Brundage, Shelley B; Spitalnick, Josh; Allen, Peter J; Beilby, Janet

2016-02-27

Advanced communication skills are vital for allied health professionals, yet students often have limited opportunities in which to develop them. The option of increasing clinical placement hours is unsustainable in a climate of constrained budgets, limited placement availability and increasing student numbers. Consequently, many educators are considering the potentials of alternative training methods, such as simulation. Simulations provide safe, repeatable and standardised learning environments in which students can practice a variety of clinical skills. This study investigated students' self-rated communication skill, knowledge, confidence and empathy across simulated and traditional learning environments. Undergraduate speech pathology students were randomly allocated to one of three communication partners with whom they engaged conversationally for up to 30 min: a patient in a nursing home (n = 21); an elderly trained patient actor (n = 22); or a virtual patient (n = 19). One week prior to, and again following the conversational interaction, participants completed measures of self-reported communication skill, knowledge and confidence (developed by the authors based on the Four Habit Coding Scheme), as well as the Jefferson Scale of Empathy - Health Professionals (student version). All three groups reported significantly higher communication knowledge, skills and confidence post-placement (Median d = .58), while the degree of change did not vary as a function of group membership (Median η (2)  < .01). In addition, only students interacting with a nursing home resident reported higher empathy after the placement. Students reported that conversing with the virtual patient was more challenging than conversing with a nursing home patient or actor, and students appeared to derive the same benefit from the experience. Participants self-reported higher communication skill, knowledge and confidence, though not empathy, following a brief placement

Standardised assessment of functioning in ADHD: consensus on the ICF Core Sets for ADHD.

PubMed

Bölte, Sven; Mahdi, Soheil; Coghill, David; Gau, Susan Shur-Fen; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Levy, Florence; Rohde, Luis A; Segerer, Wolfgang; de Vries, Petrus J; Selb, Melissa

2018-02-12

Attention-deficit/hyperactivity disorder (ADHD) is associated with significant impairments in social, educational, and occupational functioning, as well as specific strengths. Currently, there is no internationally accepted standard to assess the functioning of individuals with ADHD. WHO's International Classification of Functioning, Disability and Health-child and youth version (ICF) can serve as a conceptual basis for such a standard. The objective of this study is to develop a comprehensive, a common brief, and three age-appropriate brief ICF Core Sets for ADHD. Using a standardised methodology, four international preparatory studies generated 132 second-level ICF candidate categories that served as the basis for developing ADHD Core Sets. Using these categories and following an iterative consensus process, 20 ADHD experts from nine professional disciplines and representing all six WHO regions selected the most relevant categories to constitute the ADHD Core Sets. The consensus process resulted in 72 second-level ICF categories forming the comprehensive ICF Core Set-these represented 8 body functions, 35 activities and participation, and 29 environmental categories. A Common Brief Core Set that included 38 categories was also defined. Age-specific brief Core Sets included a 47 category preschool version for 0-5 years old, a 55 category school-age version for 6-16 years old, and a 52 category version for older adolescents and adults 17 years old and above. The ICF Core Sets for ADHD mark a milestone toward an internationally standardised functional assessment of ADHD across the lifespan, and across educational, administrative, clinical, and research settings.

Probability density functions for use when calculating standardised drought indices

NASA Astrophysics Data System (ADS)

Svensson, Cecilia; Prosdocimi, Ilaria; Hannaford, Jamie

2015-04-01

Time series of drought indices like the standardised precipitation index (SPI) and standardised flow index (SFI) require a statistical probability density function to be fitted to the observed (generally monthly) precipitation and river flow data. Once fitted, the quantiles are transformed to a Normal distribution with mean = 0 and standard deviation = 1. These transformed data are the SPI/SFI, which are widely used in drought studies, including for drought monitoring and early warning applications. Different distributions were fitted to rainfall and river flow data accumulated over 1, 3, 6 and 12 months for 121 catchments in the United Kingdom. These catchments represent a range of catchment characteristics in a mid-latitude climate. Both rainfall and river flow data have a lower bound at 0, as rains and flows cannot be negative. Their empirical distributions also tend to have positive skewness, and therefore the Gamma distribution has often been a natural and suitable choice for describing the data statistically. However, after transformation of the data to Normal distributions to obtain the SPIs and SFIs for the 121 catchments, the distributions are rejected in 11% and 19% of cases, respectively, by the Shapiro-Wilk test. Three-parameter distributions traditionally used in hydrological applications, such as the Pearson type 3 for rainfall and the Generalised Logistic and Generalised Extreme Value distributions for river flow, tend to make the transformed data fit better, with rejection rates of 5% or less. However, none of these three-parameter distributions have a lower bound at zero. This means that the lower tail of the fitted distribution may potentially go below zero, which would result in a lower limit to the calculated SPI and SFI values (as observations can never reach into this lower tail of the theoretical distribution). The Tweedie distribution can overcome the problems found when using either the Gamma or the above three-parameter distributions. The

A quality improvement project using a problem based post take ward round proforma based on the SOAP acronym to improve documentation in acute surgical receiving.

PubMed

Dolan, R; Broadbent, P

2016-02-01

Ward round documentation provides one of the most important means of communication between healthcare professionals. We aimed to establish if the use of a problem based standardised proforma can improve documentation in acute surgical receiving. Gold standards were established using the RCSE record keeping guidelines. We audited documentation for seven days using the following headings: patient name/identification number, subjective findings, objective findings, clinical impression/diagnosis, plan, diet status, discharge decision, discharge planning, signature, and grade. After the initial audit cycle, a ward round proforma was introduced using the above headings and re-audited over a seven day period. The pre-intervention arm contained 50 patients and the post intervention arm contained 47. The following headings showed an improvement in documentation compliance to 100%: patient name/identification number vs 96%, subjective findings vs 84%, objective findings vs 48%, plan vs 98%, signature vs 96%, and grade vs 62%. Documentation of the clinical impression/diagnosis improved to 98% vs 30%, diet status rose to 83% vs 16%, discharge decision to 66% vs 16%, and discharge planning to 40% vs 20%. Standardised proformas improve the documentation of post-take ward round notes. This helps to clarify the onward management plan for all aspects of a patient's care and will help avoid adverse events and litigation. This should improve the quality and safety of Patient Care.

46 CFR 160.066-12 - Operational tests.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160... the pyrotechnic candle; (2) Color; (3) Whether the pyrotechnic candle burns out above, at, or below... pyrotechnic candle fails to ignite, (3) The pyrotechnic candle continues to burn after it falls back to the...

Integrated interpretation of overlapping AEM datasets achieved through standardisation

NASA Astrophysics Data System (ADS)

Sørensen, Camilla C.; Munday, Tim; Heinson, Graham

2015-12-01

Numerous airborne electromagnetic surveys have been acquired in Australia using a variety of systems. It is not uncommon to find two or more surveys covering the same ground, but acquired using different systems and at different times. Being able to combine overlapping datasets and get a spatially coherent resistivity-depth image of the ground can assist geological interpretation, particularly when more subtle geophysical responses are important. Combining resistivity-depth models obtained from the inversion of airborne electromagnetic (AEM) data can be challenging, given differences in system configuration, geometry, flying height and preservation or monitoring of system acquisition parameters such as waveform. In this study, we define and apply an approach to overlapping AEM surveys, acquired by fixed wing and helicopter time domain electromagnetic (EM) systems flown in the vicinity of the Goulds Dam uranium deposit in the Frome Embayment, South Australia, with the aim of mapping the basement geometry and the extent of the Billeroo palaeovalley. Ground EM soundings were used to standardise the AEM data, although results indicated that only data from the REPTEM system needed to be corrected to bring the two surveys into agreement and to achieve coherent spatial resistivity-depth intervals.

Airborne trace element pollution in 11 European cities assessed by exposure of standardised ryegrass cultures

NASA Astrophysics Data System (ADS)

Klumpp, Andreas; Ansel, Wolfgang; Klumpp, Gabriele; Breuer, Jörn; Vergne, Philippe; Sanz, María José; Rasmussen, Stine; Ro-Poulsen, Helge; Ribas Artola, Àngela; Peñuelas, Josep; He, Shang; Garrec, Jean Pierre; Calatayud, Vicent

Within a European biomonitoring programme, Italian ryegrass ( Lolium multiflorum Lam.) was employed as accumulative bioindicator of airborne trace elements (As, Cd, Cr, Cu, Fe, Ni, Pb, Sb, V, Zn) in urban agglomerations. Applying a highly standardised method, grass cultures were exposed for consecutive periods of four weeks each to ambient air at up to 100 sites in 11 cities during 2000-2002. Results of the 2001 exposure experiments revealed a clear differentiation of trace element pollution within and among local monitoring networks. Pollution was influenced particularly by traffic emissions. Especially Sb, Pb, Cr, Fe, and Cu exhibited a very uneven distribution within the municipal areas with strong accumulation in plants from traffic-exposed sites in the city centres and close to major roads, and moderate to low levels in plants exposed at suburban or rural sites. Accumulation of Ni and V was influenced by other emission sources. The biomonitoring sites located in Spanish city centres featured a much higher pollution load by trace elements than those in other cities of the network, confirming previously reported findings obtained by chemical analyses of dust deposition and aerosols. At some heavily-trafficked sites, legal thresholds for Cu, Pb, and V contents in foodstuff and animal feed were reached or even surpassed. The study confirmed that the standardised grass exposure is a useful and reliable tool to monitor and to assess environmental levels of potentially toxic compounds of particulate matter.

Standardisation of the (129)I, (151)Sm and (166m)Ho activity concentration using the CIEMAT/NIST efficiency tracing method.

PubMed

Altzitzoglou, Timotheos; Rožkov, Andrej

2016-03-01

The (129)I, (151)Sm and (166m)Ho standardisations using the CIEMAT/NIST efficiency tracing method, that have been carried out in the frame of the European Metrology Research Program project "Metrology for Radioactive Waste Management" are described. The radionuclide beta counting efficiencies were calculated using two computer codes CN2005 and MICELLE2. The sensitivity analysis of the code input parameters (ionization quenching factor, beta shape factor) on the calculated efficiencies was performed, and the results are discussed. The combined relative standard uncertainty of the standardisations of the (129)I, (151)Sm and (166m)Ho solutions were 0.4%, 0.5% and 0.4%, respectively. The stated precision obtained using the CIEMAT/NIST method is better than that previously reported in the literature obtained by the TDCR ((129)I), the 4πγ-NaI ((166m)Ho) counting or the CIEMAT/NIST method ((151)Sm). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

ASSET (Age/Sex Standardised Estimates of Treatment): a research model to improve the governance of prescribing funds in Italy.

PubMed

Favato, Giampiero; Mariani, Paolo; Mills, Roger W; Capone, Alessandro; Pelagatti, Matteo; Pieri, Vasco; Marcobelli, Alberico; Trotta, Maria G; Zucchi, Alberto; Catapano, Alberico L

2007-07-04

The primary objective of this study was to make the first step in the modelling of pharmaceutical demand in Italy, by deriving a weighted capitation model to account for demographic differences among general practices. The experimental model was called ASSET (Age/Sex Standardised Estimates of Treatment). Individual prescription costs and demographic data referred to 3,175,691 Italian subjects and were collected directly from three Regional Health Authorities over the 12-month period between October 2004 and September 2005. The mean annual prescription cost per individual was similar for males (196.13 euro) and females (195.12 euro). After 65 years of age, the mean prescribing costs for males were significantly higher than females. On average, costs for a 75-year-old subject would be 12 times the costs for a 25-34 year-old subject if male, 8 times if female. Subjects over 65 years of age (22% of total population) accounted for 56% of total prescribing costs. The weightings explained approximately 90% of the evolution of total prescribing costs, in spite of the pricing and reimbursement turbulences affecting Italy in the 2000-2005 period. The ASSET weightings were able to explain only about 25% of the variation in prescribing costs among individuals. If mainly idiosyncratic prescribing by general practitioners causes the unexplained variations, the introduction of capitation-based budgets would gradually move practices with high prescribing costs towards the national average. It is also possible, though, that the unexplained individual variation in prescribing costs is the result of differences in the clinical characteristics or socio-economic conditions of practice populations. If this is the case, capitation-based budgets may lead to unfair distribution of resources. The ASSET age/sex weightings should be used as a guide, not as the ultimate determinant, for an equitable allocation of prescribing resources to regional authorities and general practices.

Quality of standardised patient research reports in the medical education literature: review and recommendations.

PubMed

Howley, Lisa; Szauter, Karen; Perkowski, Linda; Clifton, Maurice; McNaughton, Nancy

2008-04-01

In order to assess or replicate the research findings of published reports, authors must provide adequate and transparent descriptions of their methods. We conducted 2 consecutive studies, the first to define reporting standards relating to the use of standardised patients (SPs) in research, and the second to evaluate the current literature according to these standards. Standards for reporting SPs in research were established by representatives of the Grants and Research Committee of the Association of Standardized Patient Educators (ASPE). An extensive literature search yielded 177 relevant English-language articles published between 1993 and 2005. Search terms included: 'standardised patient(s)'; 'simulated patient(s)'; 'objective structured clinical examination (OSCE)', and 'clinical skills assessment'. Articles were limited to those reporting the use of SPs as an outcome measure and published in 1 of 5 prominent health sciences education journals. Data regarding the SP encounter, SP characteristics, training and behavioural measure(s) were gathered. A random selection of 121 articles was evaluated according to 29 standards. Reviewers judged that few authors provided sufficient details regarding the encounter (21%, n = 25), SPs (16%, n = 19), training (15%, n = 15), and behavioural measures (38%, n = 44). Authors rarely reported SP gender (27%, n = 33) and age range (22%, n = 26), whether training was provided for the SPs (39%, n = 47) or other raters (24%, n = 29), and psychometric evidence to support the behavioural measure (23%, n = 25). The findings suggest that there is a need for increased rigor in reporting research involving SPs. In order to support the validity of research findings, journal editors, reviewers and authors are encouraged to provide adequate detail when describing SP methodology.

Age-standardisation when target setting and auditing performance of Down syndrome screening programmes.

PubMed

Cuckle, Howard; Aitken, David; Goodburn, Sandra; Senior, Brian; Spencer, Kevin; Standing, Sue

2004-11-01

To describe and illustrate a method of setting Down syndrome screening targets and auditing performance that allows for differences in the maternal age distribution. A reference population was determined from a Gaussian model of maternal age. Target detection and false-positive rates were determined by standard statistical modelling techniques, except that the reference population rather than an observed population was used. Second-trimester marker parameters were obtained for Down syndrome from a large meta-analysis, and for unaffected pregnancies from the combined results of more than 600,000 screens in five centres. Audited detection and false-positive rates were the weighted average of the rates in five broad age groups corrected for viability bias. Weights were based on the age distributions in the reference population. Maternal age was found to approximate reasonably well to a Gaussian distribution with mean 27 years and standard deviation 5.5 years. Depending on marker combination, the target detection rates were 59 to 64% and false-positive rate 4.2 to 5.4% for a 1 in 250 term cut-off; 65 to 68% and 6.1 to 7.3% for 1 in 270 at mid-trimester. Among the five centres, the audited detection rate ranged from 7% below target to 10% above target, with audited false-positive rates better than the target by 0.3 to 1.5%. Age-standardisation should help to improve screening quality by allowing for intrinsic differences between programmes, so that valid comparisons can be made. Copyright 2004 John Wiley & Sons, Ltd.

The standardised freight container: vector of vectors and vector-borne diseases.

PubMed

Reiter, P

2010-04-01

The standardised freight container was one of the most important innovations of the 20th Century. Containerised cargoes travel from their point of origin to their destination by ship, road and rail as part of a single journey, without unpacking. This simple concept is the key element in cheap, rapid transport by land and sea, and has led to a phenomenal growth in global trade. Likewise, containerised air cargo has led to a remarkable increase in the inter-continental transportation of goods, particularly perishable items such as flowers, fresh vegetables and live animals. In both cases, containerisation offers great advantages in speed and security, but reduces the opportunity to inspect cargoes in transit. An inevitable consequence is the globalisation of undesirable species of animals, plants and pathogens. Moreover, cheap passenger flights offer worldwide travel for viral and parasitic pathogens in infected humans. The continued emergence of exotic pests, vectors and pathogens throughout the world is an unavoidable consequence of these advances in transportation technology.

Pervasive monitoring--an intelligent sensor pod approach for standardised measurement infrastructures.

PubMed

Resch, Bernd; Mittlboeck, Manfred; Lippautz, Michael

2010-01-01

Geo-sensor networks have traditionally been built up in closed monolithic systems, thus limiting trans-domain usage of real-time measurements. This paper presents the technical infrastructure of a standardised embedded sensing device, which has been developed in the course of the Live Geography approach. The sensor pod implements data provision standards of the Sensor Web Enablement initiative, including an event-based alerting mechanism and location-aware Complex Event Processing functionality for detection of threshold transgression and quality assurance. The goal of this research is that the resultant highly flexible sensing architecture will bring sensor network applications one step further towards the realisation of the vision of a "digital skin for planet earth". The developed infrastructure can potentially have far-reaching impacts on sensor-based monitoring systems through the deployment of ubiquitous and fine-grained sensor networks. This in turn allows for the straight-forward use of live sensor data in existing spatial decision support systems to enable better-informed decision-making.

Pervasive Monitoring—An Intelligent Sensor Pod Approach for Standardised Measurement Infrastructures

PubMed Central

Resch, Bernd; Mittlboeck, Manfred; Lippautz, Michael

2010-01-01

Geo-sensor networks have traditionally been built up in closed monolithic systems, thus limiting trans-domain usage of real-time measurements. This paper presents the technical infrastructure of a standardised embedded sensing device, which has been developed in the course of the Live Geography approach. The sensor pod implements data provision standards of the Sensor Web Enablement initiative, including an event-based alerting mechanism and location-aware Complex Event Processing functionality for detection of threshold transgression and quality assurance. The goal of this research is that the resultant highly flexible sensing architecture will bring sensor network applications one step further towards the realisation of the vision of a “digital skin for planet earth”. The developed infrastructure can potentially have far-reaching impacts on sensor-based monitoring systems through the deployment of ubiquitous and fine-grained sensor networks. This in turn allows for the straight-forward use of live sensor data in existing spatial decision support systems to enable better-informed decision-making. PMID:22163537

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

Murphy, Timothy A; Tupy, Michael J; Abraham, Timothy W

A wax comprises a metathesis product and/or a product that resembles, at least in part, a product which may be formed from a metathesis reaction. The wax may be used to form articles for example, candles (container candles, votive candles, and/or a pillar candles), crayons, fire logs or tarts. The wax commonly includes other components in addition to the metathesis product.

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

Murphy, Timothy A.; Tupy, Michael J.; Abraham, Timothy W.

A wax comprises a metathesis product and/or a product that resembles, at least in part, a product which may be formed from a metathesis reaction. The wax may be used to form articles, for example, candles (container candles, votive candles, and/or a pillar candles), crayons, fire logs, or tarts. The wax commonly includes other components in addition to the metathesis product.

A Hubble Space Telescope survey for novae in M87 - III. Are novae good standard candles 15 d after maximum brightness?

NASA Astrophysics Data System (ADS)

Shara, Michael M.; Doyle, Trisha F.; Pagnotta, Ashley; Garland, James T.; Lauer, Tod R.; Zurek, David; Baltz, Edward A.; Goerl, Ariel; Kovetz, Attay; Machac, Tamara; Madrid, Juan P.; Mikołajewska, Joanna; Neill, J. D.; Prialnik, Dina; Welch, D. L.; Yaron, Ofer

2018-02-01

Ten weeks of daily imaging of the giant elliptical galaxy M87 with the Hubble Space Telescope (HST) has yielded 41 nova light curves of unprecedented quality for extragalactic cataclysmic variables. We have recently used these light curves to demonstrate that the observational scatter in the so-called maximum-magnitude rate of decline (MMRD) relation for classical novae is so large as to render the nova-MMRD useless as a standard candle. Here, we demonstrate that a modified Buscombe-de Vaucouleurs hypothesis, namely that novae with decline times t2 > 10 d converge to nearly the same absolute magnitude about two weeks after maximum light in a giant elliptical galaxy, is supported by our M87 nova data. For 13 novae with daily sampled light curves, well determined times of maximum light in both the F606W and F814W filters, and decline times t2 > 10 d we find that M87 novae display M606W,15 = -6.37 ± 0.46 and M814W,15 = -6.11 ± 0.43. If very fast novae with decline times t2 < 10 d are excluded, the distances to novae in elliptical galaxies with stellar binary populations similar to those of M87 should be determinable with 1σ accuracies of ± 20 per cent with the above calibrations.

Lung sound intensity in patients with emphysema and in normal subjects at standardised airflows.

PubMed Central

Schreur, H J; Sterk, P J; Vanderschoot, J; van Klink, H C; van Vollenhoven, E; Dijkman, J H

1992-01-01

BACKGROUND: A common auscultatory finding in pulmonary emphysema is a reduction of lung sounds. This might be due to a reduction in the generation of sounds due to the accompanying airflow limitation or to poor transmission of sounds due to destruction of parenchyma. Lung sound intensity was investigated in normal and emphysematous subjects in relation to airflow. METHODS: Eight normal men (45-63 years, FEV1 79-126% predicted) and nine men with severe emphysema (50-70 years, FEV1 14-63% predicted) participated in the study. Emphysema was diagnosed according to pulmonary history, results of lung function tests, and radiographic criteria. All subjects underwent phonopneumography during standardised breathing manoeuvres between 0.5 and 2 1 below total lung capacity with inspiratory and expiratory target airflows of 2 and 1 l/s respectively during 50 seconds. The synchronous measurements included airflow at the mouth and lung volume changes, and lung sounds at four locations on the right chest wall. For each microphone airflow dependent power spectra were computed by using fast Fourier transformation. Lung sound intensity was expressed as log power (in dB) at 200 Hz at inspiratory flow rates of 1 and 2 l/s and at an expiratory flow rate of 1 l/s. RESULTS: Lung sound intensity was well repeatable on two separate days, the intraclass correlation coefficient ranging from 0.77 to 0.94 between the four microphones. The intensity was strongly influenced by microphone location and airflow. There was, however, no significant difference in lung sound intensity at any flow rate between the normal and the emphysema group. CONCLUSION: Airflow standardised lung sound intensity does not differ between normal and emphysematous subjects. This suggests that the auscultatory finding of diminished breath sounds during the regular physical examination in patients with emphysema is due predominantly to airflow limitation. Images PMID:1440459

Evaluating a standardised tool to explore the nature and extent of foot and ankle injuries in amateur and semi-professional footballers

PubMed Central

Evans, S.; Walker-Bone, K.; Otter, S.

2016-01-01

Introduction Football is a popular sport amongst amateurs as well as professionals. To date, most studies of football injuries have included only professional players and data have been collected in a variety of different ways. There is currently no single validated, standardised tool for the assessment of injures. Therefore, we developed a standardised questionnaire based upon an instrument used in rheumatoid arthritis sufferers and used it in a group of semi-professional and amateur footballers. We quantified the prevalence of foot/ankle injuries and evaluated risk factors for these injuries. Method A trained recorder administered a 33-item questionnaire (recording quantitative and qualitative data) in three football teams, 1 amateur and 2 semi-professional. The questionnaire enquired about demography, football specific information such as footwear and orthoses, and nature & extent of injuries. Results 42/42 eligible footballers completed the questionnaire. 34/42 respondents (81%) reported that they had experienced a total of 273 football-related injuries, 114 of which occurred at the foot or ankle. 70 injuries occurred at the ankle and 44 at the foot and 44% of the footballers had suffered one or more foot/ankle injuries in the past 12 months. Statistically significant relationships were seen between occurrence of lower limb and foot/ankle injuries and age, (p=0.03) weight (p=0.01) height (p=0.01) and shorter duration of warm-up (p). Conclusion The standardised tool performed well with an excellent response rate. Foot and ankle injuries were common in semi-professional and amateur footballers. Amongst this relatively small sample, statistically significant risk factors were identified which may be potential targets for prevention strategies but larger studies will be required. PMID:25605413

Effectiveness of a new standardised Urinary Continence Physiotherapy Programme for community-dwelling older women in Hong Kong.

PubMed

Leong, B S; Mok, Nicola W

2015-02-01

To examine the effectiveness of a standardised Urinary Continence Physiotherapy Programme for older Chinese women with stress, urge, or mixed urinary incontinence. A controlled trial. Six elderly community health centres in Hong Kong. A total of 55 women aged over 65 years with mild-to-moderate urinary incontinence. Participants were randomly assigned to the intervention group (n=27) where they received eight sessions of Urinary Continence Physiotherapy Programme for 12 weeks. This group received education about urinary incontinence, pelvic floor muscle training with manual palpation and verbal feedback, and behavioural therapy. The control group (n=28) was given advice and an educational pamphlet on urinary incontinence. There was significant improvement in urinary symptoms in the intervention group, especially in the first 5 weeks. Compared with the control group, participants receiving the intervention showed significant reduction in urinary incontinence episodes per week with a mean difference of -6.4 (95% confidence interval, -8.9 to -3.9; t= -5.3; P<0.001) and significant improvement of quality of life with a mean difference of -3.93 (95% confidence interval, -5.08 to -2.78; t= -6.9; P<0.001) measured by Incontinence Impact Questionnaire Short Form modified Chinese (Taiwan) version. The subjective perception of improvement, measured by an 11-point visual analogue scale, was markedly better in the intervention group (mean, 8.7; standard deviation, 1.0; 95% confidence interval, 8.4-9.1) than in the control group (mean, 1.4; standard deviation, 0.7; 95% confidence interval, 1.2-1.7; t=33.9; P<0.001). The mean treatment satisfaction in the intervention group was 9.5 (standard deviation, 0.8) as measured by an 11-point visual analogue scale. This study demonstrated that the Urinary Continence Physiotherapy Programme was effective in alleviating urinary symptoms among older Chinese women with mild-to-moderate heterogeneous urinary incontinence.

Effects of limited midwifery clinical education and practice standardisation of student preparedness.

PubMed

Vuso, Zanyiwe; James, Sindiwe

2017-08-01

To explore the perceptions of midwifery educators regarding effects of limited standardisation of midwifery clinical education and practice on clinical preparedness of midwifery students. Investigation of levels of clinical competency of students is a critical need in the current era. Such competency levels are especially important in midwifery practice in South Africa as there is a significant increase of maternal deaths and litigations in the country. Most of the deaths are in the primary healthcare level maternity units where the newly qualified midwives practise. These areas are mainly run by midwives only. The current article seeks to report the findings of the study that was conducted to investigate how midwifery educators prepare students adequately for clinical readiness. The study was conducted amongst midwifery nurse educators on three campuses of the Nursing College in the Eastern Cape. A qualitative, explorative, descriptive and contextual research design was used for the study. Seventeen purposively selected midwifery educators, with the researcher using set criteria, from a Nursing college in the Eastern Cape, were the participants in the study. Data was collected using focus-group interviews that were captured by means of an audio-voice recorder. Tesch's data-analysis method was used to develop themes and sub-themes. Trustworthiness of the study was ensured using the criteria of credibility, transferability, dependability and confirmability. Inconsistent clinical practice amongst midwifery educators in their clinical teaching and assessment were found to be the major factors resulting from limited standardisation. The inconsistent clinical practice and assessments of midwifery educators was found to lead to loss of the necessary skills required by the students which led them to perform poorly in their final clinical assessments. There are some barriers in the current clinical teaching and education strategy used in this college that prohibit the

ASSET (Age/Sex Standardised Estimates of Treatment): A Research Model to Improve the Governance of Prescribing Funds in Italy

PubMed Central

Favato, Giampiero; Mariani, Paolo; Mills, Roger W.; Capone, Alessandro; Pelagatti, Matteo; Pieri, Vasco; Marcobelli, Alberico; Trotta, Maria G.; Zucchi, Alberto; Catapano, Alberico L.

2007-01-01

Background The primary objective of this study was to make the first step in the modelling of pharmaceutical demand in Italy, by deriving a weighted capitation model to account for demographic differences among general practices. The experimental model was called ASSET (Age/Sex Standardised Estimates of Treatment). Methods and Major Findings Individual prescription costs and demographic data referred to 3,175,691 Italian subjects and were collected directly from three Regional Health Authorities over the 12-month period between October 2004 and September 2005. The mean annual prescription cost per individual was similar for males (196.13 euro) and females (195.12 euro). After 65 years of age, the mean prescribing costs for males were significantly higher than females. On average, costs for a 75-year-old subject would be 12 times the costs for a 25–34 year-old subject if male, 8 times if female. Subjects over 65 years of age (22% of total population) accounted for 56% of total prescribing costs. The weightings explained approximately 90% of the evolution of total prescribing costs, in spite of the pricing and reimbursement turbulences affecting Italy in the 2000–2005 period. The ASSET weightings were able to explain only about 25% of the variation in prescribing costs among individuals. Conclusions If mainly idiosyncratic prescribing by general practitioners causes the unexplained variations, the introduction of capitation-based budgets would gradually move practices with high prescribing costs towards the national average. It is also possible, though, that the unexplained individual variation in prescribing costs is the result of differences in the clinical characteristics or socio-economic conditions of practice populations. If this is the case, capitation-based budgets may lead to unfair distribution of resources. The ASSET age/sex weightings should be used as a guide, not as the ultimate determinant, for an equitable allocation of prescribing resources to

Effects and feasibility of a standardised orientation and mobility training in using an identification cane for older adults with low vision: design of a randomised controlled trial.

PubMed

Zijlstra, G A R; van Rens, G H M B; Scherder, E J A; Brouwer, D M; van der Velde, J; Verstraten, P F J; Kempen, G I J M

2009-08-27

Orientation and mobility training (O&M-training) in using an identification cane, also called symbol cane, is provided to people with low vision to facilitate independent participation in the community. In The Netherlands this training is mainly practice-based because a standardised and validly evaluated O&M-training in using the identification cane is lacking. Recently a standardised O&M-training in using the identification cane was developed. This training consists of two face-to-face sessions and one telephone session during which, in addition to usual care, the client's needs regarding mobility are prioritised, and cognitive restructuring techniques, action planning and contracting are applied to facilitate the use of the cane. This paper presents the design of a randomised controlled trial aimed to evaluate this standardised O&M-training in using the identification cane in older adults with low vision. A parallel group randomised controlled trial was designed to compare the standardised O&M-training with usual care, i.e. the O&M-training commonly provided by the mobility trainer. Community-dwelling older people who ask for support at a rehabilitation centre for people with visual impairment and who are likely to receive an O&M-training in using the identification cane are included in the trial (N = 190). The primary outcomes of the effect evaluation are ADL self care and visual functioning with respect to distance activities and mobility. Secondary outcomes include quality of life, feelings of anxiety, symptoms of depression, fear of falling, and falls history. Data for the effect evaluation are collected by means of telephone interviews at baseline, and at 5 and 17 weeks after the start of the O&M-training. In addition to an effect evaluation, a process evaluation to study the feasibility of the O&M-training is carried out. The screening procedure for eligible participants started in November 2007 and will continue until October 2009. Preliminary findings

Standardised extract of Bacopa monniera (CDRI-08) improves contextual fear memory by differentially regulating the activity of histone acetylation and protein phosphatases (PP1α, PP2A) in hippocampus.

PubMed

Preethi, Jayakumar; Singh, Hemant K; Venkataraman, Jois Shreyas; Rajan, Koilmani Emmanuvel

2014-05-01

Contextual fear conditioning is a paradigm for investigating cellular mechanisms involved in hippocampus-dependent memory. Earlier, we showed that standardised extract of Bacopa monniera (CDRI-08) improves hippocampus-dependent learning in postnatal rats by elevating the level of serotonin (5-hydroxytryptamine, 5-HT), activate 5-HT3A receptors, and cyclic adenosine monophosphate (cAMP) response element binding (CREB) protein. In this study, we have further examined the molecular mechanism of CDRI-08 in hippocampus-dependent memory and compared to the histone deacetylase (HDACs) inhibitor sodium butyrate (NaB). To assess the hippocampus-dependent memory, wistar rat pups were subjected to contextual fear conditioning (CFC) following daily (postnatal days 15-29) administration of vehicle solution (0.5 % gum acacia + 0.9 % saline)/CDRI-08 (80 mg/kg, p.o.)/NaB (1.2 g/kg in PBS, i.p.). CDRI-08/NaB treated group showed enhanced freezing behavior compared to control group when re-exposed to the same context. Administration of CDRI-08/NaB resulted in activation of extracellular signal-regulated kinase ERK/CREB signaling cascade and up-regulation of p300, Ac-H3 and Ac-H4 levels, and down-regulation of HDACs (1, 2) and protein phosphatases (PP1α, PP2A) in hippocampus following CFC. This would subsequently result in an increased brain-derived neurotrophic factor (Bdnf) (exon IV) mRNA in hippocampus. Altogether, our results indicate that CDRI-08 enhances hippocampus-dependent contextual memory by differentially regulating histone acetylation and protein phosphatases in hippocampus.

Using interprofessional simulation to improve collaborative competences for nursing, physiotherapy, and respiratory therapy students.

PubMed

King, Judy; Beanlands, Sarah; Fiset, Valerie; Chartrand, Louise; Clarke, Shelley; Findlay, Tarra; Morley, Michelle; Summers, Ian

2016-09-01

Within the care of people living with respiratory conditions, nursing, physiotherapy, and respiratory therapy healthcare professionals routinely work in interprofessional teams. To help students prepare for their future professional roles, there is a need for them to be involved in interprofessional education. The purpose of this project was to compare two different methods of patient simulation in improving interprofessional competencies for students in nursing, physiotherapy, and respiratory therapy programmes. The Canadian Interprofessional Health Collaborative competencies of communication, collaboration, conflict resolution patient/family-centred care, roles and responsibilities, and team functioning were measured. Using a quasi-experimental pre-post intervention approach two different interprofessional workshops were compared: the combination of standardised and simulated patients, and exclusively standardised patients. Students from nursing, physiotherapy, and respiratory therapy programmes worked together in these simulation-based activities to plan and implement care for a patient with a respiratory condition. Key results were that participants in both years improved in their self-reported interprofessional competencies as measured by the Interprofessional Collaborative Competencies Attainment Survey (ICCAS). Participants indicated that they found their interprofessional teams did well with communication and collaboration. But the participants felt they could have better involved the patients and their family members in the patient's care. Regardless of method of patient simulation used, mannequin or standardised patients, students found the experience beneficial and appreciated the opportunity to better understand the roles of other healthcare professionals in working together to help patients living with respiratory conditions.

A Hubble Space Telescope survey for novae in M87 – III. Are novae good standard candles 15 d after maximum brightness?

DOE PAGES

Shara, Michael M.; Doyle, Trisha F.; Pagnotta, Ashley; ...

2017-11-16

Ten weeks of daily imaging of the giant elliptical galaxy M87 with the Hubble Space Telescope (HST) has yielded 41 nova light curves of unprecedented quality for extragalactic cataclysmic variables. We have recently used these light curves to demonstrate that the observational scatter in the so-called maximum-magnitude rate of decline (MMRD) relation for classical novae is so large as to render the nova-MMRD useless as a standard candle. Here in this paper, we demonstrate that a modified Buscombe–de Vaucouleurs hypothesis, namely that novae with decline times t2 > 10 d converge to nearly the same absolute magnitude about two weeksmore » after maximum light in a giant elliptical galaxy, is supported by our M87 nova data. For 13 novae with daily sampled light curves, well determined times of maximum light in both the F606W and F814W filters, and decline times t 2 > 10 d we find that M87 novae display M606W,15 = -6.37 ± 0.46 and M814W,15 = -6.11 ± 0.43. If very fast novae with decline times t 2 < 10 d are excluded, the distances to novae in elliptical galaxies with stellar binary populations similar to those of M87 should be determinable with 1σ accuracies of ± 20 percent with the above calibrations.« less

A Hubble Space Telescope survey for novae in M87 – III. Are novae good standard candles 15 d after maximum brightness?

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

Shara, Michael M.; Doyle, Trisha F.; Pagnotta, Ashley

Ten weeks of daily imaging of the giant elliptical galaxy M87 with the Hubble Space Telescope (HST) has yielded 41 nova light curves of unprecedented quality for extragalactic cataclysmic variables. We have recently used these light curves to demonstrate that the observational scatter in the so-called maximum-magnitude rate of decline (MMRD) relation for classical novae is so large as to render the nova-MMRD useless as a standard candle. Here in this paper, we demonstrate that a modified Buscombe–de Vaucouleurs hypothesis, namely that novae with decline times t2 > 10 d converge to nearly the same absolute magnitude about two weeksmore » after maximum light in a giant elliptical galaxy, is supported by our M87 nova data. For 13 novae with daily sampled light curves, well determined times of maximum light in both the F606W and F814W filters, and decline times t 2 > 10 d we find that M87 novae display M606W,15 = -6.37 ± 0.46 and M814W,15 = -6.11 ± 0.43. If very fast novae with decline times t 2 < 10 d are excluded, the distances to novae in elliptical galaxies with stellar binary populations similar to those of M87 should be determinable with 1σ accuracies of ± 20 percent with the above calibrations.« less

COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES): statistical and economic analysis plan for a randomised controlled trial.

PubMed

Robinson, Emily J; Goldstein, Laura H; McCrone, Paul; Perdue, Iain; Chalder, Trudie; Mellers, John D C; Richardson, Mark P; Murray, Joanna; Reuber, Markus; Medford, Nick; Stone, Jon; Carson, Alan; Landau, Sabine

2017-06-06

Dissociative seizures (DSs), also called psychogenic non-epileptic seizures, are a distressing and disabling problem for many patients in neurological settings with high and often unnecessary economic costs. The COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES) trial is an evaluation of a specifically tailored psychological intervention with the aims of reducing seizure frequency and severity and improving psychological well-being in adults with DS. The aim of this paper is to report in detail the quantitative and economic analysis plan for the CODES trial, as agreed by the trial steering committee. The CODES trial is a multicentre, pragmatic, parallel group, randomised controlled trial performed to evaluate the clinical effectiveness and cost-effectiveness of 13 sessions of cognitive behavioural therapy (CBT) plus standardised medical care (SMC) compared with SMC alone for adult outpatients with DS. The objectives and design of the trial are summarised, and the aims and procedures of the planned analyses are illustrated. The proposed analysis plan addresses statistical considerations such as maintaining blinding, monitoring adherence with the protocol, describing aspects of treatment and dealing with missing data. The formal analysis approach for the primary and secondary outcomes is described, as are the descriptive statistics that will be reported. This paper provides transparency to the planned inferential analyses for the CODES trial prior to the extraction of outcome data. It also provides an update to the previously published trial protocol and guidance to those conducting similar trials. ISRCTN registry ISRCTN05681227 (registered on 5 March 2014); ClinicalTrials.gov NCT02325544 (registered on 15 December 2014).

Publications - RDF 2015-4 | Alaska Division of Geological & Geophysical

Science.gov Websites

, and the northern Darby Mountains, Bendeleben, Candle, Kotzebue, and Solomon quadrangles, Alaska publication sales page for more information. Quadrangle(s): Bendeleben; Candle; Kotzebue; Solomon drainages, Granite Mountain, and the northern Darby Mountains, Bendeleben, Candle, Kotzebue, and Solomon

[Calculation of standardised unit costs from a societal perspective for health economic evaluation].

PubMed

Bock, J-O; Brettschneider, C; Seidl, H; Bowles, D; Holle, R; Greiner, W; König, H H

2015-01-01

Due to demographic aging, economic evaluation of health care technologies for the elderly becomes more important. A standardised questionnaire to measure the health-related resource utilisation has been designed. The monetary valuation of the resource use documented by the questionnaire is a central step towards the determination of the corresponding costs. The aim of this paper is to provide unit costs for the resources in the questionnaire from a societal perspective. The unit costs are calculated pragmatically based on regularly published sources. Thus, an easy update is possible. This paper presents the calculated unit costs for outpatient medical care, inpatient care, informal and formal nursing care and pharmaceuticals from a societal perspective. The calculated unit costs can serve as a reference case in health economic evaluations and hence help to increase their comparability. © Georg Thieme Verlag KG Stuttgart · New York.

Monitoring and evaluating surgical care: defining perioperative mortality rate and standardising data collection.

PubMed

Palmqvist, Charlotta L; Ariyaratnam, Roshan; Watters, David A; Laing, Grant L; Stupart, Douglas; Hider, Phil; Ng-Kamstra, Joshua S; Wilson, Leona; Clarke, Damian L; Hagander, Lars; Greenberg, Sarah L M; Gruen, Russell L

2015-04-27

Case volume per 100 000 population and perioperative mortality rate (POMR) are key indicators to monitor and strengthen surgical services. However, comparisons of POMR have been restricted by absence of standardised approaches to when it is measured, the ideal denominator, need for risk adjustment, and whether data are available. We aimed to address these issues and recommend a minimum dataset by analysing four large mixed surgical datasets, two from well-resourced settings with sophisticated electronic patient information systems and two from resource-limited settings where clinicians maintain locally developed databases. We obtained data from the New Zealand (NZ) National Minimum Dataset, the Geelong Hospital patient management system in Australia, and purpose-built surgical databases in Pietermaritzburg, South Africa (PMZ) and Port Moresby, Papua New Guinea (PNG). Information was sought on inclusion and exclusion criteria, coding criteria, and completeness of patient identifiers, admission, procedure, discharge and death dates, operation details, urgency of admission, and American Society of Anesthesiologists (ASA) score. Date-related errors were defined as missing dates and impossible discrepancies. For every site, we then calculated the POMR, the effect of admission episodes or procedures as denominator, and the difference between in-hospital POMR and 30-day POMR. To determine the need for risk adjustment, we used univariate and multivariate logistic regression to assess the effect on relative POMR for each site of age, admission urgency, ASA score, and procedure type. 1 365 773 patient admissions involving 1 514 242 procedures were included, among which 8655 deaths were recorded within 30 days. Database inclusion and exclusion criteria differed substantially. NZ and Geelong records had less than 0·1% date-related errors and greater than 99·9% completeness. PMZ databases had 99·9% or greater completeness of all data except date-related items (94�

[Standardisation and validation of an HPLC method for determining serum posaconazole levels in Colombia].

PubMed

Cáceres, Diego H; Zapata, Juan David; Granada, Sinar D; Cano, Luz E; Naranjo, Tonny W

Colombia currently does not have a specialised service for measuring antifungal levels in serum, which is of prime importance for the proper treatment and correct management of invasive fungal infections. To standardise and validate a simple, sensitive, and specific protocol, based on high performance liquid chromatography, complying with the parameters recommended by the Food and Drug Administration, to detect, identify, and quantify serum concentrations of posaconazole. A high performance liquid chromatography Agilent series-1 200 equipment was used with ultraviolet diode array detector and analytical column-Eclipse XDB-C18. Posaconazole-SCH56592 (batch IRQ-PAZ-10-X-103) was used as the primary control and itraconazole (batch ZR051211PUC921) was used as an internal control. The validation was performed taking into account all criteria recommended by the Food and Drug Administration (selectivity, calibration curves, recovery, accuracy, precision, sensitivity, reproducibility, and stability of the sample). The most suitable chromatographic conditions were the following: column temperature 25°C, ultraviolet detection at 261nm, 50μl injection volume, flow volume 0.8ml/min, 10min running time, mobile phase of acetonitrile:water (70:30), and final retention times of 3.4 and 7.2min for posaconazole and itraconazole, respectively, with a wide and reliable quantification range (0.125μg/ml to 16μg/ml). Using these parameters, the method was selective, R 2 in the calibration curves was≥0.99, and the percentage recovery was 98.7%, with a coefficient of variation less than 10%. The relative error for accuracy and the coefficient of variation for precision were less than 15%, all meeting the acceptance criteria recommended by the Food and Drug Administration. The selectivity and chromatographic purity of the obtained signal, as well as the standardised limits of detection and quantification, make this method an excellent tool for therapeutic monitoring of patients

A Standardised Vocabulary for Identifying Benthic Biota and Substrata from Underwater Imagery: The CATAMI Classification Scheme

PubMed Central

Jordan, Alan; Rees, Tony; Gowlett-Holmes, Karen

2015-01-01

Imagery collected by still and video cameras is an increasingly important tool for minimal impact, repeatable observations in the marine environment. Data generated from imagery includes identification, annotation and quantification of biological subjects and environmental features within an image. To be long-lived and useful beyond their project-specific initial purpose, and to maximize their utility across studies and disciplines, marine imagery data should use a standardised vocabulary of defined terms. This would enable the compilation of regional, national and/or global data sets from multiple sources, contributing to broad-scale management studies and development of automated annotation algorithms. The classification scheme developed under the Collaborative and Automated Tools for Analysis of Marine Imagery (CATAMI) project provides such a vocabulary. The CATAMI classification scheme introduces Australian-wide acknowledged, standardised terminology for annotating benthic substrates and biota in marine imagery. It combines coarse-level taxonomy and morphology, and is a flexible, hierarchical classification that bridges the gap between habitat/biotope characterisation and taxonomy, acknowledging limitations when describing biological taxa through imagery. It is fully described, documented, and maintained through curated online databases, and can be applied across benthic image collection methods, annotation platforms and scoring methods. Following release in 2013, the CATAMI classification scheme was taken up by a wide variety of users, including government, academia and industry. This rapid acceptance highlights the scheme’s utility and the potential to facilitate broad-scale multidisciplinary studies of marine ecosystems when applied globally. Here we present the CATAMI classification scheme, describe its conception and features, and discuss its utility and the opportunities as well as challenges arising from its use. PMID:26509918

Comparison of Rotavirus and Norovirus transport in standardised and natural soil-water systems

NASA Astrophysics Data System (ADS)

Gamazo, P. A.; Schijven, J. F.; Victoria, M.; Alvareda, E.; Lopez, F.; Ramos, J.; Lizasoain, A.; Sapriza-Azuri, G.; Castells, M.; Colina, R.

2016-12-01

Rotavirus and Norovirus are waterborne viruses that are major causes of diarrhea and others symptoms of acute gastroenteritis. An important pathway of these viruses is groundwater. In Uruguay, as in many developed and developing countries, there are areas where the only source of water for human consumption is groundwater. In the rural area of the Salto district, groundwater is commonly used without any treatment, as it is traditionally considered as a safe source. However, virus contamination have been detected in several wells in the area. The most probable source of contamination are nearby septic systems, since the sewer coverage is scarce. This work aims to evaluate and compare the virus transport processes for a standardised soil-water systems and for the Salto aquifer system. For this, the transport of Rotavirus and Norovirus from clinic samples was studied in two sets of column experiments: 6.7 cm columns with quartz sand under saturated conditions (ionic strength 1mM, pH 7.0) and with sand from the Salto aquifer (Uruguay) (9,2% coarse sand, 47,8% medium sand, 40,5% fine sand, magnesium/calcium bicarbonate water, Ionic strength 15.1 mM, pH 7.2). Both viruses were seeded for 2 pore volumes on the columns. Samples were collected at the column outlet and viruses were enumerated by Q-PRCR. Breakthrough curves were constructed and fitted to a two-site kinetic attachment/detachment model, including blocking using Hydrus-1D. In the quartz sand column, both Rotavirus and Norovirus were removed two orders in magnitude. In the Salto sand column, Rotavirus was removed 2 log10 as well, but Norovirus was removed 4 log10. The fitting of the breakthrough curves indicated that blocking played a role for Rotavirus in the Salto sand column. These results are consistent with field observation where only Rotavirus was detected in the Salto aquifer, while similar concentrations in Salto sewer effluent was measured for these two viruses. This work, besides reporting actual

Performance characteristics of a quantitative, standardised varicella zoster IgG time resolved fluorescence immunoassay (VZV TRFIA) for measuring antibody following natural infection.

PubMed

Chris Maple, P A; Gray, Jim; Brown, Kevin; Brown, David

2009-04-01

Infection by Varicella Zoster virus (VZV) during pregnancy has been associated with adverse foetal development and more severe disease in the mother. Accurate determination of VZV immunity in pregnant women exposed to VZV, with no history of chickenpox, guides therapeutic interventions. The accepted gold standard assay for the determination of immunity/protection against Varicella Zoster virus was for many years the fluorescent antibody to membrane antigen (FAMA) assay which is labour intensive and subjective. A validated alternative is the Merck glycoprotein EIA (Merck Sharp & Dohme Research Laboratories, West Point, PA, USA) which reports VZV IgG levels in enzyme units per ml (EU/ml) because an internal, non-international reference serum is used as calibrator. Comparison of different VZV IgG detection assays is hampered by a lack of an agreed cut-off in standardised units. A time resolved fluorescence immunoassay (TRFIA) for VZV IgG using British Standard VZV antibody has been developed and standardised. The limit of detection of VZV IgG by this assay was of the order 39-78mIU/ml. Following comparison with the Merck glycoprotein EIA and the application of the USA Advisory Committee on Immunization Practices recommended 5.0EU/ml cut-off the following standardised cut-offs in mIU/ml are proposed. A VZV TRFIA IgG cut-off of less than 100mIU/ml VZV IgG equates with susceptibility and an equivocal range of 100mIU/ml to less than 150mIU/ml is proposed. VZV IgG levels of 150mIU/ml, or greater, are indicative of natural infection at some time and the ability to mount a protective immune response is inferred.

Standardising the reporting of outcomes in gastric cancer surgery trials: protocol for the development of a core outcome set and accompanying outcome measurement instrument set (the GASTROS study).

PubMed

Alkhaffaf, Bilal; Glenny, Anne-Marie; Blazeby, Jane M; Williamson, Paula; Bruce, Iain A

2017-08-09

Gastric cancer is one of the leading causes of cancer-related deaths worldwide. Whilst surgery is the mainstay of curative treatment, it is associated with significant risks. Surgical strategies for treating gastric cancer should be based on evidence from systematic reviews of well-designed randomised controlled trials. However, inconsistencies in the reporting of outcomes from these trials makes evidence synthesis unreliable. We present a protocol for an international consensus study to develop a standardised set of outcomes and measurement tools - a 'core outcome set' (COS) - to be used by all future trials examining therapeutic surgical interventions for gastric cancer. The GASTROS study aims to standardise the reporting of outcomes in gastric cancer surgery trials through an international consensus process of key stakeholders including health care professionals and patients. The first of three stages in the study will identify a 'long-list' of potentially important outcomes to be prioritised. These will be extracted from a systematic review of relevant academic literature and patient interviews. Stage 2 will comprise an eDelphi survey which will consider the views of patients, nurse specialists and surgeons to prioritise the most important outcomes. A meeting of stakeholder representatives will ratify the COS. Stage 3 will focus on identifying appropriate instruments to measure the prioritised outcomes by means of quality assessment of available measurement instruments and stakeholder consultation. This study aims to standardise the reporting of outcomes in future trials examining therapeutic surgical interventions for gastric cancer. It is anticipated that standardisation of outcome reporting in these surgical effectiveness trials will enhance the evidence base for clinical practice. Highlighting outcomes of greatest importance to patients will ensure that their perspectives are central to research in this field.

Aluminium-gold reference material for the k0-standardisation of neutron activation analysis

NASA Astrophysics Data System (ADS)

Ingelbrecht, C.; Peetermans, F.; De Corte, F.; De Wispelaere, A.; Vandecasteele, C.; Courtijn, E.; D'Hondt, P.

1991-05-01

Gold is an excellent comparator material for the k0-standardisation of neutron activation analysis because of its convenient and well defined nuclear properties. The most suitable form for a reference material is a dilute aluminium-gold alloy, for which the self-shielding effect for neutrons is small. Castings of composition Al-0.1 wt.% Au were prepared by crucible-less levitation melting, which gives close control of ingot composition with minimal contamination of the melt. The alloy composition was checked using induction-coupled plasma source emission spectrometry. The homogeneity of the alloy was measured by neutron activation analysis and a relative standard deviation of the gold content of 0.30% was found (10 mg samples). Metallography revealed a homogeneous distribution of AuAl 2 particles. The alloy was certified as Reference Material CBNM-530, with certified gold mass fraction 0.100±0.002 wt.%.

Using multifaceted education to improve management in acute viral bronchiolitis.

PubMed

Murch, Hannah; Oakley, Juliette; Pierrepoint, Marcus; Powell, Colin

2015-07-01

To establish current bronchiolitis management across hospitals in Wales, improve compliance with national guidelines and standardise evidence-based clinical practice. A complete audit cycle with implementation of a multifaceted education bundle prior to the follow-up audit. Twelve acute paediatric departments between 1 November and 31 December in 2012 and 2013. All infants under 12 months with a clinical diagnosis of bronchiolitis. The first audit assessed management of bronchiolitis with reference to both the Scottish Intercollegiate Guideline Network (SIGN) guidelines and local hospital guidelines. Following analysis and dissemination of these results, an education bundle was implemented nationwide, with completion of the audit cycle to assess change. Compliance with SIGN recommendations for investigation, treatment and discharge. Compliance with the education bundle requirements also assessed in 2013. Data were collected for 1599 infants. The education bundle was delivered in all hospitals. The level of severity, defined by oxygen saturations in air at presentation, length of stay and paediatric intensive care unit transfers, was equivalent for both years. Mean compliance percentage (95% CI) across Wales significantly improved between 2012 and 2013, with compliance with investigations increasing from 50% (46% to 53%) to 71% (68% to 74%), with management increasing from 65% (61% to 68%) to 74% (71% to 77%), and overall compliance improving from 38% (37% to 39%) to 59% (56% to 62%) in 2013. This audit demonstrated a significant improvement in compliance following implementation of our educational bundle. This has enabled improvement in standardised and evidence-based patient care across Wales. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Working Up a Good Sweat – The Challenges of Standardising Sweat Collection for Metabolomics Analysis

PubMed Central

Hussain, Joy N; Mantri, Nitin; Cohen, Marc M

2017-01-01

Introduction Human sweat is a complex biofluid of interest to diverse scientific fields. Metabolomics analysis of sweat promises to improve screening, diagnosis and self-monitoring of numerous conditions through new applications and greater personalisation of medical interventions. Before these applications can be fully developed, existing methods for the collection, handling, processing and storage of human sweat need to be revised. This review presents a cross-disciplinary overview of the origins, composition, physical characteristics and functional roles of human sweat, and explores the factors involved in standardising sweat collection for metabolomics analysis. Methods A literature review of human sweat analysis over the past 10 years (2006–2016) was performed to identify studies with metabolomics or similarly applicable ‘omics’ analysis. These studies were reviewed with attention to sweat induction and sampling techniques, timing of sweat collection, sweat storage conditions, laboratory derivation, processing and analytical platforms. Results Comparative analysis of 20 studies revealed numerous factors that can significantly impact the validity, reliability and reproducibility of sweat analysis including: anatomical site of sweat sampling, skin integrity and preparation; temperature and humidity at the sweat collection sites; timing and nature of sweat collection; metabolic quenching; transport and storage; qualitative and quantitative measurements of the skin microbiota at sweat collection sites; and individual variables such as diet, emotional state, metabolic conditions, pharmaceutical, recreational drug and supplement use. Conclusion Further development of standard operating protocols for human sweat collection can open the way for sweat metabolomics to significantly add to our understanding of human physiology in health and disease. PMID:28798503

Enhancing the performance of gastrointestinal tumour board by improving documentation.

PubMed

Alsuhaibani, Roaa Saleh; Alzahrani, Hajer; Algwaiz, Ghada; Alfarhan, Haneen; Alolayan, Ashwaq; Abdelhafiz, Nafisa; Ali, Yosra; Jazieh, Abdul Rahman

2018-01-01

Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan-Do-Study-Act (PDSA) cycles, were conducted. The first cycle focused on updating the case discussion summary form (CDSF) based on experts' input and previous identified deficiencies to enhance documentation and improve performance. The second PDSA cycle aimed at incorporating the CDSF into the electronic medical records system and assessing its functionality. The third cycle was to orient and train staff on using the form and launching it. The fourth PDSA cycle aimed at assessing the ability to obtain tumour board performance measures. Adherence to completion of the CDSF improved from 82% (baseline) to 94% after the fourth PDSA cycle. Over 104 consecutive cases discussed in the tumour board between January and July 2016 and 76 cases discussed in 2015, results were as follows: adherence to National Comprehensive Cancer Network guidelines in 2016 was observed in 141 (95%) recommendations, while it was observed in 90 (92%) recommendations in 2015. Changes in the management plans were observed in 37 (36%) cases in 2016 and in 6 (8%) cases in 2015. Regarding tumour board recommendations, 87% were done within 3 months of tumour board discussion in 2016, while 69% were done in 2015. Implementing electronic standardised documentation tool improved communication among the team and enabled getting accurate data about performance measures of the tumour board with positive impact on healthcare process and

Enhancing the performance of gastrointestinal tumour board by improving documentation

PubMed Central

Alsuhaibani, Roaa Saleh; Alzahrani, Hajer; Algwaiz, Ghada; Alfarhan, Haneen; Alolayan, Ashwaq; Abdelhafiz, Nafisa; Ali, Yosra; Jazieh, Abdul Rahman

2018-01-01

Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan–Do–Study–Act (PDSA) cycles, were conducted. The first cycle focused on updating the case discussion summary form (CDSF) based on experts’ input and previous identified deficiencies to enhance documentation and improve performance. The second PDSA cycle aimed at incorporating the CDSF into the electronic medical records system and assessing its functionality. The third cycle was to orient and train staff on using the form and launching it. The fourth PDSA cycle aimed at assessing the ability to obtain tumour board performance measures. Adherence to completion of the CDSF improved from 82% (baseline) to 94% after the fourth PDSA cycle. Over 104 consecutive cases discussed in the tumour board between January and July 2016 and 76 cases discussed in 2015, results were as follows: adherence to National Comprehensive Cancer Network guidelines in 2016 was observed in 141 (95%) recommendations, while it was observed in 90 (92%) recommendations in 2015. Changes in the management plans were observed in 37 (36%) cases in 2016 and in 6 (8%) cases in 2015. Regarding tumour board recommendations, 87% were done within 3 months of tumour board discussion in 2016, while 69% were done in 2015. Implementing electronic standardised documentation tool improved communication among the team and enabled getting accurate data about performance measures of the tumour board with positive impact on healthcare process

Using a standardised protocol was effective in reducing hospitalisation and treatment use in children with newly diagnosed immune thrombocytopenia.

PubMed

Labrosse, R; Vincent, M; Nguyen, U-P; Chartrand, C; Di Liddo, L; Pastore, Y

2017-10-01

Childhood immune thrombocytopenia (ITP) has been associated with low bleeding rates and a high frequency of spontaneous remission. Although current guidelines suggest that most patients are just observed, children still receive platelet-enhancing therapies for fear of bleeding complications. We hypothesised that a standardised protocol with a step-down approach would reduce hospitalisation and treatment use. A retrospective chart review was performed on patients diagnosed with acute ITP between January 2010 and December 2014, before (n = 54) and after (n = 37) the standardised protocol, which was introduced in January 2013. Management and events during the first 3 months following diagnosis were recorded. The protocol resulted in a 34% decrease in the hospitalisation rate (p < 0.001) at diagnosis. Prednisone treatment duration at diagnosis was also significantly reduced (13.1 versus 5.8 days, p = 0.004). Children over 3 years of age were 3.8 times less likely to be hospitalised (95% CI 1.94-7.61) and 2.3 times less likely to receive treatment (95% CI 1.2-4.3). There was no difference in the rate of persistent ITP (38% versus 30%, p = 0.43) or serious bleeding complications (7% versus 5%, p = 0.70). Our ITP management protocol significantly reduced hospitalisation rates and length of prednisone treatment without any increase in disease complications. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

41 CFR 102-74.180 - What illumination levels must Federal agencies maintain on Federal facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... surfaces, measured at a height of 30 inches above floor level, during working hours (for visually difficult...) 30 foot-candles in work areas during working hours, measured at 30 inches above floor level; (c) 10 foot-candles, but not less than 1 foot-candle, in non-work areas, during working hours (normally this...

Bactericidal activity and silver release of porous ceramic candle filter prepared by sintering silica with silver nanoparticles/zeolite for water disinfection

NASA Astrophysics Data System (ADS)

Trinh Nguyen, Thuy Ai; Phu Dang, Van; Duy Nguyen, Ngoc; Le, Anh Quoc; Thanh Nguyen, Duc; Hien Nguyen, Quoc

2014-09-01

Porous ceramic candle filters (PCCF) were prepared by sintering silica from rice husk with silver nanoparticles (AgNPs)/zeolite A at about 1050 °C to create bactericidal PCCF/AgNPs for water disinfection. The silver content in PCCF/AgNPs was of 300-350 mg kg-1 determined by inductively coupled plasma-atomic emission spectroscopy (ICP-AES) and the average pore size of PCCF/AgNPs was of 50-70 Å measured by Brunauer-Emmett-Teller (BET) method. The bactericidal activity and silver release of PCCF/AgNPs have been investigated by flow test with water flow rate of 5 L h-1 and initial inoculation of E. coli in inlet water of 106 CFU/100 mL. The volume of filtrated water was collected up to 500 L. Results showed that the contamination of E. coli in filtrated water was <1 CFU/100 mL and the content of silver released from PCCF/AgNPs into filtrated water was <1 μg L-1, it is low, far under the WHO guideline of 100 μg L-1 at maximum for drinking water. Based on the content of silver in PCCF/AgNPs and in filtrated water, it was estimated that one PCCF/AgNPs could be used to filtrate of ˜100 m3 water. Thus, as-prepared PCCF/AgNPs releases low content of silver into water and shows effectively bactericidal activity that is promising to apply as point-of-use water treatment technology for drinking water disinfection.

Can't see the woods for the trees: exploring the range and connection of tobacco industry argumentation in the 2012 UK standardised packaging consultation.

PubMed

Lie, Jessamina Lih Yan; Fooks, Gary; de Vries, Nanne K; Heijndijk, Suzanne M; Willemsen, Marc C

2017-07-25

Transnational tobacco company (TTC) submissions to the 2012 UK standardised packaging consultation are studied to examine TTC argumentation in the context of Better Regulation practices. A content analysis was conducted of Philip Morris International and British American Tobacco submissions to the 2012 UK consultation. Industry arguments concerning expected costs and (contested) benefits of the policy were categorised into themes and frames. The inter-relationship between frames through linked arguments was mapped to analyse central arguments using an argumentation network. 173 arguments were identified. Arguments fell into one of five frames: ineffectiveness, negative economic consequences, harm to public health, increased crime or legal ramifications. Arguments highlighted high costs to a wide range of groups, including government, general public and other businesses. Arguments also questioned the public health benefits of standardised packaging and highlighted the potential benefits to undeserving groups. An increase in illicit trade was the most central argument and linked to the greatest variety of arguments. In policy-making systems characterised by mandatory impact assessments and public consultations, the wide range of cost (and contested benefits) based arguments highlights the risk of TTCs overloading policy actors and causing delays in policy adoption. Illicit trade related arguments are central to providing a rationale for these arguments, which include the claim that standardised packaging will increase health risks. The strategic importance of illicit trade arguments to industry argumentation in public consultations underlines the risks of relying on industry data relating to the scale of the illicit trade. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Polymerase chain reaction with phase change as intrinsic thermal control

NASA Astrophysics Data System (ADS)

Hsieh, Yi-Fan; Yonezawa, Eri; Kuo, Long-Sheng; Yeh, Shiou-Hwei; Chen, Pei-Jer; Chen, Ping-Hei

2013-04-01

This research demonstrated that without any external temperature controller, the capillary convective polymerase chain reaction (ccPCR) powered by a candle can operate with the help of phase change. The candle ccPCR system productively amplified hepatitis B virus 122 base-pairs DNA fragment. The detection sensitivity can achieve at an initial DNA concentration to 5 copies per reaction. The results also show that the candle ccPCR system can operate functionally even the ambient temperature varies from 7 °C to 45 °C. These features imply that the candle ccPCR system can provide robust medical detection services.

Impact of the introduction of standardised packaging on smokers' brand awareness and identification in Australia.

PubMed

Balmford, James; Borland, Ron; Yong, Hua-Hie

2016-01-01

The introduction of standardised packaging (SP) in Australia in December 2012 has heightened interest in how image and branding might affect smoking. This paper tests the hypothesis that brand awareness and identification among smokers will decline after the introduction of SP. Longitudinal study of three waves of smokers in Australia, conducted between October 2011-February 2012 (pre-SP) (n = 1104), February-May 2013 (post-SP1) (n = 1093) and August-December 2014 (post-SP2) (n = 1090). We explored the extent of changes in two variables, brand awareness (noticing others with the brand of cigarettes you smoke) and brand identification (perceiving something in common among smokers of your brand), and examined change in a number of other measures of brand appeal, brand characteristics and determinants of brand choice. Brand awareness 'at least sometimes' reduced from 45.3% pre-SP to 26.9% at post-SP2 [odds ratio (OR) 0.35 (0.27-0.45)]. Brand identification also decreased from 18.2% to 12.7% [OR 0.62 (0.42-0.91)]. Significant decline was also found in measures of perceived brand prestige [OR 0.51 (0.39-0.66)] and choice of brand for health reasons [OR 0.45 (0.32-0.63)]. Liking the look of the pack was strongly associated with brand identification, but only post-SP (P = 0.02 for interaction across the three waves). The introduction of SP of tobacco products in Australia has been associated with reductions in brand awareness and identification, and changes in related measures. The findings support the notion that SP has reduced the capacity for smokers to use pack branding to create and communicate a desired identity. [Balmford J, Borland R, Yong H-H. Impact of the introduction of standardised packaging on smokers' brand awareness and identification in Australia. Drug Alcohol Rev 2015;00:000-000]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Standardisation of information submitted to an endpoint committee for cause of death assignment in a cancer screening trial – lessons learnt from CAP (Cluster randomised triAl of PSA testing for Prostate cancer).

PubMed

Williams, Naomi J; Hill, Elizabeth M; Ng, Siaw Yein; Martin, Richard M; Metcalfe, Chris; Donovan, Jenny L; Evans, Simon; Hughes, Laura J; Davies, Charlotte F; Hamdy, Freddie C; Neal, David E; Turner, Emma L

2015-01-23

In cancer screening trials where the primary outcome is target cancer-specific mortality, the unbiased determination of underlying cause of death (UCD) is crucial. To minimise bias, the UCD should be independently verified by expert reviewers, blinded to death certificate data and trial arm. We investigated whether standardising the information submitted for UCD assignment in a population-based randomised controlled trial of prostate-specific antigen (PSA) testing for prostate cancer reduced the reviewers' ability to correctly guess the trial arm. Over 550 General Practitioner (GP) practices (>415,000 men aged 50-69 years) were cluster-randomised to PSA testing (intervention arm) or the National Health Service (NHS) prostate cancer risk management programme (control arm) between 2001 and 2007. Assignment of UCD was by independent reviews of researcher-written clinical vignettes that masked trial arm and death certificate information. A period of time after the process began (the initial phase), we analysed whether the reviewers could correctly identify trial arm from the vignettes, and the reasons for their choice. This feedback led to further standardisation of information (second phase), after which we re-assessed the extent of correct identification of trial arm. 1099 assessments of 509 vignettes were completed by January 2014. In the initial phase (n = 510 assessments), reviewers were unsure of trial arm in 33% of intervention and 30% of control arm assessments and were influenced by symptoms at diagnosis, PSA test result and study-specific criteria. In the second phase (n = 589), the respective proportions of uncertainty were 45% and 48%. The percentage of cases whereby reviewers were unable to determine the trial arm was greater following the standardisation of information provided in the vignettes. The chances of a correct guess and an incorrect guess were equalised in each arm, following further standardisation. It is possible to mask trial arm from

Standardised Embedded Data framework for Drones [SEDD

NASA Astrophysics Data System (ADS)

Wyngaard, J.; Barbieri, L.; Peterson, F. S.

2015-12-01

A number of barriers to entry remain for UAS use in science. One in particular is that of implementing an experiment and UAS specific software stack. Currently this stack is most often developed in-house and customised for a particular UAS-sensor pairing - limiting its reuse. Alternatively, when adaptable a suitable commercial package may be used, but such systems are both costly and usually suboptimal.In order to address this challenge the Standardised Embedded Data framework for Drones [SEDD] is being developed in μpython. SEDD provides an open source, reusable, and scientist-accessible drop in solution for drone data capture and triage. Targeted at embedded hardware, and offering easy access to standard I/O interfaces, SEDD provides an easy solution for simply capturing data from a sensor. However, the intention is rather to enable more complex systems of multiple sensors, computer hardware, and feedback loops, via 3 primary components.A data asset manager ensures data assets are associated with appropriate metadata as they are captured. Thereafter, the asset is easily archived or otherwise redirected, possibly to - onboard storage, onboard compute resource for processing, an interface for transmission, another sensor control system, remote storage and processing (such as EarthCube's CHORDS), or to any combination of the above.A service workflow managerenables easy implementation of complex onboard systems via dedicated control of multiple continuous and periodic services. Such services will include the housekeeping chores of operating a UAS and multiple sensors, but will also permit a scientist to drop in an initial scientific data processing code utilising on-board compute resources beyond the autopilot. Having such capabilities firstly enables easy creation of real-time feedback, to the human- or auto- pilot, or other sensors, on data quality or needed flight path changes. Secondly, compute hardware provides the opportunity to carry out real-time data triage

Biomarkers for the differentiation of sepsis and SIRS: the need for the standardisation of diagnostic studies.

PubMed

Hall, T C; Bilku, D K; Al-Leswas, D; Horst, C; Dennison, A R

2011-12-01

Sepsis is a leading cause of death in the critically ill patient. It is a heterogeneous disease and it is frequently difficult to make an unequivocal and expeditious diagnosis. The current 'gold standard' in diagnosing sepsis is the blood culture but this is only available after a significant time delay. Mortality rates from sepsis remain high, however, the introduction of sepsis care bundles in its management has produced significant improvements in patient outcomes. Central to goal-directed resuscitation is the timely and accurate diagnosis of sepsis. The rapid diagnosis and commencement of the appropriate therapies has been shown to reduce the mortality. Biomarkers are already used in clinical practice to aid other more traditional diagnostic tests. In the absence of an adequate gold standard to diagnose sepsis, there has been considerable and growing interest in trying to identify suitable biomarkers. There is currently an unmet need in the medical literature to communicate the importance of the challenges relating to the rapid diagnosis and implementation of goal-directed therapy in sepsis and the underlying concepts that are directing these investigations. This article reviews the more novel biomarkers investigated to differentiate systemic inflammatory response syndrome from sepsis. The biomarkers described reflect the difficulties in making evidence-based recommendations particularly when interpreting studies where the methodology is of poor quality and the results are conflicting. We are reminded of our responsibilities to ensure high quality and standardised study design as articulated by the STAndards for the Reporting of Diagnostic accuracy studies (STARD) initiative.

A service evaluation and improvement project: a three year systematic audit cycle of the physiotherapy treatment for Lateral Epicondylalgia.

PubMed

Barratt, Paul A; Selfe, James

2018-06-01

To improve outcomes of physiotherapy treatment for patients with Lateral Epicondylalgia. A systematic audit and quality improvement project over three phases, each of one year duration. Salford Royal NHS Foundation Trust Teaching Hospital Musculoskeletal Physiotherapy out-patients department. n=182. Phase one - individual discretion; Phase two - strengthening as a core treatment however individual discretion regarding prescription and implementation; Phase three - standardised protocol using high load isometric exercise, progressing on to slow combined concentric & eccentric strengthening. Global Rating of Change Scale, Pain-free grip strength, Patient Rated Tennis Elbow Evaluation, Tampa Scale of Kinesophobia-11. Phase three demonstrated a reduction in the average number of treatments by 42% whilst improving the number of responders to treatment by 8% compared to phase one. Complete cessation of non-evidence based treatments was also observed by phase three. Strengthening should be a core treatment for LE. Load setting needs to be sufficient. In phase three of the audit a standardised tendon loading programme using patient specific high load isometric exercises into discomfort/pain demonstrated a higher percentage of responders compared to previous phases. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The Feasibility of Standardised Geriatric Assessment Tools and Physical Exercises in Frail Older Adults.

PubMed

Jadczak, A D; Mahajan, N; Visvanathan, R

2017-01-01

Geriatric assessment tools are applicable to the general geriatric population; however, their feasibility in frail older adults is yet to be determined. The study aimed to determine the feasibility of standardised geriatric assessment tools and physical exercises in hospitalised frail older adults. Various assessment tools including the FRAIL Screen, the Charlson Comorbidity Index, the SF-36, the Trail Making Test (TMT), the Rapid Cognitive Screen, the Self Mini Nutritional Assessment (MNA-SF) and the Lawton iADL as well as standard physical exercises were assessed using observational protocols. The FRAIL Screen, MNA-SF, Rapid Cognitive Screen, Lawton iADL and the physical exercises were deemed to be feasible with only minor comprehension, execution and safety issues. The TMT was not considered to be feasible and the SF-36 should be replaced by its shorter form, the SF-12. In order to ensure the validity of these findings a study with a larger sample size should be undertaken.

Melorheostosis – Case Report of Rare Disease

PubMed Central

Kumar, Rakesh; Sankhala, S.S.; Bijarnia, Isha

2014-01-01

Introduction: Melorheostosis(synonyms: candle bone disease, melting wax syndrome, Leri disease) is a rare chronic bone disorder, first described in 1922 by Leri and Joanny. Men and women are equally affected, and no hereditary features have been discovered. Onset is insidious, and most common symptom is pain. Most common part of bone is diaphysis of the long bone of lower limb rarely the axial skeleton. Classical radiological appearance of ’flowing hyperosteosis’ resembling hardened wax that has dripped down the side of a candle. Case Report: A 35 years old woman presented with left leg pain with mild swelling and limitation of knee movement. On examination non tender bony heard swelling, hyperpigmented and restriction of knee movement present. Plain radiographs showed extensive, dense, undulating or irregular cortical hyperostosis, resembling candle wax, extending along the length of bone. Pamidronate as well asanalgesic were given to the patient. Physiotherepy started for the deformity. Conclusion: Routine laboratory findings usually are normal. The exact cause remain unclear. There is no definite treatment available for this disease. Only symptomatic treatment improve the condition of the patients, more fruitful result obtain with pamidronate and physiotherapy. PMID:27298954

Biomedical laboratory science education: standardising teaching content in resource-limited countries.

PubMed

Arneson, Wendy; Robinson, Cathy; Nyary, Bryan

2013-01-01

There is a worldwide shortage of qualified laboratory personnel to provide adequate testing for the detection and monitoring of diseases. In an effort to increase laboratory capacity in developing countries, new skills have been introduced into laboratory services. Curriculum revision with a focus on good laboratory practice is an important aspect of supplying entry-level graduates with the competencies needed to meet the current needs. Gaps in application and problem-solving competencies of newly graduated laboratory personnel were discovered in Ethiopia, Tanzania and Kenya. New medical laboratory teaching content was developed in Ethiopia, Tanzania and Kenya using national instructors, tutors, and experts and consulting medical laboratory educators from the United States of America (USA). Workshops were held in Ethiopia to create standardised biomedical laboratory science (BMLS) lessons based on recently-revised course objectives with an emphasis on application of skills. In Tanzania, course-module teaching guides with objectives were developed based on established competency outcomes and tasks. In Kenya, example interactive presentations and lesson plans were developed by the USA medical laboratory educators prior to the workshop to serve as resources and templates for the development of lessons within the country itself. The new teaching materials were implemented and faculty, students and other stakeholders reported successful outcomes. These approaches to updating curricula may be helpful as biomedical laboratory schools in other countries address gaps in the competencies of entry-level graduates.

Towards a standardised approach for evaluating guidelines and guidance documents on palliative sedation: study protocol

PubMed Central

2014-01-01

Background Sedation in palliative care has received growing attention in recent years; and so have guidelines, position statements, and related literature that provide recommendations for its practice. Yet little is known collectively about the content, scope and methodological quality of these materials. According to research, there are large variations in palliative sedation practice, depending on the definition and methodology used. However, a standardised approach to comparing and contrasting related documents, across countries, associations and governmental bodies is lacking. This paper reports on a protocol designed to enable thorough and systematic comparison of guidelines and guidance documents on palliative sedation. Methods and design A multidisciplinary and international group of palliative care researchers, identified themes and clinical issues on palliative sedation based on expert consultations and evidence drawn from the EAPC (European Association of Palliative Care) framework for palliative sedation and AGREE II (Appraisal Guideline Research and Evaluation) instrument for guideline assessment. The most relevant themes were selected and built into a comprehensive checklist. This was tested on people working closely with practitioners and patients, for user-friendliness and comprehensibility, and modified where necessary. Next, a systematic search was conducted for guidelines in English, Dutch, Flemish, or Italian. The search was performed in multiple databases (PubMed, CancerLit, CNAHL, Cochrane Library, NHS Evidence and Google Scholar), and via other Internet resources. Hereafter, the final version of the checklist will be used to extract data from selected literature, and the same will be compiled, entered into SPSS, cleaned and analysed systematically for publication. Discussion We have together developed a comprehensive checklist in a scientifically rigorous manner to allow standardised and systematic comparison. The protocol is applicable to all

Towards a standardised approach for evaluating guidelines and guidance documents on palliative sedation: study protocol.

PubMed

Abarshi, Ebun; Rietjens, Judith; Caraceni, Augusto; Payne, Sheila; Deliens, Luc; Van Den Block, Lieve

2014-01-01

Sedation in palliative care has received growing attention in recent years; and so have guidelines, position statements, and related literature that provide recommendations for its practice. Yet little is known collectively about the content, scope and methodological quality of these materials. According to research, there are large variations in palliative sedation practice, depending on the definition and methodology used. However, a standardised approach to comparing and contrasting related documents, across countries, associations and governmental bodies is lacking. This paper reports on a protocol designed to enable thorough and systematic comparison of guidelines and guidance documents on palliative sedation. A multidisciplinary and international group of palliative care researchers, identified themes and clinical issues on palliative sedation based on expert consultations and evidence drawn from the EAPC (European Association of Palliative Care) framework for palliative sedation and AGREE II (Appraisal Guideline Research and Evaluation) instrument for guideline assessment. The most relevant themes were selected and built into a comprehensive checklist. This was tested on people working closely with practitioners and patients, for user-friendliness and comprehensibility, and modified where necessary. Next, a systematic search was conducted for guidelines in English, Dutch, Flemish, or Italian. The search was performed in multiple databases (PubMed, CancerLit, CNAHL, Cochrane Library, NHS Evidence and Google Scholar), and via other Internet resources. Hereafter, the final version of the checklist will be used to extract data from selected literature, and the same will be compiled, entered into SPSS, cleaned and analysed systematically for publication. We have together developed a comprehensive checklist in a scientifically rigorous manner to allow standardised and systematic comparison. The protocol is applicable to all guidelines on palliative sedation, and

The FOBIMO (FOraminiferal BIo-MOnitoring) initiative—Towards a standardised protocol for soft-bottom benthic foraminiferal monitoring studies

USGS Publications Warehouse

Schoenfeld, Joachim; Alve, Elisabeth; Geslin, Emmanuelle; Jorissen, Frans; Korsun, Sergei; Spezzaferri, Silva; Abramovich, Sigal; Almogi-Labin, Ahuva; Armynot du Chatelet, Eric; Barras, Christine; Bergamin, Luisa; Bicchi, Erica; Bouchet, Vincent; Cearreta, Alejandro; Di Bella, Letizia; Dijkstra, Noortje; Trevisan Disaro, Sibelle; Ferraro, Luciana; Frontalini, Fabrizio; Gennari, Giordana; Golikova, Elena; Haynert, Kristin; Hess, Silvia; Husum, Katrine; Martins, Virginia; McGann, Mary; Oron, Shai; Romano, Elena; Mello Sousa, Silvia; Tsujimoto, Akira

2012-01-01

The European Community Marine Strategy Framework Directive (MSFD) was established to provide guidelines for monitoring the quality of marine ecosystems. Monitoring the status of marine environments is traditionally based on macrofauna surveys, for which standardised methods have been established. Benthic foraminifera are also good indicators of environmental status because of their fast turnover rates, high degree of specialisation, and the preservation of dead assemblages in the fossil record. In spite of the growing interest in foraminiferal bio-monitoring during the last decades, no standardised methodology has been proposed until today. The aim of the FOraminiferal BIo-MOnitoring (FOBIMO) expert workshop, held in June 2011 at Fribourg, Switzerland, which assembled 37 scientists from 24 research groups and 13 countries, was to develop a suite of standard methods. This paper presents the main outcome of the workshop, a list of motivated recommendations with respect to sampling devices, sample storage, treatment, faunal analysis and documentation. Our recommendations fulfil the criteria imposed both by scientific rigour and by the practical limitations of routine studies. Hence, our aim is to standardise methodologies used in bio-monitoring only and not to limit the use of different methods in pure scientific studies. Unless otherwise stated, all recommendations concern living (stained) benthic foraminiferal assemblages. We have chosen to propose two types of recommendations. Mandatory recommendations have to be followed if a study wants to qualify as sound and compatible to the norms. The most important of these recommendations are the interval from 0 to 1 cm below the sediment surface has to be sampled, and an interface corer or box corer that keeps the sediment surface intact is to be used for offshore surveys. A grab sampler must not be deployed in soft sediments. Three replicate samples are to be taken and analysed separately. Samples are to be washed on a

Extreme Historical Droughts in the South-Eastern Alps — Analyses Based on Standardised Precipitation Index

NASA Astrophysics Data System (ADS)

Brenčič, Mihael

2016-10-01

Droughts are natural phenomena affecting the environment and human activities. There are various drought definitions and quantitative indices; among them is the Standardised Precipitation Index (SPI). In the drought investigations, historical events are poorly characterised and little data are available. To decipher past drought appearances in the southeastern Alps with a focus on Slovenia, precipitation data from HISTALP data repository were taken to identify extreme drought events (SPI ≤ -2.00) from the second half of the 19th century to the present day. Several long-term extreme drought crises were identified in the region (between the years 1888 and 1896; after World War I, during and after World War II). After 1968, drought patterns detected with SPI changed: shorter, extreme droughts with different time patterns appeared. SPI indices of different time spans showed correlated structures in space and between each other, indicating structured relations.

[QUIPS: quality improvement in postoperative pain management].

PubMed

Meissner, Winfried

2011-01-01

Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. The QUIPS (Quality Improvement in Postoperative Pain Management) project aims to improve treatment quality by means of standardised data acquisition, analysis of quality and process indicators, and feedback and benchmarking. During a pilot phase funded by the German Ministry of Health (BMG), a total of 12,389 data sets were collected from six participating hospitals. Outcome improved in four of the six hospitals. Process indicators, such as routine pain documentation, were only poorly correlated with outcomes. To date, more than 130 German hospitals use QUIPS as a routine quality management tool. An EC-funded parallel project disseminates the concept internationally. QUIPS demonstrates that patient-reported outcomes in postoperative pain management can be benchmarked in routine clinical practice. Quality improvement initiatives should use outcome instead of structural and process parameters. The concept is transferable to other fields of medicine. Copyright © 2011. Published by Elsevier GmbH.

[Improving patient safety through voluntary peer review].

PubMed

Kluge, S; Bause, H

2015-01-01

The intensive care unit (ICU) is one area of the hospital in which processes and communication are of primary importance. Errors in intensive care units can lead to serious adverse events with significant consequences for patients. Therefore quality and risk-management are important measures when treating critically ill patients. A pragmatic approach to support quality and safety in intensive care is peer review. This approach has gained significant acceptance over the past years. It consists of mutual visits by colleagues who conduct standardised peer reviews. These reviews focus on the systematic evaluation of the quality of an ICU's structure, its processes and outcome. Together with different associations, the State Chambers of Physicians and the German Medical Association have developed peer review as a standardized tool for quality improvement. The common goal of all stakeholders is the continuous and sustainable improvement in intensive care with peer reviews significantly increasing and improving communication between professions and disciplines. Peer reviews secure the sustainability of planned change processes and consequently lead the way to an improved culture of quality and safety.

Rainfall characterisation by application of standardised precipitation index (SPI) in Peninsular Malaysia

NASA Astrophysics Data System (ADS)

Yusof, Fadhilah; Hui-Mean, Foo; Suhaila, Jamaludin; Yusop, Zulkifli; Ching-Yee, Kong

2014-02-01

The interpretations of trend behaviour for dry and wet events are analysed in order to verify the dryness and wetness episodes. The fitting distribution of rainfall is computed to classify the dry and wet events by applying the standardised precipitation index (SPI). The rainfall amount for each station is categorised into seven categories, namely extremely wet, severely wet, moderately wet, near normal, moderately dry, severely dry and extremely dry. The computation of the SPI is based on the monsoon periods, which include the northeast monsoon, southwest monsoon and inter-monsoon. The trends of the dry and wet periods were then detected using the Mann-Kendall trend test and the results indicate that the major parts of Peninsular Malaysia are characterised by increasing droughts rather than wet events. The annual trends of drought and wet events of the randomly selected stations from each region also yield similar results. Hence, the northwest and southwest regions are predicted to have a higher probability of drought occurrence during a dry event and not much rain during the wet event. The east and west regions, on the other hand, are going through a significant upward trend that implies lower rainfall during the drought episodes and heavy rainfall during the wet events.

Factors associated with early outcomes following standardised therapy in children with ulcerative colitis (PROTECT): a multicentre inception cohort study.

PubMed

Hyams, Jeffrey S; Davis, Sonia; Mack, David R; Boyle, Brendan; Griffiths, Anne M; LeLeiko, Neal S; Sauer, Cary G; Keljo, David J; Markowitz, James; Baker, Susan S; Rosh, Joel; Baldassano, Robert N; Patel, Ashish; Pfefferkorn, Marian; Otley, Anthony; Heyman, Melvin; Noe, Joshua; Oliva-Hemker, Maria; Rufo, Paul; Strople, Jennifer; Ziring, David; Guthery, Stephen L; Sudel, Boris; Benkov, Keith; Wali, Prateek; Moulton, Dedrick; Evans, Jonathan; Kappelman, Michael D; Marquis, Alison; Sylvester, Francisco A; Collins, Margaret H; Venkateswaran, Suresh; Dubinsky, Marla; Tangpricha, Vin; Spada, Krista L; Britt, Ashley; Saul, Bradley; Gotman, Nathan; Wang, Jessie; Serrano, Jose; Kugathasan, Subra; Walters, Thomas; Denson, Lee A

2017-12-01

oral corticosteroid group, and 30 (21%) in the intravenous corticosteroid group (p<0·0001). Treatment escalation was required by nine (7%) patients in the mesalazine group, 21 (15%) in the oral corticosteroid group, and 52 (36%) in the intravenous corticosteroid group (p<0·0001). Eight patients, all of whom were initially treated with intravenous corticosteroids, underwent colectomy. Predictors of week 12 corticosteroid-free remission were baseline PUCAI less than 35 (odds ratio 2·44, 95% CI 1·41-4·22; p=0·0015), higher baseline albumin by 1 g/dL increments among children younger than 12 years (4·05, 1·90-8·64; p=0·00030), and week 4 remission (6·26, 3·79-10·35; p<0·0001). Predictors of treatment escalation by week 12 in patients initially treated with intravenous corticosteroids included baseline total Mayo score of 11 or higher (2·59, 0·93-7·21; p=0·068 [retained in model due to clinical relevance]), rectal biopsy eosinophil count less than or equal to 32 cells per high power field (4·55, 1·62-12·78; p=0·0040), rectal biopsy surface villiform changes (3·05, 1·09-8·56; p=0·034), and not achieving week 4 remission (30·28, 6·36-144·20; p<0·0001). Our findings provide guidelines to assess the response of children newly diagnosed with ulcerative colitis to standardised initial therapy and identify predictors of treatment response and failure. These data suggest that additional therapeutic interventions might be warranted to improve early outcomes, especially in patients presenting with severe disease and requiring intravenous corticosteroids. National Institutes of Health. Copyright © 2017 Elsevier Ltd. All rights reserved.

A win for the patient: Direct patient notification improves treatment rates of active Helicobacter pylori infection.

PubMed

Selvaratnam, Sriharan; Yeoh, Joey; Hsiang, John; Patrick, Alasdair B

2014-01-01

Current international guidelines recommend the commencement of effective eradication therapy as soon as active Helicobacter pylori (H. pylori) infection is confirmed. At our institution, all positive Campylobacter-like Organism (CLO) test results were automatically communicated to general practitioners (GPs) via a standardised letter, which also advised the commencement of eradication therapy. Despite this endeavour, a clinical audit conducted in 2011 demonstrated that only 66 per cent of confirmed H. pylori-positive South Auckland patients received eradication treatment and only 83 per cent of these patients received treatment within one month. Improve the timely initiation of H. pylori eradication therapy through direct patient notification. A prospective clinical audit of 109 consecutive outpatients with a positive CLO test identified at gastroscopy. In addition to standard general practitioner notification, patients were also directly notified of their positive CLO test result via a standardised letter, which provided information about H. pylori and its disease associations as well as advising patients to seek consultation with their GP to commence eradication therapy. Dispensing data was examined using Test Safe electronic records to determine the total uptake and timing of treatment compared to data from a preliminary 2011 audit. Ninety-five per cent of H. pylori-positive patients received standard triple therapy; therefore, treatment of active H. pylori infection was significantly higher when patients were directly notified in addition to standard GP notification, when compared to GP notification alone (95 per cent vs 66 per cent, p<0.001). All patients who received eradication therapy did so within one month of notification, a significant improvement compared to data from the previous audit in 2011 (100 per cent vs. 83 per cent, p<0.001). Direct patient notification using a standardised letter is a simple and economical strategy that significantly improves

The effect of a standardised source of divided attention in airway management: A randomised, crossover, interventional manikin study.

PubMed

Prottengeier, Johannes; Petzoldt, Marlen; Jess, Nikola; Moritz, Andreas; Gall, Christine; Schmidt, Joachim; Breuer, Georg

2016-03-01

Dual-tasking, the need to divide attention between concurrent tasks, causes a severe increase in workload in emergency situations and yet there is no standardised training simulation scenario for this key difficulty. We introduced and validated a quantifiable source of divided attention and investigated its effects on performance and workload in airway management. A randomised, crossover, interventional simulation study. Center for Training and Simulation, Department of Anaesthesiology, Erlangen University Hospital, Germany. One hundred and fifty volunteer medical students, paramedics and anaesthesiologists of all levels of training. Participants secured the airway of a manikin using a supraglottic airway, conventional endotracheal intubation and video-assisted endotracheal intubation with and without the Paced Auditory Serial Addition Test (PASAT), which served as a quantifiable source of divided attention. Primary endpoint was the time for the completion of each airway task. Secondary endpoints were the number of procedural mistakes made and the perceived workload as measured by the National Aeronautics and Space Administration's task load index (NASA-TLX). This is a six-dimensional questionnaire, which assesses the perception of demands, performance and frustration with respect to a task on a scale of 0 to 100. All 150 participants completed the tests. Volunteers perceived our test to be challenging (99%) and the experience of stress and distraction true to an emergency situation (80%), but still fair (98%) and entertaining (95%). The negative effects of divided attention were reproducible in participants of all levels of expertise. Time consumption and perceived workload increased and almost half the participants make procedural mistakes under divided attention. The supraglottic airway technique was least affected by divided attention. The scenario was effective for simulation training involving divided attention in acute care medicine. The significant effects

46 CFR 160.066-9 - Labeling.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...: (1) The manufacturer's name, (2) The designed burning time of the pyrotechnic candle(s), (3) The...

46 CFR 160.066-9 - Labeling.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...: (1) The manufacturer's name, (2) The designed burning time of the pyrotechnic candle(s), (3) The...

Comparison of standardised dietary folate intake across ten countries participating in the European Prospective Investigation into Cancer and Nutrition.

PubMed

Park, Jin Young; Nicolas, Genevieve; Freisling, Heinz; Biessy, Carine; Scalbert, Augustin; Romieu, Isabelle; Chajès, Véronique; Chuang, Shu-Chun; Ericson, Ulrika; Wallström, Peter; Ros, Martine M; Peeters, Petra H M; Mattiello, Amalia; Palli, Domenico; María Huerta, José; Amiano, Pilar; Halkjær, Jytte; Dahm, Christina C; Trichopoulou, Antonia; Orfanos, Philippos; Teucher, Birgit; Feller, Silke; Skeie, Guri; Engeset, Dagrun; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Crowe, Francesca; Khaw, Kay-Tee; Vineis, Paolo; Slimani, Nadia

2012-08-01

Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbon metabolism. Inadequate folate intake has been linked to adverse health events. However, comparable information on dietary folate intake across European countries has never been reported. The objective of the present study was to describe the dietary folate intake and its food sources in ten countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cross-sectional analysis was conducted in 36 034 participants (aged 35-74 years) who completed a single 24 h dietary recall using a computerised interview software program, EPIC-Soft® (International Agency for Research on Cancer, Lyon). Dietary folate intake was estimated using the standardised EPIC Nutrient DataBase, adjusted for age, energy intake, weight and height and weighted by season and day of recall. Adjusted mean dietary folate intake in most centres ranged from 250 to 350 μg/d in men and 200 to 300 μg/d in women. Folate intake tended to be lower among current smokers and heavier alcohol drinkers and to increase with educational level, especially in women. Supplement users (any types) were likely to report higher dietary folate intake in most centres. Vegetables, cereals and fruits, nuts and seeds were the main contributors to folate intake. Nonetheless, the type and pattern of consumption of these main food items varied across the centres. These first comparisons of standardised dietary folate intakes across different European populations show moderate regional differences (except the UK health conscious group), and variation by sex, educational level, smoking and alcohol-drinking status, and supplement use.

Adapting a standardised international 24 h dietary recall methodology (GloboDiet software) for research and dietary surveillance in Korea.

PubMed

Park, Min Kyung; Park, Jin Young; Nicolas, Geneviève; Paik, Hee Young; Kim, Jeongseon; Slimani, Nadia

2015-06-14

During the past decades, a rapid nutritional transition has been observed along with economic growth in the Republic of Korea. Since this dramatic change in diet has been frequently associated with cancer and other non-communicable diseases, dietary monitoring is essential to understand the association. Benefiting from pre-existing standardised dietary methodologies, the present study aimed to evaluate the feasibility and describe the development of a Korean version of the international computerised 24 h dietary recall method (GloboDiet software) and its complementary tools, developed at the International Agency for Research on Cancer (IARC), WHO. Following established international Standard Operating Procedures and guidelines, about seventy common and country-specific databases on foods, recipes, dietary supplements, quantification methods and coefficients were customised and translated. The main results of the present study highlight the specific adaptations made to adapt the GloboDiet software for research and dietary surveillance in Korea. New (sub-) subgroups were added into the existing common food classification, and new descriptors were added to the facets to classify and describe specific Korean foods. Quantification methods were critically evaluated and adapted considering the foods and food packages available in the Korean market. Furthermore, a picture book of foods/dishes was prepared including new pictures and food portion sizes relevant to Korean diet. The development of the Korean version of GloboDiet demonstrated that it was possible to adapt the IARC-WHO international dietary tool to an Asian context without compromising its concept of standardisation and software structure. It, thus, confirms that this international dietary methodology, used so far only in Europe, is flexible and robust enough to be customised for other regions worldwide.

Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer's disease (GuidAge): a randomised placebo-controlled trial.

PubMed

Vellas, Bruno; Coley, Nicola; Ousset, Pierre-Jean; Berrut, Gilles; Dartigues, Jean-François; Dubois, Bruno; Grandjean, Hélène; Pasquier, Florence; Piette, François; Robert, Philippe; Touchon, Jacques; Garnier, Philippe; Mathiex-Fortunet, Hélène; Andrieu, Sandrine

2012-10-01

Prevention strategies are urgently needed to tackle the growing burden of Alzheimer's disease. We aimed to assess efficacy of long-term use of standardised ginkgo biloba extract for the reduction of incidence of Alzheimer's disease in elderly adults with memory complaints. In the randomised, parallel-group, double-blind, placebo-controlled GuidAge clinical trial, we enrolled adults aged 70 years or older who spontaneously reported memory complaints to their primary-care physician in France. We randomly allocated participants in a 1:1 ratio according to a computer-generated sequence to a twice per day dose of 120 mg standardised ginkgo biloba extract (EGb761) or matched placebo. Participants and study investigators and personnel were masked to study group assignment. Participants were followed-up for 5 years by primary-care physicians and in expert memory centres. The primary outcome was conversion to probable Alzheimer's disease in participants who received at least one dose of study drug or placebo, compared by use of the log-rank test. This study is registered with ClinicalTrials.gov, number NCT00276510. Between March, 2002, and November, 2004, we enrolled and randomly allocated 2854 participants, of whom 1406 received at least one dose of ginkgo biloba extract and 1414 received at least one dose of placebo. By 5 years, 61 participants in the ginkgo group had been diagnosed with probable Alzheimer's disease (1·2 cases per 100 person-years) compared with 73 participants in the placebo group (1·4 cases per 100 person-years; hazard ratio [HR] 0·84, 95% CI 0·60-1·18; p=0·306), but the risk was not proportional over time. Incidence of adverse events was much the same between groups. 76 participants in the ginkgo group died compared with 82 participants in the placebo group (0·94, 0·69-1·28; p=0·68). 65 participants in the ginkgo group had a stroke compared with 60 participants in the placebo group (risk ratio 1·12, 95% CI 0·77-1·63; p=0·57). Incidence of

Biomedical laboratory science education: standardising teaching content in resource-limited countries

PubMed Central

Robinson, Cathy; Nyary, Bryan

2013-01-01

Background There is a worldwide shortage of qualified laboratory personnel to provide adequate testing for the detection and monitoring of diseases. In an effort to increase laboratory capacity in developing countries, new skills have been introduced into laboratory services. Curriculum revision with a focus on good laboratory practice is an important aspect of supplying entry-level graduates with the competencies needed to meet the current needs. Objectives Gaps in application and problem-solving competencies of newly graduated laboratory personnel were discovered in Ethiopia, Tanzania and Kenya. New medical laboratory teaching content was developed in Ethiopia, Tanzania and Kenya using national instructors, tutors, and experts and consulting medical laboratory educators from the United States of America (USA). Method Workshops were held in Ethiopia to create standardised biomedical laboratory science (BMLS) lessons based on recently-revised course objectives with an emphasis on application of skills. In Tanzania, course-module teaching guides with objectives were developed based on established competency outcomes and tasks. In Kenya, example interactive presentations and lesson plans were developed by the USA medical laboratory educators prior to the workshop to serve as resources and templates for the development of lessons within the country itself. Results The new teaching materials were implemented and faculty, students and other stakeholders reported successful outcomes. Conclusions These approaches to updating curricula may be helpful as biomedical laboratory schools in other countries address gaps in the competencies of entry-level graduates. PMID:29043162

Childproofing

MedlinePlus

... better safety Burns: Replace traditional flame candles with battery-operated candles. Use knob covers on stoves. Turn ... carbon monoxide detectors throughout your home. Change the batteries twice a year when you change your smoke ...

Towards a Global Understanding and Standardisation of Education and Training in Microsurgery

PubMed Central

Leung, Clement Chi Ming; Tos, Pierluigi; Ionac, Mihai; Froschauer, Stefan; Myers, Simon R

2013-01-01

With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid), and EMBASE (Ovid) searches, and from information available on the Internet of up to six established microsurgery course from each of the six continents of the World. Fellowships and courses that concentrate on flap harvesting rather than microsurgical techniques were excluded. We identified 27 centres offering 39 courses. Total course length ranged from 20 hours to 1,950 hours. Student-to-teacher ratios ranged from 2:1 to 8:1. Only two-thirds of courses offered in-vivo animal models. Instructions in microvascular end-to-end and end-to-side anastomoses were common, but peripheral nerve repair or free groin flap transfer were not consistently offered. Methods of assessment ranged from no formal assessment, where an instructor monitored and gave instant feedback, through immediate assessment of patency and critique on quality of repair, to delayed re-assessment of patency after a 12 to 24 hours period. Globally, training in microsurgery is heterogeneous, with variations primarily due to resource and regulation of animal experimentation. Despite some merit to diversity in curricula, there should be a global minimum standard for microsurgery training. PMID:23898423

41 CFR 102-74.180 - What illumination levels must Federal agencies maintain on Federal facilities?

Code of Federal Regulations, 2011 CFR

2011-01-01

... middle of corridors and stairwells as measured at the walking surface, 1 foot-candle at the middle of corridors and stairwells as measured at the walking surface, and 10 foot-candles in storage areas); and (d...

41 CFR 102-74.180 - What illumination levels must Federal agencies maintain on Federal facilities?

Code of Federal Regulations, 2013 CFR

2013-07-01

... middle of corridors and stairwells as measured at the walking surface, 1 foot-candle at the middle of corridors and stairwells as measured at the walking surface, and 10 foot-candles in storage areas); and (d...

41 CFR 102-74.180 - What illumination levels must Federal agencies maintain on Federal facilities?

Code of Federal Regulations, 2014 CFR

2014-01-01

... middle of corridors and stairwells as measured at the walking surface, 1 foot-candle at the middle of corridors and stairwells as measured at the walking surface, and 10 foot-candles in storage areas); and (d...

41 CFR 102-74.180 - What illumination levels must Federal agencies maintain on Federal facilities?

Code of Federal Regulations, 2012 CFR

2012-01-01

... middle of corridors and stairwells as measured at the walking surface, 1 foot-candle at the middle of corridors and stairwells as measured at the walking surface, and 10 foot-candles in storage areas); and (d...

Standardised anatomical alignment of the head in a clinical photography studio. A comparison between the Frankfort Horizontal and the natural head position.

PubMed

Capon, Thomas

The Frankfort Horizontal (FH) is used by clinical photographers as a reference plane to help maintain Standardised Representational Photography (SRP) when photographing a patients head. A comparative method of alignment is the Natural Head Position (NHP). For this study a survey was created that asked consultants and clinical photographers which method of alignment they considered to be the most effective. The survey found that 77% of respondents thought the FH was the most effective method of alignment. This high figure is due to some confirmation bias as the FH is the industry standard.

Standardised outcomes in nephrology - Haemodialysis (SONG-HD): study protocol for establishing a core outcome set in haemodialysis.

PubMed

Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C; Tugwell, Peter; Winkelmayer, Wolfgang C; van Biesen, Wim; Crowe, Sally; Kerr, Peter G; Polkinghorne, Kevan R; Howard, Kirsten; Pollock, Carol; Hawley, Carmel M; Johnson, David W; McDonald, Stephen P; Gallagher, Martin P; Urquhart-Secord, Rachel; Craig, Jonathan C

2015-08-19

Chronic kidney disease is a significant contributor to mortality and morbidity worldwide, and the number of people who require dialysis or transplantation continues to increase. People on dialysis are 15 times more likely to die than the general population. Dialysis is also costly, intrusive, and time-consuming and imposes an enormous burden on patients and their families. This escalating problem has spurred a proliferation of trials in dialysis, yet health and quality of life remain poor. The reasons for this are complex and varied but are attributable in part to problems in the design and reporting of studies, particularly outcome selection. Problems related to outcomes include use of unvalidated surrogates, outcomes of little or no relevance to patients, highly variable outcome selection limiting comparability across studies, and bias in reporting outcomes. The aim of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) study is to establish a core outcome set for haemodialysis trials, to improve the quality of reporting, and the relevance of trials conducted in people on haemodialysis. SONG-HD is a five-phase project that includes the following: a systematic review to identify outcomes that have been reported in haemodialysis systematic reviews and trials; nominal group technique with patients and caregivers to identify, rank, and describe reasons for their choices; qualitative stakeholder interviews with patients, caregivers, clinicians, researchers, and policy makers to elicit individual values and perspectives on outcomes for haemodialysis trials; a three-round Delphi survey with stakeholder groups to distil and generate a prioritised list of core outcomes; and a consensus workshop to establish a core outcome set for haemodialysis trials. Establishing a core outcome set to be consistently measured and reported in haemodialysis trials will improve the integrity, transparency, usability, and contribution of research relevant to patients requiring

Effects of a standardised extract of Trifolium pratense (Promensil) at a dosage of 80mg in the treatment of menopausal hot flushes: A systematic review and meta-analysis.

PubMed

Myers, S P; Vigar, V

2017-01-15

To critically assess the evidence for a specific standardised extract of Trifolium pratense isoflavones (Promensil) at a dosage of 80mg/day in the treatment of menopausal hot flushes. Systematic literature searches were performed in Medline, Scopus, CINAHL Plus, Cochrane, AMED and InforRMIT and citations obtained from 1996 to March 2016. Reference lists were checked; corresponding authors contacted and the grey literature searched for additional publications. Studies were selected according to predefined inclusion and exclusion criteria. All randomised clinical trials of a specific standardised extract of Trifolium pratense isoflavones (Promensil) used as a mono-component at 80mg/day and measuring vasomotor symptoms were included. The data extraction and quality assessment were performed independently by one reviewer and validated by a second with any disagreements being settled by discussion. Weighted mean differences and 95% confidence intervals were calculated for continuous data using the fixed-effects model. Twenty potentially relevant papers were identified, with only five studies meeting the inclusion criteria. The meta-analysis demonstrated a statistical and clinically relevant reduction in hot flush frequency in the active treatment group compared to placebo. Weighted mean difference 3.63 hot flushes per day: [95% CI 2.70-4.56]; p˂0.00001). Due to a lack of homogeneity a priori defined sub-group analyses were performed demonstrating a substantive difference between cross-over and parallel-arm clinical trial designs. There is evidence for a statistical and clinically significant benefit for using a specific standardised extract of red clover isoflavones (Promensil) at 80mg/day for treating hot flushes in menopausal women across the 3 studies included in the meta-analysis. The preparation was safe over the short-term duration of the studies (3 months). Copyright © 2016 The Authors. Published by Elsevier GmbH.. All rights reserved.

Research needs for an improved primary care response to chronic non-communicable diseases in Africa.

PubMed

Maher, D; Sekajugo, J; Harries, A D; Grosskurth, H

2010-02-01

With non-communicable diseases (NCDs) projected to become leading causes of morbidity and mortality in developing countries, research is needed to improve the primary care response, especially in sub-Saharan Africa. This region has a particularly high double burden of communicable diseases and NCDs and the least resources for an effective response. There is a lack of good quality epidemiological data from diverse settings on chronic NCD burden in sub-Saharan Africa, and the approach to primary care of people with chronic NCDs is currently often unstructured. The main primary care research needs are therefore firstly, epidemiological research to document the burden of chronic NCDs, and secondly, health system research to deliver the structured, programmatic, public health approach that has been proposed for the primary care of people with chronic NCDs. Documentation of the burden and trends of chronic NCDs and associated risk factors in different settings and different population groups is needed to enable health system planning for an improved primary care response. Key research issues in implementing the programmatic framework for an improved primary care response are how to (i) integrate screening and prevention within health delivery; (ii) validate the use of standard diagnostic protocols for NCD case-finding among patients presenting to the local health facilities; (iii) improve the procurement and provision of standardised treatment and (iv) develop and implement a data collection system for standardised monitoring and evaluation of patient outcomes. Important research considerations include the following: selection of research sites and the particular NCDs targeted; research methodology; local research capacity; research collaborations; ethical issues; translating research findings into policy and practice and funding. Meeting the research needs for an improved health system response is crucial to deliver effective, affordable and equitable care for the

Scale-dependent effect sizes of ecological drivers on biodiversity: why standardised sampling is not enough.

PubMed

Chase, Jonathan M; Knight, Tiffany M

2013-05-01

There is little consensus about how natural (e.g. productivity, disturbance) and anthropogenic (e.g. invasive species, habitat destruction) ecological drivers influence biodiversity. Here, we show that when sampling is standardised by area (species density) or individuals (rarefied species richness), the measured effect sizes depend critically on the spatial grain and extent of sampling, as well as the size of the species pool. This compromises comparisons of effects sizes within studies using standard statistics, as well as among studies using meta-analysis. To derive an unambiguous effect size, we advocate that comparisons need to be made on a scale-independent metric, such as Hurlbert's Probability of Interspecific Encounter. Analyses of this metric can be used to disentangle the relative influence of changes in the absolute and relative abundances of individuals, as well as their intraspecific aggregations, in driving differences in biodiversity among communities. This and related approaches are necessary to achieve generality in understanding how biodiversity responds to ecological drivers and will necessitate a change in the way many ecologists collect and analyse their data. © 2013 John Wiley & Sons Ltd/CNRS.

Adapting High-Resolution Respirometry to Glucose-Limited Steady State Mycelium of the Filamentous Fungus Penicillium ochrochloron: Method Development and Standardisation

PubMed Central

Schinagl, Christoph W.; Vrabl, Pamela; Burgstaller, Wolfgang

2016-01-01

Fungal electron transport systems (ETS) are branched, involving alternative NADH dehydrogenases and an alternative terminal oxidase. These alternative respiratory enzymes were reported to play a role in pathogenesis, production of antibiotics and excretion of organic acids. The activity of these alternative respiratory enzymes strongly depends on environmental conditions. Functional analysis of fungal ETS under highly standardised conditions for cultivation, sample processing and respirometric assay are still lacking. We developed a highly standardised protocol to explore in vivo the ETS—and in particular the alternative oxidase—in Penicillium ochrochloron. This included cultivation in glucose-limited chemostat (to achieve a defined and reproducible physiological state), direct transfer without any manipulation of a broth sample to the respirometer (to maintain the physiological state in the respirometer as close as possible to that in the chemostat), and high-resolution respirometry (small sample volume and high measuring accuracy). This protocol was aimed at avoiding any changes in the physiological phenotype due to the high phenotypic plasticity of filamentous fungi. A stable oxygen consumption (< 5% change in 20 minutes) was only possible with glucose limited chemostat mycelium and a direct transfer of a broth sample into the respirometer. Steady state respiration was 29% below its maximum respiratory capacity. Additionally to a rotenone-sensitive complex I and most probably a functioning complex III, the ETS of P. ochrochloron also contained a cyanide-sensitive terminal oxidase (complex IV). Activity of alternative oxidase was present constitutively. The degree of inhibition strongly depended on the sequence of inhibitor addition. This suggested, as postulated for plants, that the alternative terminal oxidase was in dynamic equilibrium with complex IV—independent of the rate of electron flux. This means that the onset of activity does not depend on a

"It is not just about the alcohol": service users' views about individualised and standardised clinical assessment in a therapeutic community for alcohol dependence.

PubMed

Alves, Paula Cristina Gomes; Sales, Célia Maria Dias; Ashworth, Mark

2016-07-19

The involvement of service users in health care provision in general, and specifically in substance use disorder treatment, is of growing importance. This paper explores the views of patients in a therapeutic community for alcohol dependence about clinical assessment, including general aspects about the evaluation process, and the specific characteristics of four measures: two individualised and two standardised. A focus group was conducted and data were analysed using a framework synthesis approach. Service users welcomed the experience of clinical assessment, particularly when conducted by therapists. The duration of the evaluation process was seen as satisfactory and most of its contents were regarded as relevant for their population. Regarding the evaluation measures, patients diverged in their preferences for delivery formats (self-report vs. interview). Service users enjoyed the freedom given by individualised measures to discuss topics of their own choosing. However, they felt that part of the standardised questions were difficult to answer, inadequate (e.g. quantification of health status in 0-20 points) and sensitive (e.g. suicide-related issues), particularly for pre-treatment assessments. Patients perceived clinical assessment as helpful for their therapeutic journey, including the opportunity to reflect about their problems, either related or unrelated to alcohol use. Our study suggests that patients prefer to have evaluation protocols administered by therapists, and that measures should ideally be flexible in their formats to accommodate for patient preferences and needs during the evaluation.

Hypothyroidism in patients treated with radiotherapy for head and neck carcinoma: standardised long-term follow-up study.

PubMed

Alba, J R; Basterra, J; Ferrer, J C; Santonja, F; Zapater, E

2016-05-01

Hypothyroidism is a common complication when radiotherapy is part of the treatment for head and neck tumours. This study aimed to show the incidence of hypothyroidism and possible risk factors in these patients. Factors related to the population, tumour, treatment and occurrence of hypothyroidism were analysed in 241 patients diagnosed with head and neck carcinoma. Approximately 53 per cent of patients were diagnosed with radiation-induced hypothyroidism. Its occurrence was related to: tumour location, laryngeal surgery type, neck dissection type, post-operative complications, cervical radiotherapy and radiotherapy unit type (linear particle accelerator or telecobalt therapy technology). Control of thyroid function should be standardised for several years after treatment, particularly in patients with risk factors, such as those treated with telecobalt therapy, those with post-operative complications and for whom the thyroid parenchyma is included in the irradiated area (laryngeal or pharyngeal location and bilateral cervical radiation).

Assessment of psychosocial problems in children with type 1 diabetes and their families: the added value of using standardised questionnaires in addition to clinical estimations of nurses and paediatricians.

PubMed

Boogerd, Emiel A; Damhuis, Anouk M A; van Alfen-van der Velden, Janiëlle A A E m; Steeghs, Marley C C H; Noordam, Cees; Verhaak, Chris M; Vermaes, Ignace P R

2015-08-01

To investigate the assessment of psychosocial problems in children with type 1 diabetes by means of clinical estimations made by nurses and paediatricians and by using standardised questionnaires. Although children with type 1 diabetes and their parents show increased risk for psychosocial problems, standardised assessment of these problems lacks in diabetes care. By comparing these different modes of assessment, using a cross-sectional design, information about the additional value of using standardised questionnaires is provided. Participants were 110 children with type 1 diabetes (aged 4-16), their parents, and healthcare professionals. Children filled out the Strengths and Difficulties Questionnaire and the Paediatric Quality of Life Inventory, Diabetes Module. Parents filled out the Strengths and Difficulties Questionnaire parent-report and the Parenting Stress Index. Independently, nurses and paediatricians filled out a short questionnaire, which assessed their clinical estimations of the children's psychosocial problems and quality of life, and parents' levels of parenting stress. Reports of children and parents were compared to clinical estimations. Children in our sample showed more psychosocial problems and lower health-related quality of life than their healthy peers. In approximately half of the children, dichotomous estimations by healthcare professionals and dichotomised reports by patients and parents were in agreement. In 10% of the children, no psychosocial problems were present according to professionals' estimations, although patients and parents-reported psychosocial problems. In 40%, psychosocial problems were present according to professionals' estimations, although parents and patients did not report psychosocial problems. Children with type 1 diabetes show more psychosocial problems than healthy children. Professionals seem to tend towards overestimating psychosocial problems. Extending the assessment of psychosocial problems with routine

Do low-cost ceramic water filters improve water security in rural South Africa?

NASA Astrophysics Data System (ADS)

Lange, Jens; Materne, Tineke; Grüner, Jörg

2016-10-01

This study examined the performance of a low-cost ceramic candle filter system (CCFS) for point of use (POU) drinking water treatment in the village of Hobeni, Eastern Cape Province, South Africa. CCFSs were distributed in Hobeni and a survey was carried out among their users. The performance of 51 CCFSs was evaluated by dip slides and related to human factors. Already after two-thirds of their specified lifetime, none of the distributed CCFSs produced water without distinct contamination, and more than one-third even deteriorated in hygienic water quality. Besides the water source (springs were preferable compared to river or rain water), a high water throughput was the dominant reason for poor CCFS performance. A stepwise laboratory test documented the negative effects of repeated loading and ambient field temperatures. These findings suggest that not every CCFS type per se guarantees improved drinking water security and that the efficiency of low-cost systems should continuously be monitored. For this purpose, dip slides were found to be a cost-efficient alternative to standard laboratory tests. They consistently underestimated microbial counts but can be used by laypersons and hence by the users themselves to assess critical contamination of their filter systems.

Understanding the Haugh Unit.

USDA-ARS?s Scientific Manuscript database

Objectively determining interior egg quality in a fast, efficient manner is difficult. Candling is most often utilized as a quick method for non-destructive assessment of egg quality, but is highly subjective. As you have experienced this week when candling, it is almost impossible for multiple pe...

Using 1H and 13C NMR chemical shifts to determine cyclic peptide conformations: a combined molecular dynamics and quantum mechanics approach.

PubMed

Nguyen, Q Nhu N; Schwochert, Joshua; Tantillo, Dean J; Lokey, R Scott

2018-05-10

Solving conformations of cyclic peptides can provide insight into structure-activity and structure-property relationships, which can help in the design of compounds with improved bioactivity and/or ADME characteristics. The most common approaches for determining the structures of cyclic peptides are based on NMR-derived distance restraints obtained from NOESY or ROESY cross-peak intensities, and 3J-based dihedral restraints using the Karplus relationship. Unfortunately, these observables are often too weak, sparse, or degenerate to provide unequivocal, high-confidence solution structures, prompting us to investigate an alternative approach that relies only on 1H and 13C chemical shifts as experimental observables. This method, which we call conformational analysis from NMR and density-functional prediction of low-energy ensembles (CANDLE), uses molecular dynamics (MD) simulations to generate conformer families and density functional theory (DFT) calculations to predict their 1H and 13C chemical shifts. Iterative conformer searches and DFT energy calculations on a cyclic peptide-peptoid hybrid yielded Boltzmann ensembles whose predicted chemical shifts matched the experimental values better than any single conformer. For these compounds, CANDLE outperformed the classic NOE- and 3J-coupling-based approach by disambiguating similar β-turn types and also enabled the structural elucidation of the minor conformer. Through the use of chemical shifts, in conjunction with DFT and MD calculations, CANDLE can help illuminate conformational ensembles of cyclic peptides in solution.

The relevance, biases, and importance of digitising opportunistic non-standardised collections: A case study in Iberian harvestmen fauna with BOS Arthropod Collection datasets (Arachnida, Opiliones).

PubMed

Merino-Sáinz, Izaskun; Torralba-Burrial, Antonio; Anadón, Araceli

2014-01-01

In this study, we analyse the relevance of harvestmen distribution data derived from opportunistic, unplanned, and non-standardised collection events in an area in the north of the Iberian Peninsula. Using specimens deposited in the BOS Arthropod Collection at the University of Oviedo, we compared these data with data from planned, standardised, and periodic collections with pitfall traps in several locations in the same area. The Arthropod Collection, begun in 1977, includes specimens derived from both sampling types, and its recent digitisation allows for this type of comparative analysis. Therefore, this is the first data-paper employing a hybrid approach, wherein subset metadata are described alongside a comparative analysis. The full dataset can be accessed through Spanish GBIF IPT at http://www.gbif.es:8080/ipt/archive.do?r=Bos-Opi, and the metadata of the unplanned collection events at http://www.gbif.es:8080/ipt/resource.do?r=bos-opi_unplanned_collection_events. We have mapped the data on the 18 harvestmen species included in the unplanned collections and provided records for some species in six provinces for the first time. We have also provided the locations of Phalangium opilio in eight provinces without published records. These results highlight the importance of digitising data from unplanned biodiversity collections, as well as those derived from planned collections, especially in scarcely studied groups and areas.

The relevance, biases, and importance of digitising opportunistic non-standardised collections: A case study in Iberian harvestmen fauna with BOS Arthropod Collection datasets (Arachnida, Opiliones)

PubMed Central

Merino-Sáinz, Izaskun; Torralba-Burrial, Antonio; Anadón, Araceli

2014-01-01

Abstract In this study, we analyse the relevance of harvestmen distribution data derived from opportunistic, unplanned, and non-standardised collection events in an area in the north of the Iberian Peninsula. Using specimens deposited in the BOS Arthropod Collection at the University of Oviedo, we compared these data with data from planned, standardised, and periodic collections with pitfall traps in several locations in the same area. The Arthropod Collection, begun in 1977, includes specimens derived from both sampling types, and its recent digitisation allows for this type of comparative analysis. Therefore, this is the first data-paper employing a hybrid approach, wherein subset metadata are described alongside a comparative analysis. The full dataset can be accessed through Spanish GBIF IPT at http://www.gbif.es:8080/ipt/archive.do?r=Bos-Opi, and the metadata of the unplanned collection events at http://www.gbif.es:8080/ipt/resource.do?r=bos-opi_unplanned_collection_events. We have mapped the data on the 18 harvestmen species included in the unplanned collections and provided records for some species in six provinces for the first time. We have also provided the locations of Phalangium opilio in eight provinces without published records. These results highlight the importance of digitising data from unplanned biodiversity collections, as well as those derived from planned collections, especially in scarcely studied groups and areas. PMID:24843271

46 CFR 160.066-13 - Technical tests.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160... signal, or; (iii) Two or more of the signals fail to project and ignite the pyrotechnic candle. (c) The... in the following manner: (1) Remove the pyrotechnic candle from the remaining three signals. (2...

The development of a standardised diet history tool to support the diagnosis of food allergy.

PubMed

Skypala, Isabel J; Venter, Carina; Meyer, Rosan; deJong, Nicolette W; Fox, Adam T; Groetch, Marion; Oude Elberink, J N; Sprikkelman, Aline; Diamandi, Louiza; Vlieg-Boerstra, Berber J

2015-01-01

The disparity between reported and diagnosed food allergy makes robust diagnosis imperative. The allergy-focussed history is an important starting point, but published literature on its efficacy is sparse. Using a structured approach to connect symptoms, suspected foods and dietary intake, a multi-disciplinary task force of the European Academy of Allergy and Clinical Immunology developed paediatric and adult diet history tools. Both tools are divided into stages using traffic light labelling (red, amber and green). The red stage requires the practitioner to gather relevant information on symptoms, atopic history, food triggers, foods eaten and nutritional issues. The amber stage facilitates interpretation of the responses to the red-stage questions, thus enabling the practitioner to prepare to move forward. The final green stage provides a summary template and test algorithm to support continuation down the diagnostic pathway. These tools will provide a standardised, practical approach to support food allergy diagnosis, ensuring that all relevant information is captured and interpreted in a robust manner. Future work is required to validate their use in diverse age groups, disease entities and in different countries, in order to account for differences in health care systems, food availability and dietary norms.

Components of a standardised olive leaf dry extract (Ph. Eur.) promote hypothiocyanite production by lactoperoxidase.

PubMed

Flemmig, Jörg; Rusch, Dorothea; Czerwińska, Monika Ewa; Rauwald, Hans-Wilhelm; Arnhold, Jürgen

2014-05-01

We investigated in vitro the ability of a standardised olive leaf dry extract (Ph. Eur.) (OLE) as well as of its single components to circumvent the hydrogen peroxide-induced inhibition of the hypothiocyanite-producing activity of lactoperoxidase (LPO). The rate of hypothiocyanite (⁻OSCN) formation by LPO was quantified by spectrophotometric detection of the oxidation of 5-thio-2-nitrobenzoic acid (TNB). By using excess hydrogen peroxide, we forced the accumulation of inactive enzymatic intermediates which are unable to promote the two-electronic oxidation of thiocyanate. Both OLE and certain extract components showed a strong LPO-reactivating effect. Thereby an o-hydroxyphenolic moiety emerged to be essential for a good reactivity with the inactive LPO redox states. This basic moiety is found in the main OLE components oleuropein, oleacein, hydroxytyrosol, caffeic acid as well as in different other constituents including the OLE flavone luteolin. As LPO is a key player in the humoral immune response, these results propose a new mode of action regarding the well-known bacteriostatic and anti-inflammatory properties of the leaf extract of Olea europaea L. Copyright © 2014 Elsevier Inc. All rights reserved.

Geochemical reanalysis of historical U.S. Geological Survey sediment samples from the Inmachuk, Kugruk, Kiwalik, and Koyuk River drainages, Granite Mountain, and the northern Darby Mountains, Bendeleben, Candle, Kotzebue, and Solomon quadrangles, Alaska

USGS Publications Warehouse

Werdon, Melanie B.; Granitto, Matthew; Azain, Jaime S.

2015-01-01

The State of Alaska’s Strategic and Critical Minerals (SCM) Assessment project, a State-funded Capital Improvement Project (CIP), is designed to evaluate Alaska’s statewide potential for SCM resources. The SCM Assessment is being implemented by the Alaska Division of Geological & Geophysical Surveys (DGGS), and involves obtaining new airborne-geophysical, geological, and geochemical data. As part of the SCM Assessment, thousands of historical geochemical samples from DGGS, U.S. Geological Survey (USGS), and U.S. Bureau of Mines archives are being reanalyzed by DGGS using modern, quantitative, geochemical-analytical methods. The objective is to update the statewide geochemical database to more clearly identify areas in Alaska with SCM potential. The USGS is also undertaking SCM-related geologic studies in Alaska through the federally funded Alaska Critical Minerals cooperative project. DGGS and USGS share the goal of evaluating Alaska’s strategic and critical minerals potential and together created a Letter of Agreement (signed December 2012) and a supplementary Technical Assistance Agreement (#14CMTAA143458) to facilitate the two agencies’ cooperative work. Under these agreements, DGGS contracted the USGS in Denver to reanalyze historical USGS sediment samples from Alaska. For this report, DGGS funded reanalysis of 653 historical USGS sediment samples from the statewide Alaska Geochemical Database Version 2.0 (AGDB2; Granitto and others, 2013). Samples were chosen from an area covering portions of the Inmachuk, Kugruk, Kiwalik, and Koyuk river drainages, Granite Mountain, and the northern Darby Mountains, located in the Bendeleben, Candle, Kotzebue, and Solomon quadrangles of eastern Seward Peninsula, Alaska (fig. 1). The USGS was responsible for sample retrieval from the National Geochemical Sample Archive (NGSA) in Denver, Colorado through the final quality assurance/quality control (QA/QC) of the geochemical analyses obtained through the USGS contract

Dietary incorporation of feedstuffs naturally high in organic selenium for racing pigeons (Columba livia): effects on plasma antioxidant markers after a standardised simulation of a flying effort.

PubMed

Schoonheere, N; Dotreppe, O; Pincemail, J; Istasse, L; Hornick, J L

2009-06-01

Selenium is a trace element of importance for animal health. It is essential for adequate functioning of many enzymes such as, the antioxidant enzyme, glutathione peroxidase, which protects the cell against free radicals. A muscular effort induces a rise in reactive oxygen species production which, in turn, can generate an oxidative stress. Two groups of eight racing pigeons were fed respectively with a diet containing 30.3 (control group) and 195.3 (selenium group) microg selenium/kg diet. The pigeons were submitted to a standardised simulation of a flying effort during 2 h. Blood was taken before and after the effort to measure antioxidant markers and blood parameters related to muscle metabolism. Plasma selenium concentration and glutathione peroxidase activity were significantly higher in the selenium group. There were no significant differences for the other measured parameters. As a consequence of the effort, the pigeons of the selenium group showed a higher increase of glutathione peroxidase activity and a smaller increase of plasma lactate concentration. Variations because of the effort in the other markers were not significantly different between the two groups. It is concluded that the selenium status was improved with the feeding of feedstuffs high in Selenium.

Isolated soya protein with standardised levels of isoflavones, cotyledon soya fibres and soya phospholipids improves plasma lipids in hypercholesterolaemia: a double-blind, placebo-controlled trial of a yoghurt formulation.

PubMed

Puska, Pekka; Korpelainen, Vesa; Høie, Lars H; Skovlund, Eva; Smerud, Knut T

2004-03-01

The objective was to study whether a yoghurt containing isolated soya protein with standardised levels of isoflavones, cotyledon soya fibres and soya phospholipids is more effective in lowering total and LDL-cholesterol than a placebo. One hundred and forty-three subjects were randomised to the soya group (n 69) or to the placebo (n 74). The mean baseline levels were 7.6 and 5.1 mmol/l for total and LDL-cholesterol, respectively. Fasting serum lipoproteins were assessed five times during the 8-week intervention period, and 4 weeks thereafter. The results were analysed by a mixed model for unbalanced repeated measurements. During the intervention, there were highly significant differences in lipid-lowering effect in favour of the active soya intervention group compared with the control group. The significant differences were for total cholesterol (estimated mean difference 0.40 mmol/l; P<0.001), LDL-cholesterol (0.39 mmol/l; P<0.001), non-HDL-cholesterol (0.40 mmol/l; P<0.001) and for the total:HDL-cholesterol ratio (0.23; P=0.005). There was no difference in the effects on HDL-cholesterol, triacylglycerols or homocysteine. The lipid-lowering effect occurred within 1-2 weeks of intervention, and was not due to weight loss. The safety profile for active soya was similar to the placebo group, except for gastrointestinal symptoms, which caused a significantly higher dropout rate (fourteen v. three subjects) among the subjects taking active soya.

Using the REACT Strategy to Understand Physical and Chemical Changes

ERIC Educational Resources Information Center

Ültay, Neslihan; Güngören, Seda Çavus; Ültay, Eser

2017-01-01

Students often struggle to determine whether changes in matter are physical or chemical; for example, they may have difficulty labelling a candle melting as a physical change but a candle burning as chemical change. Here we describe a lesson that we used to integrate conceptual learning about physical and chemical changes using the…

A Comprehensive General Chemistry Demonstration

ERIC Educational Resources Information Center

Sweeder, Ryan D.; Jeffery, Kathleen A.

2013-01-01

This article describes the use of a comprehensive demonstration suitable for a high school or first-year undergraduate introductory chemistry class. The demonstration involves placing a burning candle in a container adjacent to a beaker containing a basic solution with indicator. After adding a lid, the candle will extinguish and the produced…

Determination of significance in Ecological Impact Assessment: Past change, current practice and future improvements

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

Briggs, Sam; Hudson, Malcolm D., E-mail: mdh@soton.ac.uk

2013-01-15

Ecological Impact Assessment (EcIA) is an important tool for conservation and achieving sustainable development. 'Significant' impacts are those which disturb or alter the environment to a measurable degree. Significance is a crucial part of EcIA, our understanding of the concept in practice is vital if it is to be effective as a tool. This study employed three methods to assess how the determination of significance has changed through time, what current practice is, and what would lead to future improvements. Three data streams were collected: interviews with expert stakeholders, a review of 30 Environmental Statements and a broad-scale survey ofmore » the United Kingdom Institute of Ecology and Environmental Management (IEEM) members. The approach taken in the determination of significance has become more standardised and subjectivity has become constrained through a transparent framework. This has largely been driven by a set of guidelines produced by IEEM in 2006. The significance of impacts is now more clearly justified and the accuracy with which it is determined has improved. However, there are limitations to accuracy and effectiveness of the determination of significance. These are the quality of baseline survey data, our scientific understanding of ecological processes and the lack of monitoring and feedback of results. These in turn are restricted by the limited resources available in consultancies. The most notable recommendations for future practice are the implementation of monitoring and the publication of feedback, the creation of a central database for baseline survey data and the streamlining of guidance. - Highlights: Black-Right-Pointing-Pointer The assessment of significance has changed markedly through time. Black-Right-Pointing-Pointer The IEEM guidelines have driven a standardisation of practice. Black-Right-Pointing-Pointer Currently limited by quality of baseline data and scientific understanding. Black-Right-Pointing-Pointer Monitoring

36 CFR 1192.31 - Lighting.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., when the door is open, at least 2 foot-candles of illumination measured on the step tread or lift platform. (b) Other stepwells and doorways, including doorways in which lifts or ramps are installed, shall have, at all times, at least 2 foot-candles of illumination measured on the step tread, or lift or ramp...

36 CFR 1192.31 - Lighting.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., when the door is open, at least 2 foot-candles of illumination measured on the step tread or lift platform. (b) Other stepwells and doorways, including doorways in which lifts or ramps are installed, shall have, at all times, at least 2 foot-candles of illumination measured on the step tread, or lift or ramp...

A randomised controlled trial of blended learning to improve the newborn examination skills of medical students.

PubMed

Stewart, Alice; Inglis, Garry; Jardine, Luke; Koorts, Pieter; Davies, Mark William

2013-03-01

To evaluate the hypotheses that a blended learning approach would improve the newborn examination skills of medical students and yield a higher level of satisfaction with learning newborn examination. Undergraduate medical students at a tertiary teaching hospital were individually randomised to receive either a standard neonatology teaching programme (control group), or additional online access to the PENSKE Baby Check Learning Module (blended learning group). The primary outcome was performance of newborn examination on standardised assessment by blinded investigators. The secondary outcomes were performance of all 'essential' items of the examination, and participant satisfaction. The recruitment rate was 88% (71/81). The blended learning group achieved a significantly higher mean score than the control group (p=0.02) for newborn examination. There was no difference for performance of essential items, or satisfaction with learning newborn examination. The blended learning group rated the module highly for effective use of learning time and ability to meet specific learning needs. A blended learning approach resulted in a higher level of performance of newborn examination on standardised assessment. This is consistent with published literature on blended learning and has implications for all neonatal clinicians including junior doctors, midwifes and nurse practitioners.

Audit of prostate cancer: lessons learnt for current clinical practice, surrogates for quality of care and standardisation and quality assurance.

PubMed

Silcocks, P; Needham, P; Hemsley, F

1999-07-01

Two-hundred and fifty-one prostate cancer patients first registered during 1994 were sampled from a Regional Cancer Registry. In the six months after diagnosis, 39% received drug treatment alone, while 37% had no active treatment. Eighty-one percent of cases were histologically proven. Seventy-six percent had a prostate specific antigen (PSA) test and in 3% the PSA test was the basis for diagnosis. Of histologically proven cases 29% had a Gleason grade. None were staged by clinicians. Key lessons were: The result was a snapshot of current clinical practice which suggested other possible surrogates for quality of care, such as basis of stage and timing of investigations; There is a need for standardisation and quality assurance of the content of pathology reports; Standard treatment protocols would aid recording and comparison of treatments.

Group-based parent training programmes for improving parental psychosocial health.

PubMed

Barlow, Jane; Smailagic, Nadja; Huband, Nick; Roloff, Verena; Bennett, Cathy

2014-05-17

Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). We searched the following databases on 5 December 2011: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo. At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we

Group-based parent training programmes for improving parental psychosocial health.

PubMed

Barlow, Jane; Smailagic, Nadja; Huband, Nick; Roloff, Verena; Bennett, Cathy

2012-06-13

Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). We searched the following databases on 5 December 2012: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo. At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we

A standardised individual unsupervised water exercise intervention for healthy pregnant women. A qualitative feasibility study.

PubMed

Backhausen, Mette G; Katballe, Malene; Hansson, Helena; Tabor, Ann; Damm, Peter; Hegaard, Hanne K

2014-12-01

Low back pain during pregnancy is common and associated with sick leave. Studies suggest that exercise may reduce low back pain during pregnancy. Before carrying out a randomised controlled trail with individual water exercise as intervention a qualitative feasibility study was done. To explore women's views and experiences of the acceptability and benefits of and possible barriers to the standardised individual unsupervised water exercise intervention. Eleven women were interviewed after participating in a water exercise intervention. Content analysis was used. Four main categories emerged: motivation to participate, attitudes towards the exercise programme, perception of benefits, and acceptability of supportive components. The women had a desire to stay physically active during pregnancy and found water exercise a suitable, type of exercise to perform during pregnancy. The intervention was experienced to have benefits on both their physical health and their mental well-being. Crowded swimming pools were perceived as the greatest barrier. It is feasible to perform a RCT using the described intervention. The intervention was accepted by the participants because it supported their desire to be physically active during pregnancy. The main barrier was crowded swimming pools and this issue must be addressed in a future RCT. Copyright © 2014 Elsevier B.V. All rights reserved.

Translation procedures for standardised quality of life questionnaires: The European Organisation for Research and Treatment of Cancer (EORTC) approach.

PubMed

Koller, Michael; Aaronson, Neil K; Blazeby, Jane; Bottomley, Andrew; Dewolf, Linda; Fayers, Peter; Johnson, Colin; Ramage, John; Scott, Neil; West, Karen

2007-08-01

The European Organisation for Research and Treatment of Cancer quality of life (EORTC QL) questionnaires are used in international trials and therefore standardised translation procedures are required. This report summarises the EORTC translation procedure, recent accomplishments and challenges. Translations follow a forward-backward procedure, independently carried out by two native-speakers of the target language. Discrepancies are arbitrated by a third consultant, and solutions are reached by consensus. Translated questionnaires undergo a pilot-testing. Suggestions are incorporated into the final questionnaire. Requests for translations originate from the module developers, physicians or pharmaceutical industry, and most translations are performed by professional translators. The translation procedure is managed and supervised by a Translation Coordinator within the EORTC QL Unit in Brussels. To date, the EORTC QLQ-C30 has been translated and validated into more than 60 languages, with further translations in progress. Translations include all major Western, and many African and Asian languages. The following translation problems were encountered: lack of expressions for specific symptoms in various languages, the use of old-fashioned language, recent spelling reforms in several European countries and different priorities of social issues between Western and Eastern cultures. The EORTC measurement system is now registered for use in over 9000 clinical trials worldwide. The EORTC provides strong infrastructure and quality control to produce robust translated questionnaires. Nevertheless, translation problems have been identified. The key to improvements may lie in the particular features and strengths of the group, consisting of researchers from 21 countries representing 25 languages and include the development of simple source versions, the use of advanced computerised tools, rigorous pilot-testing, certification procedures and insights from a unique cross

Validated modified Lycopodium spore method development for standardisation of ingredients of an ayurvedic powdered formulation Shatavaryadi churna.

PubMed

Kumar, Puspendra; Jha, Shivesh; Naved, Tanveer

2013-01-01

Validated modified lycopodium spore method has been developed for simple and rapid quantification of herbal powdered drugs. Lycopodium spore method was performed on ingredients of Shatavaryadi churna, an ayurvedic formulation used as immunomodulator, galactagogue, aphrodisiac and rejuvenator. Estimation of diagnostic characters of each ingredient of Shatavaryadi churna individually was carried out. Microscopic determination, counting of identifying number, measurement of area, length and breadth of identifying characters were performed using Leica DMLS-2 microscope. The method was validated for intraday precision, linearity, specificity, repeatability, accuracy and system suitability, respectively. The method is simple, precise, sensitive, and accurate, and can be used for routine standardisation of raw materials of herbal drugs. This method gives the ratio of individual ingredients in the powdered drug so that any adulteration of genuine drug with its adulterant can be found out. The method shows very good linearity value between 0.988-0.999 for number of identifying character and area of identifying character. Percentage purity of the sample drug can be determined by using the linear equation of standard genuine drug.

THE EFFECTS OF LIGHT ON LUMINOUS BACTERIA

PubMed Central

Harvey, E. Newton

1925-01-01

A conservative statement would therefore be that luminous bacteria show no changes in luminescence as a result of illumination by 625 foot candles for 1.5 minutes when examined 1/200 of a second after exposure, and none as the result of illumination by 15,000 foot candles for 6 minutes when examined ⅙ of a second after exposure. PMID:19872170

Computerised lung sound analysis to improve the specificity of paediatric pneumonia diagnosis in resource-poor settings: protocol and methods for an observational study

PubMed Central

Gilman, Robert H; Tielsch, James M; Steinhoff, Mark; Figueroa, Dante; Rodriguez, Shalim; Caffo, Brian; Tracey, Brian; Elhilali, Mounya; West, James; Checkley, William

2012-01-01

Introduction WHO case management algorithm for paediatric pneumonia relies solely on symptoms of shortness of breath or cough and tachypnoea for treatment and has poor diagnostic specificity, tends to increase antibiotic resistance. Alternatives, including oxygen saturation measurement, chest ultrasound and chest auscultation, exist but with potential disadvantages. Electronic auscultation has potential for improved detection of paediatric pneumonia but has yet to be standardised. The authors aim to investigate the use of electronic auscultation to improve the specificity of the current WHO algorithm in developing countries. Methods This study is designed to test the hypothesis that pulmonary pathology can be differentiated from normal using computerised lung sound analysis (CLSA). The authors will record lung sounds from 600 children aged ≤5 years, 100 each with consolidative pneumonia, diffuse interstitial pneumonia, asthma, bronchiolitis, upper respiratory infections and normal lungs at a children's hospital in Lima, Peru. The authors will compare CLSA with the WHO algorithm and other detection approaches, including physical exam findings, chest ultrasound and microbiologic testing to construct an improved algorithm for pneumonia diagnosis. Discussion This study will develop standardised methods for electronic auscultation and chest ultrasound and compare their utility for detection of pneumonia to standard approaches. Utilising signal processing techniques, the authors aim to characterise lung sounds and through machine learning, develop a classification system to distinguish pathologic sounds. Data will allow a better understanding of the benefits and limitations of novel diagnostic techniques in paediatric pneumonia. PMID:22307098

Effects of the pharmaceuticals gemfibrozil and diclofenac on biomarker expression in the zebra mussel (Dreissena polymorpha) and their comparison with standardised toxicity tests.

PubMed

Quinn, Brian; Schmidt, Wiebke; O'Rourke, Kathleen; Hernan, Robert

2011-07-01

Pharmaceuticals, including the lipid regulator gemfibrozil and the non-steroidal anti-inflammatory drug diclofenac have been identified in waste water treatment plant effluents and receiving waters throughout the western world. The acute and chronic toxicity of these compounds was assessed for three freshwater species (Daphnia magna, Pseudokirchneriella subcapitata, Lemna minor) using standardised toxicity tests with toxicity found in the non-environmentally relevant mid mg L(-1) concentration range. For the acute endpoints (IC(50) and EC(50)) gemfibrozil showed higher toxicity ranging from 29 to 59 mg L(-1) (diclofenac 47-67 mg L(-1)), while diclofenac was more toxic for the chronic D. magna 21 d endpoints ranging from 10 to 56 mg L(-1) (gemfibrozil 32-100 mg L(-1)). These results were compared with the expression of several biomarkers in the zebra mussel (Dreissena polymorpha) 24 and 96 h after exposure by injection to concentrations of 21 and 21,000 μg L(-1) corresponding to nominal concentrations of 1 and 1000 μg L(-1). Exposure to gemfibrozil and diclofenac at both concentrations significantly increased the level of lipid peroxidation, a biomarker of damage. At the elevated nominal concentration of 1000 μg L(-1) the biomarkers of defence glutathione transferase and metallothionein were significantly elevated for gemfibrozil and diclofenac respectively, as was DNA damage after 96 h exposure to gemfibrozil. No evidence of endocrine disruption was observed using the alkali-labile phosphate technique. Results from this suite of biomarkers indicate these compounds can cause significant stress at environmentally relevant concentrations acting primarily through oxidation pathways with significant destabilization of the lysosomal membrane and that biomarker expression is a more sensitive endpoint than standardised toxicity tests. Copyright © 2011 Elsevier Ltd. All rights reserved.

Proposed phase 2/ step 2 in-vitro test on basis of EN 14561 for standardised testing of the wound antiseptics PVP-iodine, chlorhexidine digluconate, polihexanide and octenidine dihydrochloride.

PubMed

Schedler, Kathrin; Assadian, Ojan; Brautferger, Uta; Müller, Gerald; Koburger, Torsten; Classen, Simon; Kramer, Axel

2017-02-13

Currently, there is no agreed standard for exploring the antimicrobial activity of wound antiseptics in a phase 2/ step 2 test protocol. In the present study, a standardised in-vitro test is proposed, which allows to test potential antiseptics in a more realistically simulation of conditions found in wounds as in a suspension test. Furthermore, factors potentially influencing test results such as type of materials used as test carrier or various compositions of organic soil challenge were investigated in detail. This proposed phase 2/ step 2 test method was modified on basis of the EN 14561 by drying the microbial test suspension on a metal carrier for 1 h, overlaying the test wound antiseptic, washing-off, neutralization, and dispersion at serial dilutions at the end of the required exposure time yielded reproducible, consistent test results. The difference between the rapid onset of the antiseptic effect of PVP-I and the delayed onset especially of polihexanide was apparent. Among surface-active antimicrobial compounds, octenidine was more effective than chlorhexidine digluconate and polihexanide, with some differences depending on the test organisms. However, octenidine and PVP-I were approximately equivalent in efficiency and microbial spectrum, while polihexanide required longer exposure times or higher concentrations for a comparable antimicrobial efficacy. Overall, this method allowed testing and comparing differ liquid and gel based antimicrobial compounds in a standardised setting.

Standardised Outcomes in Nephrology-Children and Adolescents (SONG-Kids): a protocol for establishing a core outcome set for children with chronic kidney disease.

PubMed

Tong, Allison; Samuel, Susan; Zappitelli, Michael; Dart, Allison; Furth, Susan; Eddy, Allison; Groothoff, Jaap; Webb, Nicholas J A; Yap, Hui-Kim; Bockenhauer, Detlef; Sinha, Aditi; Alexander, Stephen I; Goldstein, Stuart L; Gipson, Debbie S; Hanson, Camilla S; Evangelidis, Nicole; Crowe, Sally; Harris, Tess; Hemmelgarn, Brenda R; Manns, Braden; Gill, John; Tugwell, Peter; Van Biesen, Wim; Wheeler, David C; Winkelmayer, Wolfgang C; Craig, Jonathan C

2016-08-12

Children with chronic kidney disease (CKD), requiring dialysis or kidney transplantation, have a mortality rate of up to 30-fold higher than the general aged-matched population, and severely impaired quality of life. Symptoms such as fatigue and pain are prevalent and debilitating. Children with CKD are at risk of cognitive impairment, and poorer educational, vocational, and psychosocial outcomes compared with their well peers, which have consequences through to adulthood. Treatment regimens for children with CKD are long-term, complex, and highly intrusive. While many trials have been conducted to improve outcomes in children with CKD, the outcomes measured and reported are often not relevant to patients and clinicians, and are highly variable. These problems can diminish the value of trials as a means to improve the lives of children with CKD. The Standardised Outcomes in Nephrology-Children and Adolescents (SONG-Kids) study aims to develop a core outcome set for trials in children and adolescents with any stage of CKD that is based on the shared priorities of all stakeholders. SONG-Kids involves five phases: a systematic review to identify outcomes (both domains and measures) that have been reported in randomised controlled trials involving children aged up to 21 years with CKD; focus groups (using nominal group technique) with adolescent patients and caregivers of paediatric patients (all ages) to identify outcomes that are relevant and important to patients and their family and the reasons for their choices; semistructured key informant interviews with health professionals involved in the care of children with CKD to ascertain their views on establishing core outcomes in paediatric nephrology; an international three-round online Delphi survey with patients, caregivers, clinicians, researchers, policy-makers, and members from industry to develop consensus on important outcome domains; and a stakeholder workshop to review and finalise the set of core outcome

Use of non-standardised micro-destructive techniques in the characterization of traditional construction materials

NASA Astrophysics Data System (ADS)

Ioannou, Ioannis; Theodoridou, Magdalini; Modestou, Sevasti; Fournari, Revecca; Dagrain, Fabrice

2013-04-01

The characterization of material properties and the diagnosis of their state of weathering and conservation are three of the most important steps in the field of cultural heritage preservation. Several standardised experimental methods exist, especially for determining the material properties and their durability. However, they are limited in their application by the required size of test specimens and the controlled laboratory conditions needed to undertake the tests; this is especially true when the materials under study constitute immovable parts of heritage structures. The current use of other advanced methods of analysis, such as imaging techniques, in the aforementioned field of research offers invaluable results. However, these techniques may not always be accessible to the wider research community due to their complex nature and relatively high cost of application. This study presents innovative applications of two recently developed cutting techniques; the portable Drilling Resistance Measuring System (DRMS) and the scratch tool. Both methods are defined as micro-destructive, since they only destroy a very small portion of sample material. The general concept of both methods lies within the forces needed to cut a material by linear (scratch tool) or rotational (DRMS) cutting action; these forces are related to the mechanical properties of the material and the technological parameters applied on the tool. Therefore, for a given testing configuration, the only parameter influencing the forces applied is the strength of the material. These two techniques have been used alongside a series of standardised laboratory tests aiming at the correlation of various stone properties (density, porosity, dynamic elastic modulus and uniaxial compressive strength). The results prove the potential of both techniques in assessing the uniaxial compressive strength of stones. The scratch tool has also been used effectively to estimate the compressive strength of mud bricks. It

Management of paediatric periorbital cellulitis: Our experience of 243 children managed according to a standardised protocol 2012-2015.

PubMed

Crosbie, Robin A; Nairn, Jonathan; Kubba, Haytham

2016-08-01

Paediatric periorbital cellulitis is a common condition. Accurate assessment can be challenging and appropriate use of CT imaging is essential. We audited admissions to our unit over a four year period, with reference to CT scanning and adherence to our protocol. Retrospective audit of paediatric patients admitted with periorbital cellulitis, 2012-2015. Total of 243 patients included, mean age 4.7 years with slight male predominance, the median length of admission was 2 days. 48/243 (20%) underwent CT during admission, 25 (52%) of these underwent surgical drainage. As per protocol, CT brain performed with all orbital scans; no positive intracranial findings on any initial scan. Three children developed intracranial complications subsequently; all treated with antibiotics. Our re-admission rate within 30 days was 2.5%. Our audit demonstrates benefit of standardising practice and the low CT rate, with high percentage taken to theatre and no missed abscesses, supports the protocol. There may be an argument to avoid CT brain routinely in all initial imaging sequences in those children without neurological signs or symptoms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stress reactivity to and recovery from a standardised exercise bout: a study of 31 runners practising relaxation techniques.

PubMed

Solberg, E E; Ingjer, F; Holen, A; Sundgot-Borgen, J; Nilsson, S; Holme, I

2000-08-01

To compare the efficacy in runners of two relaxation techniques with regard to exercise reactivity and recovery after exercise. Thirty one adult male runners were studied prospectively for six months in three groups practising either meditation (n = 11) or autogenic training (n = 11) or serving as controls (n = 10). Before and after the six months relaxation intervention, indicators of reactivity to exercise and metabolism after exercise (blood lactate concentration, heart rate (HR), and oxygen consumption (VO2)), were tested immediately after and 10 minutes after exercise. Resting HR was also assessed weekly at home during the trial. State anxiety was measured before and after the intervention. After the relaxation training, blood lactate concentration after exercise was significantly (p<0.01) decreased in the meditation group compared with the control group. No difference was observed in lactate responses between the autogenic training group and the control group. There were no significant differences among the groups with regard to HR, VO2, or levels of anxiety. Meditation training may reduce the lactate response to a standardised exercise bout.

Standardisation of a novel sperm banking kit - NextGen(®) - to preserve sperm parameters during shipment.

PubMed

Agarwal, A; Sharma, R; Singh, A; Gupta, S; Sharma, R

2016-08-01

Many male patients diagnosed with cancer are within their reproductive years. These men are advised to freeze their spermatozoa prior to the start of cancer treatment. Very often, sperm banking facilities may not be readily available and patients may be required to travel to distant sperm bank centres. Our objective was to design and standardise a remote home shipping sperm kit that allows patients to collect a semen sample at home and ship it overnight to a sperm bank. A total of 21 semen samples and two transport media (refrigeration media and human tubal fluid) and five different combinations of ice packs were tested for maintaining desired shipping temperature. Ten semen samples were assessed for pre- and post-shipment changes in sperm motility, membrane integrity, total motile spermatozoa and recovery of motile spermatozoa. Even though motility, membrane integrity and total motile spermatozoa declined both in samples examined under simulated shipped conditions and in overnight-shipped samples, the observed motility and total motile spermatozoa were adequate for use with assisted reproductive techniques. Using refrigeration media, cooling sleeve and ice packs, adequate sperm motility can be maintained utilising NextGen(®) kit and these spermatozoa can be used for procreation utilising ART techniques such as intracytoplasmic sperm injection. © 2015 Blackwell Verlag GmbH.

Large Variations in Declared Serving Sizes of Packaged Foods in Australia: A Need for Serving Size Standardisation?

PubMed Central

Yang, Suzie; Gemming, Luke

2018-01-01

Declared serving sizes on food packaging are unregulated in Australia, and variations in serving size within similar products reduces the usability of this information. This study aimed to (i) assess the variations in declared serving sizes of packaged foods from the Five Food Groups, and (ii) compare declared serving sizes to the Australian Dietary Guidelines standard serves and typical portion sizes consumed by Australian adults. Product information, including serving size, was collected for 4046 products from four major Australian retailers. Within product categories from the Five Food Groups, coefficients of variation ranged from 0% to 59% for declared serving size and 9% to 64% for energy per serving. Overall, 24% of all products displayed serving sizes similar (within ±10%) to the standard serves, and 23–28% were similar to typical portion sizes consumed by adults, for females and males, respectively. In conclusion, there is substantial variation in the declared serving sizes of packaged foods from the Five Food Groups, and serving sizes are not aligned with either the Dietary Guidelines or typical portion sizes consumed. Future research into effective means of standardising serving sizes is warranted. PMID:29382083

Cherry-Slush-Candling Apparatus

NASA Technical Reports Server (NTRS)

Stephens, James B.; Weiss, James R.; Hoover, Gordon

1996-01-01

Proposed infrared-scanning apparatus for use in bakeries making cherry pies detect cherry pits remaining in cherry slush after pitting process. Pits detected via their relative opacity to infrared radiation.

The Dutch Hospital Standardised Mortality Ratio (HSMR) method and cardiac surgery: benchmarking in a national cohort using hospital administration data versus a clinical database

PubMed Central

Siregar, S; Pouw, M E; Moons, K G M; Versteegh, M I M; Bots, M L; van der Graaf, Y; Kalkman, C J; van Herwerden, L A; Groenwold, R H H

2014-01-01

Objective To compare the accuracy of data from hospital administration databases and a national clinical cardiac surgery database and to compare the performance of the Dutch hospital standardised mortality ratio (HSMR) method and the logistic European System for Cardiac Operative Risk Evaluation, for the purpose of benchmarking of mortality across hospitals. Methods Information on all patients undergoing cardiac surgery between 1 January 2007 and 31 December 2010 in 10 centres was extracted from The Netherlands Association for Cardio-Thoracic Surgery database and the Hospital Discharge Registry. The number of cardiac surgery interventions was compared between both databases. The European System for Cardiac Operative Risk Evaluation and hospital standardised mortality ratio models were updated in the study population and compared using the C-statistic, calibration plots and the Brier-score. Results The number of cardiac surgery interventions performed could not be assessed using the administrative database as the intervention code was incorrect in 1.4–26.3%, depending on the type of intervention. In 7.3% no intervention code was registered. The updated administrative model was inferior to the updated clinical model with respect to discrimination (c-statistic of 0.77 vs 0.85, p<0.001) and calibration (Brier Score of 2.8% vs 2.6%, p<0.001, maximum score 3.0%). Two average performing hospitals according to the clinical model became outliers when benchmarking was performed using the administrative model. Conclusions In cardiac surgery, administrative data are less suitable than clinical data for the purpose of benchmarking. The use of either administrative or clinical risk-adjustment models can affect the outlier status of hospitals. Risk-adjustment models including procedure-specific clinical risk factors are recommended. PMID:24334377

COgnitive behavioural therapy vs standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES): a multicentre randomised controlled trial protocol.

PubMed

Goldstein, Laura H; Mellers, John D C; Landau, Sabine; Stone, Jon; Carson, Alan; Medford, Nick; Reuber, Markus; Richardson, Mark; McCrone, Paul; Murray, Joanna; Chalder, Trudie

2015-06-27

The evidence base for the effectiveness of psychological interventions for patients with dissociative non-epileptic seizures (DS) is currently extremely limited, although data from two small pilot randomised controlled trials (RCTs), including from our group, suggest that Cognitive Behavioural Therapy (CBT) may be effective in reducing DS occurrence and may improve aspects of psychological status and psychosocial functioning. The study is a multicentre, pragmatic parallel group RCT to evaluate the clinical and cost-effectiveness of specifically-tailored CBT plus standardised medical care (SMC) vs SMC alone in reducing DS frequency and improving psychological and health-related outcomes. In the initial screening phase, patients with DS will receive their diagnosis from a neurologist/epilepsy specialist. If patients are eligible and interested following the provision of study information and a booklet about DS, they will consent to provide demographic information and fortnightly data about their seizures, and agree to see a psychiatrist three months later. We aim to recruit ~500 patients to this screening stage. After a review three months later by a psychiatrist, those patients who have continued to have DS in the previous eight weeks and who meet further eligibility criteria will be told about the trial comparing CBT + SMC vs SMC alone. If they are interested in participating, they will be given a further booklet on DS and study information. A research worker will see them to obtain their informed consent to take part in the RCT. We aim to randomise 298 people (149 to each arm). In addition to a baseline assessment, data will be collected at 6 and 12 months post randomisation. Our primary outcome is monthly seizure frequency in the preceding month. Secondary outcomes include seizure severity, measures of seizure freedom and reduction, psychological distress and psychosocial functioning, quality of life, health service use, cost effectiveness and adverse

Injury severity in ice skating: an epidemiologic analysis using a standardised injury classification system.

PubMed

Ostermann, Roman C; Hofbauer, Marcus; Tiefenböck, Thomas M; Pumberger, Matthias; Tiefenböck, Michael; Platzer, Patrick; Aldrian, Silke

2015-01-01

Although injuries sustained during ice skating have been reported to be more serious than other forms of skating, the potential injury risks are often underestimated by skating participants. The purpose of this study was to give a descriptive overview of injury patterns occurring during ice skating. Special emphasis was put on injury severity by using a standardised injury classification system. Over a six month period, all patients treated with ice-skating-related injuries at Europe's largest hospital were included. Patient demographics were collected and all injuries categorised according to the Abbreviated Injury Scale (AIS) 2005. A descriptive statistic and logistic regression analysis was performed. Three hundred and forty-one patients (134 M, 207 F) were included in this study. Statistical analysis revealed that age had a significant influence on injury severity. People > 50 years had a higher risk of sustaining a more severe injury according to the AIS compared with younger skaters. Furthermore, the risk of head injury was significantly lower for people aged between 18 and 50 years than for people < 18 years (p = 0.0007) and significantly higher for people > 50 years than for people aged between 18 and 50 years (p = 0.04). The severity of ice-skating injuries is associated with the patient's age, showing more severe injuries in older patients. Awareness should be raised among the public and physicians about the risks associated with this activity in order to promote further educational interventions and the use of protective gear.

Standardised Testing: What Space for Professional Judgement?

ERIC Educational Resources Information Center

Doecke, Brenton; Reynolds, Gail; Roberts, Arlene

2002-01-01

Gives an account of Gail Reynolds's experience in administrating the DART (Developmental assessment resource for teachers) and AIM (Achievement improvement monitor) tests at her school. Reflects on how the test results compared with her own judgments of the literacy abilities of individual students in her class. Offers four case studies that draw…

Containing diffusion: the tobacco industry's multipronged trade strategy to block tobacco standardised packaging.

PubMed

Crosbie, Eric; Eckford, Robert; Bialous, Stella

2018-04-21

To analyse the tobacco industry's strategy of using trade and investment agreements to prevent the global diffusion of standardised packaging (SP) of tobacco products. Review of tobacco industry documents, relevant government documents and media items. The data were triangulated and thematically analysed. Internal tobacco industry documents reveal that during the early 1990s, tobacco companies developed a multipronged trade strategy to prevent the global diffusion of progressive tobacco packaging and labelling proposals, including SP. This strategy consisted of (1) framing the health issue in terms of trade and investment, (2) detailing alleged legal violations concerning trade barriers, intellectual property and investment rights, (3) threatening legal suits and reputational damage, and (4) garnering third-party support. These efforts helped delay SP until 2010 when Australia became the first country to reintroduce SP proposals, followed by governments in the UK and New Zealand in 2012, Ireland in 2013 and France in 2014. Review of government documents and media sources in each of the five countries indicate the industry continues to employ this multipronged strategy throughout the SP policy's progression. Although this strategy is tailored towards each domestic context, the overall tobacco industry's trade strategy remains consistently focused on shifting the attention away from public health and towards the realm of trade and investment with more corporate-friendly allies. Governments seeking to implement SP need to be prepared to resist and counter the industry's multipronged trade strategy by avoiding trade diversions, exposing false industry legal and reputational claims, and monitoring third-party support. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.

PubMed

van Dorp, Sofie M; Kinross, Pete; Gastmeier, Petra; Behnke, Michael; Kola, Axel; Delmée, Michel; Pavelkovich, Anastasia; Mentula, Silja; Barbut, Frédéric; Hajdu, Agnes; Ingebretsen, André; Pituch, Hanna; Macovei, Ioana S; Jovanović, Milica; Wiuff, Camilla; Schmid, Daniela; Olsen, Katharina Ep; Wilcox, Mark H; Suetens, Carl; Kuijper, Ed J

2016-07-21

Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe. This article is copyright of The Authors, 2016.

Standardised classification of pre-release development in male-brooding pipefish, seahorses, and seadragons (Family Syngnathidae)

PubMed Central

2012-01-01

Background Members of the family Syngnathidae share a unique reproductive mode termed male pregnancy. Males carry eggs in specialised brooding structures for several weeks and release free-swimming offspring. Here we describe a systematic investigation of pre-release development in syngnathid fishes, reviewing available data for 17 species distributed across the family. This work is complemented by in-depth examinations of the straight-nosed pipefish Nerophis ophidion, the black-striped pipefish Syngnathus abaster, and the potbellied seahorse Hippocampus abdominalis. Results We propose a standardised classification of early syngnathid development that extends from the activation of the egg to the release of newborn. The classification consists of four developmental periods – early embryogenesis, eye development, snout formation, and juvenile – which are further divided into 11 stages. Stages are characterised by morphological traits that are easily visible in live and preserved specimens using incident-light microscopy. Conclusions Our classification is derived from examinations of species representing the full range of brooding-structure complexity found in the Syngnathidae, including tail-brooding as well as trunk-brooding species, which represent independent evolutionary lineages. We chose conspicuous common traits as diagnostic features of stages to allow for rapid and consistent staging of embryos and larvae across the entire family. In view of the growing interest in the biology of the Syngnathidae, we believe that the classification proposed here will prove useful for a wide range of studies on the unique reproductive biology of these male-brooding fish. PMID:23273265

Standardised classification of pre-release development in male-brooding pipefish, seahorses, and seadragons (Family Syngnathidae).

PubMed

Sommer, Stefan; Whittington, Camilla M; Wilson, Anthony B

2012-12-29

Members of the family Syngnathidae share a unique reproductive mode termed male pregnancy. Males carry eggs in specialised brooding structures for several weeks and release free-swimming offspring. Here we describe a systematic investigation of pre-release development in syngnathid fishes, reviewing available data for 17 species distributed across the family. This work is complemented by in-depth examinations of the straight-nosed pipefish Nerophis ophidion, the black-striped pipefish Syngnathus abaster, and the potbellied seahorse Hippocampus abdominalis. We propose a standardised classification of early syngnathid development that extends from the activation of the egg to the release of newborn. The classification consists of four developmental periods - early embryogenesis, eye development, snout formation, and juvenile - which are further divided into 11 stages. Stages are characterised by morphological traits that are easily visible in live and preserved specimens using incident-light microscopy. Our classification is derived from examinations of species representing the full range of brooding-structure complexity found in the Syngnathidae, including tail-brooding as well as trunk-brooding species, which represent independent evolutionary lineages. We chose conspicuous common traits as diagnostic features of stages to allow for rapid and consistent staging of embryos and larvae across the entire family. In view of the growing interest in the biology of the Syngnathidae, we believe that the classification proposed here will prove useful for a wide range of studies on the unique reproductive biology of these male-brooding fish.

Standardisation of delivery and assessment of research training for specialty trainees based on curriculum requirements: recommendations based on a scoping review.

PubMed

Rangan, Amar; Pitchford, James; Williams, Penny; Wood, Brian; Robson, Stephen

2017-02-06

(1) To conduct a scoping review of postgraduate specialty training (ST) curricula for doctors within Health Education England in order to identify common themes and variations in requirements for training and assessment of research competencies. (2) To make recommendations on standardisation of training for clinical research across ST programmes. Health Education England North East and National Institute for Health Research Clinical Research Network (CRN)-North East and North Cumbria. Annual Review of Competence Progression (ARCP); Certificate of Completion of Training (CCT) checklists and curricula for ST were obtained from Health Education England North East and reviewed between June and September 2015. Research competence requirements based on knowledge, skills or behaviour-based domains were identified and entered onto a spreadsheet for analysis. Common themes with levels of competence required were identified. This information was used to construct and propose a model for delivery of training in clinical research across ST programmes. Sixty-two ST curricula were reviewed and seven common themes for research training were found in up to 97% of the curricula. Requirement for good clinical practice (GCP) in research training was included in 15% of curricula. One of the common themes involved knowledge-based competency, and three each of the remaining seven involved skills or behaviour-based competencies. There was less clarity and larger variation between specialties in how research competencies were assessed; and what evidence was required for ARCP and CCT to assure competence. 63% (19/30) of curricula from medical specialties had no mention of research requirements within their ARCP guidelines. Given that the majority of specialty curricula contain consistent themes around core research knowledge, consideration should be given to standardising the delivery and assessment of generic research competencies within ST. Our recommendations from this review could form

Impact of missing data on standardised mortality ratios for acute myocardial infarction: evidence from the Myocardial Ischaemia National Audit Project (MINAP) 2004-7.

PubMed

Gale, C P; Cattle, B A; Moore, J; Dawe, H; Greenwood, D C; West, R M

2011-12-01

Standardised mortality ratios (SMR) are often used to depict cardiovascular care. Data missingness, data quality, temporal variation and case-mix can, however, complicate the assessment of clinical performance. To study Primary Care Trust (PCT) 30-day SMRs for STEMI and NSTEMI whilst considering the impact of missing data for age, sex and IMD score. Observational study using data from the Myocardial Ischaemia National Audit Project (MINAP) database to generate PCT SMR maps and funnel plots for England, 2004-2007. 217,157 40.4% STEMI and 59.6% NSTEMI. 95% CI 30-day unadjusted mortality: STEMI 5.8% to 6.2%; NSTEMI 6.6% to 6.9%; relative risk, 95% CI 1.14, 1.10 to 1.19. Median (IQR) data missingess by PCT for composite of age, sex and IMD score was 1.4% (0.7% to 2.2%). For STEMI and NSTEMI statistically significant predictors of mortality were mean age (STEMI: P<0.001; NSTEMI: P<0.001), proportion of females (STEMI: P<0.001; NSTEMI: P<0.001) and proportion of missing ages (STEMI: P=0.02; NSTEMI: P<0.001). Proportion of missing sex also predicted 30-day mortality for NSTEMI (P=0.01). Maps of SMRs demonstrated substantial mortality variation, but no evidence of North / South divide. There were significant correlations between STEMI and NSTEMI observed (R² 0.72) and standardised mortality (R² 0.49) rates. PCT data aggregation gave an acceptable model fit in terms of deviance explained. For STEMI there were 33 (21.7%) regions below the 99.8% lower limit of the associated performance funnel plot, and 28 (18.4%) for NSTEMI; the inclusion of missing data did not affect the distribution of SMRs. The proportion of missing data was associated with 30-day mortality for STEMI and NSTEMI, however it did not influence the distribution of PCTs within the funnel plots. There was considerable variation in mortality not attributable to key patient-specific factors, supporting the notion of regional-dependent variation in STEMI and NSTEMI care.

A standardised approach towards PROving the efficacy of foods and food constituents for health CLAIMs (PROCLAIM): providing guidance.

PubMed

Gallagher, Alison M; Meijer, Gert W; Richardson, David P; Rondeau, Virginie; Skarp, Maria; Stasse-Wolthuis, Marianne; Tweedie, Guy C; Witkamp, Renger

2011-11-01

Diet is well known to have beneficial health properties that extend beyond traditionally accepted nutritional effects. The approach involved in elucidating these beneficial physiological effects is becoming more important, as reflected by increasing research being undertaken. With growing consumer awareness of foods and food constituents and their relationship to health, the key questions for regulators, scientists and the food industry continue to relate to: (1) how consumers could be protected and have confidence that the health claims on foods are well supported by the evidence; (2) how research on physiological effects of food (constituents) and their health benefits could be stimulated and supported; (3) how research findings could be used in the development of innovative new food products. The objectives of this paper are to provide a set of recommendations on the substantiation of health claims for foods, to develop further guidance on the choice of validated markers (or marker patterns) and what effects are considered to be beneficial to the health of the general public (or specific target groups). Finally, the case for developing a standardised approach for assessing the totality of the available scientific data and weighing the evidence is proposed.

Stress reactivity to and recovery from a standardised exercise bout: a study of 31 runners practising relaxation techniques

PubMed Central

Solberg, E; Ingjer, F; Holen, A; Sundgot-Borgen, J; Nilsson, S; Holme, I

2000-01-01

Objective—To compare the efficacy in runners of two relaxation techniques with regard to exercise reactivity and recovery after exercise. Methods—Thirty one adult male runners were studied prospectively for six months in three groups practising either meditation (n = 11) or autogenic training (n = 11) or serving as controls (n = 10). Before and after the six months relaxation intervention, indicators of reactivity to exercise and metabolism after exercise (blood lactate concentration, heart rate (HR), and oxygen consumption (VO2)), were tested immediately after and 10 minutes after exercise. Resting HR was also assessed weekly at home during the trial. State anxiety was measured before and after the intervention. Results—After the relaxation training, blood lactate concentration after exercise was significantly (p<0.01) decreased in the meditation group compared with the control group. No difference was observed in lactate responses between the autogenic training group and the control group. There were no significant differences among the groups with regard to HR, VO2, or levels of anxiety. Conclusion—Meditation training may reduce the lactate response to a standardised exercise bout. Key Words: autogenic training; lactate; meditation; recovery; relaxation; psychology PMID:10953899

'Do not attempt resuscitation'--do standardised order forms make a clinical difference above hand-written note entries?

PubMed

Lewis, Keir Edward; Edwards, Victoria Middleton; Hall, Sian; Temblett, Paul; Hutchings, Hayley

2009-01-01

To quantify any effect of Standardised Order Forms (SOFs), versus hand-written note entries for 'Do Not Attempt Resuscitation'--on the selection and survival of remaining cardiopulmonary resuscitation (CPR) attempts. A prospective, observational study in two UK Hospitals, comparing numbers, demographics and survival rates from CPR attempts for 2 years prior to and 2 years after the introduction of SOFs (the only change in DNAR policy). There were 133 CPR attempts, representing 0.30% of the 44,792 admissions, pre SOFs and 147 CPR attempts representing 0.32% of the 45,340 admissions following the SOFs (p=0.46). The median duration of a CPR attempt was 11min prior to and 15min following the SOFs (p=0.02). Of the CPR attempts, there was no change in mean age (p=0.34), proportions occurring outside working hours (p=0.70) or proportions presenting with an initial shockable rhythm (p=0.30). Survival to discharge following CPR was unchanged (p=0.23). The introduction of SOFs for DNAR orders was associated with a significantly longer duration of CPR (on average by 3-4min) but no difference in overall number, demographics or type of arrest or survival in the remaining CPR attempts.

‘Wanted—standard guinea pigs’: standardisation and the experimental animal market in Britain ca. 1919–1947

PubMed Central

Kirk, Robert G.W.

2012-01-01

In 1942 a coalition of twenty scientific societies formed the Conference on the Supply of Experimental Animals (CSEA) in an attempt to pressure the Medical Research Council to accept responsibility for the provision of standardised experimental animals in Britain. The practice of animal experimentation was subject to State regulation under the Cruelty to Animals Act of 1876, but no provision existed for the provision of animals for experimental use. Consequently, day-to-day laboratory work was reliant on a commercial small animal market which had emerged to sustain the hobby of animal fancying. This paper explores how difficulties encountered in experimental practice within the laboratory led to the problematisation of biomedical science’s reliance upon a commercial market for animals during the inter-war period. This is shown to have produced a crisis within animal reliant experimental science in the early 1940s which enabled the left-wing Association of Scientific Workers to cast science’s reliance on a free market as economically inefficient and a threat to the reliability of British research. It is argued that the development of standard experimental animals in Britain was, therefore, embedded within the wider cultural, societal, political and economic national context of the time. PMID:18761280

Improved predictability of droughts over southern Africa using the standardized precipitation evapotranspiration index and ENSO

NASA Astrophysics Data System (ADS)

Manatsa, Desmond; Mushore, Terrence; Lenouo, Andre

2017-01-01

The provision of timely and reliable climate information on which to base management decisions remains a critical component in drought planning for southern Africa. In this observational study, we have not only proposed a forecasting scheme which caters for timeliness and reliability but improved relevance of the climate information by using a novel drought index called the standardised precipitation evapotranspiration index (SPEI), instead of the traditional precipitation only based index, the standardised precipitation index (SPI). The SPEI which includes temperature and other climatic factors in its construction has a more robust connection to ENSO than the SPI. Consequently, the developed ENSO-SPEI prediction scheme can provide quantitative information about the spatial extent and severity of predicted drought conditions in a way that reflects more closely the level of risk in the global warming context of the sub region. However, it is established that the ENSO significant regional impact is restricted only to the period December-March, implying a revisit to the traditional ENSO-based forecast scheme which essentially divides the rainfall season into the two periods, October to December and January to March. Although the prediction of ENSO events has increased with the refinement of numerical models, this work has demonstrated that the prediction of drought impacts related to ENSO is also a reality based only on observations. A large temporal lag is observed between the development of ENSO phenomena (typically in May of the previous year) and the identification of regional SPEI defined drought conditions. It has been shown that using the Southern Africa Regional Climate Outlook Forum's (SARCOF) traditional 3-month averaged Nino 3.4 SST index (June to August) as a predictor does not have an added advantage over using only the May SST index values. In this regard, the extended lead time and improved skill demonstrated in this study could immensely benefit

Cohort study of Gorlin syndrome with emphasis on standardised phenotyping and quality of life assessment.

PubMed

Huq, Aamira J; Bogwitz, Michael; Gorelik, Alexandra; Winship, Ingrid M; White, Susan M; Trainer, Alison H

2017-06-01

Gorlin syndrome (nevoid basal cell carcinoma syndrome) is a rare genetic predisposition to basal cell carcinomas (BCC), keratocysts of the jaw and calcification of the falx cerebri among other clinical features. With the advent of sonic hedgehog inhibitors for the treatment of BCC, it is timely to establish a cohort of individuals with Gorlin syndrome and collect standardised phenotypic information on these individuals. Moreover, the health-related quality of life (QoL) in individuals with Gorlin syndrome is not well studied. To establish a Victorian cohort of Gorlin syndrome and study the QoL in these individuals. Phenotypic data were obtained by reviewing medical records of individuals attending two major tertiary/quaternary genetic referral centres in Victoria, followed by telephone or face-to-face interviews where possible. QoL information was obtained utilising the AQoL-6D quality of life survey form. The median number of BCC in the 19 individuals studied was 17.5 (interquartile range 3-70). The number of patients with ≥100 BCC in this group was similar to a previously described national cohort (22.2 vs 27% respectively). A total of 58% of referrals to the genetics clinics originated from maxillofacial surgeons and 42% from dermatologists. Individuals with ≥100 BCC had worse median QoL scores compared to those with <100 BCC (36 vs 29, P-value of 0.031). The clinical features in our cohort were congruent with those previously described in Australia. The QoL is adversely correlated with increased BCC burden. © 2017 Royal Australasian College of Physicians.

National assessment of validity of coding of acute mastoiditis: a standardised reassessment of 1966 records.

PubMed

Stalfors, J; Enoksson, F; Hermansson, A; Hultcrantz, M; Robinson, Å; Stenfeldt, K; Groth, A

2013-04-01

To investigate the internal validity of the diagnosis code used at discharge after treatment of acute mastoiditis. Retrospective national re-evaluation study of patient records 1993-2007 and make comparison with the original ICD codes. All ENT departments at university hospitals and one large county hospital department in Sweden. A total of 1966 records were reviewed for patients with ICD codes for in-patient treatment of acute (529), chronic (44) and unspecified mastoiditis (21) and acute otitis media (1372). ICD codes were reviewed by the authors with a defined protocol for the clinical diagnosis of acute mastoiditis. Those not satisfying the diagnosis were given an alternative diagnosis. Of 529 records with ICD coding for acute mastoiditis, 397 (75%) were found to meet the definition of acute mastoiditis used in this study, while 18% were not diagnosed as having any type of mastoiditis after review. Review of the in-patients treated for acute media otitis identified an additional 60 cases fulfilling the definition of acute mastoiditis. Overdiagnosis was common, and many patients with a diagnostic code indicating acute mastoiditis had been treated for external otitis or otorrhoea with transmyringeal drainage. The internal validity of the diagnosis acute mastoiditis is dependent on the use of standardised, well-defined criteria. Reliability of diagnosis is fundamental for the comparison of results from different studies. Inadequate reliability in the diagnosis of acute mastoiditis also affects calculations of incidence rates and statistical power and may also affect the conclusions drawn from the results. © 2013 Blackwell Publishing Ltd.

Standardisation and application of the single-breath determination of nitric oxide uptake in the lung.

PubMed

Zavorsky, Gerald S; Hsia, Connie C W; Hughes, J Michael B; Borland, Colin D R; Guénard, Hervé; van der Lee, Ivo; Steenbruggen, Irene; Naeije, Robert; Cao, Jiguo; Dinh-Xuan, Anh Tuan

2017-02-01

Diffusing capacity of the lung for nitric oxide ( D LNO ), otherwise known as the transfer factor, was first measured in 1983. This document standardises the technique and application of single-breath D LNO This panel agrees that 1) pulmonary function systems should allow for mixing and measurement of both nitric oxide (NO) and carbon monoxide (CO) gases directly from an inspiratory reservoir just before use, with expired concentrations measured from an alveolar "collection" or continuously sampled via rapid gas analysers; 2) breath-hold time should be 10 s with chemiluminescence NO analysers, or 4-6 s to accommodate the smaller detection range of the NO electrochemical cell; 3) inspired NO and oxygen concentrations should be 40-60 ppm and close to 21%, respectively; 4) the alveolar oxygen tension ( P AO 2 ) should be measured by sampling the expired gas; 5) a finite specific conductance in the blood for NO (θNO) should be assumed as 4.5 mL·min -1 ·mmHg -1 ·mL -1 of blood; 6) the equation for 1/θCO should be (0.0062· P AO 2 +1.16)·(ideal haemoglobin/measured haemoglobin) based on breath-holding P AO 2 and adjusted to an average haemoglobin concentration (male 14.6 g·dL -1 , female 13.4 g·dL -1 ); 7) a membrane diffusing capacity ratio ( D MNO / D MCO ) should be 1.97, based on tissue diffusivity. Copyright ©ERS 2017.

The quality of websites addressing fibromyalgia: an assessment of quality and readability using standardised tools

PubMed Central

MacDermid, Joy C; Wilkins, Seanne; Gibson, Jane; Shaw, Lynn

2011-01-01

Background Patients living with fibromyalgia strongly prefer to access health information on the web. However, the majority of subjects in previous studies strongly expressed their concerns about the quality of online information resources. Objectives The purpose of this study was to evaluate existing online fibromyalgia information resources for content, quality and readability by using standardised quality and readability tools. Methods The first 25 websites were identified using Google and the search keyword ‘fibromyalgia’. Pairs of raters independently evaluated website quality using two structured tools (DISCERN and a quality checklist). Readability was assessed using the Flesch Reading Ease score maps. Results Ranking of the websites' quality varied by the tool used, although there was general agreement about the top three websites (Fibromyalgia Information, Fibromyalgia Information Foundation and National Institute of Arthritis and Musculoskeletal and Skin Diseases). Content analysis indicated that 72% of websites provided information on treatment options, 68% on symptoms, 60% on diagnosis and 40% on coping and resources. DISCERN ratings classified 32% websites as ‘very good’, 32% as ‘good and 36% as ‘marginal’. The mean overall DISCERN score was 36.88 (good). Only 16% of websites met the recommended literacy level grade of 6–8 (range 7–15). Conclusion Higher quality websites tended to be less readable. Online fibromyalgia information resources do not provide comprehensive information about fibromyalgia, and have low quality and poor readability. While information is very important for those living with fibromyalgia, current resources are unlikely to provide necessary or accurate information, and may not be usable for most people. PMID:22021777

The quality of websites addressing fibromyalgia: an assessment of quality and readability using standardised tools.

PubMed

Daraz, Lubna; Macdermid, Joy C; Wilkins, Seanne; Gibson, Jane; Shaw, Lynn

2011-07-31

Background Patients living with fibromyalgia strongly prefer to access health information on the web. However, the majority of subjects in previous studies strongly expressed their concerns about the quality of online information resources. Objectives The purpose of this study was to evaluate existing online fibromyalgia information resources for content, quality and readability by using standardised quality and readability tools. Methods The first 25 websites were identified using Google and the search keyword 'fibromyalgia'. Pairs of raters independently evaluated website quality using two structured tools (DISCERN and a quality checklist). Readability was assessed using the Flesch Reading Ease score maps. Results Ranking of the websites' quality varied by the tool used, although there was general agreement about the top three websites (Fibromyalgia Information, Fibromyalgia Information Foundation and National Institute of Arthritis and Musculoskeletal and Skin Diseases). Content analysis indicated that 72% of websites provided information on treatment options, 68% on symptoms, 60% on diagnosis and 40% on coping and resources. DISCERN ratings classified 32% websites as 'very good', 32% as 'good and 36% as 'marginal'. The mean overall DISCERN score was 36.88 (good). Only 16% of websites met the recommended literacy level grade of 6-8 (range 7-15). Conclusion Higher quality websites tended to be less readable. Online fibromyalgia information resources do not provide comprehensive information about fibromyalgia, and have low quality and poor readability. While information is very important for those living with fibromyalgia, current resources are unlikely to provide necessary or accurate information, and may not be usable for most people.

Can pharmaco-electroencephalography help improve survival of central nervous system drugs in early clinical development?

PubMed

Wilson, Frederick J; Leiser, Steven C; Ivarsson, Magnus; Christensen, Søren R; Bastlund, Jesper F

2014-03-01

Pharmaco-electroencephalography has significant yet unrealised promise as a translatable intermediate biomarker of central pharmacodynamic activity that could help reduce Phase 2 attrition in the development of central nervous system drugs. In an effort to understand its true potential, a framework for decision-making was proposed and the utility of pharmaco-electroencephalography was assessed through several case studies. A key finding was that lack of standardisation reduces the value of data pooling and meta-analyses and renders assessment of translatability difficult, limiting utility in all but simple cases. Pre-competitive collaboration is essential both to improving understanding of translation and developing modern signal processing techniques. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Simulation in health to improve the delivery of care].

PubMed

Tesnière, Antoine; Fleury, Cynthia

2017-11-01

Simulation in health care is a very effective training tool. Using mannequins, 'standardised patients' or virtual care environments, it encourages participants to reflect on nursing practices while practising in a safe and controlled space. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A basis for translational cancer research on aetiology, pathogenesis and prognosis: Guideline for standardised and population-based linkages of biobanks to cancer registries.

PubMed

Dillner, Joakim

2015-06-01

Population-based cancer research is paramount for controlling cancer. Cancer research is increasingly dependent on access to biospecimens from subjects that have been followed-up for future health outcomes. This is achieved using longitudinal follow-up of cohorts and biobanks using cancer registry linkages. All over the world, more and more large population-based cohorts and advanced biobanking facilities are established. International standardisation and networking in the linkage of cohorts and biobanks to cancer registries is required in order to enable international cancer research and comparability of research results. An international operating procedure and standard minimum dataset for linkages of biobanks, cohorts and cancer registries is proposed. An internationally comparable provision of well characterised study bases for molecular cancer research will be an essential prerequisite for the success of translational medicine. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluating Rotavirus and Norovirus transport processes in standardised and natural soil-water columns experiments

NASA Astrophysics Data System (ADS)

Gamazo, Pablo; Schijven, Jack; Victoria, Matias; Alvareda, Elena; López Tort, Fernando; Ramos, Julián; Lizasoain, Andrés; Sapriza, Gonzalo; Castells, Matias; Colina, Rodney

2017-04-01

In Uruguay, as in many developed and developing countries, rotavirus and norovirus are major causes of diarrhea and others symptoms of acute gastroenteritis. In some areas of Uruguay, groundwater is the only source of water for human consumption. In the rural area of the Salto district, virus contamination has been detected in several groundwater wells. Because sewer coverage is low, the most probable sources of contamination are nearby septic systems. This work aims to evaluate the transport of rotavirus and norovirus from clinic samples in two sets of column experiments under saturated conditions: 6.7-cm columns with quartz sand (ionic strength 1mM, pH 7.0) and with sand from the Salto aquifer (Uruguay) (9,2% coarse sand, 47,8% medium sand, 40,5% fine sand, magnesium/calcium bicarbonate water, Ionic strength 15.1 mM, pH 7.2). Both viruses were seeded for 2 pore volumes onto the columns. Samples were collected at the column outlet and viruses were enumerated by Q-PRCR. Breakthrough curves were constructed and fitted to a two-site kinetic attachment/detachment model, including blocking using Hydrus-1D. In the quartz sand column, both rotavirus and norovirus were removed two orders in magnitude. In the Salto sand column, rotavirus was removed 2 log10 as well, but norovirus was removed 4 log10. The fitting of the breakthrough curves indicated that blocking played a role for rotavirus in the Salto sand column. These results are consistent with the field observation where only rotavirus was detected in the Salto aquifer, while similar concentrations in Salto sewer effluent were measured for both viruses. This work, besides reporting actual parameters values for human virus transport modelling, shows the significant differences in transport that human viruses can have in standardised and natural soil-water systems.

Standardised online data access and publishing for Earth Systems and Climate data in Australia

NASA Astrophysics Data System (ADS)

Evans, B. J. K.; Druken, K. A.; Trenham, C.; Wang, J.; Wyborn, L. A.; Smillie, J.; Allen, C.; Porter, D.

2015-12-01

The National Computational Infrastructure (NCI) hosts Australia's largest repository (10+ PB) of research data collections spanning a wide range of fields from climate, coasts, oceans, and geophysics through to astronomy, bioinformatics, and the social sciences. Spatial scales range from global to local ultra-high resolution, requiring storage volumes from MB to PB. The data have been organised to be highly connected to both the NCI HPC and cloud resources (e.g., interactive visualisation and analysis environments). Researchers can login to utilise the high performance infrastructure for these data collections, or access the data via standards-based web services. Our aim is to provide a trusted platform to support interdisciplinary research across all the collections as well as services for use of the data within individual communities. We thus cater to a wide range of researcher needs, whilst needing to maintain a consistent approach to data management and publishing. All research data collections hosted at NCI are governed by a data management plan, prior to being published through a variety of platforms and web services such as OPeNDAP, HTTP, and WMS. The data management plan ensures the use of standard formats (when available) that comply with relevant data conventions (e.g., CF-Convention) and metadata standards (e.g., ISO19115). Digital Object Identifiers (DOIs) can be minted at NCI and assigned to datasets and collections. Large scale data growth and use in a variety of research fields has led to a rise in, and acceptance of, open spatial data formats such as NetCDF4/HDF5, prompting a need to extend these data conventions to fields such as geophysics and satellite Earth observations. The fusion of DOI-minted data that is discoverable and accessible via metadata and web services, creates a complete picture of data hosting, discovery, use, and citation. This enables standardised and reproducible data analysis.

Curved reformat of the paediatric brain MRI into a 'flat-earth map' - standardised method for demonstrating cortical surface atrophy resulting from hypoxic-ischaemic encephalopathy.

PubMed

Simpson, Ewan; Andronikou, Savvas; Vedajallam, Schadie; Chacko, Anith; Thai, Ngoc Jade

2016-09-01

Hypoxic-ischaemic encephalopathy is optimally imaged with brain MRI in the neonatal period. However neuroimaging is often also performed later in childhood (e.g., when parents seek compensation in cases of alleged birth asphyxia). We describe a standardised technique for creating two curved reconstructions of the cortical surface to show the characteristic surface changes of hypoxic-ischaemic encephalopathy in children imaged after the neonatal period. The technique was applied for 10 cases of hypoxic-ischaemic encephalopathy and also for age-matched healthy children to assess the visibility of characteristic features of hypoxic-ischaemic encephalopathy. In the abnormal brains, fissural or sulcal widening was seen in all cases and ulegyria was identifiable in 7/10. These images could be used as a visual aid for communicating MRI findings to clinicians and other interested parties.

Highly Efficient In Vitro Reparative Behaviour of Dental Pulp Stem Cells Cultured with Standardised Platelet Lysate Supplementation.

PubMed

Marrazzo, Pasquale; Paduano, Francesco; Palmieri, Francesca; Marrelli, Massimo; Tatullo, Marco

2016-01-01

Dental pulp is an accessible source of multipotent mesenchymal stromal cells (MSCs). The perspective role of dental pulp stem cells (DPSCs) in regenerative medicine demands an in vitro expansion and in vivo delivery which must deal with the safety issues about animal serum, usually required in cell culture practice. Human platelet lysate (PL) contains autologous growth factors and has been considered as valuable alternative to fetal bovine serum (FBS) in cell cultures. The optimum concentration to be added of such supplement is highly dependent on its preparation whose variability limits comparability of results. By in vitro experiments, we aimed to evaluate a standardised formulation of pooled PL. A low selected concentration of PL (1%) was able to support the growth and maintain the viability of the DPSCs. The use of PL in cell cultures did not impair cell surface signature typically expressed by MSCs and even upregulated the transcription of Sox2. Interestingly, DPSCs cultured in presence of PL exhibited a higher healing rate after injury and are less susceptible to toxicity mediated by exogenous H 2 O 2 than those cultured with FBS. Moreover, PL addition was shown as a suitable option for protocols promoting osteogenic and chondrogenic differentiation of DPSCs. Taken together, our results indicated that PL is a valid substitute of FBS to culture and differentiate DPSCs for clinical-grade use.

Highly Efficient In Vitro Reparative Behaviour of Dental Pulp Stem Cells Cultured with Standardised Platelet Lysate Supplementation

PubMed Central

Palmieri, Francesca; Marrelli, Massimo

2016-01-01

Dental pulp is an accessible source of multipotent mesenchymal stromal cells (MSCs). The perspective role of dental pulp stem cells (DPSCs) in regenerative medicine demands an in vitro expansion and in vivo delivery which must deal with the safety issues about animal serum, usually required in cell culture practice. Human platelet lysate (PL) contains autologous growth factors and has been considered as valuable alternative to fetal bovine serum (FBS) in cell cultures. The optimum concentration to be added of such supplement is highly dependent on its preparation whose variability limits comparability of results. By in vitro experiments, we aimed to evaluate a standardised formulation of pooled PL. A low selected concentration of PL (1%) was able to support the growth and maintain the viability of the DPSCs. The use of PL in cell cultures did not impair cell surface signature typically expressed by MSCs and even upregulated the transcription of Sox2. Interestingly, DPSCs cultured in presence of PL exhibited a higher healing rate after injury and are less susceptible to toxicity mediated by exogenous H2O2 than those cultured with FBS. Moreover, PL addition was shown as a suitable option for protocols promoting osteogenic and chondrogenic differentiation of DPSCs. Taken together, our results indicated that PL is a valid substitute of FBS to culture and differentiate DPSCs for clinical-grade use. PMID:27774106

Periorbital Biometric Measurements using ImageJ Software: Standardisation of Technique and Assessment Of Intra- and Interobserver Variability

PubMed Central

Rajyalakshmi, R.; Prakash, Winston D.; Ali, Mohammad Javed; Naik, Milind N.

2017-01-01

Purpose: To assess the reliability and repeatability of periorbital biometric measurements using ImageJ software and to assess if the horizontal visible iris diameter (HVID) serves as a reliable scale for facial measurements. Methods: This study was a prospective, single-blind, comparative study. Two clinicians performed 12 periorbital measurements on 100 standardised face photographs. Each individual’s HVID was determined by Orbscan IIz and used as a scale for measurements using ImageJ software. All measurements were repeated using the ‘average’ HVID of the study population as a measurement scale. Intraclass correlation coefficient (ICC) and Pearson product-moment coefficient were used as statistical tests to analyse the data. Results: The range of ICC for intra- and interobserver variability was 0.79–0.99 and 0.86–0.99, respectively. Test-retest reliability ranged from 0.66–1.0 to 0.77–0.98, respectively. When average HVID of the study population was used as scale, ICC ranged from 0.83 to 0.99, and the test-retest reliability ranged from 0.83 to 0.96 and the measurements correlated well with recordings done with individual Orbscan HVID measurements. Conclusion: Periorbital biometric measurements using ImageJ software are reproducible and repeatable. Average HVID of the population as measured by Orbscan is a reliable scale for facial measurements. PMID:29403183

Repeatability and validity of a standardised maximal step-up test for leg function-a diagnostic accuracy study

PubMed Central

2011-01-01

Background Objectively assessed physical performance is a strong predictor for morbidity and premature death and there is an increasing interest in the role of sarcopenia in many chronic diseases. There is a need for robust and valid functional tests in clinical practice. Therefore, the repeatability and validity of a newly developed maximal step up test (MST) was assessed. Methods The MST, assessing maximal step-up height (MSH) in 3-cm increments, was evaluated in 60 healthy middle-aged subjects, 30 women and 30 men. The repeatability of MSH and the correlation between MSH and isokinetic knee extension peak torque (IKEPT), self-reported physical function (SF-36, PF), patient demographics and self-reported physical activity were investigated. Results The repeatability between occasions and between testers was 6 cm. MSH (range 12-45 cm) was significantly correlated to IKEPT, (r = 0.68, P < 0.001), SF-36 PF score, (r = 0.29, P = 0.03), sex, age, weight and BMI. The results also show that MSH above 32 cm discriminates subjects in our study with no limitation in self-reported physical function. Conclusions The standardised MST is considered a reliable leg function test for clinical practice. The MSH was related to knee extension strength and self-reported physical function. The precision of the MST for identification of limitations in physical function needs further investigation. PMID:21854575

A tailored intervention to improving the quality of intrahospital nursing handover.

PubMed

Bergs, Jochen; Lambrechts, Frank; Mulleneers, Ines; Lenaerts, Kim; Hauquier, Caroline; Proesmans, Geert; Creemers, Sarah; Vandijck, Dominique

2018-01-01

Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU). A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure. In total 130 nurses participated, 66 before and 64 after the intervention. Initial structure of the HES showed no good fit to our data; the questions were reshaped into 3 dimensions: Quality of information, Interaction and support, and Relevance of information. Following the intervention, mean changes in HES factor scores ranged from -3.99 to +15.9. No significant difference in factor scoring by ward and ICU nurses was found. Emergency department nurses, however, perceived Interaction and support to be improved following the intervention. The intervention did not result in an improved perception of handover quality by ward and ICU nurses. There was improvement in the perception of Interaction and support among emergency department nurses. The intervention positively effected teamwork and mutual understanding concerning nursing handover practice amongst emergency nurses. In order to improve intrahospital nursing handover, hospital-wide interventions are suggested. These interventions should be aimed at creating a generative story, improving mutual understanding, and establishing a supportive attitude regarding standardised procedures to reduce human error. Copyright © 2017 Elsevier Ltd. All rights reserved.

Collaborative study for the standardisation of the histamine sensitizing test in mice and the CHO cell-based assay for the residual toxicity testing of acellular pertussis vaccines.

PubMed

Xing, D; Maes, A; Behr-Gross, M-E; Costanzo, A; Daas, A; Buchheit, K-H

2010-04-01

Rs principle). Based on the results of the collaborative study, a potency of 7500 IU/vial (International Units per vial) was assigned to the current Ph. Eur. Biological Reference Preparation (BRP) for PT. The results of the study also show that 1) intra- and inter-laboratory variations can be improved by the use of a validated standard operating procedure; 2) inclusion in each assay of a standard reference sample, calibrated in IU, can increase comparability of results among laboratories and thus help to reduce repeat testing; 3) a correlation between mortality data and temperature data was observed although, due to the limited number of data sets and the lack of a common method for the temperature end-point, further investigation of this point is required; 4) the CHO-cell-based assay did not yield comparable results and further standardisation of the assay procedure may be investigated in a follow-up project.

Diagnostic monitoring by infrared imaging of avian embryos

NASA Astrophysics Data System (ADS)

Wurzbach, Richard N.

1998-03-01

For large scale chicken and turkey raising operations, automated 'candling' of eggs for monitoring embryonic development is effective and efficient. Candling is accomplished by the transmission of high intensity light such that it penetrates the translucent egg and gives indications of embryonic position and development. When monitoring the development of other species, however, mixed results are obtained with this technique. For instance, the Emu egg is virtually opaque to transmitted visible light, and thus cannot be candled by traditional means. During the development cycle all avian embryos, and for that mater all egg-laying creatures, exhibit changes in shell surface temperatures that indicate on-going development, or a lack of that development. Additionally, such hazards as bacterial or viral growth within the shell produce atypical thermal signatures. Analysis of the shell surface temperatures may be useful in monitoring the development of these embryos. Further applications of IR thermography in farming of avian species may make it an economically viable monitoring technique.

How far is it? Distance measurements and their consequences

NASA Astrophysics Data System (ADS)

Krełowski, Jacek

2017-08-01

Methods of measuring distances to objects in our Milky Way are briefly discussed. They generally base on three principles: of using a standard rod, of standard candle and of column density of interstellar matter. Weak and strong points of these methods are presented. The presence of gray extinction towards some objects is suggested which makes the most universal method of standard candle (spectroscopic parallax) very uncertain. Hard to say whether gray extinc-tion appears only in the form of circumstellar debris discs or is present also in the general interstellar medium. The application of the method of measuring column densities of interstellar gases suggests that the rotation curve of our Milky Way system is rather Keplerian than flat which creates doubts as to whether any Dark Matter halo is present around our Galaxy. It is emphasized that the most universal method, i.e. that of standard candle, used to estimate distances to cosmological objects, may suffer serious errors because of improper subtraction of extinction effects.

The Infrared Hubble Diagram of Type Ia Supernovae

NASA Astrophysics Data System (ADS)

Krisciunas, Kevin

Photometry of Type Ia supernovae reveals that these objects are standardizable candles in optical passbands - the peak luminosities are related to the rate of decline after maximum light. In the near-infrared bands, there is essentially a characteristic brightness at maximum light for each photometric band. Thus, in the near-infrared they are better than standardizable candles; they are essentially standard candles. Their absolute magnitudes are known to ±0.15 magnitude or better. The infrared observations have the extra advantage that interstellar extinction by dust along the line of sight is a factor of 3-10 smaller than in the optical B- and V -bands. The size of any systematic errors in the infrared extinction corrections typically become smaller than the photometric errors of the observations. Thus, we can obtain distances to the hosts of Type Ia supernovae to ±8 % or better. This is particularly useful for extragalactic astronomy and precise measurements of the dark energy component of the universe.

Evaluation of prognostic models developed using standardised image features from different PET automated segmentation methods.

PubMed

Parkinson, Craig; Foley, Kieran; Whybra, Philip; Hills, Robert; Roberts, Ashley; Marshall, Chris; Staffurth, John; Spezi, Emiliano

2018-04-11

Prognosis in oesophageal cancer (OC) is poor. The 5-year overall survival (OS) rate is approximately 15%. Personalised medicine is hoped to increase the 5- and 10-year OS rates. Quantitative analysis of PET is gaining substantial interest in prognostic research but requires the accurate definition of the metabolic tumour volume. This study compares prognostic models developed in the same patient cohort using individual PET segmentation algorithms and assesses the impact on patient risk stratification. Consecutive patients (n = 427) with biopsy-proven OC were included in final analysis. All patients were staged with PET/CT between September 2010 and July 2016. Nine automatic PET segmentation methods were studied. All tumour contours were subjectively analysed for accuracy, and segmentation methods with < 90% accuracy were excluded. Standardised image features were calculated, and a series of prognostic models were developed using identical clinical data. The proportion of patients changing risk classification group were calculated. Out of nine PET segmentation methods studied, clustering means (KM2), general clustering means (GCM3), adaptive thresholding (AT) and watershed thresholding (WT) methods were included for analysis. Known clinical prognostic factors (age, treatment and staging) were significant in all of the developed prognostic models. AT and KM2 segmentation methods developed identical prognostic models. Patient risk stratification was dependent on the segmentation method used to develop the prognostic model with up to 73 patients (17.1%) changing risk stratification group. Prognostic models incorporating quantitative image features are dependent on the method used to delineate the primary tumour. This has a subsequent effect on risk stratification, with patients changing groups depending on the image segmentation method used.

Impaired Neurobehavioural Performance in Untreated Obstructive Sleep Apnea Patients Using a Novel Standardised Test Battery.

PubMed

D'Rozario, Angela L; Field, Clarice J; Hoyos, Camilla M; Naismith, Sharon L; Dungan, George C; Wong, Keith K H; Grunstein, Ronald R; Bartlett, Delwyn J

2018-01-01

Although polysomnography (PSG) is the gold-standard measure for assessing disease severity in obstructive sleep apnea (OSA), it has limited value in identifying individuals experiencing significant neurobehavioural dysfunction. This study used a brief and novel computerised test battery to examine neurobehavioural function in adults with and without OSA. 204 patients with untreated OSA [age 49.3 (12.5) years; body mass index, [BMI] 33.6 (8.0) kg/m 2 ; Epworth sleepiness scale 12 (4.9)/24; apnea hypopnea index 33.6 (25.8)/h] and 50 non-OSA participants [age 39.2 (14.0) years; BMI 25.8 (4.2) kg/m 2 , ESS 3.6 (2.3)/24]. All participants completed a computerised neurobehavioural battery during the daytime in the sleep clinic. The OSA group subsequently underwent an overnight PSG. The 30 min test battery assessed cognitive domains of visual spatial scanning and selective attention (Letter Cancellation Test), executive function (Stroop task) and working memory (2- and 3-Back tasks), and a validated sustained attention task (psychomotor vigilance task, PVT). Group differences in performance were compared. Associations between disease severity and performance were examined in the OSA group. After controlling for age, gender and education, OSA patients demonstrated impaired performance on the Stroop-Text, 2 and 3-Back tasks, and the PVT compared with the non-OSA group. OSA patients had worse performance on the LCT with fewer average hits albeit with better accuracy. Some OSA polysomnographic disease severity measures were weakly correlated with performance. This brief test battery may provide a sensitive, standardised method of assessing daytime dysfunction in OSA.

A Simple Insightful Approach to Investigating a Hospital Standardised Mortality Ratio: An Illustrative Case-Study

PubMed Central

Mohammed, Mohammed A.; Stevens, Andrew J.

2013-01-01

Background Despite methodological concerns Hospital Standardised Mortality Ratios (HSMRs) are promoted as measures of performance. Hospitals that experience an increase in their HSMR are presented with a serious challenge but with little guidance on how to investigate this complex phenomenon. We illustrate a simple penetrating approach. Methods Retrospective analysis of routinely collected hospital admissions data comparing observed and expected deaths predicted by the Dr Foster Unit case mix adjustment method over three years (n = 74,860 admissions) in Shropshire and Telford NHS Trust Hospital (SaTH) constituting PRH (Princess Royal Hospital) and RSH (Royal Shrewsbury Hospital); whose HSMR increased from 99 in the year 2008/09 to 118 in the year 2009/10. Results The step up in HSMR was primarily located in PRH (109 to 130 vs. 105 to 118 RSH). Disentangling the HSMR by plotting run charts of observed and expected deaths showed that observed deaths were stable in RSH and PRH but expected deaths, especially at PRH, had fallen. The fall in expected deaths has two possible explanations–genuinely lower risk admissions or that the case-mix adjustment model is underestimating the risk of admissions perhaps because of inadequate clinical coding. There was no evidence that the case-mix profile of admissions had changed but there was considerable evidence that clinical coding process at PRH was producing a lower depth of coding resulting in lower expected mortality. Conclusion Knowing whether the change (increase/decrease) in HSMR is driven by the numerator or the denominator is a crucial pivotal first step in understanding a given HSMR and so such information should be an integral part of the HSMR reporting methodology. PMID:23472111

A Hubble Space Telescope survey for Novae in M87. II. Snuffing out the maximum magnitude–rate of decline relation for novae as a non-standard candle, and a prediction of the existence of ultrafast novae

DOE PAGES

Shara, Michael M.; Doyle, Trisha; Lauer, Tod R.; ...

2017-04-20

The extensive grid of numerical simulations of nova eruptions first predicted that some classical novae might significantly deviate from the Maximum Magnitude–Rate of Decline (MMRD) relation, which purports to characterize novae as standard candles. Kasliwal et al. have announced the observational detection of a new class of faint, fast classical novae in the Andromeda galaxy. These objects deviate strongly from the MMRD relationship, as predicted by Yaron et al. Recently, Shara et al. reported the first detections of faint, fast novae in M87. These previously overlooked objects are as common in the giant elliptical galaxy M87 as they are inmore » the giant spiral M31; they comprise about 40% of all classical nova eruptions and greatly increase the observational scatter in the MMRD relation. We use the extensive grid of the nova simulations of Yaron et al. to identify the underlying causes of the existence of faint, fast novae. These are systems that have accreted, and can thus eject, only very low-mass envelopes, of the order of 10 –7–10 –8 M ⊙, on massive white dwarfs. Such binaries include, but are not limited to, the recurrent novae. As a result, these same models predict the existence of ultrafast novae that display decline times, t 2, to be as short as five hours. We outline a strategy for their future detection.« less

A Hubble Space Telescope survey for Novae in M87. II. Snuffing out the maximum magnitude–rate of decline relation for novae as a non-standard candle, and a prediction of the existence of ultrafast novae

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

Shara, Michael M.; Doyle, Trisha; Lauer, Tod R.

The extensive grid of numerical simulations of nova eruptions first predicted that some classical novae might significantly deviate from the Maximum Magnitude–Rate of Decline (MMRD) relation, which purports to characterize novae as standard candles. Kasliwal et al. have announced the observational detection of a new class of faint, fast classical novae in the Andromeda galaxy. These objects deviate strongly from the MMRD relationship, as predicted by Yaron et al. Recently, Shara et al. reported the first detections of faint, fast novae in M87. These previously overlooked objects are as common in the giant elliptical galaxy M87 as they are inmore » the giant spiral M31; they comprise about 40% of all classical nova eruptions and greatly increase the observational scatter in the MMRD relation. We use the extensive grid of the nova simulations of Yaron et al. to identify the underlying causes of the existence of faint, fast novae. These are systems that have accreted, and can thus eject, only very low-mass envelopes, of the order of 10 –7–10 –8 M ⊙, on massive white dwarfs. Such binaries include, but are not limited to, the recurrent novae. As a result, these same models predict the existence of ultrafast novae that display decline times, t 2, to be as short as five hours. We outline a strategy for their future detection.« less

A Hubble Space Telescope Survey for Novae in M87. II. Snuffing out the Maximum Magnitude–Rate of Decline Relation for Novae as a Non-standard Candle, and a Prediction of the Existence of Ultrafast Novae

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

Shara, Michael M.; Doyle, Trisha; Zurek, David

The extensive grid of numerical simulations of nova eruptions from the work of Yaron et al. first predicted that some classical novae might significantly deviate from the Maximum Magnitude–Rate of Decline (MMRD) relation, which purports to characterize novae as standard candles. Kasliwal et al. have announced the observational detection of a new class of faint, fast classical novae in the Andromeda galaxy. These objects deviate strongly from the MMRD relationship, as predicted by Yaron et al. Recently, Shara et al. reported the first detections of faint, fast novae in M87. These previously overlooked objects are as common in the giantmore » elliptical galaxy M87 as they are in the giant spiral M31; they comprise about 40% of all classical nova eruptions and greatly increase the observational scatter in the MMRD relation. We use the extensive grid of the nova simulations of Yaron et al. to identify the underlying causes of the existence of faint, fast novae. These are systems that have accreted, and can thus eject, only very low-mass envelopes, of the order of 10{sup −7}–10{sup −8} M {sub ⊙}, on massive white dwarfs. Such binaries include, but are not limited to, the recurrent novae. These same models predict the existence of ultrafast novae that display decline times, t {sub 2,} to be as short as five hours. We outline a strategy for their future detection.« less

Quality assessment and improvement of post graduate family medicine training in the USA.

PubMed

Hoekzema, Grant S; Maxwell, Lisa; Gravel, Joseph W; Mills, Walter W; Geiger, William; Honeycutt, J David

2016-09-01

In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD's strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.

A practical approach to estimate emission rates of indoor air pollutants due to the use of personal combustible products based on small-chamber studies.

PubMed

Szulejko, Jan E; Kim, Ki-Hyun

2016-02-01

As emission rates of airborne pollutants are commonly measured from combusting substances placed inside small chambers, those values need to be re-evaluated for the possible significance under practical conditions. Here, a simple numerical procedure is investigated to extrapolate the chamber-based emission rates of formaldehyde that can be released from various combustible sources including e-cigarettes, conventional cigarettes, or scented candles to their concentration levels in a small room with relatively poor ventilation. This simple procedure relies on a mass balance approach by considering the masses of pollutants emitted from source and lost through ventilation under the assumption that mixing occurs instantaneously in the room without chemical reactions or surface sorption. The results of our study provide valuable insights into re-evaluation procedure of chamber data to allow comparison between extrapolated and recommended values to judge the safe use of various combustible products in confined spaces. If two scented candles with a formaldehyde emission rate of 310 µg h(-1) each were lit for 4 h in a small 20 m(3) room with an air change rate of 0.5 h(-1), then the 4-h (candle lit) and 8-h (up to 8 h after candle lighting) TWA [FA] were determined to be 28.5 and 23.5 ppb, respectively. This is clearly above the 8-h NIOSH recommended exposure limit (REL) time weighted average of 16 ppb. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving driving advice provided to cardiology patients on discharge.

PubMed

Vusirikala, Amoolya; Backhouse, Mark; Schimansky, Sarah

2018-01-01

Certain cardiac conditions can limit patients' ability to drive. It remains the doctors' responsibility to advise patients of any driving restrictions and is particularly important after certain diagnoses or procedures. We identified that the quality of documented advice was variable and frequently no written driving advice was recorded on discharge. It was apparent that there was a lack of awareness and knowledge of the current Driving and Vehicle Licensing Agency (DVLA) guidance among junior doctors. We therefore designed a quality improvement project using Plan-Do-Study-Act (PDSA) methodology to improve the provision of driving advice on discharge from a cardiology ward by focusing on staff education. After collecting baseline data, we created a template with cardiology-specific DVLA advice. During the second PDSA cycle, we improved the electronic template and also introduced a hard copy on the ward. During the third PDSA cycle, we incorporated information on DVLA guidance in the specialty induction session. We also evaluated junior doctors' confidence of providing driving advice before and after this intervention. Baseline measurements showed that 10% (9/92) of all discharge summaries included driving advice. This improved to 49% (34/69) after the third PDSA cycle. Importantly, after receiving information on driving advice in the induction, junior doctors felt more confident in providing driving advice to cardiology patients on discharge. In conclusion, the provision of driving advice on discharge is an important element of patient safety. However, clinicians' knowledge and awareness of current DVLA guidance is often limited. We demonstrated a significant increase in the provision of driving advice by introducing a standardised template.

[Improving inpatient pharmacoterapeutic process by Lean Six Sigma methodology].

PubMed

Font Noguera, I; Fernández Megía, M J; Ferrer Riquelme, A J; Balasch I Parisi, S; Edo Solsona, M D; Poveda Andres, J L

2013-01-01

Lean Six Sigma methodology has been used to improve care processes, eliminate waste, reduce costs, and increase patient satisfaction. To analyse the results obtained with Lean Six Sigma methodology in the diagnosis and improvement of the inpatient pharmacotherapy process during structural and organisational changes in a tertiary hospital. 1.000 beds tertiary hospital. prospective observational study. The define, measure, analyse, improve and control (DMAIC), were deployed from March to September 2011. An Initial Project Charter was updated as results were obtained. 131 patients with treatments prescribed within 24h after admission and with 4 drugs. safety indicators (medication errors), and efficiency indicators (complaints and time delays). Proportion of patients with a medication error was reduced from 61.0% (25/41 patients) to 55.7% (39/70 patients) in four months. Percentage of errors (regarding the opportunities for error) decreased in the different phases of the process: Prescription: from 5.1% (19/372 opportunities) to 3.3% (19/572 opportunities); Preparation: from 2.7% (14/525 opportunities) to 1.3% (11/847 opportunities); and administration: from 4.9% (16/329 opportunities) to 3.0% (13/433 opportunities). Nursing complaints decreased from 10.0% (2119/21038 patients) to 5.7% (1779/31097 patients). The estimated economic impact was 76,800 euros saved. An improvement in the pharmacotherapeutic process and a positive economic impact was observed, as well as enhancing patient safety and efficiency of the organization. Standardisation and professional training are future Lean Six Sigma candidate projects. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

Resident-initiated interventions to improve inpatient heart-failure management.

PubMed

Oujiri, James; Hakeem, Abdul; Pack, Quinn; Holland, Robert; Meyers, David; Hildebrand, Christopher; Bridges, Alan; Roach, Mary A; Vogelman, Bennett

2011-02-01

Third-year internal medicine residents participating in a quality improvement rotation identified gaps between the Joint Commission's ORYX quality guidelines and clinical practices for the inpatient management of heart failure (HF) at the William S. Middleton Memorial Veterans Hospital. Residents focused on the performance metrics associated with tobacco-cessation counselling documentation, ejection fraction assessment and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescriptions. After analysing data collected by the External Peer Review Program, residents reviewed the institution's admissions and discharge processes with the aim of improving quality and compliance. In redesigning these processes, residents created an admissions template and a discharge face sheet, and compared specific ORYX measure compliance rates before and after institution-wide implementation. Following implementation of the tobacco-cessation admissions template, 100% of HF patients who used tobacco received documented cessation counselling, compared with 59% prior to intervention (p<0.01, n=32). Following implementation of the mandatory discharge face sheet, 97% of HF patients (compared with 92% preintervention, p>0.05) received comprehensive discharge instruction; LV function assessment went from 98% to 100% (p>0.05); and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription for left ventricular systolic dysfunction at discharge (or documentation of a contra-indication) went from 82% to 100% (p<0.01, n=48). By implementing a standardised admissions template and a mandatory discharge face sheet, the hospital improved its processes of documentation and increased adherence to quality-performance measures. By strengthening residents' learning and commitment to quality improvement, the hospital created a foundation for future changes in the systems that affect patient care.

Optimisation of Healthcare Contracts: Tensions Between Standardisation and Innovation

PubMed Central

Mikkers, Misja; Ryan, Padhraig

2016-01-01

An important determinant of health system performance is contracting. Providers often respond to financial incentives, despite the ethical underpinnings of medicine, and payers can craft contracts to influence performance. Yet contracting is highly imperfect in both single-payer and multi-payer health systems. Arguably, in a competitive, multi-payer environment, contractual innovation may occur more rapidly than in a single-payer system. This innovation in contract design could enhance performance. However, contractual innovation often fails to improve performance as payer incentives are misaligned with public policy objectives. Numerous countries seek to improve healthcare contracts, but thus far no health system has demonstrably crafted the necessary blend of incentives to stimulate optimal contracting. PMID:26927400

Assessment of two alternative standardised tests for the vascular component of the hand-arm vibration syndrome (HAVS).

PubMed

Ye, Ying; Griffin, Michael J

2016-10-01

Vibration-induced white finger (VWF) is the vascular component of the hand-arm vibration syndrome (HAVS). Two tests have been standardised so as to assist the diagnosis of VWF: the measurement of finger rewarming times and the measurement of finger systolic blood pressures (FSBPs). This study investigates whether the two tests distinguish between fingers with and without symptoms of whiteness and compares individual results between the two test methods. In 60 men reporting symptoms of the HAVS, the times for their fingers to rewarm by 4°C (after immersion in 15°C water for 5 min) and FSBPs at 30°C, 15°C and 10°C were measured on the same day. There were significant increases in finger rewarming times and significant reductions in FSBPs at both 15°C and 10°C in fingers reported to suffer blanching. The FSBPs had sensitivities and specificities >90%, whereas the finger rewarming test had a sensitivity of 77% and a specificity of 79%. Fingers having longer rewarming times had lower FSBPs at both temperatures. The findings suggest that, when the test conditions are controlled according to the relevant standard, finger rewarming times and FSBPs can provide useful information for the diagnosis of VWF, although FSBPs are more sensitive and more specific. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting, Tanzania.

PubMed

Mgaya, Andrew H; Litorp, Helena; Kidanto, Hussein L; Nyström, Lennarth; Essén, Birgitta

2016-11-08

In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting. During 2013-2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited. Two registered nurses under supervision of a nurse midwife, a specialist obstetrician and a consultant obstetrician, reviewed the case files. Criteria for standard diagnosis and management of foetal distress were developed based on international and national guidelines, and literature reviews, and then, stepwise applied, in an audit cycle. During the baseline audit, substandard care was identified, and recommendations for improvement of care were proposed and implemented. The effect of the implementations was assessed by the differences in percentage of standard diagnosis and management between the baseline and re-audit, using Chi-square test or Fisher's exact test, when appropriate. In the baseline audit and re-audit, 248 and 251 deliveries with a diagnosis of foetal distress were identified and audited, respectively. The standard of diagnosis increased significantly from 52 to 68 % (p < 0.001). Standards of management improved tenfold from 0.8 to 8.8 % (p < 0.001). Improved foetal heartbeat monitoring using a Fetal Doppler was the major improvement in diagnoses, while change of position of the mother and reduced time interval from decision to perform caesarean section to delivery were the major improvements in management (all p < 0.001). Percentage of cases with substandard diagnosis and management was significantly reduced in both referred public and non-referred private patients (all p ≤ 0.01) but not in non-referred public and

Increased Standardised Incidence Ratio of Malignant Pleural Mesothelioma in Taiwanese Asbestos Workers: A 29-Year Retrospective Cohort Study

PubMed Central

Lin, Cheng-Kuan; Chang, Yu-Ying; Wang, Jung-Der

2015-01-01

Objective. This paper aimed to determine the standardised incidence ratio (SIR) of malignant pleural mesothelioma (MPM) in workers exposed to asbestos in Taiwan. Methods. All workers employed in asbestos-related factories and registered by the Bureau of Labour Insurance between 1 March, 1950, and 31 December, 1989, were included in the study and were followed from 1 January, 1980, through 31 December, 2009. Incident cases of all cancers, including MPM (ICD-9 code: 163), were obtained from the Taiwan Cancer Registry. SIRs were calculated based on comparison with the incidence rate of the general population of Taiwan and adjusted for age, calendar period, sex, and duration of employment. Results. The highest SIR of MPM was found for male workers first employed before 1979, with a time since first employment more than 30 years (SIR 4.52, 95% CI: 2.25–8.09). After consideration of duration of employment, the SIR for male MPM was 5.78 (95% CI: 1.19–16.89) for the workers employed for more than 20 years in asbestos-related factories. Conclusions. This study corroborates the association between occupational asbestos exposure and MPM. The highest risk of MPM was found among male asbestos workers employed before 1979 and working for more than 20 years in asbestos-related factories. PMID:26290869

Protective effects of a standardised red orange extract on air pollution-induced oxidative damage in traffic police officers.

PubMed

Bonina, Francesco P; Puglia, Carmelo; Frasca, Giuseppina; Cimino, Francesco; Trombetta, Domenico; Tringali, Giovanni; Roccazzello, Annamaria; Insiriello, Elio; Rapisarda, Paolo; Saija, Antonella

2008-01-01

Several pathological conditions have all been associated with a higher release of atmospheric pollutants. There is growing evidence that oxidative stress may represent one of the agents involved in the initiation and/or progression of many of these pathologies. The aim of the present study was to evaluate the effects of short-term dietary supplementation with a standardised red orange extract (ROC) on a group of traffic police officers exposed to traffic exhaust pollution and cigarette smoking, by measuring some noninvasive biomarkers of oxidative stress. At the beginning of the study, all the groups showed similar serum lipid hydroperoxide levels, but traffic officers showed lower serum concentrations of thiol (SH) groups; furthermore, the frequency of spontaneous sister chromatide exchanges (SCEs) in peripheral lymphocytes was increased by smoking (but not by pollution exposure alone) at a higher degree in subjects exposed to traffic pollution. After 1 month of ROC administration, serum lipid hydroperoxide levels decreased only in all non-smoking subjects; furthermore, SH group levels measured in traffic officers appeared restored to normal values observed in the respective controls. Finally, the increase in SCE frequency induced by smoking was reduced by treatment with ROC especially in traffic officers. Our study suggests that ROC supplementation could be useful to minimise the detrimental effects caused by exposure to air pollution and smoking.

Effectiveness of a standardised exercise programme for recurrent neck and low back pain: a multicentre, randomised, two-arm, parallel group trial across 34 fitness clubs in Finland.

PubMed

Suni, Jaana H; Rinne, Marjo; Tokola, Kari; Mänttäri, Ari; Vasankari, Tommi

2017-01-01

Neck and low back pain (LBP) are common in office workers. Exercise trials to reduce neck and LBP conducted in sport sector are lacking. We investigated the effectiveness of the standardised Fustra20Neck&Back exercise program for reducing pain and increasing fitness in office workers with recurrent non-specific neck and/or LBP. Volunteers were recruited through newspaper and Facebook. The design is a multi-centre randomised, two-arm, parallel group trial across 34 fitness clubs in Finland. Eligibility was determined by structured telephone interview. Instructors were specially educated professionals. Neuromuscular exercise was individually guided twice weekly for 10 weeks. Webropol survey, and objective measurements of fitness, physical activity, and sedentary behavior were conducted at baseline, and at 3 and 12 months. Mean differences between study groups (Exercise vs Control) were analysed using a general linear mixed model according to the intention-to-treat principle. At least moderate intensity pain (≥40 mm) in both the neck and back was detected in 44% of participants at baseline. Exercise compliance was excellent: 92% participated 15-20 times out of 20 possible. Intensity and frequency of neck pain, and strain in neck/shoulders decreased significantly in the Exercise group compared with the Control group. No differences in LBP and strain were detected. Neck/shoulder and trunk flexibility improved, as did quality of life in terms of pain and physical functioning. The Fustra20Neck&Back exercise program was effective for reducing neck/shoulder pain and strain, but not LBP. Evidence-based exercise programs of sports clubs have potential to prevent persistent, disabling musculoskeletal problems.

Traumatic brain injury in England and Wales: prospective audit of epidemiology, complications and standardised mortality

PubMed Central

Lawrence, T; Bouamra, O; Woodford, M; Lecky, F; Hutchinson, P J

2016-01-01

Objectives To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. Design The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. Setting Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14n) model multivariate TBI outcome prediction model. The frequency and timing of secondary transfer to neurosurgical centres was assessed. Results We identified 15 820 patients with TBI presenting to neurosurgical centres directly (6258), transferred from a district hospital to a neurosurgical centre (3682) and remaining in a district general hospital (5880). The commonest mechanisms of injury were falls in the elderly and road traffic collisions in the young, which were more likely to present in coma. In severe TBI (Glasgow Coma Score (GCS) ≤8), the median time from admission to imaging with CT scan is 0.5 hours. Median time to craniotomy from admission is 2.6 hours and median time to intracranial pressure monitoring is 3 hours. The most frequently documented complication of severe TBI is bronchopneumonia in 5% of patients. Risk-adjusted W scores derived from the Ps14n model indicate that no neurosurgical unit fell outside the 3 SD limits on a funnel plot. Conclusions We provide the first comprehensive report of the management of TBI in England and Wales, including data from all neurosurgical units. These data provide transparency and suggests equity of access to high-quality TBI management provided in England and Wales. PMID:27884843

Impact of the introduction of standardised packaging on smokers’ brand awareness and identification in Australia

PubMed Central

Balmford, James; Borland, Ron; Yong, Hua-Hie

2015-01-01

Introduction and aims The introduction of standardised packaging (SP) in Australia in December 2012 has heightened interest in how image and branding might affect smoking. This paper tests the hypothesis that brand awareness and identification among smokers will decline after the introduction of SP. Design and methods Longitudinal study of three waves of smokers in Australia, conducted between October 2011–February 2012 (pre-SP) (n=1104), February-May 2013 (post-SP1) (n=1093), and August-December 2014 (post-SP2) (n=1090). We explored the extent of changes in two variables, brand awareness (noticing others with the brand of cigarettes you smoke) and brand identification (perceiving something in common among smokers of your brand), and examined change in a number of other measures of brand appeal, brand characteristics and determinants of brand choice. Results Brand awareness ‘at least sometimes’ reduced from 45.3% pre-SP to 26.9% at post-SP2 (odds ratio [OR] 0.35 (0.27–0.45)). Brand identification also decreased from 18.2% to 12.7% (OR 0.62 (0.42–0.91)). Significant decline was also found in measures of perceived brand prestige (OR 0.51 (0.39–0.66), and choice of brand for health reasons (OR 0.45 (0.32–0.63). Liking the look of the pack was strongly associated with brand identification, but only post-SP (P=0.02 for interaction across the 3 waves). Discussion The introduction of SP of tobacco products in Australia has been associated with reductions in brand awareness and identification, and changes in related measures. Conclusions The findings support the notion that SP has reduced the capacity for smokers to use pack branding to create and communicate a desired identity. PMID:26369651

Improvement in bronchial hyper-responsiveness in patients with moderate asthma after treatment with a hypnotic technique: a randomised controlled trial.

PubMed Central

Ewer, T C; Stewart, D E

1986-01-01

A prospective, randomised, single blind, and controlled trial of a hypnotic technique was undertaken in 39 adults with mild to moderate asthma graded for low and high susceptibility to hypnosis. After a six week course of hypnotherapy 12 patients with a high susceptibility score showed a 74.9% improvement (p less than 0.01) in the degree of bronchial hyper-responsiveness to a standardised methacholine challenge test. Daily home recordings of symptoms improved by 41% (p less than 0.01), peak expiratory flow rates improved by 5.5% (p less than 0.01), and use of bronchodilators decreased by 26.2% (p less than 0.05). The improvement in bronchial hyper-reactivity occurred without a change in subjective appreciation of the degree of bronchoconstriction. A control group 17 patients and 10 patients undergoing treatment with low susceptibility to hypnosis had no change in either bronchial hyper-responsiveness or any of the symptoms recorded at home. This study shows the efficacy of a hypnotic technique in adult asthmatics who are moderately to highly susceptible to hypnosis. PMID:3094804

[Acceptance of the Implementation of Standardised Patient Education Programmes by the Multidisciplinary Rehabilitation Team Using the Example of a Back School - A Qualitative Study].

PubMed

Peters, S; Schultze, A; Pfeifer, K; Faller, H; Meng, K

2016-03-01

The transfer of standardised patient education programmes into practice is a complex process with a multitude of influencing factors. Determinants relate among others to the organisation and individuals (e. g., practitioner, patient). Knowledge about individual factors regarding the trainers of patient education programmes in the German rehabilitation system is scarce. The aim of this study is to explore the acceptance of trainers concerning the implementation of a standardised back school and to derive facilitators and barriers to the implementation of patient education programmes. Semi-structured guideline-based interviews were conducted in 10 rehabilitation clinics. The sample consisted of 46 trainers (25 women): 11 physicians, 11 psychologists, 21 physio-/exercise therapists and 3 occupational therapists with a mean age of 41. The opinions of the trainers regarding the central components of back schools in general, their opinions about the new curriculum, their expectations on its implementation, anticipated difficulties with implementation and requests to the project team were explored as indicators for acceptance. The data were analysed with a multi-step qualitative content analysis. 6 main categories comprising 136 subcategories were created and 729 quotations coded. Regarding the central components that should be covered by back schools, back-friendly behaviour was addressed most often. Opinions regarding the new curriculum were mostly positive. Trainers' approval of content and methods was highlighted and the similarity with existing offers in the clinics as well as the structure of the programme were rated positively. The trainers expected an increased patient orientation and personal development as well as a common, coherent language and interdisciplinarity. Difficulties were anticipated regarding time and personnel as well as therapy and appointment planning and also regarding the motivation/acceptance of patients. A wish for communication, education

Towards a standardised informed consent procedure for live donor nephrectomy: the PRINCE (Process of Informed Consent Evaluation) project—study protocol for a nationwide prospective cohort study

PubMed Central

Kortram, Kirsten; Spoon, Emerentia Q W; Ismail, Sohal Y; d'Ancona, Frank C H; Christiaans, Maarten H L; van Heurn, L W Ernest; Hofker, H Sijbrand; Hoksbergen, Arjan W J; Homan van der Heide, Jaap J; Idu, Mirza M; Looman, Caspar W N; Nurmohamed, S Azam; Ringers, Jan; Toorop, Raechel J; van de Wetering, Jacqueline; Ijzermans, Jan N M; Dor, Frank J M F

2016-01-01

Introduction Informed consent is mandatory for all (surgical) procedures, but it is even more important when it comes to living kidney donors undergoing surgery for the benefit of others. Donor education, leading to informed consent, needs to be carried out according to certain standards. Informed consent procedures for live donor nephrectomy vary per centre, and even per individual healthcare professional. The basis for a standardised, uniform surgical informed consent procedure for live donor nephrectomy can be created by assessing what information donors need to hear to prepare them for the operation and convalescence. Methods and analysis The PRINCE (Process of Informed Consent Evaluation) project is a prospective, multicentre cohort study, to be carried out in all eight Dutch kidney transplant centres. Donor knowledge of the procedure and postoperative course will be evaluated by means of pop quizzes. A baseline cohort (prior to receiving any information from a member of the transplant team in one of the transplant centres) will be compared with a control group, the members of which receive the pop quiz on the day of admission for donor nephrectomy. Donor satisfaction will be evaluated for all donors who completed the admission pop-quiz. The primary end point is donor knowledge. In addition, those elements that have to be included in the standardised format informed consent procedure will be identified. Secondary end points are donor satisfaction, current informed consent practices in the different centres (eg, how many visits, which personnel, what kind of information is disclosed, in which format, etc) and correlation of donor knowledge with surgeons' estimation thereof. Ethics and dissemination Approval for this study was obtained from the medical ethical committee of the Erasmus MC, University Medical Center, Rotterdam, on 18 February 2015. Secondary approval has been obtained from the local ethics committees in six participating centres. Approval in the

St Elsewhere's or St Everywhere's: improving patient throughput in the private hospital sector.

PubMed

Laffey, Jennifer A; Wasson, Moran

2007-01-01

Communication errors have been found to be most common root cause of medical errors by the US-based Agency for Healthcare Research and Quality [1]. Although elective admissions to hospital involves a high volume of important healthcare communications where incorrect, missing or illegible information could result in a serious medical error, there is little published research on the impact of improving pre-admission communication flow between admitting doctors and hospitals. The Sydney Adventist Hospital (the San) is a 341-bed private hospital in Sydney's northern suburbs that provides a comprehensive range of health services. A process improvement program began in early 2005 to streamline preadmission communications. The objectives of this ongoing program are broadly to improve patient safety and to increase operating efficiency. The first major initiative within this program was to implement a standardised method for inpatient booking/referral with over three hundred admitting doctors. Eighteen months on, the hospital has been able to demonstrate a significant shift in the timeliness of patient bookings from specialists' rooms, more comprehensive provision of clinical indicators that can facilitate resource planning in operating theatres and on the wards, and reduction in the ratio of bookings made in areas other than the hospital bookings department. The program continues with focus on improving accuracy of data entry, rationalising patient forms, making more effective use of information received and automation of pre-admission information flows.

A new ovitrap made of slow release natural materials containing pyriproxyfen for Aedes aegypti (Diptera:Culicidae) control.

PubMed

Juan, Laura; Seccacini, Emilia; Zerba, Eduardo; Licastro, Susana

2013-07-01

ABSTRACT This initial study is aimed to measure the performance of incorporating pyriproxyfen in natural materials with low environmental impact to obtain slow release formulations that can be used as larvicidal or autocidal ovitraps avoiding hatched Aedes aegypti (L.) eggs to emerge as adults. Hollow candles made of beeswax or paraffin:stearin 1:1 mixture containing pyriproxyfen 0.01 and 0.05% were prepared and used as holding water containers for larval bioassay. Pyriproxyfen was released quickly into the larvae-breeding water. Ae. aegypti larvae were introduced immediately after the addition of tap water to the hollow candles (t = 1 min) or after 1, 4, and 8 h. More than 40% of the larvae did not emerge as adults for t = 1 min, reaching 80-100% when the larvae were added after 1 or 4 h, respectively. The hollow candles were kept at room temperature, and water was replaced every 15 d. Bioassays performed every 30 d showed that the residual activity obtained for both matrices and both concentrations of pyriproxyfen was higher than 360 d, with 100% inhibition of adult emergence.

CRADA opportunities with METC`s gasification and hot gas cleanup facility

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

Galloway, E N; Rockey, J M; Tucker, M S

1995-06-01

Opportunities exist for Cooperative Research and Development Agreements (CRADA) at the Morgantown Energy Technology Center (METC) to support commercialization of IGCC power systems. METC operates an integrated gasifier and hot gas cleanup facility for the development of gasification and hot gas cleanup technologies. The objective of our program is to gather performance data on gasifier operation, particulate removal, desulfurization and regeneration technologies. Additionally, slip streams are provided for developing various technologies such as; alkali monitoring, particulate measuring, chloride removal, and contaminate recovery processes. METC`s 10-inch diameter air blown Fluid Bed Gasifier (FBG) provides 300 lb/hr of coal gas at 1100{degrees}Fmore » and 425 psig. The particulate laden gas is transported to METC`s Modular Gas Cleanup Rig (MGCR). The gas pressure is reduced to 285 psig before being fed into a candle filter vessel. The candle filter vessel houses four candle filters and multiple test coupons. The particulate free gas is then desulfurized in a sorbent reactor. Starting in 1996 the MGCR system will be able to regenerate the sorbent in the same vessel.« less

A standardised equine-based welfare assessment tool used for six years in low and middle income countries

PubMed Central

Brown, Ashleigh F.; Upjohn, Melissa

2018-01-01

The majority of horses, donkeys and mules (equids) are in low- and middle-income countries, where they remain a key source of labour in the construction, agriculture and tourism industries, as well as supporting households daily through transporting people and staple goods. Globally, approximately 600 million people depend on working equids for their livelihood. Safeguarding the welfare of these animals is essential for them to work, as well as for the intrinsic value of the animal’s quality of life. In order to manage animal welfare, it must be measured. Over the past decade, welfare assessment methodologies have emerged for different species, more recently for equids. We present the Standardised Equine-Based Welfare Assessment Tool (SEBWAT) for working equids. The tool is unique, in that it has been applied in practice by a non-governmental organisation (NGO) for six years across Low-Middle-Income Countries (LMICs). We describe the revision of the tool from an original to a second version, the tool methodology and user training process and how data collection and analysis have been conducted. We describe its application at scale, where it has been used more than 71,000 times in 11 countries. Case study examples are given from the tool being used for a needs assessment in Guatemala and monitoring welfare change in Jordan. We conclude by describing the main benefits and limitations for how the tool could be applied by others on working equids in LMICs and how it may develop in the future. PMID:29466391

KENNEDY SPACE CENTER, FLA. - Like candles embedded in a sculptured “cake,” the Mobile Launcher Platform (MLP) number 3 with twin solid rocket boosters bolted to it inches along the crawlerway at various speeds up to 1 mph in an effort to achieve vibration data gathering goals. The boosters are braced at the top for stability. The primary purpose of these rollout tests is to gather data to develop future maintenance requirements on the transport equipment and the flight hardware. Various parts of the MLP and crawler transporter have been instrumented with vibration data collection equipment.

NASA Image and Video Library

2003-11-21

KENNEDY SPACE CENTER, FLA. - Like candles embedded in a sculptured “cake,” the Mobile Launcher Platform (MLP) number 3 with twin solid rocket boosters bolted to it inches along the crawlerway at various speeds up to 1 mph in an effort to achieve vibration data gathering goals. The boosters are braced at the top for stability. The primary purpose of these rollout tests is to gather data to develop future maintenance requirements on the transport equipment and the flight hardware. Various parts of the MLP and crawler transporter have been instrumented with vibration data collection equipment.

Technical Note: Harmonizing met-ocean model data via standard web services within small research groups

USGS Publications Warehouse

Signell, Richard; Camossi, E.

2016-01-01

Work over the last decade has resulted in standardised web services and tools that can significantly improve the efficiency and effectiveness of working with meteorological and ocean model data. While many operational modelling centres have enabled query and access to data via common web services, most small research groups have not. The penetration of this approach into the research community, where IT resources are limited, can be dramatically improved by (1) making it simple for providers to enable web service access to existing output files; (2) using free technologies that are easy to deploy and configure; and (3) providing standardised, service-based tools that work in existing research environments. We present a simple, local brokering approach that lets modellers continue to use their existing files and tools, while serving virtual data sets that can be used with standardised tools. The goal of this paper is to convince modellers that a standardised framework is not only useful but can be implemented with modest effort using free software components. We use NetCDF Markup language for data aggregation and standardisation, the THREDDS Data Server for data delivery, pycsw for data search, NCTOOLBOX (MATLAB®) and Iris (Python) for data access, and Open Geospatial Consortium Web Map Service for data preview. We illustrate the effectiveness of this approach with two use cases involving small research modelling groups at NATO and USGS.

Technical note: Harmonising metocean model data via standard web services within small research groups

NASA Astrophysics Data System (ADS)

Signell, Richard P.; Camossi, Elena

2016-05-01

Work over the last decade has resulted in standardised web services and tools that can significantly improve the efficiency and effectiveness of working with meteorological and ocean model data. While many operational modelling centres have enabled query and access to data via common web services, most small research groups have not. The penetration of this approach into the research community, where IT resources are limited, can be dramatically improved by (1) making it simple for providers to enable web service access to existing output files; (2) using free technologies that are easy to deploy and configure; and (3) providing standardised, service-based tools that work in existing research environments. We present a simple, local brokering approach that lets modellers continue to use their existing files and tools, while serving virtual data sets that can be used with standardised tools. The goal of this paper is to convince modellers that a standardised framework is not only useful but can be implemented with modest effort using free software components. We use NetCDF Markup language for data aggregation and standardisation, the THREDDS Data Server for data delivery, pycsw for data search, NCTOOLBOX (MATLAB®) and Iris (Python) for data access, and Open Geospatial Consortium Web Map Service for data preview. We illustrate the effectiveness of this approach with two use cases involving small research modelling groups at NATO and USGS.

Is secondary preventive care improving? Observational study of 10-year trends in emergency admissions for conditions amenable to ambulatory care

PubMed Central

Bardsley, Martin; Blunt, Ian; Davies, Sian; Dixon, Jennifer

2013-01-01

Objective To identify trends in emergency admissions for patients with clinical conditions classed as ‘ambulatory care sensitive’ (ACS) and assess if reductions might be due to improvements in preventive care. Design Observational study of routinely collected hospital admission data from March 2001 to April 2011. Admission rates were calculated at the population level using national population estimates for area of residence. Participants All emergency admissions to National Health Service (NHS) hospitals in England from April 2001 to March 2011 for people residents in England. Main outcome measures Age-standardised emergency admissions rates for each of 27 specific ACS conditions (ICD-10 codes recorded as primary or secondary diagnoses). Results Between April 2001 and March 2011 the number of admissions for ACS conditions increased by 40%. When ACS conditions were defined solely on primary diagnosis, the increase was less at 35% and similar to the increase in emergency admissions for non-ACS conditions. Age-standardised rates of emergency admission for ACS conditions had increased by 25%, and there were notable variations by age group and by individual condition. Overall, the greatest increases were for urinary tract infection, pyelonephritis, pneumonia, gastroenteritis and chronic obstructive pulmonary disease. There were significant reductions in emergency admission rates for angina, perforated ulcers and pelvic inflammatory diseases but the scale of these successes was relatively small. Conclusions Increases in rates of emergency admissions suggest that efforts to improve the preventive management of certain clinical conditions have failed to reduce the demand for emergency care. Tackling the demand for hospital care needs more radical approaches than those adopted hitherto if reductions in emergency admission rates for ACS conditions overall are to be seen as a positive outcome of for NHS. PMID:23288268

[Interventions to improve quality of life in oncological patients].

PubMed

Klinkhammer-Schalke, Monika; Steinger, Brunhilde; Koller, Michael; Lindberg, Patricia

2017-05-01

The assessment of quality of life is a central aspect in the current debate in support groups, certified cancer centres, benefit assessment, and also in palliative care. Accordingly, quality of life has become an essential part of clinical trials for more than two decades. But most of the time results are presented in a descriptive manner without any concrete therapeutic consequences for the improvement of quality of life. Likewise, there are no uniform recommendations for considering quality of life data in the decision-making process. Therefore, a guide with recommendations for the assessment of quality of life in trials has been developed. Its implementation is illustrated by a complex intervention for a targeted diagnosis and therapy of quality of life in patients with breast cancer or colorectal cancer. The basis is a standardised quality of life assessment and the presentation of results in an intelligible fashion as well as the close collaboration of all healthcare providers to create regional network structures for the targeted support of patients in both the inpatient and outpatient sector. Copyright © 2017. Published by Elsevier GmbH.

Protocol for a prospective, school-based standardisation study of a digital social skills assessment tool for children: The Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS) study.

PubMed

Thompson, Emma J; Beauchamp, Miriam H; Darling, Simone J; Hearps, Stephen J C; Brown, Amy; Charalambous, George; Crossley, Louise; Darby, David; Dooley, Julian J; Greenham, Mardee; Jaimangal, Mohinder; McDonald, Skye; Muscara, Frank; Turkstra, Lyn; Anderson, Vicki A

2018-02-08

Humans are by nature a social species, with much of human experience spent in social interaction. Unsurprisingly, social functioning is crucial to well-being and quality of life across the lifespan. While early intervention for social problems appears promising, our ability to identify the specific impairments underlying their social problems (eg, social communication) is restricted by a dearth of accurate, ecologically valid and comprehensive child-direct assessment tools. Current tools are largely limited to parent and teacher ratings scales, which may identify social dysfunction, but not its underlying cause, or adult-based experimental tools, which lack age-appropriate norms. The present study describes the development and standardisation of Paediatric Evaluation of Emotions, Relationships, and Socialisation ( PEERS®), an iPad-based social skills assessment tool. The PEERS project is a cross-sectional study involving two groups: (1) a normative group, recruited from early childhood, primary and secondary schools across metropolitan and regional Victoria, Australia; and (2) a clinical group, ascertained from outpatient services at The Royal Children's Hospital Melbourne (RCH). The project aims to establish normative data for PEERS®, a novel and comprehensive app-delivered child-direct measure of social skills for children and youth. The project involves recruiting and assessing 1000 children aged 4.0-17.11 years. Assessments consist of an intellectual screen, PEERS® subtests, and PEERS-Q, a self-report questionnaire of social skills. Parents and teachers also complete questionnaires relating to participants' social skills. Main analyses will comprise regression-based continuous norming, factor analysis and psychometric analysis of PEERS® and PEERS-Q. Ethics approval has been obtained through the RCH Human Research Ethics Committee (34046), the Victorian Government Department of Education and Early Childhood Development (002318), and Catholic Education

Protocol for a prospective, school-based standardisation study of a digital social skills assessment tool for children: The Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS) study

PubMed Central

Thompson, Emma J; Beauchamp, Miriam H; Darling, Simone J; Hearps, Stephen J C; Brown, Amy; Charalambous, George; Crossley, Louise; Darby, David; Dooley, Julian J; Greenham, Mardee; Jaimangal, Mohinder; McDonald, Skye; Muscara, Frank; Turkstra, Lyn; Anderson, Vicki A

2018-01-01

Background Humans are by nature a social species, with much of human experience spent in social interaction. Unsurprisingly, social functioning is crucial to well-being and quality of life across the lifespan. While early intervention for social problems appears promising, our ability to identify the specific impairments underlying their social problems (eg, social communication) is restricted by a dearth of accurate, ecologically valid and comprehensive child-direct assessment tools. Current tools are largely limited to parent and teacher ratings scales, which may identify social dysfunction, but not its underlying cause, or adult-based experimental tools, which lack age-appropriate norms. The present study describes the development and standardisation of Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS®), an iPad-based social skills assessment tool. Methods The PEERS project is a cross-sectional study involving two groups: (1) a normative group, recruited from early childhood, primary and secondary schools across metropolitan and regional Victoria, Australia; and (2) a clinical group, ascertained from outpatient services at The Royal Children’s Hospital Melbourne (RCH). The project aims to establish normative data for PEERS®, a novel and comprehensive app-delivered child-direct measure of social skills for children and youth. The project involves recruiting and assessing 1000 children aged 4.0–17.11 years. Assessments consist of an intellectual screen, PEERS® subtests, and PEERS-Q, a self-report questionnaire of social skills. Parents and teachers also complete questionnaires relating to participants’ social skills. Main analyses will comprise regression-based continuous norming, factor analysis and psychometric analysis of PEERS® and PEERS-Q. Ethics and dissemination Ethics approval has been obtained through the RCH Human Research Ethics Committee (34046), the Victorian Government Department of Education and Early Childhood

The best choice of equipment to obtain high quality standardised results in intra-oral photography - a comparison between the common practice in the UK and the gold standard set by the literature.

PubMed

Marcato, Laura; Sandler, Jonathan

2018-04-01

Since digital technology made dental photography widely available, photographers have been trying to establish the 'gold standard' when obtaining intra-oral photographs. A basic knowledge of photographic principles, familiarity with particular dental techniques and a correct choice and use of equipment contribute significantly both to the standardisation and quality of photographs. A recent survey between members of the Institute of Medical Illustrators shed a light on the current practice in the UK. Medical photographers do not always have access to the full range of suitable equipment. A better selection of retractors and occlusal mirrors would undoubtedly contribute to higher quality images.

Improving driving advice provided to cardiology patients on discharge

PubMed Central

Vusirikala, Amoolya; Backhouse, Mark; Schimansky, Sarah

2018-01-01

Certain cardiac conditions can limit patients’ ability to drive. It remains the doctors' responsibility to advise patients of any driving restrictions and is particularly important after certain diagnoses or procedures. We identified that the quality of documented advice was variable and frequently no written driving advice was recorded on discharge. It was apparent that there was a lack of awareness and knowledge of the current Driving and Vehicle Licensing Agency (DVLA) guidance among junior doctors. We therefore designed a quality improvement project using Plan–Do–Study–Act (PDSA) methodology to improve the provision of driving advice on discharge from a cardiology ward by focusing on staff education. After collecting baseline data, we created a template with cardiology-specific DVLA advice. During the second PDSA cycle, we improved the electronic template and also introduced a hard copy on the ward. During the third PDSA cycle, we incorporated information on DVLA guidance in the specialty induction session. We also evaluated junior doctors’ confidence of providing driving advice before and after this intervention. Baseline measurements showed that 10% (9/92) of all discharge summaries included driving advice. This improved to 49% (34/69) after the third PDSA cycle. Importantly, after receiving information on driving advice in the induction, junior doctors felt more confident in providing driving advice to cardiology patients on discharge. In conclusion, the provision of driving advice on discharge is an important element of patient safety. However, clinicians’ knowledge and awareness of current DVLA guidance is often limited. We demonstrated a significant increase in the provision of driving advice by introducing a standardised template. PMID:29610769

Effectiveness of a multi-component quality improvement intervention on rates of hyperglycaemia

PubMed Central

Franco, Thérèse; Aaronson, Barry; Brown, Laurel; Blackmore, Craig; Rupp, Stephen; Lee, Grace

2017-01-01

Purpose To evaluate the effectiveness of a multifaceted, hospital-wide glycaemic control quality improvement programme. Methods The quality improvement intervention comprised three components, derived through root cause analysis: standardising and simplifying care (including evidence-based order sets), increasing visibility (through provider access to clinical data and direct feedback) and educational outreach (directed at the entire institution). Effectiveness was determined at a single urban acute care hospital through time-series analysis with statistical process control charts. Primary outcomes included rate of hyperglycaemia and rate of hypoglycaemia. Results The study included 70 992 hospital admissions for 50 404 patients, with 3 35 645 patient days. The hyperglycaemia ratio decreased 25.2% from 14.1% to 10.5% (95% CI 3.3 to 3.9 percentage points, p<0.001). The ratio of patient days with highly elevated blood glucose (>299 mg/dL) decreased 31.8% from 4.8% to 3.3% (95% CI 1.4 to 1.7 percentage points, p<0.001). Hypoglycaemia ratio decreased from 5.2% to 4.6% (95% CI 0.27 to 0.89 percentage points, p<0.001) in patients with diabetes, but increased in patients without diabetes from 1.2% to 1.7% (95% CI 0.46 to 0.70 percentage points, p<0.001). Conclusions We demonstrate improved hospital-wide glycaemic control after a multifaceted quality improvement intervention in the context of strong institutional commitment, national mentorship and Lean management PMID:29450273

Using Six Sigma to improve once daily gentamicin dosing and therapeutic drug monitoring performance.

PubMed

Egan, Sean; Murphy, Philip G; Fennell, Jerome P; Kelly, Sinead; Hickey, Mary; McLean, Carolyn; Pate, Muriel; Kirke, Ciara; Whiriskey, Annette; Wall, Niall; McCullagh, Eddie; Murphy, Joan; Delaney, Tim

2012-12-01

Safe, effective therapy with the antimicrobial gentamicin requires good practice in dose selection and monitoring of serum levels. Suboptimal therapy occurs with breakdown in the process of drug dosing, serum blood sampling, laboratory processing and level interpretation. Unintentional underdosing may result. This improvement effort aimed to optimise this process in an academic teaching hospital using Six Sigma process improvement methodology. A multidisciplinary project team was formed. Process measures considered critical to quality were defined, and baseline practice was examined through process mapping and audit. Root cause analysis informed improvement measures. These included a new dosing and monitoring schedule, and standardised assay sampling and drug administration timing which maximised local capabilities. Three iterations of the improvement cycle were conducted over a 24-month period. The attainment of serum level sampling in the required time window improved by 85% (p≤0.0001). A 66% improvement in accuracy of dosing was observed (p≤0.0001). Unnecessary dose omission while awaiting level results and inadvertent disruption to therapy due to dosing and monitoring process breakdown were eliminated. Average daily dose administered increased from 3.39 mg/kg to 4.78 mg/kg/day. Using Six Sigma methodology enhanced gentamicin usage process performance. Local process related factors may adversely affect adherence to practice guidelines for gentamicin, a drug which is complex to use. It is vital to adapt dosing guidance and monitoring requirements so that they are capable of being implemented in the clinical environment as a matter of routine. Improvement may be achieved through a structured localised approach with multidisciplinary stakeholder involvement.

A semantically rich and standardised approach enhancing discovery of sensor data and metadata

NASA Astrophysics Data System (ADS)

Kokkinaki, Alexandra; Buck, Justin; Darroch, Louise

2016-04-01

The marine environment plays an essential role in the earth's climate. To enhance the ability to monitor the health of this important system, innovative sensors are being produced and combined with state of the art sensor technology. As the number of sensors deployed is continually increasing,, it is a challenge for data users to find the data that meet their specific needs. Furthermore, users need to integrate diverse ocean datasets originating from the same or even different systems. Standards provide a solution to the above mentioned challenges. The Open Geospatial Consortium (OGC) has created Sensor Web Enablement (SWE) standards that enable different sensor networks to establish syntactic interoperability. When combined with widely accepted controlled vocabularies, they become semantically rich and semantic interoperability is achievable. In addition, Linked Data is the recommended best practice for exposing, sharing and connecting information on the Semantic Web using Uniform Resource Identifiers (URIs), Resource Description Framework (RDF) and RDF Query Language (SPARQL). As part of the EU-funded SenseOCEAN project, the British Oceanographic Data Centre (BODC) is working on the standardisation of sensor metadata enabling 'plug and play' sensor integration. Our approach combines standards, controlled vocabularies and persistent URIs to publish sensor descriptions, their data and associated metadata as 5 star Linked Data and OGC SWE (SensorML, Observations & Measurements) standard. Thus sensors become readily discoverable, accessible and useable via the web. Content and context based searching is also enabled since sensors descriptions are understood by machines. Additionally, sensor data can be combined with other sensor or Linked Data datasets to form knowledge. This presentation will describe the work done in BODC to achieve syntactic and semantic interoperability in the sensor domain. It will illustrate the reuse and extension of the Semantic Sensor

Traumatic brain injury in England and Wales: prospective audit of epidemiology, complications and standardised mortality.

PubMed

Lawrence, T; Helmy, A; Bouamra, O; Woodford, M; Lecky, F; Hutchinson, P J

2016-11-24

To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14 n ) model multivariate TBI outcome prediction model. The frequency and timing of secondary transfer to neurosurgical centres was assessed. We identified 15 820 patients with TBI presenting to neurosurgical centres directly (6258), transferred from a district hospital to a neurosurgical centre (3682) and remaining in a district general hospital (5880). The commonest mechanisms of injury were falls in the elderly and road traffic collisions in the young, which were more likely to present in coma. In severe TBI (Glasgow Coma Score (GCS) ≤8), the median time from admission to imaging with CT scan is 0.5 hours. Median time to craniotomy from admission is 2.6 hours and median time to intracranial pressure monitoring is 3 hours. The most frequently documented complication of severe TBI is bronchopneumonia in 5% of patients. Risk-adjusted W scores derived from the Ps14 n model indicate that no neurosurgical unit fell outside the 3 SD limits on a funnel plot. We provide the first comprehensive report of the management of TBI in England and Wales, including data from all neurosurgical units. These data provide transparency and suggests equity of access to high-quality TBI management provided in England and Wales. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Towards a standardised informed consent procedure for live donor nephrectomy: the PRINCE (Process of Informed Consent Evaluation) project-study protocol for a nationwide prospective cohort study.

PubMed

Kortram, Kirsten; Spoon, Emerentia Q W; Ismail, Sohal Y; d'Ancona, Frank C H; Christiaans, Maarten H L; van Heurn, L W Ernest; Hofker, H Sijbrand; Hoksbergen, Arjan W J; Homan van der Heide, Jaap J; Idu, Mirza M; Looman, Caspar W N; Nurmohamed, S Azam; Ringers, Jan; Toorop, Raechel J; van de Wetering, Jacqueline; Ijzermans, Jan N M; Dor, Frank J M F

2016-04-01

Informed consent is mandatory for all (surgical) procedures, but it is even more important when it comes to living kidney donors undergoing surgery for the benefit of others. Donor education, leading to informed consent, needs to be carried out according to certain standards. Informed consent procedures for live donor nephrectomy vary per centre, and even per individual healthcare professional. The basis for a standardised, uniform surgical informed consent procedure for live donor nephrectomy can be created by assessing what information donors need to hear to prepare them for the operation and convalescence. The PRINCE (Process of Informed Consent Evaluation) project is a prospective, multicentre cohort study, to be carried out in all eight Dutch kidney transplant centres. Donor knowledge of the procedure and postoperative course will be evaluated by means of pop quizzes. A baseline cohort (prior to receiving any information from a member of the transplant team in one of the transplant centres) will be compared with a control group, the members of which receive the pop quiz on the day of admission for donor nephrectomy. Donor satisfaction will be evaluated for all donors who completed the admission pop-quiz. The primary end point is donor knowledge. In addition, those elements that have to be included in the standardised format informed consent procedure will be identified. Secondary end points are donor satisfaction, current informed consent practices in the different centres (eg, how many visits, which personnel, what kind of information is disclosed, in which format, etc) and correlation of donor knowledge with surgeons' estimation thereof. Approval for this study was obtained from the medical ethical committee of the Erasmus MC, University Medical Center, Rotterdam, on 18 February 2015. Secondary approval has been obtained from the local ethics committees in six participating centres. Approval in the last centre has been sought. Outcome will be published in a

Health resorts as gateways for regional, standardised, sports club based exercise programmes to increase the weekly time of moderate- to vigorous-intensity physical activity: study protocol.

PubMed

Lackinger, Christian; Strehn, Albert; Dorner, Thomas Ernst; Niebauer, Josef; Titze, Sylvia

2015-12-21

More than 10 % (approximately 60,000) of the adult population in Styria, a federal state in the south of Austria, is granted a residential stay in a health resort each year. The target group for these stays is the general population aged between 30 and 65 years with minor symptoms such as risk factors for cardio-metabolic diseases. Stays are financed by health insurance companies and last up to three weeks. The treatment during the stays consists of exercise and nutritional intervention as well as psychological support when needed. However, because of the absence of regional programmes linked with the residential stay, the sustainability of the interventions is questionable. This prospective, controlled, multicentre, open-label study will compare two groups. Participants will be included in the study if they live in any of eight predefined Styrian regions and do not meet the minimal WHO physical activity guidelines. Those allocated to the intervention group will receive a voucher for 12 regional, standardised, sports club based exercise sessions. The members of the control group will come from different but matched Styrian regions and will receive an informative written brochure. The primary outcome will be the weekly level of health-enhancing physical activity, which will be objectively measured with an accelerometer and supplemented by an activity log book. Together with potential determinants of physical activity it will be assessed before, 10 weeks after and 12 months after the residential stay. Additionally, psychosocial determinants will be assessed by questionnaire and fitness (cardiorespiratory fitness, handgrip, balance) will be measured. In addition to the changes in measurable parameters, processes will be evaluated to learn about the facilitators and barriers of the implementation of the programme. It is known that during the residential stay, participants are receptive to new opportunities supporting health behaviour change, but that these measures

Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study.

PubMed

Montgomery, Anthony J; McGee, Hannah M; Shannon, William; Donohoe, John

2006-09-13

To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. Randomly selected general practitioners (N = 51) were interviewed using 32 standardised written patient scenarios to elicit referral strategies. General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians); influence of patient age, marital status and co-morbidity on referral. Referral levels varied widely with the full range of cases (0-32; median = 15) referred by different doctors after consideration of first laboratory results. Less than half (44%) of cases were referred to a nephrologist. Patient age (40 vs 70 years), marital status, co-morbidity (none vs rheumatoid arthritis) and general practitioner prior specialist renal training (yes or no) did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 micromol/l (47% not referred) or 250 micromol/l (45%). While all patients were referred at higher levels (350 and 480 micromol/l), referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 micromol/l creatinine; 28% at 250 micromol/l; 18% at 350 micromol/l and 14% at 480 micromol/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3). The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition.

Standardised alcohol screening in primary health care services targeting Aboriginal and Torres Strait Islander peoples in Australia.

PubMed

Islam, M Mofizul; Oni, Helen T; Lee, K S Kylie; Hayman, Noel; Wilson, Scott; Harrison, Kristie; Hummerston, Beth; Ivers, Rowena; Conigrave, Katherine M

2018-03-29

Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHSs) around Australia have been asked to standardise screening for unhealthy drinking. Accordingly, screening with the 3-item AUDIT-C (Alcohol Use Disorders Identification Test-Consumption) tool has become a national key performance indicator. Here we provide an overview of suitability of AUDIT-C and other brief alcohol screening tools for use in ACCHSs. All peer-reviewed literature providing original data on validity, acceptability or feasibility of alcohol screening tools among Indigenous Australians was reviewed. Narrative synthesis was used to identify themes and integrate results. Three screening tools-full AUDIT, AUDIT-3 (third question of AUDIT) and CAGE (Cut-down, Annoyed, Guilty and Eye-opener) have been validated against other consumption measures, and found to correspond well. Short forms of AUDIT have also been found to compare well with full AUDIT, and were preferred by primary care staff. Help was often required with converting consumption into standard drinks. Researchers commented that AUDIT and its short forms prompted reflection on drinking. Another tool, the Indigenous Risk Impact Screen (IRIS), jointly screens for alcohol, drug and mental health risk, but is relatively long (13 items). IRIS has been validated against dependence scales. AUDIT, IRIS and CAGE have a greater focus on dependence than on hazardous or harmful consumption. Detection of unhealthy drinking before harms occur is a goal of screening, so AUDIT-C offers advantages over tools like IRIS or CAGE which focus on dependence. AUDIT-C's brevity suits integration with general health screening. Further research is needed on facilitating implementation of systematic alcohol screening into Indigenous primary healthcare.

Determination of washout performance of various monochrome displays under simulated flight ambient and solar lighting conditions

NASA Technical Reports Server (NTRS)

Batson, Vernon M.; Robertson, James B.; Parrish, Russell V.

1990-01-01

The aircraft cockpit ambient lighting simulation system (ACALSS) has been developed to study display readability and associated pilot/vehicle performance effects in a part-task simulator cockpit. In the study reported here, the ACALSS was used to determine the illumination levels at which subjects lose the ability to maintain aircraft states when using three display technologies as display media for primary flight displays: a standard monochrome EL (electroluminescent) flat-panel, a laboratory-class monochrome CRT, and an enhanced-brightness EL flat-panel. The multivariate statistical technique of modified profile analysis was used to test for performance differences between display devices as functions of illumination levels. The standard monochrome EL flat-panel display began to washout after the 2500 foot-candle level of illumination. The monochrome CRT began to washout after the 5500 foot-candle level of illumination. No performance decrements by increased illumination up to the 12,000 foot-candle level were found for the enhanced-brightness EL flat-panel display. What was not anticipated was that half the subjects would subjectively prefer the CRT over the enhanced-brightness EL, even though their performance errors would have indicated the opposite.

Could simulated emergency procedures practised in a static environment improve the clinical performance of a Critical Care Air Support Team (CCAST)? A literature review.

PubMed

Lamb, Di

2007-02-01

The Royal Air Force Critical Care Air Support Teams (CCASTs) have a philosophy to undertake transfers of critically ill patients from anywhere in the world back to a UK medical facility in a stable or improved clinical condition. The training they receive is primarily taught by traditional didactic methods, with no standardisation of education between teams that are expected to deliver care to the same standard. Notwithstanding there being no current compromise to patient care during air transfer, it was important to consider the benefits of an alternative experiential teaching modality. Experiential learning utilised in the static environment could potentially improve the current CCAST training curriculum and, therefore, improve clinical performance during air transfer. In the absence of primary research evidence investigating beneficial teaching modalities for medical flight crews, a review of recent literature was undertaken to observe any potential relevance to the aeromedical specialty. This critical review examined recent quantitative research on various modalities of experiential learning and their influence on the critical thinking, higher cognitive and psychomotor skill acquisition by healthcare professionals in a static hospital environment. The main databases were interrogated using the following inclusion criteria: patient simulation, clinical competence, aeromedical, education, computer simulation, critical thinking and problem-based learning. The number of articles obtained was 13; these were coded on methodological strength to reduce the potential for inclusion bias. Nine studies were finally selected for review. Many small studies have been undertaken, primarily observing benefits of experiential learning to medical students and doctors. No studies show conclusively that simulated learning improves patient outcome, but the body of evidence suggests human patient simulators to be advantageous over other modalities because of their realistic

Accelerating the rate of improvement in cystic fibrosis care: contributions and insights of the learning and leadership collaborative.

PubMed

Godfrey, Marjorie M; Oliver, Brant J

2014-04-01

The Learning and Leadership Collaborative (LLC) supports cystic fibrosis (CF) centres' responses to the variation in CF outcomes in the USA. Between 2002 and 2013, the Cystic Fibrosis Foundation (CFF) designed, tested and modified the LLC to guide front line staff efforts in these efforts. This paper describes the CFF LLC evolution and essential elements that have facilitated increased improvement capability of CF centres and improved CF outcomes. CF centre improvement teams across the USA have participated in 11 LLCs of 12 months' duration since 2002. Based on the Dartmouth Microsystem Improvement Curriculum, the original LLC included face to face meetings, an email listserv, conference calls and completion of between learning session task books. The LLCs evolved over time to include internet based learning, an electronic repository of improvement resources and examples, change ideas driven by evidence based clinical practice guidelines, benchmarking site visits, an applied QI measurement curriculum and team coaching. Over 90% of the CF centres in the USA have participated in the LLCs and have increased their improvement capabilities. Ten essential elements were identified as contributors to the successful LLCs: LLC national leadership and coordination, local leadership, people with CF and families involvement, registry data transparency, standardised improvement curriculum with evidence based change ideas, internet resources with reminders, team coaching, regular progress reporting and tracking, benchmarking site visits and applied improvement measurement. The LLCs have contributed to improved medical and process outcomes over the past 10 years. Ten essential elements of the LLCs may benefit improvement efforts in other chronic care populations and health systems.

Type Ia supernovae as standard candles

NASA Technical Reports Server (NTRS)

Branch, David; Miller, Douglas L.

1993-01-01

The distribution of absolute blue magnitudes among Type Ia supernovae (SNs Ia) is studied. Supernovae were used with well determined apparent magnitudes at maximum light and parent galaxies with relative distances determined by the Tully-Fisher or Dn - sigma techniques. The mean absolute blue magnitude is given and the observational dispersion is only sigma(MB) 0.36, comparable to the expected combined errors in distance, apparent magnitude, and extinction. The mean (B-V) color at maximum light is 0.03 +/- 0.04, with a dispersion sigma(B-V) = 0.20. The Cepheid-based distance to IC 4182, the parent galaxy of the normal and unextinguished Type Ia SN 1937C, leads to a Hubble constant of H(0) + 51 +/- 12 km/s Mpc. The existence of a few SNs Ia that appear to have been reddened and dimmed by dust in their parent galaxies does not seriously compromise the use of SNs Ia as distance indicators.

Improving integrity of on-line grammage measurement with traceable basic calibration.

PubMed

Kangasrääsiö, Juha

2010-07-01

The automatic control of grammage (basis weight) in paper and board production is based upon on-line grammage measurement. Furthermore, the automatic control of other quality variables such as moisture, ash content and coat weight, may rely on the grammage measurement. The integrity of Kr-85 based on-line grammage measurement systems was studied, by performing basic calibrations with traceably calibrated plastic reference standards. The calibrations were performed according to the EN ISO/IEC 17025 standard, which is a requirement for calibration laboratories. The observed relative measurement errors were 3.3% in the first time calibrations at the 95% confidence level. With the traceable basic calibration method, however, these errors can be reduced to under 0.5%, thus improving the integrity of on-line grammage measurements. Also a standardised algorithm, based on the experience from the performed calibrations, is proposed to ease the adjustment of the different grammage measurement systems. The calibration technique can basically be applied to all beta-radiation based grammage measurements. 2010 ISA. Published by Elsevier Ltd. All rights reserved.

Improvement in children's fine motor skills following a computerized typing intervention.

PubMed

McGlashan, Hannah L; Blanchard, Caroline C V; Sycamore, Nicole J; Lee, Rachel; French, Blandine; Holmes, Nicholas P

2017-12-01

Children spend a large proportion of their school day engaged in tasks that require manual dexterity. If children experience difficulties with their manual dexterity skills it can have a consequential effect on their academic achievement. The first aim of this paper was to explore whether an online interactive typing intervention could improve children's scores on a standardised measure of manual dexterity. The second aim was to implement a serial reaction time tapping task as an index of children's finger movement learning, and to see whether performance on this task would improve after the intervention. Seventy-eight typically developing children aged between 8 and 10 were tested at their school on the pre-intervention Movement Assessment Battery for Children (2nd edition; MABC-2) and tapping tasks. Twenty-eight of these children volunteered to be randomly allocated to the intervention or control group. Children in the intervention group had a choice of two online games to play at home over a period of four weeks, while the children in the control group were not given these games to play. The intervention and control groups were then re-tested on the MABC-2 manual dexterity and the tapping task. Children in the intervention group significantly improved their manual dexterity scores in the MABC-2 compared to the control group. On average, all children learnt the tapping sequence, however, there were no group differences and no effect of the intervention on the tapping task. These results have important implications for implementing a freely available, easy to administer, fun and interactive intervention to help children improve their manual dexterity skills. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Improving Child Oral Health: Cost Analysis of a National Nursery Toothbrushing Programme

PubMed Central

Anopa, Yulia; McMahon, Alex D.; Conway, David I.; Ball, Graham E.; McIntosh, Emma; Macpherson, Lorna M. D.

2015-01-01

Dental caries is one of the most common diseases of childhood. The aim of this study was to compare the cost of providing the Scotland-wide nursery toothbrushing programme with associated National Health Service (NHS) cost savings from improvements in the dental health of five-year-old children: through avoided dental extractions, fillings and potential treatments for decay. Methods Estimated costs of the nursery toothbrushing programme in 2011/12 were requested from all Scottish Health Boards. Unit costs of a filled, extracted and decayed primary tooth were calculated using verifiable sources of information. Total costs associated with dental treatments were estimated for the period from 1999/00 to 2009/10. These costs were based on the unit costs above and using the data of the National Dental Inspection Programme and then extrapolated to the population level. Expected cost savings were calculated for each of the subsequent years in comparison with the 2001/02 dental treatment costs. Population standardised analysis of hypothetical cohorts of 1000 children per deprivation category was performed. Results The estimated cost of the nursery toothbrushing programme in Scotland was £1,762,621 per year. The estimated cost of dental treatments in the baseline year 2001/02 was £8,766,297, while in 2009/10 it was £4,035,200. In 2002/03 the costs of dental treatments increased by £213,380 (2.4%). In the following years the costs decreased dramatically with the estimated annual savings ranging from £1,217,255 in 2003/04 (13.9% of costs in 2001/02) to £4,731,097 in 2009/10 (54.0%). Population standardised analysis by deprivation groups showed that the largest decrease in modelled costs was for the most deprived cohort of children. Conclusions The NHS costs associated with the dental treatments for five-year-old children decreased over time. In the eighth year of the toothbrushing programme the expected savings were more than two and a half times the costs of the

Improving text comprehension strategies in upper primary school children: a design experiment.

PubMed

De Corte, E; Verschaffel, L; Van De Ven, A

2001-12-01

classrooms by immersing them in a powerful learning environment. But this intervention does not automatically result in improvement of performance on a standardised reading comprehension test.

Evaluation of the efficacy and safety of a standardised intracameral combination of mydriatics and anaesthetics for cataract surgery

PubMed Central

Labetoulle, Marc; Findl, Oliver; Malecaze, François; Alió, Jorge; Cochener, Béatrice; Lobo, Conceição; Lazreg, Sihem; Hartani, Dahbia; Colin, Joseph; Tassignon, Marie-José; Behndig, Anders

2016-01-01

Background/aims To compare the efficacy and safety of intracameral (IC) administration at the beginning of cataract surgery, of Mydrane, a standardised ophthalmic combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%, to a standard topical regimen. Methods In this international phase III, prospective, randomised study, the selected eye of 555 patients undergoing phacoemulsification with intraocular lens (IOL) implantation received 200 μL of Mydrane (Mydrane group) just after the first incision or a topical regimen of one drop each of tropicamide 0.5% and phenylephrine 10% repeated three times (reference group). The primary efficacy variable was achievement of capsulorhexis without additional mydriatics. The non-inferiority of Mydrane to the topical regimen was tested. The main outcome measures were pupil size, patient perception of ocular discomfort and safety. Results Capsulorhexis without additional mydriatics was performed in 98.9% of patients and 94.7% in the Mydrane and reference groups, respectively. Both groups achieved adequate mydriasis (>7 mm) during capsulorhexis, phacoemulsification and IOL insertion. IOL insertion was classified as ‘routine’ in a statistically greater number of eyes in the Mydrane group compared with the reference group (p=0.047). Patients in the Mydrane group reported statistically greater comfort than the reference group before IOL insertion (p=0.034). Safety data were similar between groups. Conclusions Mydrane is an effective and safe alternative to standard eye drops for initiating and maintaining intraoperative mydriasis and analgesia. Patients who received IC Mydrane were significantly more comfortable before IOL insertion than the reference group. Surgeons found IOL insertion less technically challenging with IC Mydrane. Trial registration number NCT02101359; Results. PMID:26531052

Development of the first standardised panel of two new microsatellite multiplex PCRs for gilthead seabream (Sparus aurata L.).

PubMed

Lee-Montero, I; Navarro, A; Borrell, Y; García-Celdrán, M; Martín, N; Negrín-Báez, D; Blanco, G; Armero, E; Berbel, C; Zamorano, M J; Sánchez, J J; Estévez, A; Ramis, G; Manchado, M; Afonso, J M

2013-08-01

The high number of multiplex PCRs developed for gilthead seabream (Sparus aurata L.) from many different microsatellite markers does not allow comparison among populations. This highlights the need for developing a reproducible panel of markers, which can be used with safety and reliability by all users. In this study, the first standardised panel of two new microsatellite multiplex PCRs was developed for this species. Primers of 138 specific microsatellites from the genetic linkage map were redesigned and evaluated according to their genetic variability, allele size range and genotyping reliability. A protocol to identify and classify genotyping errors or potential errors was proposed to assess the reliability of each marker. Two new multiplex PCRs from the best assessed markers were designed with 11 markers in each, named SMsa1 and SMsa2 (SuperMultiplex Sparus aurata). Three broodstocks (59, 47 and 98 breeders) from different Spanish companies, and a sample of 80 offspring from each one, were analysed to validate the usefulness of these multiplexes in the parental assignation. It was possible to assign each offspring to a single parent pair (100% success) using the exclusion method with SMsa1 and/or SMsa2. In each genotyped a reference sample (Ref-sa) was used, and its DNA is available on request similar to the kits of bin set to genotype by genemapper (v.3.7) software (kit-SMsa1 and kit-SMsa2). This will be a robust and effective tool for pedigree analysis or characterisation of populations and will be proposed as an international panel for this species. © 2013 The Authors, Animal Genetics © 2013 Stichting International Foundation for Animal Genetics.

The Use of Hydrograph Analysis and Impulse Response Functions to Improve Understanding of Groundwater Flooding: A Case Study from the Chalk Aquifer, United Kingdom.

NASA Astrophysics Data System (ADS)

Ascott, M.; Bloomfield, J.; Macdonald, D.; Marchant, B.; McKenzie, A.

2017-12-01

The Cretaceous Chalk, the most important aquifer in the United Kingdom (UK) for public water supply, underlies many large cities in southern and eastern England including parts of London, however, it is prone to groundwater flooding. We have developed a new approach to analyse the spatio-temporal extent of groundwater flooding using statistical analysis of groundwater level hydrographs and impulse response functions (IRFs) applied to a major Chalk groundwater flooding event in the UK during winter 2013/14. Using monthly groundwater levels for 26 boreholes in the Chalk and a new standardised index for groundwater flooding, we have: estimated standardised series; grouped them using k-means cluster analysis; and, cross-correlated the cluster centroids with the Standardised Precipitation Index accumulated over time intervals between 1 and 60 months. This analysis reveals two spatially coherent groups of standardised hydrographs which respond to precipitation over different timescales. We estimate IRF models of the groundwater level response to effective precipitation for three boreholes in each group. The IRF models support the SPI analysis showing different response functions between the two groups. If we apply identical effective precipitation inputs to each of the IRF models we see differences between the hydrographs from each group. It is proposed that these differences are due to the intrinsic, hydrogeological properties of the Chalk and of overlying relatively low permeability superficial deposits. Consequently, it is concluded that the overarching controls on groundwater flood response are a complex combination of antecedent conditions, rainfall and catchment hydrogeological properties. These controls should be taken into consideration when anticipating and managing future groundwater flood events.

[An extreme case of undoing and posing in a case of murder-suicide. A forensic pathological approach to crime scene investigation].

PubMed

Guddat, Saskia S; Schalinski, Sarah; Püschel, Klaus; Tsokos, Michael; Schulz, Friedrich

2007-01-01

A 7-year-old boy was killed by his father by manual strangulation during a murder-suicide. After the killing of the son, the father showed typical "undoing" behaviour: He changed the boy's clothes and laid him down on the bed. Then he placed candles around his head, put pictures of the parents' wedding around him and a crucifix and a picture of the family into his hands. He broke off a rose in a vase next to the bed, lit the candles and took photographs of his dead son. Later he called his wife, threatened to kill the son and finally called the police to confess the murder and to announce his forthcoming suicide.

Blood-brain barrier specific permeability assay reveals N-methylated tyramine derivatives in standardised leaf extracts and herbal products of Ginkgo biloba.

PubMed

Könczöl, Árpád; Rendes, Kata; Dékány, Miklós; Müller, Judit; Riethmüller, Eszter; Balogh, György Tibor

2016-11-30

The linkage between the central nervous system availability and neuropharmacological activity of the constituents of Ginkgo biloba L. extracts (GBE) is still incomplete. In this study, the in vitro blood-brain barrier (BBB) permeability profile of the standardised GBE was investigated by the parallel artificial membrane permeability assay (PAMPA). Biomarkers, such as terpene trilactones, flavonoid aglycones and ginkgotoxin exerted moderate or good BBB-permeability potential (BBB+), while glycosides and biflavones were predicted as unable to pass the BBB. N-methyltyramine (NMT) and N,N-dimethyltyramine or hordenine (Hor) were identified among BBB+ compounds, while subsequent direct HRMS analysis revealed tyramine (Tyr) and N,N,N-trimethyltyramine or candicine (Can) in GBE as trace constituents. Distribution of Tyr, NMT, Hor and Can was determined by a validated ion-exchange mechanism-based liquid chromatography-electrospray ionisation-mass spectrometry (LC-ESI-MS) method in G. biloba samples, such as herbal drugs and dietary supplements. The total content of the four tyramine derivatives in various GBEs ranged from 7.3 up to 6357μg/g dry extract with NMT and Hor as most abundant ones. Considering the pharmacological activities and the revealed fluctuation in the concentration of the analysed adrenergic protoalkaloids, the presented rapid LC-ESI-MS method is proposed for monitoring of the levels of Tyr, NMT, Hor and Can in G. biloba products. Copyright © 2016 Elsevier B.V. All rights reserved.

Current National Approach to Healthcare ICT Standardization: Focus on Progress in New Zealand.

PubMed

Park, Young-Taek; Atalag, Koray

2015-07-01

Many countries try to efficiently deliver high quality healthcare services at lower and manageable costs where healthcare information and communication technologies (ICT) standardisation may play an important role. New Zealand provides a good model of healthcare ICT standardisation. The purpose of this study was to review the current healthcare ICT standardisation and progress in New Zealand. This study reviewed the reports regarding the healthcare ICT standardisation in New Zealand. We also investigated relevant websites related with the healthcare ICT standards, most of which were run by the government. Then, we summarised the governance structure, standardisation processes, and their output regarding the current healthcare ICT standards status of New Zealand. New Zealand government bodies have established a set of healthcare ICT standards and clear guidelines and procedures for healthcare ICT standardisation. Government has actively participated in various enactments of healthcare ICT standards from the inception of ideas to their eventual retirement. Great achievements in eHealth have already been realized, and various standards are currently utilised at all levels of healthcare regionally and nationally. Standard clinical terminologies, such as International Classification of Diseases (ICD) and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) have been adopted and Health Level Seven (HL7) standards are actively used in health information exchanges. The government to New Zealand has well organised ICT institutions, guidelines, and regulations, as well as various programs, such as e-Medications and integrated care services. Local district health boards directly running hospitals have effectively adopted various new ICT standards. They might already be benefiting from improved efficiency resulting from healthcare ICT standardisation.

Improving stroke knowledge through a 'volunteer-led' community education program in Australia.

PubMed

Kilkenny, Monique F; Purvis, Tara; Werner, Megan; Reyneke, Megan; Czerenkowski, Jude; Cadilhac, Dominique A

2016-05-01

Public awareness of stroke risks and warning signs remains poor. The National Stroke Foundation (NSF) in Australia has been undertaking a StrokeSafe Ambassador Education program to raise awareness of stroke. The format includes presentations by volunteers trained to be 'ambassadors' to spread standard information about stroke to the public. Our aim was to determine the change in knowledge of participants who attended presentations. Participants completed questionnaires before immediately after presentations, and at 3months following the presentation. Information was collected on knowledge of risk factors and signs of stroke. McNemar's test was used to compare paired-responses over time. A p value of <0.05 was considered significant. Between March and April 2014, 591 participants attended 185 presentations and 591 (100%) completed them before and immediately after presentation questionnaires: 68% were female and 75% were aged 65years or more. 258 consented for further follow-up with 192 completing follow-up. Comparing immediately after with before presentation showed significantly improved knowledge for all 10 stroke risk factors and all signs of stroke. Significantly improved knowledge for 7/10 risk factors and 1/3 signs of stroke was found when comparing follow-up and immediately after presentation results. Knowledge of 5/10 risk factors and 2/3 signs of stroke improved when comparing follow-up and before presentation. This study describes a novel approach to support the use of trained volunteers to provide a community-based, standardised education program for stroke. This program shows that community presentations can improve immediate and short-term knowledge of signs and risk factors for stroke. Copyright © 2016. Published by Elsevier Inc.

Doctors in China: improving quality through modernisation of residency education.

PubMed

Zhu, Jiming; Li, Wenkai; Chen, Lincoln

2016-10-15

There is growing recognition that the ultimate success of China's ambitious health reform (enacted in 2009) and higher education reform (1998) depends on well educated health professionals who have the clinical, ethical, and human competencies necessary for the provision of quality services. In this Review, we describe and analyse graduate education of doctors in China by discussing the country's health workforce and their clinical residency education. China has launched a new system called the 5 + 3 (5 year undergraduate and 3 year residency [standardised residency training]), which aims to set national quality standards. To improve understanding for the Chinese model, we present a comparative perspective with systems from the UK and USA. To succeed, the 5 + 3 model will need to overcome major challenges of accreditation and certification, alternative education pathways, and China's unique degree and credentialing system. We conclude by reviewing the challenges of clinical competencies in China, especially the complementarity of specialist training and general practitioner training, which are essential for the quality and equity of China's health-care system. Copyright © 2016 Elsevier Ltd. All rights reserved.

The extended statistical analysis of toxicity tests using standardised effect sizes (SESs): a comparison of nine published papers.

PubMed

Festing, Michael F W

2014-01-01

The safety of chemicals, drugs, novel foods and genetically modified crops is often tested using repeat-dose sub-acute toxicity tests in rats or mice. It is important to avoid misinterpretations of the results as these tests are used to help determine safe exposure levels in humans. Treated and control groups are compared for a range of haematological, biochemical and other biomarkers which may indicate tissue damage or other adverse effects. However, the statistical analysis and presentation of such data poses problems due to the large number of statistical tests which are involved. Often, it is not clear whether a "statistically significant" effect is real or a false positive (type I error) due to sampling variation. The author's conclusions appear to be reached somewhat subjectively by the pattern of statistical significances, discounting those which they judge to be type I errors and ignoring any biomarker where the p-value is greater than p = 0.05. However, by using standardised effect sizes (SESs) a range of graphical methods and an over-all assessment of the mean absolute response can be made. The approach is an extension, not a replacement of existing methods. It is intended to assist toxicologists and regulators in the interpretation of the results. Here, the SES analysis has been applied to data from nine published sub-acute toxicity tests in order to compare the findings with those of the author's. Line plots, box plots and bar plots show the pattern of response. Dose-response relationships are easily seen. A "bootstrap" test compares the mean absolute differences across dose groups. In four out of seven papers where the no observed adverse effect level (NOAEL) was estimated by the authors, it was set too high according to the bootstrap test, suggesting that possible toxicity is under-estimated.

A standardised graphic method for describing data privacy frameworks in primary care research using a flexible zone model.

PubMed

Kuchinke, Wolfgang; Ohmann, Christian; Verheij, Robert A; van Veen, Evert-Ben; Arvanitis, Theodoros N; Taweel, Adel; Delaney, Brendan C

2014-12-01

To develop a model describing core concepts and principles of data flow, data privacy and confidentiality, in a simple and flexible way, using concise process descriptions and a diagrammatic notation applied to research workflow processes. The model should help to generate robust data privacy frameworks for research done with patient data. Based on an exploration of EU legal requirements for data protection and privacy, data access policies, and existing privacy frameworks of research projects, basic concepts and common processes were extracted, described and incorporated into a model with a formal graphical representation and a standardised notation. The Unified Modelling Language (UML) notation was enriched by workflow and own symbols to enable the representation of extended data flow requirements, data privacy and data security requirements, privacy enhancing techniques (PET) and to allow privacy threat analysis for research scenarios. Our model is built upon the concept of three privacy zones (Care Zone, Non-care Zone and Research Zone) containing databases, data transformation operators, such as data linkers and privacy filters. Using these model components, a risk gradient for moving data from a zone of high risk for patient identification to a zone of low risk can be described. The model was applied to the analysis of data flows in several general clinical research use cases and two research scenarios from the TRANSFoRm project (e.g., finding patients for clinical research and linkage of databases). The model was validated by representing research done with the NIVEL Primary Care Database in the Netherlands. The model allows analysis of data privacy and confidentiality issues for research with patient data in a structured way and provides a framework to specify a privacy compliant data flow, to communicate privacy requirements and to identify weak points for an adequate implementation of data privacy. Copyright © 2014 Elsevier Ireland Ltd. All rights

Focal Plant Observations as a Standardised Method for Pollinator Monitoring: Opportunities and Limitations for Mass Participation Citizen Science

PubMed Central

Roy, Helen E.; Baxter, Elizabeth; Saunders, Aoine; Pocock, Michael J. O.

2016-01-01

Background Recently there has been increasing focus on monitoring pollinating insects, due to concerns about their declines, and interest in the role of volunteers in monitoring pollinators, particularly bumblebees, via citizen science. Methodology / Principal Findings The Big Bumblebee Discovery was a one-year citizen science project run by a partnership of EDF Energy, the British Science Association and the Centre for Ecology & Hydrology which sought to assess the influence of the landscape at multiple scales on the diversity and abundance of bumblebees. Timed counts of bumblebees (Bombus spp.; identified to six colour groups) visiting focal plants of lavender (Lavendula spp.) were carried out by about 13 000 primary school children (7–11 years old) from over 4000 schools across the UK. 3948 reports were received totalling 26 868 bumblebees. We found that while the wider landscape type had no significant effect on reported bumblebee abundance, the local proximity to flowers had a significant effect (fewer bumblebees where other flowers were reported to be >5m away from the focal plant). However, the rate of mis-identifcation, revealed by photographs uploaded by participants and a photo-based quiz, was high. Conclusions / Significance Our citizen science results support recent research on the importance of local flocal resources on pollinator abundance. Timed counts of insects visiting a lure plant is potentially an effective approach for standardised pollinator monitoring, engaging a large number of participants with a simple protocol. However, the relatively high rate of mis-identifications (compared to reports from previous pollinator citizen science projects) highlights the importance of investing in resources to train volunteers. Also, to be a scientifically valid method for enquiry, citizen science data needs to be sufficiently high quality, so receiving supporting evidence (such as photographs) would allow this to be tested and for records to be verified

Evaluation of the efficacy and safety of a standardised intracameral combination of mydriatics and anaesthetics for cataract surgery.

PubMed

Labetoulle, Marc; Findl, Oliver; Malecaze, François; Alió, Jorge; Cochener, Béatrice; Lobo, Conceição; Lazreg, Sihem; Hartani, Dahbia; Colin, Joseph; Tassignon, Marie-José; Behndig, Anders

2016-07-01

To compare the efficacy and safety of intracameral (IC) administration at the beginning of cataract surgery, of Mydrane, a standardised ophthalmic combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%, to a standard topical regimen. In this international phase III, prospective, randomised study, the selected eye of 555 patients undergoing phacoemulsification with intraocular lens (IOL) implantation received 200 μL of Mydrane (Mydrane group) just after the first incision or a topical regimen of one drop each of tropicamide 0.5% and phenylephrine 10% repeated three times (reference group). The primary efficacy variable was achievement of capsulorhexis without additional mydriatics. The non-inferiority of Mydrane to the topical regimen was tested. The main outcome measures were pupil size, patient perception of ocular discomfort and safety. Capsulorhexis without additional mydriatics was performed in 98.9% of patients and 94.7% in the Mydrane and reference groups, respectively. Both groups achieved adequate mydriasis (>7 mm) during capsulorhexis, phacoemulsification and IOL insertion. IOL insertion was classified as 'routine' in a statistically greater number of eyes in the Mydrane group compared with the reference group (p=0.047). Patients in the Mydrane group reported statistically greater comfort than the reference group before IOL insertion (p=0.034). Safety data were similar between groups. Mydrane is an effective and safe alternative to standard eye drops for initiating and maintaining intraoperative mydriasis and analgesia. Patients who received IC Mydrane were significantly more comfortable before IOL insertion than the reference group. Surgeons found IOL insertion less technically challenging with IC Mydrane. NCT02101359; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Focal Plant Observations as a Standardised Method for Pollinator Monitoring: Opportunities and Limitations for Mass Participation Citizen Science.

PubMed

Roy, Helen E; Baxter, Elizabeth; Saunders, Aoine; Pocock, Michael J O

2016-01-01

Recently there has been increasing focus on monitoring pollinating insects, due to concerns about their declines, and interest in the role of volunteers in monitoring pollinators, particularly bumblebees, via citizen science. The Big Bumblebee Discovery was a one-year citizen science project run by a partnership of EDF Energy, the British Science Association and the Centre for Ecology & Hydrology which sought to assess the influence of the landscape at multiple scales on the diversity and abundance of bumblebees. Timed counts of bumblebees (Bombus spp.; identified to six colour groups) visiting focal plants of lavender (Lavendula spp.) were carried out by about 13 000 primary school children (7-11 years old) from over 4000 schools across the UK. 3948 reports were received totalling 26 868 bumblebees. We found that while the wider landscape type had no significant effect on reported bumblebee abundance, the local proximity to flowers had a significant effect (fewer bumblebees where other flowers were reported to be >5m away from the focal plant). However, the rate of mis-identifcation, revealed by photographs uploaded by participants and a photo-based quiz, was high. Our citizen science results support recent research on the importance of local flocal resources on pollinator abundance. Timed counts of insects visiting a lure plant is potentially an effective approach for standardised pollinator monitoring, engaging a large number of participants with a simple protocol. However, the relatively high rate of mis-identifications (compared to reports from previous pollinator citizen science projects) highlights the importance of investing in resources to train volunteers. Also, to be a scientifically valid method for enquiry, citizen science data needs to be sufficiently high quality, so receiving supporting evidence (such as photographs) would allow this to be tested and for records to be verified.

Translational Research to Improve the Treatment of Severe Extremity Injuries

DTIC Science & Technology

2014-01-24

implantation of antibiotic-impregnated PMMA beads) was delayed by 2, 6 or 24 h and subsequent bacterial load in the wounds quantified 2 weeks later. Bacterial...supplemented by local antibiotics in the form of non-biodegradable antibiotic-impregnated poly- methymethacrylate ( PMMA ) beads, which will require removal at a...which K wires are passed to fix the implant to the femur. This produces a standardised and reproducible bone defect which will not heal spontaneously

78 FR 60763 - Clarification on Fireworks Policy Regarding Approvals or Certifications for Firework Series

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... Fountain Cylindrical Fountain Illuminating Torch Mine and Shell Missile with Fin-type Rocket Roman Candle Sky Rocket/Bottle Rocket Toy Smoke Device Wire Sparkler/Dipped Sparkler Display Aerial Shell...

The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review.

PubMed

Bee, Penny; Bower, Peter; Byford, Sarah; Churchill, Rachel; Calam, Rachel; Stallard, Paul; Pryjmachuk, Steven; Berzins, Kathryn; Cary, Maria; Wan, Ming; Abel, Kathryn

2014-02-01

Serious parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents. Improving the lives of these children is a political and public health concern. To conduct an evidence synthesis of the clinical effectiveness, cost-effectiveness and acceptability of community-based interventions for improving QoL in children of parents with serious mental illness (SMI). Nineteen health, allied health and educational databases, searched from database inception to May 2012, and supplemented with hand searches, reference checking, searches of grey literature, dissertations, ongoing research registers, forward citation tracking and key author contact. Inclusion criteria required≥50% of parents to have SMI or severe depression confirmed by clinical diagnosis or baseline symptoms. Children were ≤18 years of age. Community-based interventions included any non-residential psychological/psychosocial intervention involving parents or children for the purposes of improving health or well-being. Intervention comparators were not predefined and primary outcomes were validated measures of children's QoL and emotional health. Secondary outcomes were derived from UK policy and stakeholder consultation. Data were extracted independently by two reviewers and the study quality was assessed via Cochrane criteria for randomised/non-randomised designs, Critical Appraisal Skills Programme (CASP) qualitative criteria or a standard checklist for economic evaluations. Separate syntheses were conducted for SMI and severe depression. Standardised effect size (ES) trials were pooled using random-effects modelling for which sufficient data were available. Economic data were summarised and acceptability data were synthesised via a textual narrative approach. Three trials targeted mothers/the children of mothers with psychotic symptoms. Children were ≤12 years of age and no primary QoL or emotional health outcomes were reported. Insufficient

Effectiveness of Exercise Interventions to Improve Postural Control in Older Adults: A Systematic Review and Meta-Analyses of Centre of Pressure Measurements.

PubMed

Low, Daniel C; Walsh, Gregory S; Arkesteijn, Marco

2017-01-01

Previous reviews have shown balance in older adults to be improved with exercise. However, it is currently unclear whether postural control, indicated by centre of pressure (COP) measurement, can be improved in older adults and thus whether postural control could be a mechanism to improve balance. The purpose of this systematic review was to assess the effectiveness of force platform COP variables to identify changes in postural control following exercise interventions in older adults. In addition, a secondary purpose was to determine whether the exercise types (balance, resistance or multi-component exercise interventions) are equally effective to improve postural control. Randomised controlled trials were identified using searches of databases and reference lists (PROSPERO registration number CRD42014010617). Trials performing exercise interventions, reporting force platform COP measurements, in participants with a mean age of ≥60 years were included. Risk of bias assessments were performed following the Cochrane guidelines. Data were pooled in meta-analyses, and standardised mean differences (SMDs) with 95 % confidence intervals (CIs) were calculated. Twenty-three trials met the inclusion criteria for the systematic review. Twenty-two trials could be defined as either utilising a balance, resistance or multi-component exercise intervention. These 22 trials were used in the meta-analyses. All trials reported measurements of double leg stance; eight trials reported additional stance conditions. The meta-analyses of double leg stance showed that balance exercise interventions significantly decreased total sway path length/velocity [SMD -1.13, 95 % CI -1.75 to -0.51 (eyes open); SMD -0.79, 95 % CI -1.33 to -0.26 (eyes closed)] and anterior-posterior sway path length/velocity [SMD -1.02, 95 % CI -2.01 to -0.02 (eyes open); SMD -0.82, 95 % CI -1.46 to -0.17 (eyes closed)] in both eyes open and eyes closed conditions. Balance exercise interventions also

Validation of a Persian Short-Form Version of a Standardised Questionnaire Assessing Oral Cancer Knowledge, Practice and Attitudes Among Dentists.

PubMed

Navabi, Nader; Hashemipour, Maryam A; Roughani, Aida

2017-02-01

Oral cancer is a global health problem; however, many dentists lack the necessary skills, knowledge and capacity to diagnose oral cancers early. This study aimed to examine the validity and reliability of a Persian short-form version of a standardised questionnaire to assess dentists' knowledge, practice and attitudes towards oral cancer. This cross-sectional analytical study was carried out in May 2015 in Tehran, Iran. An original 39-item English-language questionnaire developed by Yellowitz et al . was translated into Persian using forward and backward translation methods. A total of 15 dental professionals were asked to assess the questionnaire for content validity. Based on their feedback, a 20-item short-form version was prepared, including six demographic, six knowledge, four attitude and four practice items. The translated short-form questionnaire was subsequently distributed to 973 general dental practitioners attending a dental conference in Tehran. Internal consistency and reliability were assessed with Cronbach's alpha coefficient and item-total correlation calculations. A total of 13 professionals and 313 general dentists participated in the study (response rates: 86.7% and 32.2%, respectively). After the elimination of six items (two knowledge, two attitude and two practice items), the validity and reliability of the questionnaire was confirmed. The final Persian 14-item version of the questionnaire had acceptable validity and internal consistency. These results indicate that researchers can use this translated short-form version to evaluate oral cancer knowledge, attitudes and practices among Persian-speaking dentists; this will allow for a comparison of data between different populations.

The probability of being identified as an outlier with commonly used funnel plot control limits for the standardised mortality ratio.

PubMed

Seaton, Sarah E; Manktelow, Bradley N

2012-07-16

Emphasis is increasingly being placed on the monitoring of clinical outcomes for health care providers. Funnel plots have become an increasingly popular graphical methodology used to identify potential outliers. It is assumed that a provider only displaying expected random variation (i.e. 'in-control') will fall outside a control limit with a known probability. In reality, the discrete count nature of these data, and the differing methods, can lead to true probabilities quite different from the nominal value. This paper investigates the true probability of an 'in control' provider falling outside control limits for the Standardised Mortality Ratio (SMR). The true probabilities of an 'in control' provider falling outside control limits for the SMR were calculated and compared for three commonly used limits: Wald confidence interval; 'exact' confidence interval; probability-based prediction interval. The probability of falling above the upper limit, or below the lower limit, often varied greatly from the nominal value. This was particularly apparent when there were a small number of expected events: for expected events ≤ 50 the median probability of an 'in-control' provider falling above the upper 95% limit was 0.0301 (Wald), 0.0121 ('exact'), 0.0201 (prediction). It is important to understand the properties and probability of being identified as an outlier by each of these different methods to aid the correct identification of poorly performing health care providers. The limits obtained using probability-based prediction limits have the most intuitive interpretation and their properties can be defined a priori. Funnel plot control limits for the SMR should not be based on confidence intervals.

Life years saved, standardised mortality rates and causes of death after hospital discharge in out-of-hospital cardiac arrest survivors.

PubMed

Lindner, T; Vossius, C; Mathiesen, W T; Søreide, E

2014-05-01

Out-of-hospital cardiac arrest (OHCA) accounts for many unexpected deaths in Europe and the survival rates in different regions vary considerably. We have previously reported excellent survival to discharge rates in the Stavanger region. We now describe the long-term outcome of OHCA victims in our region. In this retrospective observational study, we followed all OHCA hospital discharge survivors between 01.07.2002 and 30.06.2011 (n=213) for a minimum of 1 year and up to 10 years. Based on the national death statistics stratified for gender and age, we could calculate the potential life years saved, standardised mortality rates (SMR) and delineate the causes of death after hospital discharge. Of the 213 patients who were discharged from the hospital, 91% had a cardiac origin of their OHCA. The mean potential life years saved per patient was 22.8 years. The observed five-year survival rate was 76%. The overall SMR in our study cohort was 2.3 when compared to the age- and gender-matched population. Cardiac disease was a prominent cause of late deaths, with the specific SMR for cardiac disease-related deaths being as high as 42 in males and 140 in females. Resuscitation of OHCA victims lead to a significant long-term benefit with respect to life years saved. Cardiac disease was the main cause of death after hospital discharge. More studies are needed to identify the potential of therapeutic interventions and rehabilitation efforts that may further enhance the long-term outcomes in OHCA hospital discharge survivors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Watching the dark: New surveillance cameras are changing bat research

USGS Publications Warehouse

Cryan, Paul M.; Gorresen, P. Marcos

2014-01-01

It is, according to an old proverb, “better to light a candle than to curse the darkness.” And those of us trying to discover new insights into the mysterious lives of bats often do a lot of cursing in the darkness. Bats do most things under cover of night, and often in places where humans and most other animals can’t go. This dark inaccessibility is great for bats, but not so great for those of us trying to study them. Successful conservation hinges on understanding bat behaviors and needs, as well as identifying and addressing the things that threaten them in the darkness. But how do we light a candle without scaring the bats away or altering their behavior?

Using ontologies to integrate and share resuscitation data from diverse medical devices.

PubMed

Thorsen, Kari Anne Haaland; Eftestøl, Trygve; Tøssebro, Erlend; Rong, Chunming; Steen, Petter Andreas

2009-05-01

To propose a method for standardised data representation and demonstrate a technology that makes it possible to translate data from device dependent formats to this standard representation format. Outcome statistics vary between emergency medical systems organising resuscitation services. Such differences indicate a potential for improvement by identifying factors affecting outcome, but data subject to analysis have to be comparable. Modern technology for communicating information makes it possible to structure, store and transfer data flexibly. Ontologies describe entities in the world and how they relate. Letting different computer systems refer to the same ontology results in a common understanding on data content. Information on therapy such as shock delivery, chest compressions and ventilation should be defined and described in a standardised ontology to enable comparison and combining data from diverse sources. By adding rules and logic data can be merged and combined in new ways to produce new information. An example ontology is designed to demonstrate the feasibility and value of such a standardised structure. The proposed technology makes possible capturing and storing of data from different devices in a structured and standardised format. Data can easily be transformed to this standardised format, compared and combined independent of the original structure.